Monitoring Child Development
Severe malnutrition among children under 5 years of age
With survey results in Janta Colony showing that 87% of children under 5 years suffered severe malnutrition, the issue was given urgent priority. The impacts of severe malnutrition in infants and children are shown to be life-long: lack of essential vitamins and minerals stunts both physical and mental development. Many women in Indian slums are illiterate and don’t have basic knowledge of nutrition. In addition, incomes are very low and families – particularly those with many children – find it difficult to purchase adequate food. Lack of access to clean drinking water is another factor; ingestion of contaminated water leads to high incidence of diarrheal diseases, causing children to lose precious calories and nutrients.
At 16 months, Jyoti weighed only 5 kg; her pale hair, skin lesions and protruding ribs suggest the onset of protein energy malnutrition. Desperate for nourishment, her body is drawing on its own reserves of muscle and fat.
Actions taken
Every child under the age of 5 years is weighed by an HP at least once each month, and data are recorded on a weight-for-age chart. This home visit creates an opportunity to educate parents on the relationship between weight and health, and inform them on how to improve home hygiene and cooking practices.
Each month, DIR Nutritionists demonstrate to the HPs a recipe for a nutritious meal that can be made with ingredients available in the basti, which costs no more than 2 rupees (US 5 cents) per serving. In turn, HPs give cooking classes in the streets in their areas. The program is very popular: many parents tell DIR that they are now spending less on food each month, and recognize the link to healthier growth on their children’s weight charts.
DIR also undertakes to ensure that at least one person in every family knows how to make an oral rehydration solution from basic ingredients of boiled water, sugar, salt and a pinch of lime. This allows families to react quickly when diarrhea occurs, without spending the 15 rupees charged by local shops for manufactured powders.
Results
A second, independent survey carried out in 2011 showed that rates of severe malnutrition in the basti have plummeted to less than 20%.
