STATE CENTER OF EXCELLENCE FOR NUTRITION INTERVENTIONS (SCoE4N)
Vision
To assist the state government in its goal of malnutrition free and Anemia free Chhattisgarh by improving the Infant and Young Child Feeding (IYCF) Practices in the state, skilled management of children with Severe Acute Malnutrition (SAM) through facility and community care including growth faltering in under 6 months infants.
Description
Despite success in tackling malnutrition between 2016 and 2020, Chhattisgarh continues to have high levels of under nutrition in children under 5 years of age. As per the NFHS 5 reports, marginal reduction in Stunting and Underweight prevalence is observed among children under five years from 37.6 percent to 34.6 percent and 37.7 to 31.3 percentage. However, overall wasting in the state continues to be high with prevalence of 18.9 percent and severe wasting at 7.5 percent. Anemia among the under 5 children has increased from 41.6 in 2015-16 to 67.2 in 2020-21
Almost 70% of mothers have delivered in Public Health facilities but on other hand, only 32% newborns were put to the breast within first hour of birth. The wider gap here is pointing towards lost opportunity. The scenario is different in case of exclusive breastfeeding as 8 out of 10 babies are exclusive breastfed. Only half of the children are able to get complementary feeding on time (after 6 months), diet adequacy rate is even poor and only 1 in 10 children gets adequate food during infancy.
Hence a State Center of Excellence for Nutrition Interventions (SCoE4N) has been established within the department of Pediatrics, AIIMS Raipur with support from the State Government and UNICEF. SCoE4N is supporting the implementation of CMAM (Community Based Management of Malnutrition) in the state. The program at the SCoE4N is been designed and continuously redesigned in a holistic fashion to attain the following broad objectives.
Objectives:
- Improve IYCF practices in the state
- Support state in addressing early growth failure in infants under 6 months
- Strengthen quality management of children with SAM through facility and community care
- Establish management of children with SAM through pediatric wards in medical colleges and act as a referral centre for management of complicated cases of SAM through the SMART Unit (Severe Acute Malnutrition Referral & Advance Treatment Unit).
- Undertake research in fields of IYCF, SAM management, addressing early growth failure, and Anemia
- Advocacy to Government and development of guidelines for the management of malnutrition
SCoE4N has got four major components depicted below. SCoE4N is the only center in all of
India where all these four domains of work is undertaking under one roof.
1. F-SAM: Under the Facility Based Management of SAM (F-SAM), a SMART Unit is been established to demonstrate excellence in management of children with SAM. It is a 10 bedded set up at AIIMS Raipur with a dedicated team to provide efficient patient care and appropriate down referral. Through the SCoE4N, NRCs in the state are getting virtually monitored for their improved functioning. This Tele-monitoring support is augmented by physical presence of our field level staff at selected NRCs.
2. C-MAM: A team of 16 District Nutrition Coordinators and 5 Block Nutrition Coordinators are supporting district level implementation of C-MAM program and aiding to the components of Anemia Mukt Bharat program. They are working in close coordination with the Department of Women and Child Development and Department of Health and Family Welfare ensuring capacity building of service providers, community mobilization and improved enrolment and follow up of SAM children in the program.
3. IYCF: An IYCF State Resource Center is established at the SCoE4N with an IYCF Skill lab. The center is working to strengthen the IYCF Practices in the state by building the capacity of district level functionaries. Also our field staff visits maternity wards at DH and CHCs. Along with this support is provide to the trained counselors in the districts through Telementoring to improve rates of early initiation of breastfeeding and ensure exclusive breastfeeding.
4. AMB (Anemia Mukt Bharat): Our district level staff visits Anganwadi Centers and Schools to monitor supply under the AMB program and also mobilize communities at VHSND sessions.
Along with the aforementioned activities, PG students in the Pediatric department, School of Public Health and other related departments at AIIMS Raipur are motivated to select thesis topics related to malnutrition to build the academic knowledge and promote research work on different aspects of malnutrition. Extramural projects from different Government agencies & UNICEF are also being undertaken.