Why do We need less and less MNCs – the Mal- Nourished Childrens
Children are getting malnourished to a greater scale
as we see the level of education, jobs and inflation rising in the present
India. This country needs less and less numbers of MNC the Mal- Noursihed
Childrens or MNCs,
if we are ever to reach the basic needs
of an average human life.
We should try to find the
reasons for the poor state of malnourishment especially among the poor
families. I want to share with you the conditions that are prevailing in some
of the remote tribal and rural areas of Central India.
MNCs have been identified with the focus attained
through the ICDS of the country. The entry-point for the classification,
monitoring and service-providing mechanism starts from the basic Angan
Wadi Centers ( AWC)s.
Identification
of the MNCs
at AWCs:-
The job of identifying the MNCs at the grassroots level lies
with the Angan Wadi Center , the community level centers of the Integrated
Child development Scheme run and managed by the Women and Child Development
Department of the State Governments. These AWCs function in the close proximity
to the villages and urban habitats with the attention upon the newly-wed women,
pregnant and lactating women, under 18 girls and all children who are under 6years of age. The
level of Health, immunization, physical growth monitoring and awareness about
the various schemes and programmes run by the State Governments are shared in
the AWCs. Local self-help groups of women cater to the cooking and supplying of
the meals for these target-people with the help of Funds provided by the
Government.
We find that these efforts are not enough in
containing the Mal-nourishment in the under-six children. Children are
susceptible to diseases; mental retardness and socially un-useful if they get
the shock of malnourishment at the early age under five and the parents have to
suffer both financially and socially if the child happens to be a major
sufferer from the ill-effects of malnourishment.
Here I am trying to pinpoint the various reasons that
are commonly found in the working of the AWCs in the rural and tribal areas of
Madhya Pradesh. However these conditions may apply to the urban areas as well
and to the other areas o f the country.
1- Weighing of the children registered with
the AWC- Each child is weighed with the help of Salter
Scale. The height and age is also verified with the help of the Survey Data and
the parents of the child;
2- Duration of weighing at AWC may
be every month / fortnight;
3- Growth- Chart – the entry of the
weight of the boy/girl is done on this chart ( graph )by the AW Worker;
4- Grading of the Children – Male
and Female child is Graded in to one of the Four Grades where age, height and
weight is taken into consideration;
5- Identification of the MNCs- The AWC decides on who is the MNCs.
The child so
identified is taken to the nearest Child Recovery Centers CRC which functions
at the PHC level and counseling of the parents is done actively.
Remedial steps for the MNCs :-
1- Referring
the MNCs to the nearest CRCs- the AWWs are asked
to meet the parents of the MNCs so as to facilitate the child to reach the nearest
CRC as soon as possible. The Department of Health may also help in doing this
with its ASA Workers, ANM and Para-medical Staff;
2- Counseling
of the Parents of MNCs . The parents are asked
to take care of the MNCs in terms of treatment, care for proper
nutrition, moniter the growth of the MNCs;
3- Increase
the level of nutrition of the MNCs. The Atal
Baal Mission may help in increasing the dosages of the take-home-ration for
the MNCs, special menus may be suggested for the MNCs and intake of fruit and
vegetable may be done;
4- Repeated
House-visits by the AWW / ANM to the MNCs. These may be necessary to monitor
the rapid growth of the MNCs;
5- Services
by the Department of Health may be increased for the MNCs like
immunization, special kit for treatment, deworming medicines, health syrups
,etc.
These are the
routine steps that may be taken by the Departments of Women and Child
Development and Health. The local care by the parents may be supplemented by
the care by a local level NGOs, Matri-Sahyogini Mandals ( Mother’s Support Groups
) and counseling by the reputed social leaders in the area. However we need to
identify the shortcomings and rectify the loopholes in the delivery of services
in the rural areas.
Suggestions for faster relief and
rehabilitation of the MNCs may be :-
1- Regular-Checks of the Salter Scales
used- in most of the cases we find that the Salter Scale used at the Anganwadi Centers are faulty thereby
measuring incorrect weight. The random checking of the Scale and the Training
on the use of these instruments is found to be short of some standard to do the
measurements. The Department has to look for the accuracy in measurements. The
settings of the scale, correct calibrations, repair of the faulty Scale and the
training on the usage must be repeated regularly;
2-
Periodicty of weighing of
children- this is not very periodic in the tribal areas for various
reasons best known to the AWWs. Monitoring by the senior Officials and poor
training of the AWW in filling data on the Growth Chart needs to be looked
into. The AWW generally try avoiding the filling up of the growth chart. The
grading of the children in done in a way that children do NOT fall under the
MNCs categories. These are done so as to avoid questions and running around in
improving the Grade of the MNC children. There are various kinds of pressures
on the AWW so as to avoid increasing the numbers of MNCs in her AWC area.
3- Grading of the Children- Due to
the low level of education, poor training, lack of interest in her work and absenteeism
at the AWW level the grading of the children may be full of various faults. The
height-to-weight relationship might be poorly monitored in most of the MNCs.
These are very poorly done in most of the tribal and remote villages where we
finds major numbers of MNCs and death due to malnourishments;
4- Increase the number of Crèches-
to cater to the nutritionally poor children we need more and more numbers of
crèches in the poverty-ridden / tribal areas. The ratio of 2 Anganwadi Centers
to One Crèches is the required number of crèches in order to meet the needs of
the MNCs. Day-Care Centers of the MNCs are
required in Crèches at the village or hamlet level;
5- Civil Societies must adopt the MNCs :- there is no effort by the implementing
agencies for the betterment of the MNCs to involve
and support the local Matri – Shayogini Samitis, the Non Government
Agencies, the Self Help groups, The local elected representatives, the
Volunteers and the Society in general to cater to the needs of the MNCs. The AWW / Supervisors seldom discuss these
issues with the villagers in general and the above entities in particular. The
NGOs also neglect these issues fearing reactions from the Angan Wadi Workers (
who are in the most probabilities related to the local political bigwigs ) in they
intervene for the proper care of the Mal- Nourished Children on their area of
work..
6- Transparency and Openness in Reporting
the Data for the MNCs - We find
that most of the data of the AWC are now gathered in a format required for MIS
which is then uploaded at the website of the ICDS. These data cannot be looked
into by the general public and thus the valuable suggestions can never reach
the implementing Departments and Agencies. The pin pointing of the mistakes,
shortcomings and feedbacks by the general public can make a big difference in
rectifying these shortcomings. There may be chances where the problem may be
addressed by the sponsorships, donations and contributions by the agencies who
are seriously working for the welfare of the poor people and thus help the MNCs
to reach better standards of life.
7- Budgetary Allocations be made for
involving increased numbers of Non- Government Organizations working for the MNCs –MNCs need
a multidisciplinary approach and expertise . The right-based working groups,
traditional-healers, the semi-skilled adolescents girls and the local elected
representatives of the area can turn the wheel in the right direction. We need
more numbers of crèches for the MNCs. We need to create an environment best
suited for the MNCs to regain good health.
I also advocate for the change
in the overall attitude of the personnel working with the Department Of Women
and Child and Health Care from
“ I am an expert on
the needs of the MNCs”
to a working – culture of
“ I am the best Supporter for the Services to the MNCs”.
The approach from the Corporate world has to be
positive towards the MNCS . They should start taking direct steps to
help the MNCs.
I think taking these steps can see the meaning of
the - MNC
will change from the “ Mal- Nourished-
Children” to
the –
MOST -Nurtured -Children in our society. And ….yes, We need to do this fast….
All photographs are copyright of the Author. © September, 2012.
