Why do We need less and less MNCs – the Mal- Nourished Childrens

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.

Can also E-mail       parvez2ameer@indiatimes.com