Date: 09/11/2022
Relevance: GS-2: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
Key Phrases: Child and maternal health, Malnutrition, Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN) Abhiyan, Healthcare at remote areas, Role of frontline workers, Child health and Nutrition.
Context:
- For a better child and maternal health it is crucial to empower frontline health workers who are driving mother and child nutrition and development outcomes at the last mile.
Do you Know?
- According to National Family Health Survey-5 (NFHS-5)
- Child Nutrition is a concern because at all-India level
- 36% of children suffer from stunting.
- 19 % of children suffer from wasting.
- 32% of children are underweight.
- The share of overweight children stands at 3.4%.
- The incidence of anaemia in under-5 children is 67% and in women 57% (20%-40% incidence is considered moderate).
- Full immunization drive among children aged 12-23 months has recorded substantial improvement from 62% to 76% at all-India level.
- Institutional births have increased substantially from 79% to 89% at all-India Level.
- Exclusive breastfeeding to children under age 6 months has stood at 64% in 2019-21.
- Child Nutrition is a concern because at all-India level
Addressing malnutrition is critical
- Addressing malnutrition is critical to laying a strong foundation
for human development. Optimal maternal nutrition and infant & young
child feeding are the most effective set of interventions in reducing
- Child deaths and disease.
- Preventing malnutrition.
- In determining cognitive development
- Enabling adult life productivity.
- The first 1,000 days of life, i.e., from conception to the first two years of a child’s life, are key as this phase presents a critical window of opportunity in ensuring optimal growth, development, child survival and lifelong health and nutrition.
- 80% of brain development takes place in the first 1,000 days of life.
POSHAN Abhiyan to address malnutrition
- India has been undertaking several policy and programmatic efforts which include the flagship programme, POSHAN.
- The Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN) Abhiyaan which was launched in April, 2018 under the Ministry of Women and Child Development (MWCD).
- Its overarching goal is to improve nutritional outcomes by
focusing on
- Capacity building, improvement of service delivery, community mobilisation and participation, use of technology, and inter-ministerial/inter-departmental convergent planning and review.
- There has been an enhanced focus on documentation of interventions coverage in the first 1,000 days, such as registration of pregnancies, antenatal checkup, and exclusive breastfeeding, as compared to the situation in 2015-16.
Role of frontline workers in promoting healthy practices : A case Study
- In a remote village in Uttar Pradesh all families with children below two years got their children weighed at the Anganwadi centres during the Poshan Pakhwdaa in March 2022.
- This was made possible through continuous efforts by the Anganwadi Workers (AWWs), supported by the lady supervisor.
- The AWWs and the lady supervisor found support in the panchayat pradhan who had organised a community-level meeting a day before the start of the Poshan Pakhwada.
- All the men, women, AWWs, ASHAs, schoolteachers and community elders
were involved to generate awareness on the benefits of
- Weight measurement.
- Early detection of undernourished children.
- Ensure the weighing of all eligible young children.
- All these initiatives at the ground level helped locals to
overcome age-old fears and misconceptions.
- Mothers and other relatives such as grandmothers and also fathers were enlightened about the benefits of regular weight measurement.
- This is a great example which underscores the importance and role of frontline workers in improving child health and nutrition at the ground level.
Ways to improve Child health and Nutrition
- Evidence-based interventions are key
- Evidence-based interventions need to be delivered with high coverage, continuity (over the first 1,000 days of life and across delivery channels), intensity (multiple interactions), quality and equity for bringing about change in nutrition outcomes.
- Keep a check on health and nutrition status of women
- The health and nutrition status of women are critical determinants
for the child’s health, such as
- Weight and haemoglobin level.
- Age at conception.
- Levels of multiple micronutrients during the periconceptional period (5-6-month period in women embracing oocyte growth, fertilization, conceptus formation and development to Week 10 of gestation (coinciding with the closure of the secondary palate in the embryo).
- The health and nutrition status of women are critical determinants
for the child’s health, such as
- Need to improve preconception care before delivery
- Preconception care is vital and the first ever primary health-care innovation programme to promote the health of women by MoHFW in the Nashik district of Maharashtra shows its utility in improving child health.
- Promoting the health of adolescent girls and women
- It was also observed in the Nashik district that promoting the health of adolescent girls and women not only promotes the health of the newborn but also prevents low birth weight, preterm birth, and newborn deaths.
- Empower the frontline workers
- Most of the interventions related to child and mother nutrition are delivered to the last mile by the network of the frontline workers: Accredited Social Health Activists (ASHAs), Auxiliary Nurse-Midwives (ANMs) and Anganwadi Workers (AWWs).
- They play a key role in empowering the community on health planning and action.
- In many geographies, they are the only access point to basic nutrition and other health services.
- They are critical in promoting healthy practices, providing on-ground support, and improving awareness.
- Role of men is important
- Men, especially fathers, also play a very important role in ensuring maternal and newborn health (MNH).
- They can influence behaviors and good practices around MNH within their households and communities.
- Studies show that mothers are 1.5 times more likely to receive prenatal care in the first trimester when fathers are involved during pregnancy.
Conclusion
- Strengthening the nutrition system needs to be focused on regular
skilling, supportive supervision and motivation of frontline workers to
deliver contextualized, focused and quality nutrition and health services.
- Data-driven reviews must be prioritized and sustained at the programme level.
- The frontline workers because of their deeper understanding on the issues and needs at the grassroots level are crucial and their contribution to community health is huge.
- Therefore it is pivotal to empower our frontline workers who are driving change at the last mile.
Source: The Hindu
Mains Question:
Q. The first step towards universal healthcare is to empower frontline health workers who are driving mother and child nutrition and development outcomes at the last mile, critically analyze. (250 words).
