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GUJARAT STATE NUTRITION MISSION (GSNM) Departments of H&FW and WCD Presentation to Hon’ble Chief Minister.

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Presentation on theme: "GUJARAT STATE NUTRITION MISSION (GSNM) Departments of H&FW and WCD Presentation to Hon’ble Chief Minister."— Presentation transcript:

1 GUJARAT STATE NUTRITION MISSION (GSNM) Departments of H&FW and WCD Presentation to Hon’ble Chief Minister

2 Agenda of the Meeting 1.Overview of the nutrition status in Gujarat-High incidence of undernutrition in Gujarat 2.Nodal Departments for Gujarat State Nutrition Mission- HFWD & DWCD. 3.To decide the Roles, Responsibilities and Structure of Nutrition Mission 4.To evolve Concept and Approach to achieve the objective :- 3 –Tier Approach. 5.Human and Financial resources for the Mission 6.Maharashtra & Other Models – successful case study. 7.Any other agenda items from the Chair 21-Apr-152Health & FW

3 National Family Health Survey-3, 2005 – 06,Gujarat INDIA Gujarat Nutrition Situation of various States of India 45 % Children (<5 Yrs) of Gujarat are underweight. 3

4 DLHS-2, % U5 underweight 50% Breastfed in 1 st hr *** 45% Exclusively breastfed ** 56% Initiate Complementary feeding months *** 24% Get adequate Proteins & Calories* 80% Anaemic (6-35 m) 56% HHs use Iodized salt 56% Vit A supplement** NFHS * NNMB (ICMR) ** DLHS – 2008 ***CES, Unicef Nutrition Situation in Gujarat

5 Types of Malnutrition Underweight- A composite measure – Low Weight for Age Stunting- An indicator of past growth failure – Low Height for Age Wasting- Current or Acute malnutrition – Low Weight for Height Micronutrient deficiencies- Iron(Anaemia), Iodine (Hypothyroidism, Cretinism-Mental retardation), Vit-A (Night Blindness)

6 Weight for Age criteriaWeight for Height criteria Normal % [Green] Severe Under Weight % (Red ) Moderate Under Weight % [Yellow ] Nutrition Status in Gujarat Normal % Moderate Acute Malnutrition (MAM) % Severe Acute Malnutrition (SAM) % 44.6 % Underweight (%) 55.4 % 28.3 % 16.3 % 5.8% 12.9 % 55.4 % 18.7 % Wasting (%) Source:- NFHS- 3 ( ) 25.9 % SUW/ MUW

7 Weight for Age criteriaWeight for Height criteria Normal % [Green] Severe Underweight % (Red ) Moderate Under weight % [Yellow ] Nutrition Status (Hungama Report- 2011) Normal % Moderate Acute Malnutrition (MAM) % Severe Acute Malnutrition (SAM) % 42.3 % Underweight (%) 57.7 % 25.9 % 16.4 % 3.3% 8.1% 57.7 % 11.4 % Wasting (%) As per the data of 100 focus districts of six states Bihar, Jharkhand, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh 30.9 % SUW/ MUW

8

9 Distribution (%) of 1-3 yrs children according to daily intake of Food stuffs as percent RDI Source:- NNMB Tribal Survey Percent of RDI (>=70%)KeralaTNKarnataka Andhra PradeshMaharashtraGujaratMPOrissa West Bengal Cereals & Millets Pulses & Legumes GLV OV R &T M & MP Fats & Oil Sugar & Jaggery Key Points:- The daily intake of food stuff for children age group 1-3 is higher than the average in case of Cereals &Millets, Pulses & Legumes, Other Vegetables and Roots &Tubers but less in case of Fats &Oils, Milk & Milk Products, Green Leafy Vegetables and Sugar & Jaggery. When compared to other States like Andhra Pradesh, Maharashtra and Orissa..

10 Distribution (%) of 4-6yrs children according to daily intake of Food stuffs as percent RDI Source:- NNMB Tribal Survey Percent of RDI (>=70) KeralaTNKarnaAPMahaGujaratMPOrissaWB Cereals & Millets >= Pulses GLV OV R &T M & MP Fats & Oil Sugar & Jaggery Key Points:- The daily intake of food stuff for children age group 4-6 is higher than the average in case of C&M, P& L, OV and R&T but less in case of F &O, M & MP, GLV and S&J. when compared to other States like Andhra Pradesh, Maharashtra and Orissa.

11 Focus Areas Keeping in view insignificant improvement in SAM and MAM category of children, 3- tier approach seems to be necessary and desirable. Focus needs to be on adolescents, pregnant and lactating mothers. Need to strengthen micronutrient supplementation program. Special focus on Infant Young Child Feeding Practices (Especially Initiation of Breastfeeding within one hour, Exclusive Breastfeeding up to 6 months & Initiation of Complementary Feeding after 6 month ). Effective communication strategies to improve dietary practices and Life style. Emphasize on deworming of children, adolescent girls and Pregnant Women to improve absorption of nutrients.

12 Acute Malnutrition - SAM/MAM Children with Severe Acute Malnutrition (SAM) have nine times higher risk of death. SevereAcute Malnutrition (SAM) if :  W/H-L < -3SD &/or  MUAC** <11.5cm &/or  Bilateral pitting oedema SevereAcute Malnutrition (SAM) if :  W/H-L < -3SD &/or  MUAC** <11.5cm &/or  Bilateral pitting oedema ModerateAcute Malnutrition (MAM) if :  W/H-L between <-2 and -3 SD &/or  MUAC between 11.5 to <12.5 cm ModerateAcute Malnutrition (MAM) if :  W/H-L between <-2 and -3 SD &/or  MUAC between 11.5 to <12.5 cm SOURCE:- WHO & IAP Protocols **MUAC=Mid Upper Arm Circumference- an age independent screening tool

13 Underweight - SUW/MUW Severe Under Weight (SUW) if : Weight for Age < -3SD Severe Under Weight (SUW) if : Weight for Age < -3SD Moderate Under Weight (MUW) if : Weight for Age < -2SD to -3SD Moderate Under Weight (MUW) if : Weight for Age < -2SD to -3SD SOURCE:- New WHO Growth Standards

14 Ongoing Nutrition Interventions of H&FWD to tackle Malnutrition 21-Apr-1514Health & FW  Mamta Abhiyan- Health and Nutrition service delivery strategy i.e. Mamta Diwas  Micronutrient Supplementations – IFA supplements, Vitamin A supplements & Iodized salt  Conditional Cash Transfer Scheme- “Kasturba Poshan Sahay Yojana” implemented from  Facility based management of malnutrition- (a) Child Development and Nutrition Centers (CDNC) (No of Centers – 76 in20 districts)- at CHCs and District Hospitals. (b) Nutrition Counseling and Rehabilitation Centers. ( No of Centers – 6 )- at Medical College Hospitals. c)Bal Gram Parivar Yojana (pilot), A community based malnutrition management program in three villages – Positive Deviance model.

15 Ongoing Nutrition Interventions of DWCD to tackle Malnutrition 21-Apr-1515Health & FW  Growth Monitoring  Supplementary Nutrition Program in the AWC for 6 month to 6 yrs old: a) Energy dense Bal Bhog (3.5kg)/ month to 6 month to 3 yrs age. b) Hot cooked food to 3 yrs to 6 yrs. c) Energy dense Take Home Ration (THR) for severe underweight children 6m-3y – Bal Bhog (5kg)/month d) Energy dense Take Home Ration (THR) for severe underweight children 3-6y – Bal Bhog (2kg)/month  Fruits to children 3- 6 yrs, twice a week  Doodh Sanjeevani Yojana 10 Blocks of 6 Tribal districts, to children 3- 6 years, twice a week.  Mobile Anganwadi scheme for NREGA/Migrants population.  Nutri-Candy with micronutrients (Iron, Folic acid, Vitamin A and Vitamin C) for age group of 3 to 6 years  Conditional Cash Transfer Scheme- “Indira Gandhi Matratva Sahay Yojana (IGMSY) ” implemented in Bharuch and Patan.

16 Gujarat State Nutrition Mission Concept and Approach 21-Apr-1516Health & FW

17 Gujarat State Nutrition Mission Structure Autonomous and independent structure of the Mission An independent structure with autonomy in decision making and planning-in the form of Society /Trust ? Three Tier Approach Mission Director/Director General – a dedicated senior official of the level of a Principal Secretary / Secretary & not on additional charge. Joint responsibility of HFWD & DWCD Convergence with other line departments – Education, Food & Civil Supplies, Water Supply, Panchayat and Rural Development, Urban Development etc. 21-Apr-15.17Health & FW

18 Gujarat State Nutrition Mission Structure The operational structure of the Mission should include A.State Level –12 persons - Mission Director/Director General (IAS), Deputy Directors-3, Consultants and Project Officers -4, M&E Asst.-1, Data Entry Operators- 2, Finance Asst.-1, Office Asst-1. Aim is to have specialists on board. B.District Level- 3 persons – District Nutrition Officer, Dist. M&E Asst., Data entry operator, reporting to both CDHO and PO- ICDS to ensure convergence. C.Taluka Level- 2 persons – Taluka Nutrition Assistant, Date Entry Operator reporting to Taluka Health Officer and designate Taluka CDPO. 21-Apr-1518Health & FW

19 Gujarat State Nutrition Mission Structure D. Urban Level – (1) Corporation level- 3 persons – Corporation Nutrition Officer, Corporation M&E Asst & Data entry operator, reporting to both MO- Urban Health and PO- Urban ICDS to ensure convergence. (2) Zonal Level- 2 persons – Zonal Nutrition Assistant and Date Entry Operator reporting to Corporation Nutrition Officer. 21-Apr-1519Health & FW

20 21-Apr-15Health & FW20 Gujarat State Nutrition Mission Organogram (State Level Team) Mission Director/ Director General (IAS) (1) Deputy Dir (Nutrition) (1) Deputy Dir (Nutrition) (1) Deputy Dir (Health) (1) Deputy Dir (Health) (1) Deputy Dir (Mon) (1) Deputy Dir (Mon) (1) Consultants/POs (Community Nutrition, Monitoring, IEC and Capacity building) -4 Monitoring and Evaluation Asst (1) Monitoring and Evaluation Asst (1) Data Entry Operators (1) Data Entry Operators (1) Finance Asst (1) Finance Asst (1) Office Asst (1) Office Asst (1) State Level (12 members) State Level (12 members) HFWD DWCD

21 21-Apr-15Health & FW21 Gujarat State Nutrition Mission Organogram (District & Taluka level Team) District Nutrition Officer (1) District M& E Asst (1) Data Entry Operator (1) Taluka Nutrition Assistant (1) Data Entry Operator (1) Chief District Health Officer (Health) District Program Officer (WCD) District Level (3 members) Taluka Level ( 2 members) DDO

22 21-Apr-15Health & FW22 Gujarat State Nutrition Mission Organogram (Urban) Corporation Nutrition Officer (1) Corporation M& E Asst (1) Corporation Data Entry Operator (1) Zonal Nutrition Assistant (1) Data Entry Operator (1) Medical Officer (Urban Health) Municipal Commissioner /DMC Zonal level (2 members) Corporation level (3 members) CDPO

23 Focus of the Mission To strengthen growth monitoring and evaluation system and bringing in subject specialist. Ensuring growth monitoring and promotion by improving – Survey efficiency – Weighing efficiency – Plotting of weights on growth charts, and – Identification of undernourished children and detection of growth faltering and stagnation and focusing on the most vulnerable- SAM, MAM, SUW and MUW Improving Infant and Young Child Feeding (IYCF) practices to reduce malnutrition. Mass awareness (IEC) on nutrition related issues including IYCF and healthy food habits through a community based approach. 21-Apr-15Health & FW23

24 Malnutrition Screening Tools & Equipments 21-Apr-15Health & FW24 Digital Weighing Scale : Cost Rs 4000/- Spring Scale Rs /- Digital Weighing Scale : Cost Rs 4000/- Spring Scale Rs /- Weight for Height SAM if W/H <-3SD MAM if W/H <-2SD to -3SD Weight for Height SAM if W/H <-3SD MAM if W/H <-2SD to -3SD Indigenous Board:- Rs 1000/-

25 Malnutrition Screening Tools & Equipments 21-Apr-15Health & FW25 Mid Upper Arm Circumference (MUAC) SAM if MUAC <11.5cm MAM if MUAC 11.5 to 12.5 cm Mid Upper Arm Circumference (MUAC) SAM if MUAC <11.5cm MAM if MUAC 11.5 to 12.5 cm MUAC Tape - Low Cost Tool (Rs 3/-)

26 Plan of the Mission Management of SAM and MAM Children (WASTED) through 3 - tier approach 1. To adopt and follow SAM and MAM Identification Criteria as per WHO Standards. 2. To establish demand based facilities at all levels Village - Village Child Nutrition Centres (VCNCs) at AWCs. Duration of Program will be for 30 days. Cost approx Rs 40/child/day PHC/CHC/SDH - Child Malnutrition Treatment Centres (CMTCs). Duration of Program will be for 21 days. Costs approx Rs 200/ child/ day (current CDNCs will function as CMTCs) District Hospital/Medical College - Nutrition Rehabilitation Centers (NRCs). Duration of Program will be for 25 days. Costs approx Rs 250/ child/ day. P21-Apr Health & FW

27 Hierarchy of 3- tier approach NRC (At District level) CMTC (At Taluka level) VCNC (At Village level) Children admitted with defined SAM criteria with severe Medical Complications/ Oedema Children admitted with defined SAM criteria with Medical Complications Children admitted with defined SAM & MAM criteria without Medical Complications

28 Roles of HFWD and DWCD in the 3-Tier Approach Roles of HFWD and DWCD in the 3-Tier Approach HFWD & DWCD Screening at VHND HFWD & DWCD VCNC HFWD CMTC NRC HFWD

29 Village Child Nutrition Centre (VCNC) Target Group:- Both SAM and MAM children At Village level, at Anganwadi Centers managed by AWW, AWH & ASHA. Incentive to AWW, AWH & ASHA. Nutritional Supplements as per standard protocols Stay will be for 30 days Daily visit by an ANM An expenditure of Rs 40/- per child/day: Rs 20 for Diet (Dynamic as per region), Rs 10/- for Medicines and Rs.10/- for Incentives. DietMedicines Follow a camp approach. 21-Apr-1529Health & FW

30 Child Malnutrition Treatment Centre (CMTC) Target Group:- SAM Children with medical complication At PHC / CHC / SDH level Treatment as per standard protocols Daily visit by a Trained Doctor. Follow a camp approach for 21 days Expenditure of Rs. 200 per child per day Mother/guardian accompany and stay with the child throughout and compensated Rs 100 per day for wage loss. Rs. 100 is expended on diet and medicines per day/ child (Diet- Rs 60 and medicines Rs 40 per child/ day).dietmedicines 21-Apr-1530Health & FW

31 Nutritional Rehabilitation Center (NRC) Target Group:- SAM Children with severe medical complication At District Hospital and Medical Colleges level Treatment as per WHO standard protocols Daily visit by a Trained Doctor. Expenditure of Rs. 250 per child per day Mother/guardian accompany and stay with the child throughout and compensated Rs 100 per day for wage loss. Rs. 150 is for diet and medicines per day/ child (Diet- Rs 60 and medicines Rs 90 per child/day).dietmedicines 21-Apr-1531Health & FW

32 Financial Resources available for Mission Objectives State Budget 12-13:- Rs.60 Crores for Nutrition Mission which includes – a) Mission Structure. b)Conditional Cash Transfer – Kasturba Poshan Sahay Yojana (GR already issued on ). c)Anemia Management Package. d)Innovative interventions. Gujarat Integrated Nutrition Project – Out of 60 crores allocated as one time Central Assistance from GOI- Rs. 54 Crores is available ( Received in March 2010). NRHM- Rs Crores proposed for /21/2015Health & FW32

33 Roles and Responsibilities of GSNM To set-up the structure of the VCNC,CMTC,NRC through HFWD and DWCD Organize trainings/orientation workshops for the staff Review through meetings and workshops Strengthen MIS, Data collation, analysis and regular feedback Set-Up committees at State, District and Taluka level for effective monitoring and implementation of the Mission objectives. 21-Apr-1533Health & FW

34 1.State Level Gujarat State Nutrition Mission will have: a)Steering Committee under Hon’ble Chief Minister b)Monitoring Committee to be Chaired & Co-chaired by Hon’ble Ministers – HFWD and DWCD as per seniority c)Governing Body, under Chief Secretary d)Executive Committee- Chaired and Co-chaired by PS (PH&FW)/ PS DWCD as per seniority. 2.District level Committee under Dist. Collector and DDO as Chairman & Co-chairman respectively. 3. Taluka Level Nutrition Committee -Prant Officer (ATVT) 21-Apr-1534Health & FW Committees At Various Levels

35 Leveraging Partnerships (Jan-Bhagidari) Implement Positive Deviance approach by involving parents to share positive infant and young child feeding practices for making malnutrition-free village. Build strong Jan-Bhagidari through Village Health, Sanitation and Nutrition Committees (VHSNC) and Pani Samities. VHSNC/ RKS (Rogi Kalyan Samities) to be permitted to accept assistance by cheque/kind from public for this cause. Social Audit and Monitoring through Samities. Malnutrition-free village campaigns through Samities Partnership with Home Science Institutions for advocacy, capacity building, monitoring and evaluation. 21-Apr-1535Health & FW

36 Assumptions/ Basis for estimates- - Target Group:- 0 to 6 yrs - SAM Children:- 5% - MAM Children:- 10% - Total (SAM and MAM) Children:- 15% -VCNC workload: (80% of SAM + 100% of MAM) -Expenditure per child at VCNC= Rs 40/day x 30= Rs CMTC workload: (15% of SAM with Medical Complications) -Expenditure per child in CMTC = Rs 200/day x21 day= Rs NRC workload (5% of SAM with Medical Complications) Expenditure per child in NRC= Rs 250/ day x 25 days= Rs Apr-1536Health & FW MAM (10% ) SAM (5%) NOR- MAL (65%) 15% SUW/ MUW (20% )

37 21-Apr-15Health & FW37 Budget Estimates for different coverage scenarios (a)Scenario 1 All 41 backward talukas + 1 taluka each from remaining 10 districts = 51 talukas Anticipated Children: ; Budget Required:- Rs 23.7 Crores (b)Scenario 2 All 43 Vanbandhu talukas + 1 taluka each from remaining 14 districts = 57 talukas Anticipated Children: ; Budget Required:- Rs 29.0 Crores (c ) Scenario 3 Entire State Anticipated Children: ; Budget Required:- Rs Crores

38 21-Apr-15Health & FW38 Population covered under one AWC = 1000 Population of (0-6) years 12% of total pop= children 5 % = 6 children 10%=12 children Estimated Children /VCNC /(AWC)= SAM +MAM=6+12=18 Initially cover all targeted children of age group 6 months- 6 years with gradual reduction leading to closure of VCNC (Camp Approach) Also target entire population for nutrition awareness so that parents start correct feeding on their own so as to prevent onset of malnutrition. Estimated Workload SAM/MAM per Anganwadi Center(AWC)

39 Role of ASHA 1)To create awareness about nutrition in the community. 2)To counsel on Infant and Young Child Feeding (IYCF) practices. 3)To mobilize the community to access health and nutrition services. 4)To escort mothers with their SAM/ MAM children for treatment to nearest VCNC / CMTC / NRC & to motivate mothers to stay for desired duration at CMTC/ NRCs. 5)To ensure that children are followed up at AWC /VCNC CMTC/ NRCs  Incentives to be paid under NRHM. 21-Apr-15Health & FW39

40 21-Apr-15Health & FW40 Malnutrition Management Programs of other states State Programs for Under Weight Children Programs for SAM/ MAM Children Remark Maharashtra ICDS at AWC (a) Total VCDC conducted ( At Village level): (b) Total CTC completed ( At Block level):- 301 (c ) NRC :- ( At Medical College/ Super speciality) 3- tier approach for management of SAM/ MAM Madhya Pradesh ICDS at AWC NRC- 263 at District & Blocks for Management of SAM children Community Based Mngt Program on SAM/ MAM in process for 2 districts Management of SAM at District & Block level Health facilities Jharkhand ICDS at AWC + Dular Strategy implemented in 24 districts (At Village level) NRC at DH/Sub DH/CHC/PHC- (81) Community based management program ( CBMP) at Village/ AWC/ Community level to strengthen ICDS system

41 Malnutrition Management Programs of other states 21-Apr-15Health & FW41 StatePrograms for Under Weight Children Programs for SAM/ MAM Children Remark UP ICDS at AWC + IYCF Counseling through Mother Support Groups in one district NRC at DH/Sub DH/CHC/PHC- (19) West Bengal ICDS at AWC + Positive Deviance (PD) approach (9 districts ) Positive Deviance (PD) approach (9 districts ) NRC at PHC/ CHC/ SDH/DH- (11) People recognize and practice positive early childhood care in feeding, home health seeking, hygiene and psychosocial care. Bihar ICDS at AWC + Dular Strategy implemented in 24 districts (At Village level) NRC at DH/CHC- (34) Community based management program ( CBMP) at Village/ AWC/ Community level to strengthen ICDS system Andhra Pradesh ICDS at AWCNRC - 2 Karnataka ICDS at AWCNRC - 2 Chhattisgarh ICDS at AWCNRC - 25

42 Rajmata Jijau Mother –Child Health and Nutrition (RJMCHN) Mission, Maharashtra-Case Study 21-Apr-15Health & FW42

43 Operational Facets (Maharashtra) Independent and autonomous Mission Structure. Neither Society nor Trust, steering by CM Headed by a very senior IAS Officer of PS/Secretary level on full time basis as Director-General of the Mission Committed Officers (3 to 4) identified and posted in the Mission to assist the Director -General. Champions (people willing to contribute) identified in all Depts. Nodal Department is DWCD. Funding from multiple sources like DWCD, NRHM, TSP, SCSP, District Planning Boards, etc. 21-Apr-15Health & FW43

44 Organogram (Maharashtra) 21-Apr-15Health & FW44 Director General (IAS,Senior) (1) Deputy Director (Diet) (1) Deputy Director (Diet) (1) Deputy Director (Health) (1) Deputy Director (Monitoring) (1) Director (MVS Cadre) (1) Coordinator (Training) (1) Manager (MIS) (1) Supplementary Staff (2) Accounts Manager (2) State Level (11 members) State Level (11 members)

45 Levels of Intervention (Maharashtra) Three tier approach adopted in Maharashtra: 1.Village Child Development Centres / Camps (VCDC) at AWCs- 30 days camp 2.Child Treatment Centres / Camps (CTC) – at PHC/ Sub- district/ district hospitals- 21 days camp on residential basis 3.Nutrition Rehabilitation Centres (NRC)- Medical College / super specialty hospitals- as per need. 21-Apr-15Health & FW45

46 Committee Structure (Maharashtra) There are three committees :- 1.Mission Steering Committee : Headed by Hon. Chief Minister of Maharashtra 2.Mission Monitoring Committee : Headed by Hon. Minister, DWCD 3.Mission Advisory Committee : Headed by Hon. ACS (Health) 21-Apr-15Health & FW46

47 Village Child Development Camps /Centre (Maharashtra) Both SAM and MAM children At Village level, at Anganwadi Centres managed by AWW and Helper Nutritional Supplements as per protocols Incentive to AWW and AWH Stay is for full 30 days Daily visit by a Dr and an ANM An expenditure of Rs 32/- per child/day: Rs 16 for diet (Dynamic as per region), Rs 8/- for Medicines and Rs.8/- for Incentives. Done in a camp approach. 21-Apr-1547Health & FW

48 Child Treatment Centre (Maharashtra) Child Treatment Camps CTC At PHC / CHC / SDH level Treatment as per protocols Mother/guardian accompany and stay with the child throughout and compensated Rs 60 per day for wage loss. Follow a camp approach for 21 days Expenditure of Rs. 160 per child per day Rs. 100 is expended per day on the diet and medicines of the child and mother/ guardian 21-Apr-1548Health & FW

49 Efforts done on IEC/ BCC (Maharashtra) IEC Action Plan of Rs crores covering activities from state to village level for campaign. Rajmata Jijau Malnutrition- Free Village Campaign Each village attaining malnutrition free status are selected for Malnutrition- Free village award scheme which comprises of award Rs.1000/- and Rs 100/child as award for bringing each child in normal category. Rajmata Jijau Excellence award for first 3 Malnutrition Free Villages in each district i.e. (a) -1 st Prize- Rs 1,00,000 and Certificate. (b) - 2 nd Prize- Rs 50,000 and Certificate. (c ) – 3 rd Prize- Rs 50,000 and Certificate. A budget of Rs 10 crores /annum has been provided for this initiative 21-Apr-15Health & FW49

50 YearPhaseNo of Children admitted at VCTC Children admitted in CTC Severe Malnutrition Status 2002Malnutrition Removal Campaign in Aurangabad 7.2% 2005Maharashtra Nutrition Mission Mr V. Ramani Director General Expansion % nd Phase Mr Nand Kishore Director General Achievements of Rajmata Jijau Mother- Child Nutrition Mission

51 Way Forward….. Nodal Departments of Gujarat State Nutrition Mission- HFWD & WCD A separate Nutrition Mission structure Society Structure as suggested A Full time Mission Director/Director General for Gujarat State Nutrition Mission Screening criteria for SAM/MAM Children as per WHO Standard to be accepted in addition to SUW/MUW 3-Tier approach of Maharashtra namely VCNC, CMTC and NRC merits consideration. Malnutrition- Free Village Campaign. Strategy need to be separately workout by WCD and Health on Adolescent and Maternal Nutrition. 21-Apr-1551Health & FW

52 Thanks 21-Apr-1552Health & FW


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