Project Shubharambh: Empowering Adolescent Girls Against Anaemia

India’s National Family and Health Survey – 5 (2019-21) highlights a concerning rise in the prevalence of anaemia among women of reproductive age, with an alarming 57%. This signifies a 7.3% increase from NFHS 4, indicating a pressing need for targeted interventions. In the adolescent demographic, the increase is even more pronounced at 9.2%, escalating from 54.1% to 59.1%.

In response to this health crisis, Action Against Hunger India has launched Project Shubharambh, a pilot initiative in Sanand, strategically aimed at mitigating the burden of anaemia among adolescent girls.

Objectives:

  • Proactive Anaemia Testing and enhancing the quality of T3 (Test, Talk, Treat camps)
    • Strengthening T3 (Test, Talk and treat) camps to facilitate early identification and testing of anemia amongst adolescent girls.
  • Alleviating Burden on Specific Adolescent Girls:
    • Targeting high-prevalence areas in Sanand to focus resources on those most in need.
  • Nutrition Health Education sessions: Organizing nutrition and health education sessions and guiding adolescent girls on the basics of anaemia, its prevention, and treatment.
  • Community Engagement and leveraging festivals
    • Integrating community engagement and awareness programs by leveraging festivities of the traditional dance, Garba organized during and after the festival of Navratri to raise awareness on anaemia at the school and community settings.

Capacity & Ecosystem Strengthening:

In parallel, Action Against Hunger India is committed to strengthening the healthcare ecosystem. The organization will provide:

  • Capacity-Strengthening Training:
    • Focused capacity building of frontline functionaries of health and ICDS department by strengthening the current practices of identification, prevention, and treatment of anaemia.
  • Sustainability Measures:
    • Promoting sustainable practices of consuming locally and traditionally available iron rich foods in anaemia management to ensure long-term impact.
    • Establishing partnerships with local authorities and stakeholders to integrate anaemia prevention into routine healthcare services.
    • Promoting awareness among family members and adolescent girls to recognize the initial visible signs of anemia, encouraging adolescent girls to undergo testing, and facilitating early identification, prevention and treatment. This initiative not only aims to sensitize the community but also strives to promote the utilization of government-provided programs and facilities under anemia control initiatives such as free distribution of IFA tablets at schools and community settings and ensuring its consumption

Project Shubharambh is a holistic initiative designed to combat the rising numbers of anaemia among adolescent girls in Sanand. By combining targeted interventions, community engagement, and capacity-building efforts, Action Against Hunger India aims to create a sustainable model that can be scaled up to address anaemia challenges nationwide. Together, we strive for a healthier and brighter future for the adolescent girls of Sanand.



An Action Taken For Nutrition: Read Mayawati’s resilient story towards a Healthier Tomorrow.

In the remote village of Doondabar, Rajasthan lies a close-knit community of the Shahariya tribe, heavily reliant on the forest, agriculture, and daily labor for their sustenance. Amongst them, 10-month-old Mayawati’s (name changed) family struggled to make ends meet, with her parents working as daily wage laborers, earning a meager income of INR 25000/- per year.

During a routine screening, Mayawati was identified as severely acute malnourished (SAM), weighing only 5kg with a Z-Score of <-3SD. Our dedicated team, determined to help Mayawati, engaged in extensive counseling efforts to convince her mother to admit her to the nearest malnutrition treatment center. Although Mayawati’s mother agreed initially, the celebration of festivals led her parents to reconsider, and they brought Mayawati back home after two days of admission.

Undeterred by the setback, we enrolled Mayawati into the ‘Naya Savera Programme,’ a government initiative to combat malnutrition at the community level through energy-dense nutrition supplements. Despite facing challenges of inaccessibility due to heavy rainfall and adverse weather conditions, our team ensured that Mayawati received regular EDNS supplies through the Anganwadi Worker and ANM.

Monitoring her health and growth was not easy, but our team persevered. We provided the family with extensive orientation on health practices, nutrition, WASH practices, and even cooking demonstrations, ensuring they were equipped to care for Mayawati effectively.

Her health condition had left her unable to walk and visibly irritated, but with constant efforts and regular support, Mayawati began to show signs of recovery. A few moths later, her measurements were truly heartening, with her weight at 8.1kg, height at 74.5 cm, MUAC at 125 mm, and Z-Score at 1SD

Mayawati’s transformation was astounding. From a SAM child to a normal, happy, and active little one, she even began walking, much to the joy of her family and the entire community. This inspiring journey of recovery exemplifies the power of dedicated efforts, timely interventions, and community support in combating malnutrition, even in the most challenging environments. Mayawati’s story is a testament to the impact that proactive and caring organizations like ours can make in the lives of vulnerable children and their families.

From Despair to Recovery: The Inspiring Journey of Prema – A Tale of Community Mobilization, Collaboration, and Triumph Over Malnutrition

The case story of Hiral (name changed) is a testament to the dedication and effectiveness of community mobilizers like Tejas Korada, and the collaborative efforts of Action Against Hunger India, ICDS, the health department of Jawhar P.S., and local NGOs.

In the Katkari hamlets of Nandgaon village, Tejas our community mobilizer was conducting routine screening activities when he came across Hiral (name changed) and her daughter Prema (name changed). Immediately recognizing the signs of malnutrition in the 22-month-old child, Tejas decided to screen her for further evaluation. The screening revealed that Prema’s weight-for-height Z score was -3SD, indicating severe acute malnutrition (SAM).

Tejas wasted no time and, together with an Aanganwadi worker, visited Prema’s household to inform her caregivers about the seriousness of malnutrition and the need for immediate treatment. The caregivers were counseled on various aspects of malnutrition and convinced to admit Prema to the Nutrition Rehabilitation Centre (NRC) at the sub-district hospital in Jawhar.

On the same evening, Prema was admitted to the NRC, where she stayed for 14 days undergoing treatment as per protocol. Tejas provided continuous follow-up during her stay, ensuring she received the care and attention she needed to recover. However, upon discharge, it was observed that Prema had only gained 0.2 Kg of weight during her time at the NRC, which was not sufficient for her full recovery.

Recognizing the need for further intervention, Action Against Hunger India, ICDS, the health department of Jawhar P.S., and a local NGO jointly organized a health check-up camp for SAM and MAM children who were not showing progress despite treatment. Prema was referred to this camp, and transport arrangements were made to ensure her attendance.

During the camp, Prema underwent a thorough examination, and her blood and sputum samples were sent for testing. The results revealed that her hemoglobin levels were dangerously low, necessitating a blood transfusion. Additionally, it was discovered that Prema had developed a pediatric tuberculosis infection, and she was immediately put on medications to begin her treatment.

Throughout this challenging period, Mr. Tejas Korada continued to provide unwavering support. He conducted home visits to ensure Prema was receiving proper medication as directed by the medical officer.

In November, as part of routine follow-up, Prema was screened again, and the results were heartening. Her weight had increased to 8.00 Kg, and her height remained at 71 cm. Her weight-for-height Z score was now at -1SD, indicating that she had successfully overcome malnutrition and was on the path to recovery.

The success of Prema’s treatment was not only due to the efforts of the healthcare professionals and the community mobilizer but also because of the accountability and dedication shown by Prema’s caregivers. The timely and effective referral to institutional services played a vital role in ensuring Prema received the necessary medical attention and recovered from malnutrition.

Empowering Change: Shaneen Sheikh’s Inspirational Journey in Maternal and Child Healthcare Advocacy

Shaneen Sheikh’s (name changed) journey in Nehru Nagar slum became an inspiring case study for the dedicated team working on maternal and child healthcare. At 27 years old, Shaneen lived a modest life with her husband and children in a rented house, with her husband being the sole breadwinner for the family. It was during her second pregnancy that she enrolled with us in our healthcare program aimed at supporting pregnant women and new mothers in the slum.

Throughout her pregnancy, the healthcare team diligently visited Shaneen’s house, providing her with essential prenatal care and educating her about the significance of exclusive breastfeeding for her newborn. Shaneen seemed committed and assured the team that she was following their instructions carefully.

In November, Shaneen gave birth to her baby, and the team continued their regular visits. However, during one visit in April, Shaneen informed the team that she had visited Cooper Hospital and obtained the necessary medicine for her baby’s condition. However, she also revealed that her family had started giving complementary feeding to the baby, contrary to their earlier advice on exclusive breastfeeding.

The team didn’t lose hope and persisted in educating Shaneen about the significance of exclusive breastfeeding until the baby reached six months of age. They explained the potential risks of introducing solid foods too early and the benefits of breast milk for the baby’s overall health and development. Shaneen, despite her family’s pressure, promised the team that she would not initiate any complementary feeding until her baby completed six months.

Shaneen’s determination to prioritize her baby’s health and follow the team’s guidance even amidst familial pressures impressed the healthcare workers. Her willingness to embrace change and learn about better healthcare practices made her a role model for other mothers in the community.

The success story of Shaneen Sheikh and her baby became an example of how education, persistence, and genuine care can make a significant difference in the lives of vulnerable families. The healthcare program in Nehru Nagar slum continued its mission, inspired by Shaneen’s journey, to improve maternal and child healthcare outcomes in the community.

Unveiling Project Sampurna: Sculpting a Healthier Tomorrow in Ankleshwar, Gujarat!

The launch of Project Sampurna in Ankleshwar, Gujarat, supported by Glenmark Life Sciences and implemented by Action Against Hunger India, marks a pivotal moment in our collective journey. The project adopts a comprehensive life cycle approach, seamlessly integrating health and Integrated Child Development Services (ICDS) to provide holistic support to the community.

As part of the initiative, Project Sampurna will conduct a robust baseline assessment, anemia screening in adolescent girls and screening for malnutrition amongst children. Our commitment extends from the pre-conception stage in girls through adolescence, incorporating Social and Behavior Change Communication (SBCC) interventions aligned with a 1000-day approach.

This project is poised to make a significant impact on the health and well-being of mothers and children up to 5 years old. We ensure timely referrals for facility interventions when necessary, ensuring that every child receives the care they need for a healthy start in life.

Our shared goal is to sculpt a robust, anemia-free India by addressing health challenges at their roots. The project is a testament to the transformative power of unity, illustrating how collaboration can pave the way for a healthier and brighter future for all.

This initiative is not just about addressing immediate health concerns but is a long-term commitment to fostering a community that thrives. Join us in this journey as we work together to create a meaningful and lasting impact on the lives of the mothers and children we aim to serve. Together, we can build a healthier, brighter tomorrow.

 



Unquenchable Thirst: The Endless Water Crisis in Rural India by Dr Roshni Vakilna

Picture Courtesy: The Gray Matter

As we mark World Food Day under the compelling theme, “WATER IS LIFE, WATER IS FOOD. LEAVE NO ONE BEHIND,” it’s imperative that we reflect on the profound role that water plays in shaping our lives, economies, and ecosystems.


Dr. Roshni Vakilna
serves as the Technical Lead for Project Vruddhi at Action Against Hunger in Gandhinagar, Gujarat. Her dedication and expertise are driving innovative solutions to combat hunger and create a brighter, more sustainable future for communities in need. Dr. Vakilna, a brilliant mind is a passionate advocate for positive change.

Water is the lifeblood of our planet, an indispensable element that not only sustains us but also underpins the very foundation of our global food systems. As we mark World Food Day under the compelling theme, “WATER IS LIFE, WATER IS FOOD. LEAVE NO ONE BEHIND”, we must reflect on the profound role that water plays in shaping our lives, economies, and ecosystems.

With over 50% of our bodies composed of it and 71% of the Earth’s surface covered by it, water’s significance is undeniable. However, the troubling reality is that while only 2.5% of water is fresh and suitable for essential purposes like drinking and agriculture, we are facing an unprecedented challenge. Rapid population growth, urbanization, economic development, and the relentless impacts of climate change are straining our precious water resources, pushing them to the brink.

As fresh water becomes scarcer, it’s often the world’s most vulnerable communities, including smallholder farmers, Indigenous Peoples, migrants, and refugees, who bear the brunt of this crisis, sparking competition and conflicts over access to this life-sustaining source. In this pressing context, it is our collective responsibility to safeguard this invaluable resource and ensure that no one is left behind in our pursuit of a sustainable and equitable future.

In rural India, the struggle for access to clean and sufficient water is an ongoing crisis that refuses to relent. Recent data underscores the severity of the issue, with nearly one-fifth of rural habitations falling short of the minimum entitled water quantity of 40 liters per capita per day, equivalent to just two buckets a day. This water scarcity intensifies during the dry season, ushering in a period of dire need. With the onset of summer, media reports flood in from various corners of the country, highlighting the escalating drinking water crisis. For weeks, if not months, a significant portion of India’s population—especially those in rural areas—grapples with the harsh reality of water scarcity. During this time, millions of rural residents, along with their livestock, embark on a relentless battle for survival. It’s a recurring nightmare, exacerbated by insufficient rainfall and drought-like conditions in various parts of the nation. Reports indicate plummeting groundwater levels, dwindling lakes, drying wells, reservoirs, and rapidly vanishing dams.

As the mercury soars and heatwaves become increasingly severe, several regions in Gujarat face an alarming water crisis, particularly affecting Saurashtra, Kutch, North Gujarat, and parts of tribal areas in central and South Gujarat. Over 20 districts suffer from severe water scarcity, with towns and villages receiving water only twice a week. In more than 500 villages across 14 districts, drinking water is delivered via tankers, a number expected to rise.

The crisis manifests differently in rural and urban contexts, influenced by various factors such as water supply systems, institutional accountability, socio-economic conditions, and reliance on different water sources.

Historically, rural areas have leaned on community-managed water sources, like wells and ponds, accessible to specific communities. Public or common property sources, including lakes and rivers, were also used for drinking. A minority of affluent households had exclusive water sources. This reliance on community water sources introduced its own set of challenges, including laborious water collection processes, poor water quality, seasonal shortages, and a lack of maintenance. Additionally, certain social groups were excluded from specific water sources. In response to these challenges, individual and household-level piped water supply systems were introduced to complement community sources. Access to piped water at the household level came to be seen as an indicator of an improved standard of living, particularly in urban areas. This concept gradually extended to rural India in the era of local governance. Since Independence, numerous programs have aimed to provide rural households with individual water connections, a goal that remains central to all drinking water schemes today. However, despite decades of effort, progress in this area remains limited and unsatisfactory. Recent statistics reveal that only 18% of rural households have piped water supplied to their dwellings. Over half of rural households still rely on public or common water sources. The Comptroller and Auditor General (CAG) noted that despite an expenditure of Rs 81,168 crores, the coverage of rural habitations only increased by 8% at 40 liters per capita per day during 2012-17. More than half of rural households (51%) rely on sources like tubewells, handpumps, or borewells for their water needs, sources that often run dry during the summer as groundwater levels decline.

The decline in community and common property water resources, along with neglect and privatization by dominant rural sections, has led to their progressive disappearance from the rural landscape. Government water supply programs have fallen short in establishing sustainable water supply mechanisms. These programs often prioritize achieving numerical targets rather than ensuring the sustained availability of water. Consequently, there are few efforts to introduce techniques that can preserve local sources, preventing scarcity and fluctuations in drinking water availability. It’s crucial to preserve, conserve, and revive traditional and common water sources with public and state intervention as part of water supply programs. Simultaneously, access to common resources should not replace the provision of household-level piped water connections. These approaches must complement each other, adapting to local needs and conditions. Such efforts are especially critical in drought-prone regions to ensure access to clean, reliable water throughout the year.

It’s the moment to embark on a journey of prudent water management! What steps should YOU take?

    1. Rethink Our Relationship with Water: It’s crucial for all of us to recognize the value of water and cease taking it for granted.
    2. Mindful Food Choices: Our food choices have a significant impact on water resources. Opt for locally sourced, seasonal, and fresh foods to reduce water consumption in food production.
    3. Minimize Food Waste: Cutting down on food wastage is another way to conserve water. Be mindful of how much food you buy and consume and find creative ways to use leftovers.
    4. Safe Reuse Practices: Embrace safe methods of reusing water while being vigilant about preventing water pollution.
    5. Collaborative Action: Together, as a collective, we can take meaningful steps towards securing a sustainable water future for food, people, and our planet.

“Originally written and edited for The Gray Matter

Climate Change: Its impact on Food and Nutrition security, Mitigation strategies for coming decades

Comprehending Climate change

Climate change refers to long-term fluctuations in temperature and weather patterns. Variations in the solar cycle are generally responsible for such fluctuations. But, since the 1800s human activities such as burning of fossil fuels and coal have been the drivers for such changes. (1)

When fossil fuels are burned, it causes combustion which increases the heat and light leading to rise in the temperature of the earth, also known as Greenhouse effect. For Eg: Deforestation is one of the major reasons for increased emission of Carbon-Dioxide, Garbage landfills are primary source for methane emissions and if we look around the waste production has tremendously increased over the years. Also, Industrialization, fuel-based transportation and rampant construction are other major contributors for increased greenhouse gas emissions.

Alarming Numbers

Greenhouse gas concentrations are at their highest levels in 2 million years. Emissions are continuing to rise. As a result, the Earth is presently around 1.1 degrees Celsius warmer than it was in the late 1800s. The most recent decade (2011-2020) has been the warmest on record. 

It is perceived that climate change mainly entails higher temperatures. However, the temperature rise is merely the beginning of the narrative. As everything is interconnected in the ecosystem. Thus, shifts in one aspect will equally impact others. Research has shown that, If the global average surface temperatures rise between 1.5-2 degrees, then world’s wealthiest countries will experience fewer changes in their local climate as well as crop yields due to well-built information systems in place whereas low income or less developed countries will suffer more in terms of food security and food safety due to climate change and lesser resilient crop infrastructure.

Recently released “Vulnerability assessment report” by Indian Council of Agricultural Research, ICAR reveals that out of 573 rural districts (excluding Andaman and Nicobar Islands) 109 districts are very high-risk districts and 201 districts are risk districts. Considering the current situation of climate change in India integrated modeling simulation studies indicated that by 2049 the mean temperature of these districts will increase by a minimum of 1.3 degrees. For a tropical country like India, Rise in temperature may affect the various crop yields affecting the production and consumption pattern of food across the year.

The Consequences of Climate Change on Food and Nutrition security

One hand increase in CO2 concentrations are good for crop growth but on the contrary CO2 emissions are resulting in frequent climatic fluctuations like intense heat, severe weather and droughts which are huge threat to In-demand crops like wheat and maize. (2)

According to some projections, in the absence of successful adaptation, worldwide yields could fall by up to 30% by 2050. 

Countries already dealing with violence, pollution, deforestation, and other issues are likely to bear the brunt of these consequences. The 2 billion people who already lack adequate food, particularly smallholder farmers and other individuals living in poverty, will be struck the hardest. Despite decades of global commitment, hunger and food insecurity continue at alarming rates.

According to the State of Food Security and Nutrition in the World report, approximately 750 million people experienced extreme food insecurity in 2019. 

The number of undernourished people or food insecurity is increasing, with climate shocks playing a significant role. Climate change will raise food prices, reduce food supply, and promote instability and conflict due to competition for water and arable land unless immediate action is taken.

As per a recent report by Children’s Climate Risk Index (CCRI) “Climate crisis is a child crisis”. With an estimated 850 million children 1-3 worldwide are living in areas where environmental and climatic shocks overlap. Children will suffer more than adults and they require more food and water per unit body weight and have less resilience to hold up against extreme and harsh weather events. Also, Children are more susceptible to toxic chemicals, temperature changes and diseases. (3)

In the last three decades India has witnessed rise in mean temperature and increased frequency of extreme rainfall. According to estimation by National Innovations in climate resilient agriculture rainfed rice yields in India are projected to reduce marginally by <2.5% between 2050-2080, irrigated rice yields by 7%. Further, wheat yield is projected to reduce by 6-25% in 2100 and maize yields by 18-23%. It is predicted that future climatic shifts may benefit chickpea production by 54%. These figures clearly indicate the need for mitigation strategies for food and nutrition sustainability.

On the Brightside – Policy Making, Ecosystem strengthening and Advocacy

In 2021 Secretary-General of UN António Guterres organized the Food Systems Summit to inspire renewed global commitment to resilient and sustainable food systems. The summit convened governments, civil society, and the private sector to generate innovative ideas, build new partnerships, and deliver ambitious cross-sectoral actions to transform food systems to meet the Sustainable Development Goals (SDGs) and Paris Agreement emission reduction targets.

Many climate change solutions have the potential to provide economic benefits while also enhancing our lives and safeguarding the environment. Global frameworks and agreements, such as the Sustainable Development Goals, the UN Framework Convention on Climate Change, and the Paris Agreement, are also in place to steer progress. There are three basic types of action: reducing emissions, adapting to climate impacts, and financing necessary adjustments.

Switching from fossil fuels to renewables like solar and wind will lower the emissions causing climate change. But we must begin immediately. While a growing coalition of countries has committed to net zero emissions by 2050, around half of the emissions reduction must be implemented by 2030 to keep global warming below 1.5°C. Between 2020 and 2030, fossil fuel production must drop by about 6% yearly. (6)

India’s Approach towards Climate change: Mitigation strategies and preparedness

Placing climate change at the center of its environmental policy, India made bold vows in 2021, with Hon. Prime Minister Narendra Modi declaring at the critical international climate summit COP 26 that India is the only country delivering on the Paris Agreement commitments in “letter and spirit”. From vowing to become a net carbon emitter by 2070 to generating 500 gigatons of non-fossil energy capacity by 2030, India led from the front on environmental problems this year, capturing the attention of people worldwide.

To meet the challenges of sustaining domestic food production in the face of changing climate, The Indian council of agricultural research (ICAR) under ministry of agriculture and farmers welfare, has launched a flagship network project aims to study the impact of climate change on agriculture including crops, livestock ,horticulture and fisheries and to develop and promote climate resilient technologies in agriculture which will address vulnerable areas of the country and the output of the projects will help the districts and regions prone to climatic hazards. ICAR has developed resilient varieties in different crops tolerant to climatic stresses to improve the food grain production in the face of changing climate. Out of 2122, 1752 varieties are climatic stress resilient. Based on vulnerability assessment, climate resilient technologies are being demonstrated on farmer’s fields covering 446 villages. Agromet advisories are reaching the farmers through m-Kisan portal, whatsapp groups and SMS  services etc. To deal with climate change, the government of India is implementing a National action plan on climate change which aims to evolve and implement strategies to make Indian agriculture more resilient to the changing climate and to sustain increase in production. Per drop more crop schemes are being implemented to increase the irrigation area. Similarly, the Rainfed  Area Development (RAD) scheme is being implemented to promote sustainable integrated farming systems.  With the help of technological interventions GOI is preparing effectively to increase the crop produce and decrease the crop loss. (5)

How Action Against Hunger is making efforts to deal with climate crisis

Our primary goal as the world’s hunger specialist is to find a better solution to cope with hunger. For more than 40 years, we have led the global fight to end life-threatening hunger once and for all. In more than 45 countries, our professionals have been on the front lines, treating and preventing malnutrition.

We save children and their families’ lives. We are there for them both before and after a crisis occurs. We make it possible for people to provide for themselves, for their children to grow up strong, and for entire communities to thrive. We are continuously looking for more effective solutions while also sharing our knowledge and skills with the rest of the world. 

Food security and livelihoods programmes at Action Against Hunger address the core causes of hunger by addressing issues of production, access, and income. Our programmes, which include a wide range of activities tailored to a community’s specific needs, are intended to boost

agricultural production, kickstart local market activity, support micro-enterprise initiatives, and improve a vulnerable community’s access to sustainable sources of food and income.

Click here  to learn more about our work.

 


References:

  1. What is climate change:  What Is Climate Change? | United Nations
  2. Journal article, Influence of climate change on food production and safety: The influence of climate change on food production and food safety – ScienceDirect 
  3. UNICEF ,Press Release: One billion children at ‘extremely high risk’ of the impacts of the climate crisis – UNICEF 
  4. Ministry of Agriculture and Farmers welfare, Press Release: :https://pib.gov.in/PressReleasePage.aspx?PRID=1696468 
  5. Impact of climate change on agriculture:  https://pib.gov.in/PressReleasePage.aspx?PRID=1884236 
  6. Intergovernmental panel for climate change, Newsroom Post: The evidence is clear: the time for action is now. We can halve emissions by 2030. — IPCC

Annexure

The combustion of fossil fuels produces greenhouse gas emissions, which behave like a blanket wrapped over the Earth, trapping heat from the sun and rising temperatures.

Carbon dioxide and methane are two examples of greenhouse gas emissions affecting climate change. These are caused by using fuel to drive a car or coal to heat a building, for example, clearing land and forests can also result in the release of carbon dioxide. Garbage landfills are a primary source of methane emissions. Among the significant emitters are energy, industry, transportation, buildings, agriculture, and land use.

.will create difference in other as well and thus Because the Earth is a system in which everything is interconnected, changes in one region might impact all others.

Research shows that the world’s wealthiest countries will experience fewer changes in their local climate than the poorest regions if global average surface temperatures rise between 1.5 and 2 degrees Celsius.

One of the core areas that climate change threatens is food production. Wheat, maize, and other crop yields have been dropping in several nations due to intense heat, severe weather, and droughts. 

Under NICRA project, wheat germplasm comprising of advanced breeding lines and land races have been screened for heat/drought tolerance. To combat climate change Indian agricultural research institute (IARI) has released the high yielding varieties of wheat such as HD 2967 and HD 3086 which are being grown in large areas of North west and North India.

In India action against hunger is working at various peri urban, rural and tribal geographies to strengthen the communities to combat malnutrition by eco-system strengthening through infrastructure and capacity building of frontline workers and caregivers. Our unique concepts like nutri gardens are preparing communities to become self resilient. Also, we are promoting and advocating the consumption of millets in remotest of geographies to build and  maintain the Food and nutrition security of marginalized communities. 

Types of Malnutrition and its Symptoms

Malnutrition

Malnutrition refers to getting too little or too much of certain nutrients. It can lead to serious health issues, including stunted growth, eye problems, diabetes, and heart disease. Malnutrition affects billions of people worldwide.

Globally in 2020, 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 38.9 million were overweight or obese.

Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low and middle-income countries. At the same time, in these same countries, rates of childhood obesity are rising.

The types of malnutrition include:

  • Undernutrition: This type of malnutrition results from insufficient protein, calories or micronutrients. It leads to low weight-for-height (wasting), height-for-age (stunting) and weight-for-age (underweight). Undernourished people often lack vitamins and minerals, especially iron, zinc, vitamin A and iodine.
  • Overnutrition: Overconsumption of certain nutrients, such as protein, calories or fat, can also lead to Malnutrition. This usually results in being overweight or obese. Micronutrient deficiencies can also occur with overnutrition.

Malnutrition_India

Signs and Symptoms

Undernutrition

(Stunted growth, wasting, underweight and micronutrient deficiencies)

Undernutrition typically results from not getting enough nutrients in your diet.
This can cause:

  1. Weight loss
  2. Loss of fat and muscle mass
  3. Hollow cheeks and sunken eyes
  4. A swollen stomach
  5. Dry hair and skin
  6. Delayed wound healing
  7. Fatigue
  8. Difficulty concentrating
  9. Irritability
  10. Depression and anxiety

People with undernutrition may have one or several of these symptoms. Some types of undernutrition have significant effects.

Kwashiorkor, a severe protein deficiency, causes fluid retention and a protruding abdomen. On the other hand, the condition Marasmus, which results from severe calorie deficiency, leads to wasting and significant fat and muscle loss. (Butler & Streit, 2018)

Undernutrition can also result in micronutrient deficiencies. Some of the most common deficiencies and their symptoms include:

  1. Vitamin A: Dry eyes, night blindness, increased risk of infection.
  2. Zinc: Loss of appetite, stunted growth, delayed healing of wounds, hair loss, diarrhea.
  3. Iron: Impaired brain function, issues with regulating body temperature, stomach problems.
  4. Iodine: Enlarged thyroid glands (goiters), decreased production of thyroid hormone, growth and development issues. Since undernutrition leads to severe physical and health problems, it can increase your risk of death. (Streit et al. 2018)

Overnutrition

The main signs of overnutrition are overweight and obesity, which can also lead to nutrient deficiencies.
Research conducted by the World Health Organization shows that people who are overweight or obese are more likely to have inadequate intakes and low blood levels of specific vitamins and minerals compared to those who are at a normal weight.

This is likely because overweight and obesity can result from overconsumption of fast and processed foods that are high in calories and fat but low in other nutrients.

Child malnutrition in India is a complex problem.

Research has conclusively shown that Malnutrition during pregnancy causes the child to have an increased risk of future diseases, physical retardation, reduced cognitive abilities—delivery systems, and community engagement. That is where we (Action Against Hunger) step in and provide Prenatal Care –

Ante Natal Care (ANC) and Post Natal Care (PNC)

Ensuring that all pregnancies are registered early at health centers and providing the necessary care and attention for the survival and development of mother and child. This includes –

  1. Screening for malnutrition, referrals to existing health centers, and anthropometric measurements to determine the mother and child’s nutritional status.
  2. Home-based visits: Home visits are conducted for pregnant women, lactating women, SAM and MAM children by our field team which has turned out to be effective in breaking their perceptional barriers in care giving behaviours.
  3. Group activities and discussions: Targeted beneficiaries are gathered at a common place to discuss and deliver the Nutrition health sessions on wide variety of topics such as Lactation education, Pre-Natal Care, Post Natal Care, Institutional deliveries etc.
  4. Infrastructural strengthening: Remodeling of old or damaged anganwadi centers of rural and tribal blocks.
  5. Eco-system strengthening: Strengthening and Capacity building of frontline functionaries to perform anthropometric measurements, counselling of beneficiaries through IEC’s , group activities and door to door visits.
  6. Collaboration and advocacy: We closely work with  ICDS and health department of WCD and facilitate the process of service delivery and policy implementation at ground level in the remotest and challenging geographies with the support of our community mobilizers and Field officers.
  7. Nutrition security and sustainability: We are supporting communities to build self- resilient and sustainable ecosystems by building Nutri gardens, advocating and promoting the consumption of long lost weather resilient crops and maximizing the consumption of locally grown nutrient rich  wild plants, fruits and vegetables.

Malnutrition_India

About Action Against Hunger

At Action Against Hunger, we drive change from the ground up, to make this world free from hunger.

Since inception in 1979, we have led the global fight against hunger. Our work has impacted the lives of 26 million individuals, through a network of 8000 humanitarian professionals across 50 countries. In India, our operations from the grassroots upwards, are focused on taking decisive action against the causes and effects of malnutrition. We equip people with knowledge and awareness, so they can see their children grow up strong, and for whole communities to prosper.

What We Do

Our teams work tirelessly with some of India’s most vulnerable communities to detect and treat Malnutrition in children and train families on how to prevent it.
We are saving lives and enabling thousands of India’s children to beat Hunger and look forward to a brighter future where they can contribute to the country’s development. Our malnutrition programs cover 1266 villages across the States of Madhya Pradesh, Maharashtra, Rajasthan and Gujarat with a multidisciplinary approach to tackling Malnutrition among children.

Action_Against_Hunger_Malnutirition

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References

Butler, Natalie, and Lizzie Streit. 2018. “Kwashiorkor and Marasmus: What’s the Difference?” Healthline. https://www.healthline.com/health/kwashiorkor-and-marasmus.
“Fact sheets – Malnutrition.” 2021. World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/malnutrition.
“Joint child malnutrition estimates (JME) (UNICEF-WHO-WB).” n.d. World Health Organization (WHO). Accessed February 17, 2023. https://www.who.int/data/gho/data/themes/topics/joint-child-malnutrition-estimates-unicef-who-wb.
Streit, Lizzie, Debra R. Wilson, Rachel Nall, and Natalie Butler. 2018. “Malnutrition: Definition, Symptoms and Treatment.” Healthline. https://www.healthline.com/nutrition/malnutrition.

How Anganwadi workers and field team of Project Vruddhi helped Sara adopt better food practices for her child Zarine

Optimal nutrition is essential for a child’s growth and development in the first two years of life. Exclusive breastfeeding for six months and continued breastfeeding with age-appropriate, nutritionally adequate complementary feed is essential for a child after six months up to two years of age. This helps prevent stunting and prevents the child from entering the undernutrition cycle. Once the child is six months of age, the body and brain require more nutrients which breastmilk alone cannot provide. Hence, appropriate complementary feeding becomes essential. Appropriate nutrition ensures a robust immune system and the realisation of full potential for the child. Healthier children will surely be more productive and will be able to create opportunities for themselves, their families and communities to eventually break the cycle of poverty and hunger.

Sara (name changed), residing in Sabarkantha district of Gujarat, is a mother of three, preoccupied with household chores. Her father, a brick labourer, is frequently out for work. Being an informed mother, Sara did not compromise on introducing healthy food groups as part of Zarine’s (name changed) complementary feed. Earlier, Sara used to let Zarine have market-available biscuits and other snack packets, and chips, among others, to save time when she was too busy with household chores or managing the other two children.

When an Anganwadi worker from Project Vruddhi met Sara, she was advised on better food practices for Zarine. “I was aware that market-available packet food is not good for Zarine, but it was sometimes very convenient. Managing a home with three children can be difficult, especially when the other two children demand packaged foods such as cold drinks, chips, and sweets. So, I used to let Zarine eat just to manage and get some time to complete my pending chores.” said Sara. “But when I was made aware that this casual approach might cost me Zarine’s changed behaviour towards homecooked food, and may result in her weight loss, or restrict her optimal growth, I became very conscious about what I was feeding my youngest child” she added.

Zarine is now breastfed along with homemade semi-solids such as porridge, mashed vegetables, and fruits, among others, with no packaged food at all. This counselling on the mother’s feeding practice was critical in ensuring that the child does not lose adequate nutrition, fall ill, or become malnourished. This positive impact was enabled by ongoing engagement with families and their trust in Front-Line Workers and Project Vruddhi’s Field Coordinators (FCs) to guide them, and their children towards better healthy food practices

Action Against Hunger helps save the life of a newborn through collaboration and perseverance in rural India.

Sunil Patil works as a community mobilizer for Action Against Hunger India, and during his field visit to Chinchutara, he came across a newborn baby’s lactating mother, Sudheshna Vargi (name changed), who was visiting from another village. Sunil later visited Sudeshna’s home as part of his work and spoke with her about a variety of topics during his initial visit. During the conversation, Sunil learned that Sudeshna had given birth to a baby boy in a rural hospital in Mokhada, and that the baby weighed only 1.8 kg. Sudeshna expressed her concern about her baby’s low weight. It was established that the baby’s health was in poor condition, and there was a risk of further deterioration if his condition remained unaddressed.

Sunil and the Anganwadi workers attempted to persuade the baby’s mother and grandmother to take the newborn to the district hospital for a health checkup, where the SDH had a Special Newborn Care Unit (SNCU). But the family refused to take the child to Jawhar. Sunil then advised the caregivers to go to Morhanda Primary Health Centre (PHC) at the very least. This was when Sunil discovered that Sudeshna was to visit the Morhanda PHC a day before his visit. However, she had to wait for a vehicle for more than three hours and ultimately missed the appointment. However, caregivers were willing to carry the newborn to Morhanda PHC, the following day. On returning from the field, Sunil inquired about an ambulance. However, none was available. This was when the Action Against Hunger field officer arranged for a private vehicle, enabling the caregivers to take the newborn to the hospital.

The medical officer examined the newborn and advised the caregivers to take the child to Jawhar SDH. The following day, an ambulance was arranged from Aase PHC by the field supervisor, field officer, and ASHA worker. The newborn was admitted to SNCU in Jawhar sub-district hospital. The baby’s father was also present at the time of admission. The child was admitted to Jawhar SDH’s SNCU for three days. Every day, Sunil diligently followed up with the caregivers. On the day of discharge, the field officer urged Jawhar SDH staff to provide an ambulance so that the caregivers could safely travel to their home in Chinchutara – more than 40 km away. For three months, AAH provided food baskets to caregivers. Sunil also visited their home and counselled them on breastfeeding, hygiene, and other newborn care practices.

Later on, Sunil recorded the baby’s weight and it improved to reach 6.0 kg. The case story demonstrates the impact of strong convergence and local coordination between our organisation and the Government functionaries. It was a successful attempt that eventually saved a newborn’s life and restored caregiver’s confidence in improving the health and nutrition of a newborn.