Newborn Care and Breastfeeding Guide for New Moms by Dr. Bhavesh D Rathod

Introduction to Newborn Care

Newborns, or neonates, are babies from birth up to 28 days old. Approximately 85% of newborns require only basic care. This guide covers essential topics such as Kangaroo Mother Care (KMC), breastfeeding stages, the importance of vaccinations, supportive environments, and regular checkups, offering new mothers a comprehensive approach to newborn care.

Kangaroo Mother Care (KMC)

Kangaroo Mother Care (KMC) is a method of skin-to-skin contact between the mother and baby to enhance bonding and stimulate breast milk production. This technique is highly beneficial for regulating the baby’s body temperature, providing warmth without the fluctuations that can occur with other methods. The following guidelines ensure optimal results with KMC:

  • Dressing: The baby should wear a cap, socks, a diaper, and a frock covering the back, ensuring skin-to-skin contact between mother and baby.
  • Duration: Each KMC session should last at least 2-3 hours to minimize handling.
  • Family Involvement: Any adult family member, including the father, can give KMC to the baby. Studies suggest that fathers providing KMC help maintain the baby’s body temperature effectively.
  • Application Settings: KMC is recommended in delivery wards, post-natal wards, NICUs, and during baby transport to prevent hypothermia, particularly in low-birth-weight infants.

KMC Don’ts

  • Avoid applying kajal or any foreign substances to the baby’s eyes.
  • Do not use oil drops in the baby’s eyes, ears, nose, or umbilical cord.
  • Do not handle babies too frequently.
  • Do not allow the baby to be in contact with sick people.
  • Refrain from giving unnecessary medications.

Advantages of Breastfeeding and it’s Stages

Breastmilk is a complete food that meets all the nutritional needs of a baby for the first six months, addressing both hunger and thirst. It provides essential nutrients, supports immune function, and fosters a strong mother-child bond . Colostrum is the first milk produced immediately after childbirth that is thick, yellowish, and packed with proteins, vitamins, and antibodies that help build the baby’s immune system.

Benefits of Breastfeeding

For the Baby:

  • Nutritional: Provides nutrients to the child as per requirement, ensuring optimal absorption and digestion.
  • Immune Support: Helps develop a strong immune system and through antibodies, protects babies from illnesses.
  • Growth and Development: Promotes cognitive and physical development, , lowers the risk of respiratory and gastrointestinal issues, and ensures emotional attachment between mother and child.

For the Mother:

  • Postpartum Health: Helps uterus contract, reducing risk of bleeding, and promotes post-partum weight loss.
  • Long-Term Health: Lowers the risks of breast cancer, cardiovascular diseases, and type 2 diabetes.

For the Family, Environment, and Community:

  • Cost-Effective: Reduces financial expenses on formula and healthcare.
  • Eco-Friendly: Less reliance on disposable bottles and formula packaging.

Importance of Vaccinations

Vaccinations are essential for preventing life-threatening infections in newborns. The first set of vaccinations, including BCG, hepatitis B, and polio, are typically administered soon after birth. Vaccines help protect against illnesses like diphtheria, tetanus, pertussis, and measles. Maintaining a vaccination schedule is vital for the baby’s immunity, and new parents should consult their pediatrician to stay informed about required immunizations and booster shots.

Supportive Environment for Mother and Baby

The early days with a newborn are both joyful and demanding. Support from family members, especially the father and other caregivers, is crucial to ensure that the mother can focus on recovery and breastfeeding. Here are ways to create a nurturing environment:

  • Father’s Involvement: Fathers can provide KMC, assist with feedings, and support the mother emotionally, creating a bond with the baby, and ensure mothers enough time to rest.
  • Caregiver Support: Family members can help with household tasks, allowing the mother to focus on breastfeeding and bonding.
  • Emotional Support: Open communication and emotional reassurance from family members can positively impact the mother’s mental well-being.

Importance of Regular Checkups

Regular pediatric checkups ensure that the newborn’s growth, nutrition, and health milestones are on track. These visits allow early detection of any health issues and provide an opportunity for parents to ask questions about care, breastfeeding, and vaccinations. Schedule the first checkup within a few days after birth, with subsequent appointments guided by your paediatrician.

Conclusion

The first few weeks of a newborn’s life are critical for bonding, nutrition, and development. Practising Kangaroo Mother Care, ensuring successful breastfeeding, adhering to a vaccination schedule, creating a supportive environment, and scheduling regular checkups are all essential steps for maternal and infant health. This comprehensive approach to infant feeding not only promotes the baby’s growth, immunity, and attachment but also strengthens the family bond. Breastfeeding, in particular, offers numerous advantages by providing essential nutrients, supporting maternal-infant attachment, and fostering long-term health benefits.

Remember, when in doubt, always consult with a healthcare provider to address any concerns about your newborn’s health and development.


References

  1. Kangaroo Mother Care & Optimal Feeding of Low Birth Weight Infants (Operational Guidelines) Available at: https://nhm.gov.in/images/pdf/programmes/child-health/guidelines/Operational_Guidelines-KMC_&_Optimal_feeding_of_Low_Birth_Weight_Infants.pdf
  2. WHO – Infant and Young child feeding. Available at: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
  3. National Immunization Schedule. Available at: https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/report/National_%20Immunization_Schedule.pdf


Author

Dr. Bhavesh D Rathod

Dr. Bhavesh D. Rathod is an accomplished medical professional, currently practicing as a Pediatrician and Neonatologist. With an MBBS and MD in Pediatrics, he is dedicated to the healthcare and well-being of children.

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

Unraveling Malnutrition’s Global Puzzle – A Comparative Study of Interventions and Impact in India and Beyond

A Comparative Analysis of the Causes, Consequences, and Interventions Undertaken to Mitigate Malnutrition and hunger in India and Around the World

Aim: This article aims to investigate the issues of hunger and malnutrition in India and globally, comparing and contrasting the causes, consequences, and interventions. 

Abstract: This research article discusses and compares the food, nutrition insecurity of India, Yemen, Somalia and Haiti. This article also discusses the existing safety net schemes like Integrated Child development scheme and Public distribution scheme by the government of India to support the vulnerable section of the society to ensure food and nutrition security across different age groups. It further mentions Action against Hunger’s initiatives towards building a nutrition resilient community through its nutrition sensitive and nutrition specific interventions.


Introduction

Malnutrition refers to a condition that arises when the body does not receive adequate nutrients to maintain optimal health and functioning. It can result from a deficiency, an excess, or an imbalance of nutrients in the diet. Malnutrition can affect people of all ages, from infants and children to adults and older people, and is a significant global health concern. 

India has alarming malnutrition rates among children under five. Poverty, limited access to nutritious food, and inadequate healthcare contribute to this crisis. Even with the government having several initiatives to combat the issue and improve healthcare services, there are significant challenges in executing the same.  

Globally, nutrition crises continue to have devastating impacts. From Yemen and Somalia to Haiti, many countries are still struggling to address the nutritional needs of their citizens. This article aims to understand the causes and consequences of such food crises in India and globally and examine interventions undertaken to mitigate the problem.  

 

Methodology 

This article employed multiple data collection methods to facilitate comprehensive analysis and establish meaningful correlations.  

Primary data: A comprehensive interview was conducted with a distinguished expert from an esteemed organisation working in the field to address the issue – Action Against Hunger. A concise summary of the discussion, rewritten for easy understanding, has been included in the paper.  

Secondary data: Reliable sources and journal articles were used for a comparative analysis of the causes, consequences, and interventions executed to combat hunger in India and three other countries – Yemen, Somalia, and Haiti.   


Causes, Consequences, and Interventions for Hunger Crisis Around the World

Unfortunately, global hunger remains a pervasive issue today, resulting in approximately 25,000 deaths each day, with 10,000 of them being children, as reported by the United Nations. This dire situation has been further exacerbated by escalating food prices and the exorbitant fuel cost.

For this article, the food crisis is explained in these three specific countries – Yemen, Somalia, and Haiti.

 Since 2015 the civil war has led to violence, migration and breakdown of all kinds of essential infrastructure which disrupted agricultural production, distribution channels and access to food leading to a dire humanitarian situation in Yemen.  The severity of hunger has reached unparalleled levels now resulting in immense suffering for millions of individuals. It is reported that malnutrition levels are fairly high in Yemen with 1.3 million undernourished pregnant and lactating mothers, nearly 2.2 million undernourished children have been identified that need to be treated for acute malnutrition. 

 Similarly, Somalia is facing the dire hunger crisis due to grappling and devastating effects of droughts in the Horn of Africa. The situation is catastrophic as nearly 6.5 million individuals are facing food insecurity. Somalia has faced a different kind of crisis back in 2011 where nearly quarter of a million lives were lost due to famine. 

The cause of severe hunger issues in Haiti is due to food insecurity caused by poverty, deforestation and soil erosion have impacted agricultural productivity. Not only the country struggles with inadequate infrastructure but the climatic changes are badly affecting the harvests. Due to food and nutrition insecurity the population especially, children have become susceptible to infections.

Existing scenario of malnutrition in India

India has one of the highest rates of malnutrition globally. According to the National Family Health Survey (NFHS-5) conducted in 2019-21, nearly 36% of children under the age of five in India are stunted (low height for age), 19% are wasted (low weight for height), and 32% are underweight.

Malnutrition rates vary across different states and regions of India. Generally, states with higher poverty rates and lower socioeconomic indicators tend to have higher malnutrition rates. In India, Bihar has the highest malnutrition rate, while Pondicherry and Sikkim have the lowest malnutrition rates. 

 Contributing factors to malnutrition in India 

Malnutrition in India is caused by a complex interplay of factors, including poverty, limited access to nutritious food, inadequate healthcare facilities, poor sanitation and hygiene, and insufficient maternal and child care practices. These factors contribute to a significant impact on both children and mothers.For children, malnutrition poses serious health and developmental challenges, leading to physical and cognitive impairments, reduced immunity, heightened susceptibility to diseases, and increased mortality rates.

Similarly, malnourished mothers face adverse consequences. They are more likely to give birth to underweight babies, perpetuating the vicious cycle of malnutrition. Maternal malnutrition also raises the risk of complications during pregnancy and childbirth, further exacerbating the health and well-being of both mothers and their infants. 

Government Interventions to Combat Hunger in India 

The Indian government has implemented various programs to address malnutrition, including the Integrated Child Development Services (ICDS) scheme, which involves providing food, preschool education, and primary education to children under six years of age and their mothers, the National Health Mission (NHM), and the National Nutrition Mission (POSHAN Abhiyaan). These governmental programmes aim to reduce child stunting, underweight and low birth weight by two percentage points per annum and anaemia among children (and young females) by three percentage points per annum.

These governmental initiatives aim to improve the availability of nutritious food, enhance healthcare services, promote breastfeeding, and raise awareness about proper nutrition. The government also undertook the “1000-day initiative”, which provides parents and healthcare workers with the most recent and up-to-date knowledge regarding the most critical factors that can impact a child’s cognitive development during the first 1000 days of a child’s life, starting from conception. 

Challenges in Addressing the Food Crisis in India

Despite efforts to tackle malnutrition, several challenges persist, such as poverty, lack of awareness, poor infrastructure, and the complex nature of the issue. Implementation gaps, inadequate funding, and limited coordination among sectors such as health, agriculture, environment, sanitation, gender, and education hinder progress in effectively combating malnutrition.  

Insights from an expert working in the field in India 

Action Against Hunger India is actively engaged in addressing malnutrition by prioritizing various key areas. Their efforts are focused on enhancing nutrition literacy, promoting food security, and improving livelihood opportunities. Additionally, they aim to ensure access to clean water, sanitation, and hygiene, all of which are vital during the crucial 1000-day period of a child’s life.

To combat malnutrition effectively, the organization provides support and counselling to both primary and secondary caregivers of malnourished children. Through these efforts, they seek to strengthen nutrition-sensitive practices and create sustainable solutions. One way they do this is by establishing poultry farms, kitchen gardens, and pisciculture ponds. Concurrently, Action Against Hunger consistently offers guidance on WASH (Water, Sanitation, and Hygiene) practices and introduces cost-effective hand hygiene set-ups like tippy taps. 

In summary, Action Against Hunger India takes a comprehensive approach to tackle malnutrition, ensuring the well-being and development of children through improved nutrition practices, livelihood opportunities, and access to essential resources.

Conclusion

Malnutrition is a serious issue that has affected billions of people worldwide. It is an issue of concern in both developed and developing countries but is more detrimental to developing countries. A lot of people in Central African and South Asian countries are dying each year due to hunger and malnourishment. Most of India’s children under 5 years of age suffer from the severe effects of malnutrition. This is because of hunger, poverty, and food lacking essential nutrients.  

Several efforts have been taken by the government of India and globally to reduce poverty by launching initiatives at the state and national levels. The Integrated Child Development Services (ICDS) and the Midday Meal Scheme have provided supplementary nutrition, immunization, health check-ups, and preschool education to vulnerable populations in India. This has led to a positive effect. However, challenges remain in reaching remote areas and ensuring proper delivery of services.

The collaborative endeavours of both governmental and non-governmental organizations have demonstrated lasting effectiveness in addressing malnutrition and hunger. To combat these challenges successfully, it is essential to implement nutrition interventions that target not only the immediate issues of malnutrition but also the underlying social problems such as poverty, illiteracy, and unemployment. By tackling these interconnected issues, we can work towards eradicating malnutrition and securing a better future for children, ensuring they lead healthier and more fulfilling lives.

 


References

  1. Chakravorty, S., & None Manisha. (2023). Data analysis of malnutrition in India: a review of numerous factors. International Journal of Community Medicine and Public Health, 10(7), 2629–2636: https://doi.org/10.18203/2394-6040.ijcmph20232064
  2. Combating Malnutrition With More Than Income Growth. (2012, August 30). PRB. https://www.prb.org/resources/combating-malnutrition-with-more-than-income-growth/ Hunger crisis in Haiti. (n.d.). Plan International Haiti: https://plan-international.org/haiti/hunger-crisis-in-haiti/
  3. Malnutrition in India. (n.d.). NextIAS: https://www.nextias.com/current-affairs/28-07-2022/malnutrition-in-india
  4. Mathew, M., Francis, P., & Sebastian, S. (2020). Studying the prevalence of malnutrition in India: An interstate analysis: https://www.academia.edu/51930317/Studying_the_Prevalence_of_Malnutrition_in_India_An_Inter_State_Analysis?source=swp_share
  5. Somalia emergency | World Food Programme. (2023). www.wfp.org; World Food Programme: https://www.wfp.org/emergencies/somalia-emergency
  6. Towle, M. (2011, March 24). India is booming – so why are nearly half of its children malnourished? (Part 1). State of the Planet: https://news.climate.columbia.edu/2011/03/24/india-is-booming-so-why-are-nearly-half-of-its-children-malnourished-part-1/
  7. Yemen emergency | World Food Programme. (2022). Wfp.org; World Food Programme: https://www.wfp.org/emergencies/yemen-emergency


Authors

Seerath Prakash & Srinjay Mukherjee

Seerath Prakash is a Modern School Barakhamba Road student, currently studying in grade 12. She is keenly interested in human welfare and regularly organises drives to provide food for the underprivileged.

Srinjay Mukherjee is a DPS Monarch International School student in Doha, studying in grade 12. He is keenly interested in history, politics, and international relations and enjoys writing on fictional and non-fictional topics.


 

Alarming Issue Of Malnutrition In Infants Under 6 Months

Introduction 

Malnutrition remains a global health concern, affecting millions of infants and children worldwide. While malnutrition in older children is widely recognized, the alarming issue of malnutrition in infants under six months is often overlooked. This critical period of a child’s life is vital for growth and development, making early intervention essential. Unfortunately, the burden of wasting among Indian children in the first 6 months of life is not well-documented. Infants under the age of six months may exhibit various signs of malnutrition, including low birth weight (including premature birth), wasting, underweight, growth or feeding difficulties, and clinical illness. In India, the statistics reveal a concerning situation, with 27% of infants under six months being wasted or acutely malnourished (weight-for-length (WLZ) < -2), and 13% severely wasted (WLZ < -3). Additionally, 32% of infants are underweight (Weight-for-age (WAZ) < -2), and 10.6% are severely underweight (WAZ < -3) (Government of India, 2021). Furthermore, the prevalence of low-birth-weight infants stands at a staggering 18%, many of whom are already wasted or become wasted later. The rates of timely initiation of breastfeeding are low, with only 41.8% of children being breastfed within the first hour of birth, and exclusive breastfeeding is practiced by only 63.7% of infants under six months of age (Randev, 2020).


Unveiling the Etiology of Malnutrition Among Infants Less Than 6 Months of Age 

  1. Inadequate Exclusive Breastfeeding Practices: One prominent etiological factor contributing to malnutrition in this age group is the practice of suboptimal breastfeeding. Exclusive breastfeeding for the first six months of life is crucial for providing optimal nutrition and protection against infections. However, challenges such as lack of knowledge, cultural beliefs, maternal employment, and aggressive marketing of breastmilk substitutes often impede exclusive breastfeeding rates. Studies have shown that suboptimal breastfeeding practices significantly increase the risk of malnutrition among infants (Victoria et al., 2016, Islam et al., 2018).
  2. Maternal Malnutrition and Health Status: The nutritional status and overall health of mothers play a pivotal role in the etiology of malnutrition among infants. Maternal malnutrition, before and during pregnancy, can result in deficiencies of essential nutrients, which may cause prematurity or intrauterine growth retardation and directly affect the quality and quantity of breast milk. Term SGA (small for gestational age) and low birth weight babies are more likely to experiencing wasting and severe wasting (HRD, SAS & UNICEF). Furthermore, maternal illness and infections, particularly during pregnancy and lactation, can hinder the fetus’s and infant’s access to adequate nutrition and contribute to malnutrition (Bhutta et al., 2013). Addressing maternal malnutrition and improving maternal health is crucial for promoting infant nutritional well-being.
  3. Infections and Illness: Infections and illnesses have a profound impact on the etiology of malnutrition among infants. The immature immune systems of infants under six months make them susceptible to infections, which can disrupt nutrient absorption, increase nutrient requirements, and reduce appetite. Common infections such as respiratory infections, diarrheal diseases, and malaria can lead to malnutrition in this age group (Caulfield et al., 2004). Addressing infections through improved healthcare access, vaccination and hygiene practices is essential in mitigating risk of malnutrition.

In addition to these factors, there are other identified factors like lower maternal education, caesarean section, low birth weight, gender and poverty and socioeconomic factors which contribute to malnutrition among infants less than 6 months of age. Infants under six months are particularly vulnerable to malnutrition due to their physiological immaturity, high nutritional needs, and exclusive reliance on breast milk. Wasting and severe wasting among this age group of young infants is significantly associated with increased risk of morbidity, mortality, and poor cognitive and physical development and thus it is imperative to address it. 

Current Context

While India has made significant strides in improving the survival rates of high-risk newborns and infants through the identification and management of illness withing dedicated facilities and targeted programs (Kumar et al., 2020), there remains room for improvement. The nutritional interventions in India have mainly targeted children aged 6 to 59 months, with facility-based management guidelines issued in 2011 to treat severe acute malnutrition among infants and young children aged 0-59 month. Various programs and platforms in India are aimed at detecting and managing early growth failure however, the utilization of these services often falls short of expectations. To address the needs of at-risk children, existing programs such as Home-Based Newborn Care and Home-Based Young Child Care should be strengthened and expanded to include actions for infants with malnutrition. Although infants with wasting in the first six months of life are also at high risk, they receive less frequent follow-up home visitation than low birth weight babies in the current program (as per HBNC/HBYC Guidelines, 2011).  

Progression

One intervention that can prevent and treat malnutrition in children under six months of age is optimal breastfeeding practices which include timely initiation of breastfeeding and exclusive breastfeeding up to 6 months of age. In fact, exclusive or predominant breastfeeding has been shown to reduce the risk of wasting in the first six months of life (WHO 2021). However, despite the recommended guidelines promoting optimal breastfeeding for the first six months, there is a low compliance rate due to factors such as lack of awareness, social norms, deeply rooted cultural practices, and inadequate support system. Additionally, many women in India suffer from anemia, which can have negative impacts on the mother’s health and increase the risk of low-birth-weight babies. Poor sanitation and hygiene practices also contribute to malnutrition, exposing infants to diarrheal infections and other illnesses that can affect their growth and development. Other key intervention includes improving maternal nutrition during pregnancy, addressing post-partum mental health issues, enhancing skills and knowledge of frontline workers on breastfeeding counselling and resolving challenges faced by mothers in breastfeeding. There is a need for enhanced community-based interventions that address the health and nutrition of both infants and mothers.

There is a great opportunity for further strengthening community-based interventions that focus on promoting the health and nutrition of both infants and mothers. While services for pregnant women primarily address physical ailments, there is a need for increased support for maternal mental health. It is important to address regional variations, improve service integration, and bridge the gaps in referral systems to ensure the seamless delivery of high-quality care. 

To enhance the effectiveness of community-based interventions, it is crucial to address practical constraints such as the limited availability of appropriate equipment and additional efforts are warranted to improve the skill levels of community health workers to ensure strengthened service delivery. 

In India, there is a pressing need for more evidence-based initiatives that specifically focus on the prevention, identification, and management of acute malnutrition in children under six months of age.  Addressing this gap will contribute to the overall well-being and healthy development of infants in the country (Chowdhury et al., 2021). 

Therapeutic approach calls for country-specific guidelines to address the issue of malnutrition among children under 6 months of age at community level (CMAM) and Indian growth standards for early identification of MAM and SAM children under 6 months. Development of a national guideline and protocol for the community-based management of early growth failure in infants under six months, based on the MAMI Care Pathway Package, spearheaded by the National Centre of Excellence for Management of Severe Acute Malnutrition at Kalawati Saran Children’s Hospital is very promising. The MAMI Care Pathway Package is tailored to the specific context by integrating its various components into the existing community-based programs.  

Conclusion

The nutritional needs of children under the age of six demand greater attention and emphasis than they currently receive. Implementing innovative and comprehensive strategies such as Community-Based Management of Acute Malnutrition for Infants (CMAMi) can prove highly beneficial in making a significant impact on the country’s malnutrition statistics. 

To acknowledge and address this, we at Action Against Hunger, India work with mothers, families, communities, and systems to foster requisite support, knowledge, and skills to assure optimal nutritional support to the children under 6 months. 


References  

  1. India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017; 390:2437–60.
  2. World Health Organization. Updates on the Management of Severe Acute Malnutrition in Infants and Children. Guideline. 2013. Available at: https://www.who.int/publications/i/item/9789241506328 . Accessed on 17th April 2023. 
  3. Knowledge Integration and Translational Platform at Research and Development, society for Applied Studies, new Delhi, India and UNICEF, India. Analysis of wasting and severe wasting and its associated risk factors among under-5 children in India.
  4. Kumar P, Meiyappan Y, Rogers E, et al. Outcomes of hospitalized infants aged one to six months in relation to different anthropometric indices – an observational cohort study. Indian J Pediatr. 2020. https://doi.org/10.1007/s12098-020-03236-9 .
  5. National Center of Excellence for Management of Severe Acute Malnutrition, Kalawati Saran Children’s Hospital LHMC, New Delhi. National Consultation on Addressing Acute Malnutrition 2021, New Delhi.
  6. Mwangome M, Ngari M, Fegan G, et al. Diagnostic criteria for severe acute malnutrition among infants aged under 6 mo. Am J Clin Nutr. 2017; 105:1415–23. 
  7. Mwangome M, Ngari M, Bwahere P, et al. Anthropometry at birth and at age of routine vaccination to predict mortality in the first year of life: a birth cohort study in Burkina Faso. PLoS One. 2019;14: e0213523.
  8. Randev S. Malnutrition in Infants under 6 months: Is it time to change recommendations? Indian J Pediatr. 2020; 87(9):684–685.
  9. Bhutta Z. A, Das J.K, Rizvi A, et al. Evidence-based intervention for improvement of maternal and child nutrition. What can be done and at what cost? The Lancet 2013; 382 (9890): 452-477.
  10. Black R E, Victoria C G, Walker S P, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 2013; 382 (9890): 427-451. 

The Nexus of Climate Change, Environment, and Hunger: A Call to Action on World Environment Day 2023

On June 5th, every year, the world unites to celebrate World Environment Day, a momentous occasion that serves as a powerful reminder of the urgent need to protect and preserve our planet. In 2023, as we commemorate this day, we must also reflect upon the profound interconnections between climate change, the environment, and the scourge of hunger and malnutrition. For humanitarian global organizations dedicated to addressing these pressing issues, this is a pivotal moment to highlight the critical linkages and advocate for comprehensive action. It is now a matter of much discussion and global recognition that how climate change and environmental degradation impact hunger and malnutrition around the world. As a world united in many ways, we must also explore the transformative steps needed to address this multifaceted challenge.

At Action Against Hunger, we are involved in some of the initiatives to address climate change that is becoming a major determinant of hunger and environmental degradation that can undermine our food security. We are prioritizing sustainable solutions at the intersection of climate change, environment, hunger, and malnutrition.

Through ‘Farmer Field Schools’, we are building the capacities of farmers, right from Central Africa to South Asia, on climate-smart farming techniques and educating them on a variety and types of crops that survive extreme weather but are also nutritious. Using satellite imagery of crops and water, we have set up a ‘Pastoral Early Warning System’ in the Sahel region of West Africa that, combined with on-ground mobile surveys, provide real-time alerts to herders to find comparatively better grazing lands for their livestock. Implementing innovations such as hydroponics and vertical gardens, that have revolutionized the farming sector, have proved to be a boon for our farmers’ struggle with inadequate access to water and soil. We have also strengthened inter-farmer bonds through farmer cooperatives that have enabled farmers to rent larger plots, and as implemented in Uganda, get together to obtain fair prices for their produce. As climate change has impacted the duration of farming seasons, and consequently elongated the hunger seasons, we have been working closely with families to inculcate food preservation practices by providing tools and resources for increasing the shelf-life of their crops. At network level, we are widely involved in emergency relief actions, and have consistently been better advocates for action-based change.

In India, as part of our food security and livelihood initiatives, our efforts strive towards promoting climate and nutrition sensitive farming and agriculture practices and mitigating the effects of climate change. We promote cultivation of nutritious fruits and vegetables through nutri-gardens. These also account for environmentally friendly designs of nutri-gardens, natural, eco-friendly pest control, and fertilizers. We set up vermi-composting units towards inculcating sustainable composting practices that do not limit in use to just the Nutri-gardens but expand beyond till field crops as well. Through poultry farming and pisciculture, we promote livelihoods, diet diversity, and sustainable community building behaviors and practices. However, with the ever increasing burden of climate change, these vulnerable populations are left to face extreme situations of heat and drought, leaving them with little to no sources of food and income. This invokes a sense and urge to flee elsewhere in search of livelihood, pushing them in a situation of distressed migration.

A common scenario in Action Against Hunger India’s working geographies, we have devised platforms to minimize the impact of migration on malnutrition by closely following up with families and helping them in accessing the health and nutrition services for their children.

World Environment Day 2023 serves as a powerful reminder that our action today will determine the future of our planet and generation. The time to save our planet is now and we are presented with a once in a lifetime opportunity to save our planet. As we reflect upon the undeniable links between global challenges and individual well-being, we must recognize the urgent need for comprehensive and sustainable solutions.

By addressing the root causes of hunger and malnutrition, including the impacts of climate change and environmental degradation, we can pave the way for a more resilient and equitable future. This requires a collective effort that spans governments, organizations, communities, and individuals. There is so much to be done at grassroots and at the national and international levels so as to achieve SDG 13 calling for action on climate.

On this World Environment Day, let us commit to promoting climate-smart agriculture, restoring ecosystems, strengthening food systems, prioritizing climate adaptation and disaster risk reduction, and advocating for change. By embracing sustainable practices and fostering collaboration, we can ensure a world where no one goes hungry, where ecosystems thrive, and where the environment is preserved for generations to come.

Let us leverage our expertise, influence, and resources to tackle the intricate web of challenges at the intersection of hunger, malnutrition, climate change, and the environment. Together, we can forge a path toward a sustainable and food-secure future, leaving a lasting impact on the lives of the most vulnerable populations worldwide.

This World Environment Day, let us renew our commitment to a healthier planet and a hunger-free world. The time to act is now.


References:

1: UN Warns Climate Change Is Driving Global Hunger: UN Warns Climate Change Is Driving Global Hunger
2: A once-in-a-planet opportunity” UNEP Chief Inger Andersen at INC-2: A once-in-a-planet opportunity” UNEP Chief Inger Andersen at INC-2 

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

Winning the battle against Hunger is critical for a healthy society, and it is only possible with your help.

Make a donation or join as partners, organize a fundraising event with your friends, family, and coworkers, or volunteer to help us save lives!


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.

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