INTERDEPARTMENTAL CONVERGENCE FOR ... - ICDS

INTERDEPARTMENTAL

CONVERGENCE FOR ADDRESSING

MALNUTRITION

Presented By

Dr. M. Geetha Secretary, WCD

Chhattisgarh

For

Maximum outcome

of government efforts

at field level …. Mantra is......

Convergence..

Multi-factorial causes of undernutrition

Points of

Inter Departmental

Convergence at

Root Level

Implementation of Convergence Strategy

CONVERGING FOR ADDRESSING THE

IMMEDIATE CAUSES OF MALNUTRITION

HEALTH &

FAMILY

WELFARE

DEPARTMENT

Addressing

Diseases among

neonates &

children

Addressing

Dietary Diversity

among PW and

children

• Management of Diahorrea & ARI.

• Prevention and treatment of morbidity due to malaria

• Infant death audits

• Management of SAM at facility.

• Management of anaemia among PW, Adolescent girls & children

• Incorporating nutritious diet for PNC mothers in JSSK menu.

• IEC on utilization of JSY fund for diet diversity among PNC mothers.

• Capacity building of SN & Doctors on EBF & EIB.

• Nutrition Counselling of PW during ANC .

• Involving Mitanin along with AWW for BCC based on IYCN

To Sum Up

• The intervention under convergent nutrition action plan for

addressing malnutrition is based on what works to improve

nutrition:

• The expected Outcomes are:

• Increased capacity at all levels for action.

• Increased efficiency and accountability.

• Impact of Convergence:

• Reduce stunting by 6 % from current levels.

• Reduce underweight by 6% from current levels.

• Reduce prevalence of anaemia among adolescents & children by (% from

current levels.

• Reduce LBW by 6% from current levels.

Thank You

Government of U.P.

EXECUTIVE COMMITTEE MEETING,

NATIONAL NUTRITION MISSION,

BALRAMPUR

Nutritional Gaps

District Profile…..

Demographic Profile

Population 21.48 Lakh

% of Urban Population in Total Population 7.7

Total Blocks 9

Total Gram Panchayat 784

Total Revenue Village 955

Sex Ratio 928

% of Child Population (in the age group 0- 6 Years) 18.4%

Literacy Rate Male 59.7

Literacy Rate Female 38.4

Source: census 2011

1

Nutrition Indicator (%)

Indicator District State

Under Weight 43.5 39.5

Stunting 62.8 46.3

Wasting 10.3 17.9

Children age 6-59 moths who are anemic (<11.0

g/dl)72.4 63.2

Pregnant women who are anemic (<11.0

g/dl)55.3 51

Source: National family Health survey – 4 (2015.16)

2

Gaps And ChallengesSystem Level -

o Lack of human resource

o Lack of motivation among staff.

o Lack of logistics & necessary equipment's for Aganwadi Centers.

o Lack of regular capacity building training of AWW and Mukhya Sevika.

o Lack of Sub centers & Anganwadi centers in ratio of population

o Incapability of staff to organize Health and Nutrition Education sessions in the community.

3

Community Level

Lack of awareness related to nutrition.

Improper consumption of THR.

Lack of proper counseling by AWW to beneficiaries.

Cultural practices and superstitions

Poor literacy Status

• Geographical & environmental -• Most of the area is hard to reach so there is a

provision of developing NRC at block CHC/PHC level.• High prevalence of malnourished children• High prevalence of HRP cases • High number of Malnutrition children with worm

infestation.• High prevalence of diarrhea and Pneumonia.

4

Monitoring & Evaluation-

Lack of tool for estimation of Stunted.

Real time monitoring was not available.

5

ACTION PLAN TO

ADDRESS

MALNUTRITION

HR Status Under ICDS

Designation Sanction In position Vacant

District Programme Officer 1 0 1

Child development project

officer (CDPO)10 4 6

Supervisor 75 27 48

Aganwadi Workers 1882 1567 315

Helper 1712 1514 198

•We have planned supposed to fill the Vacancy as early as possible.

•Appointment of contractual ANM on Vacant Sub Centers.

•Deployment of Second ANM on Sub Centers functional as Delivery

point.

Proposed Action Plan –

1

Infrastructure & logistics:

No of total

AWC

Runs in own

building

Remaining Under

construction

Remain

1882 872 1010 200 810


• 200 AWC sanctioned for the financial year 17-18• We will try to build all AWC in Govt. building till 2022.• Maintenance of 611 AWC running by the fund of 14th vitha &

chetra Panchayat Fund.• We arrange 600 adult weighing scale from the fund of VHSNC and

try to buy child pan scale weighing machine also in the next year.• We also insure that all necessary logistics will be arranged at

AWC.

2

Proposed Action Plan- Sustaining Health Status ,

Screening of malnourished child & referral

Identification of SAM (Severe Acute Malnutrition) children’s at AWC’s & their referral to NRC will be effectively done by RBSK team.

Regular visits/health checkups by RBSK team will be ensured at every AWC’s twice in a year.

Inter-departmental convergence (Health, PRI, Education, Rural Development & Food supply department & ICDS) to address malnutrition.

Regular tracking of 0 to 3 years (Red & Yellow category Children’s) through SHABRI Sankalp Yojana.

For Kuposhan Mukta Gaon 72 villages were taken by 36 District level officers with the target to free these villages from Malnutrition by March 18.

Sensitization of ASHA, ANM & Anganwadi Workers for timely referral of Severe Acute Malnourished children's in Nutrition Rehabilitation Centre (NRC)

3

Proposed Action Plan

Strengthening VHND through Mega Call Center.

Regular Counseling of mother’s will be ensured by AWW/ASHA & ANM during VHND’s.

Household visits of SUW’s will be ensured by AWW’s.

Identification of HRP’s through effective implementation of

PMSMD(Pradhan Mantri Surakshit Matritwa Diwas). Implementation of PMMVY (Pradhan Mantri Matritwa Vandana Yojna) &

remove challenges of implementation .

Inter-departmental monitoring team for Support & monitor of VHND/IMI sessions

Weekly Iron Folic Acid Supplementation for adolescent girls through WIFS programme.

4


Strengthening of Routine Immunization Programme

Ensure availability of all equipments & logistics i.e., Weighing machine ,

hub cutter , BP equipments etc.

Regular health checkup & availability of De-worming tablets & iron syrup for

children at Anganwadi centers & Schools through BSPM/NIPI programme.

Capacity building of mother’s on WASH (water sanitation & hygiene) & distribution of ORS & Zinc

Counseling of Pregnant & lactating mother’s and adolescent on health, sanitation & nutrition on Bachpan, Mamta & Ladli Diwas (Held every month on 5,15 & 25).

Community awareness by conducting mothers meeting at AWC & in village.

5

Proposed Action Plan – capacity

Building & handholding support

Capacity building of ASHA , ASHA SANGINI , ANM Other medical staff done

by NHM on time to time regular Basis.

Capacity building of ANM/ASHA & Anganwadi worker done by Utter

Pradesh Technical Support Unit on IYCF, Breastfeeding, Complimentary

feeding, IFA & health sanitation & nutrition in 4 selected blocks of

Balrampur..

We impart this in all blocks by making master trainers & capacitated our all

FLW’s Along with Gram Pradhan, Panchyat secretary etc.

Emphasized more on home visits by FLWS.

6

Proposed Action Plan – Monitoring

Real Time Monitoring of ground situation at

multiple levels

Convergence meeting of all departments on regular basis

DHS & DNC meeting conducted every Month In

chairmanship of District Magistrate / Chief Development

Officer for review of Programmes.

7

:

Thank You

http://www.snmup.in/Index.aspx

District Bahraich

Nutrition

Particulars BAHRAICH

Total Population (in lakh) Census 2011 34.87

Literacy Rate 49.40 %

Number of Tehsil 06

Number of Block 14

Number of Gram panchayat 1054

Number of Hospitals 02

Number of community health centers (URBAN) 02

Number of community health centers 14

Number of primary health centers 49

Number of sub centers 310

Child Health And Nutrition

Indicator

Status according

to (NFHS-4)(%)

Achievement

according to

HMIS Target

next 5

Year

2017

-18

2018

-19

2019

-20

2020

-21 2021-22

District State 2016-17 2017-18

Children

(under-

5)Stunted 65.1% 46.3% NA NA 45% 62% 58% 54% 50% 45%

(Children

under-5)

Underweight 44% 39.5% NA NA 34.0% 40% 35% 30% 25% 20%

(Children

under-5)

wasted 13.7% 17.9% NA NA 9.0% 13% 12 % 11 % 10% 9%

Gaps And Challenges System Level -

Lack of human resource

Lack of motivation among staff.

Lack of Departmental building & necessary equipment's for Aganwadi Centers.

Lack of regular Training of Anganwadi, ASHA , ANM and other field level Worker.

Lack of regular capacity building training of AWW and MS.

Lack of Infrastructure & logistics

Lack of Sub centers & Anganwadi centers in ratio of population

Un utilization of funds / lack of funds

Incapability of staff to organize Health and Nutrition Education sessions in the community.

Community Level

Lack of awareness related to nutrition.

Improper consumption of THR.

Lack of proper counseling by AWW to beneficiaries.

Cultural practices and superstitions

Poor literacy Status

Monitoring & Evaluation- Lack of tool for estimation of Stunted.

Real time monitoring was not available

AAA / CLUSTER / SECTOR & others meeting not happening on regular basis.

• Geographical & environmental - • Most of the area is hard to reach so there is a provision of developing NRC at

block CHC/PHC level. • High prevalence of malnourished children • High load of deliveries , high prevalence of HRP cases • High number of Malnutrition children with worm infestation. • High prevalence of diarrhea and Pneumonia. • Out of 14 block of Bahraich district 10 blocks are affected with Arsenic & Iron

(un-absorblable) which leads various health issues

HR Status Under ICDS

Designation Sanction In position Vacant

Child development project officer (CDPO) 15 11 4

Supervisor 104 45 59

Aganwadi Workers 3094 2917 177

Helper 2619 2419 200


•We have planned supposed to fill the Vacancy as early as possible.

•Appointment of contractual ANM on Vacant Sub Centers.

•Deployment of Second ANM on Sub Centers functional as Delivery point.

Infrastructure & logistics:

No of total AWC Runs in own building

Remaining Under construction Remain

3094 935 2159 259 1700

• Proposed Action Plan – • 200 AWC sanctioned for the financial year 17-18 • We try to build all AWC till 2022. • Maintainace of 671 AWC running by the fund of 14th vitha & chetra Panchayat Fund. • We arrange 2150 adult weighing scale from the fund of VHSNC and try to buy child pan scale

weighing machine also in the next year. • We also insure that all necessary logistics will be arranged at AWC.

Proposed Action Plan- Sustaining Health Status , Screening of malnourished child & referral

Inter-departmental convergence (Health, PRI, Education, Rural Development & Food supply department & ICDS) to address malnutrition.

Regular tracking of 0 to 3 years (Red & Yellow category Children’s) through SHABRI Sankalp Yojana.

For Kuposhan Mukta Gaon 82 villages were taken by 41 District level officers with the target to free these villages from Malnutrition by March 18.

Sensitization of ASHA, ANM & Anganwadi Workers for timely referral of Severe Acute Malnourished children's in Nutrition Rehabilitation Centre (NRC)


Strengthening of VHND Routine Immunization Programme Inter-departmental

monitoring team for Support & monitor of VHND/IMI sessions

Ensure availability of all equipments & logistics i.e., Weighing machine , hub cutter , BP

equipments etc.

Regular health checkup & availability of De-worming tablets & iron syrup for children at

Anganwadi centers & Schools.

Capacity building of mother’s on WASH (water sanitation & hygiene) & distribution of ORS & Zinc

Counseling of Pregnant & lactating mother’s and adolescent on health, sanitation & nutrition on Bachpan, Mamta & Ladli Diwas (Held every month on 5,15 & 25).

Community awareness by conducting mothers meeting at AWC & in village.

Inter-departmental monitoring team for Support & monitor of VHND/IMI sessions

Proposed Action Plan – capacity Building & handholding support

Capacity building of ASHA , ASHA SANGINI , ANM Other medical staff done by NHM on time to time regular Basis.

Capacity building of ANM/ASHA & Anganwadi worker done by Utter Pradesh Technical Support Unit on IYCF,

Breastfeeding, Complimentary feeding, IFA & health sanitation & nutrition in 4 selected blocks of Bacharach..

We impart this in all blocks by making master trainers & capacitated our all FLW’s Along with Gram Pradhan,

Panchyat secretary etc.

Emphasized more on home visits by FLWS.

Proposed Action Plan – Monitoring

. Real Time Monitoring of ground situation at multiple levels

Dedicated Focus on Improving Outcomes at District level meeting in every quarter on 10th January 10th April 10th July 10th October

Convergence meeting of all departments on regular basis

DHS & DNC meeting conducted every Month In chairmanship of District Magistrate / Chief

Development Officer for review of Programmes.

District Profile

Tehsil 4

Developmental blocks 16

Gram Panchayats (GPs) 1054

Population (as per Census 2011) 3433919

Total Literacy (%) 58.71

Sex Ratio (per 1000) 921

Total child population (0- 6 years ) 572386

Source: Census,2011

Status of Infrastructure in Health & ICDS Departments

Sl. No. Particulars Status

(In numbers)

1 District Combined Hospital 01

2 Urban Primary Health Center

3 Community Health Centers (CHCs)

4 New Primary Health Centers (NPHCs)

5 Health Sub Center (HSCs)

6 Village Health Sanitation & Nutrition Committees

(VHSNCs)

8 ICDS Projects 17

9 Aanganwadi Centers (AWCs) 3095

Status of Human Resources in Health & ICDS Department

SNo. Name of Post Sanctioned In Position Vacant

1 Medical Officer 172 104 68

2 Health Supervisors 96 20 76

4 Ayush Medical Officer 24 9 15

5 Pharmasist 80 80 0

6 ANMs 314 250 74

7 ASHAs 3186 3110 76

8 CDPOs 17 10 7

9 Supervisors 110 56 54

10 AWWs 3095 2885 210

11 Helpers 2795 2617 178

Status of health and nutrition indicators

Indicators U.P. Gonda

Underweight (%) 39.5 38.6

Stunting (%) 46.3 56.9

Severe Wasting (%) 6.0 3.5

Anaemia (%)

6-59 months children

(Hb <11.0 g/dl) 63.2 72.6

Adolescents & Non PWs

(15-49 years) (Hb <12.0 g/dl) 52.5 54.4

Pregnant Women

(15-49 years ) (Hb <11.0 g/dl) 51.0 54.3

Early initiation of breastfeeding (within 1 hour) (%) 25.2 13.3

Exclusive breast-feeding (till 6 months) (%) 41.6 48.0

Initiation of complementary feeding (6-8 months) (%) 32.6 25.9

Maternal & Child Health Indicators

SNo Indicators Gonda

1 Mothers who had antenatal check-up in the first trimester

(% )

20.7

2 Mothers who had at least 4 antenatal care visits (%) 13.5

3 Institutional birth% 55.8

4 Children age 12-23 months fully immunized (BCG, measles,

and 3 doses each of polio and DPT) (%)

36.8

5 Consumption of IFA by pregnant women for 100 days or

more (%)

5.9

Source : NFHS-4 (2015-16)

Vajan Diwas 2017

S No. Districts

No of 0-5

years

Children

% of 0-5

years

Children

Normal (Green) Moderate underweight

(Yellow) Severe Underweight (Red)

0-3 yrs 3-5 yrs 0-3 yrs 3-5 yrs 0-3 yrs 3-5 yrs

1 Gonda 467165 85.55 176155 137678 29534 20444 16327 9888

State 20778738 95.03 8357196 5903126 2414524 1732772 874497 532582

• AWWs will identify SUW (red category) children on the basis of weight and age at their AWCs.

• AWWs will ensure distribution of THR to all beneficiaries (7 months to 3 years children, Pregnant women & lactating mothers).

• Regular counseling of mothers will be ensured by AWW, ASHA & ANM during VHND.

• Household visits of SUW children will be ensured by AWWs.

Action Points to Improve Health & Nutrition Indicators

UP Govt has introduced SHABRI (Sustaining Health and nutrition Above Red

Indicator) campaign to improve health and nutrition in 39 Districts of UP in

which Gonda is included.

SHABRI scheme will be implemented with the convergence of 5 departments

viz. ICDS, Health, Panchayti Raj, Rural Development and Food & supply

department.

All SUW (severely underweight or red category) and MUW (moderately

underweight or yellow category) children within the age group of 0-3 years will

be tracked monthly on www.suposhanup.in website.

All convergence departments will ensure to provide their departmental services

to these SUW & MUW children and their families. All the services will be

monitored by e-shabri portal on www.suposhanup.in website.

Kuposhan Mukt Gaon: District level officers will adopt two revenue villages

& make it kuposhan mukt within 6 months with the convergence of 6

departments viz. ICDS, Health, Panchayti Raj, Education, Rural Development

and Food & supply department.

Cont…

• Regular tracking of pregnant women and new born will be ensured by health department to reduce the prevalence of underweight, stunting and wasting in under 5 children.

• Deworming and Iron folic acid consumption by Children, adolescents, pregnant & lactating mothers will be ensured by health department. Which will reduce the prevalence of anaemia in children as well as in mother.

Action Points to Improve Health & Nutrition

Indicators in Children

To ensure the growth of a new born child it is necessary to care for the

mother from the time of first trimester. Severely anemic pregnant women

will be identified and treated before the expected date of delivery. After

birth the child will be visited according the guidelines of HBNC visit and

children who were found to be low in weight will be referred to higher

center.

ASHAs will be motivated for completion of 6 HBNC visits. Moreover

pregnant women will be tracked by ANMs to ensure identification of

severely anemic.

The number of home deliveries must be reduced to ensure clean and aseptic

environment for the new born and mother.

RBSK teams who are responsible for visiting AWW centers and schools

will maintain record of height, weight and mid upper arm circumference of

all children, identify the underweight, stunted and wasted children in the

school and AWW center and refer them to higher health facilities.

Cont..

Cont..

• Screening of 4Ds (Disease, Deficiency, Defects at birth

& developmental delay) and ensure their referral to

DEIC/DH/CHC/NRC will be ensured by RBSK

teams.

• Identification of SAM (Severe acute Malnutrition)

children at AWCs & their referral to NRC will be

effectively done by RBSK teams.

Action Points to Improve Full ANCs & Institutional Delivery

To increase the visits of pregnant women at VHND sites, it is necessary to have a separate due list of pregnant women which will be available with ANM and ASHA so that the eligible pregnant women are mobilized to session site.

All the pregnant women who require medical checkup by a

doctor will be taken to the nearest PHC by free Ambulance services (102). A list of all these pregnant women will be available with ANM at sub center level.

In respect of Women health and nutrition, SHABRI promotes

MCTS registration and ANC check-ups of all PW and THR (Take Home Ration) to all and ensures benefit from PDS.

Cont..

Each pregnant women will be tracked by ASHA and taken to the nearest hospital or delivery system by free ambulance services.

A major reason for pregnant women not getting institutional delivery services is the migration of pregnant women from their house of in laws to parental home (Maika). These PW who are registered with an ASHA from one village move to another village and hence their ANC visits are not completed and they are not tracked for institutional delivery.

To facilitate the tracking of PW who are migrating from one village to other a system for cross notification of such PW will be developed at block level and data of these PW will be shared to the concerned ANM at their parental home.

Action points to Improve Full

immunization in children

• For improving the percentage of fully immunized children in the district, ANMs and their respective ASHAs will be trained at sub center level by MOIC, BCPM and WHO monitor.

• The training will be focused on conducting quality head count survey, updating due list on time, mobilization of children to session site and tracking of left outs or drop outs.

• In respect of children Immunization SHABRI promotes VHND sessions and VHSNC in all villages.

• Repeat monitoring and analysis of these ANMs will be done after two months of their training. The ANMs who have shown improvement in their work will be removed from the list and new ANMs with poor performing sub centers will be added to the list.

• Utilization of central govt. program like intensified Mission Indra Dhanush will be done for improving the coverage.

• A roaster of poor performing ANMs and ASHAs will be prepared at block level and these workers will be a part of annual reorientation training that will be conducted by District Immunization Officer.

Thank

You…

16

NATIONAL NUTRITION MISSION

SHRAVASTI

1

District Profile

Demographic Profile

Population 1117361

% of Urban Population in Total Population 3.5

Total Blocks 5

Total Gram Panchayat 400

Total Revenue Village 536

Sex Ratio/Child Sex Ratio (0-6) 881 / 928

% of Child Population (in the age group 0- 6

Years) 18.95

Literacy Rate 46.74

Literacy Rate Male/ Female 57.16 / 34.78

Source : Census 2011

2



Under Weight (0-5 Years Children) 39.2 39.5

Stunting (0-5 Years Children)

63.5 46.3

Wasting (0-5 Years Children) 10.1 17.9

Children age 6-59 months who are anaemic (<11.0 g/dl) 69.9 63.2

Women who are anemic (Age 15-49) (<11.0 g/dl) 48.7 52.4

Source: National family Health survey – 4 (2015-16)

3



% of Women Age 20-24 years married before age 18

years 68.5 21.2

% Exclusive breastfeeding (children exclusively

breastfed for 6 months) 55.8 41.6

% Early breastfeeding (Children breastfed within the

first hour of birth) 18.0

25.2

% children age 6-8 month receiving solid/semi solid

food and breastmilk 36.7 32.6

% children received Vitamin A supplements 28.7 39.5

Source: National Family Health Survey – 4 (2015-16)

4

Nutrition Indicator

Indicator Malnourished

Children

(Red)

Malnourished

Children

(Yellow)

Total

Malnourished

Children

(Red + yellow)

Malnourished Children identified in Vajan Diwas (0-5 Years)

Total Children ( ~ 1.40 lakhs )

Nov-2014 2135 (1.50%) 16152 (11.53%) 18287 (13.03%)

Sep-2015 11859 (8.47%) 24126 (17.2%) 35975 (25.67%)

Dec-2016 12376 (8.84%) 22028 (15.7%) 34404 (24.54%)

Oct-2017 14593 (10.42%) 24028 (17.16%) 38621 (27.58%)

5

Constraints o Human Resource ( Supervisors/ AW / AW helper – 20/88/53 )

o Motivation in field staff / Capacity building/ Less honorarium

o Departmental buildings/Equipments ( 529/925)

o Co-ordination issues of AAA

o Lack of AW centers in ratio of population ( 925/1397)

o Frequent strikes

o Improper consumption of THR

o Cultural practices and superstitions

o Awareness Gap

o Terrain ( Indo-Nepal Border )

6

Strategy Proposed

o Filling of vacant posts

o Capacity building

o Convergence for infrastructure/ equipments / services

o Technical support/training

o Real time monitoring ( Shabri Sankalp Yojna )

o Mega Call centre

o NRC/ SNCU utilisation

o Strengthening VHND / Proper utilisation of VHSNC funds

o Tie up with health department ( RI, PMMVY, JSY, JSSK besides others )

o Technological Intervention

7

Initiatives taken in District

o Jeevan Camps were organised in the district to provide better health care to children and pregnant mothers. More than 2 lakh have been covered through these camps

o Operation Kayakalp aims at providing better infrastructure facilities at GP level esp. in schools/Anganwadis.

o Vajan Diwas was conducted at regular intervals to identify the nutrition level of children and tracking them on regular basis

o Transforming Sub health centres to Health and Wellness centres Taken as pilot in one block of district under NHM to provide comprehensive health care

o AAA kits : includes everything they require in field (BP instrument, digital weighing machine, hub cutter, thermometer ,haemoglobin colour check, badges, apron, umbrella, torch, dress, gupshup potli etc

8

THANK YOU

Rajiv Raushan

District Magistrate, Sitamarhi

Background

Setting up of National Nutrition Mission (NNM)- Approved on 30.11.2017.

Budget of ₹ 9 4 . crore [FY -18 to FY 2019-2020]

Budget of Rs.6724.06 lakhs in ( FY 2017-18)

BE for 2017-18: Rs. 1100 crore; RE: 550 crore; Released : Rs. 480 crore (as on date)

BE for 2018-19 is Rs. 3000 crore

All States and Union Territories- Targeted in a phased manner

Year States/districts to be covered

2017-18 315 common districts identified in the descending order

of prevalence of stunting from amongst 201 districts

identified by NITI Aayog on the basis of National Family

Health Survey-4 data, 162 ISSNIP districts and 106

districts of Scheme for Adolescent Girls.

2018-19 235 districts based on the status of under-nutrition in

various States/UTs to be identified generally based on

prevalence of stunting.

2019-20 Remaining districts of all 36 States/UTs.

Dept. of Social Welfare

Dept. of f Health & family welfare

Dept. of Drinking Water & Sanitation( Bihar State Water & Sanitation Mission (BSWSM) Dept. of Consumer Affairs, Food and Public Distribution( Food & Consumer Protection

Dept.)

Dept. of Rural Development

Dept. of Panchayati Raj

Dept. of Public Health Engineering Department

NITI Aayog

Dept. of School Education & Literacy , HRD

Information & Broadcasting

Dept. of School Education & Literacy , HRD

Dept. of Tribal Affairs

Dept. of Urban Development

CONVERGENCE OF DEPARTMENTS

Grievance Redressal

(Call Centre)

Training & Capacity Building

(ILA)

Behavioural Change CBE, Jan Andolan

Innovations Incentives

Convergence (CAP)

ICDS- CAS

ICT-RTM

NNM: Common Application Software

Incremental Learning Approach Capacity building program

setting priorities among front line workers.

Strengthening supervisory structure at district level/HSC level and sector level.

Enable coordinated functioning of ICDS and health programme to achieve common goals.

Arranging meeting every month for issues resolving at all level(district/projects)

DPMU-ISSNIP Sitamarhi BRG meeting ANM meeting HSC meeting

Sector meeting

CBE Event :Annaprasan Community Based event organized at each AWC every

month.

Amount of 250 is given to AWW for organizing Annaprasan per month.

Demonstration of variety of foodstuff which can be given to 6 month child inaddtional to breastfeeding.

DPMU-ISSNIP Sitamarhi

ICT-RTM (Information and

Communication technology-Real

Time Monitoring)

Mobile for AWC and Tablets given to Lady Supervisors

ICDS-CAS(AWW) App for AWW and ICDS-CAS(LS) for LS and ICDS-CAS(issue tracker) for District & Block helpdesk.

Sitamarhi succeeded as pilot project and till feb-18, 81% sevika is working/active on ICDS-CAS.


Dashboard Overview-OLD






NNM Respected Prime minister Mr. Narendra Modi will launch NNM on 8th

March 2018 with the help of ICT-RTM, and this programe will be telecasted on WCD site and NIC.

Improve Nutrition services delivery.

Analyzing nutrition data.

Monitor and make stetegies for its improvement based on ICT-RTM.

AIM Mapping nutrition gap

Reduce low birth weight.

Reduce Anemia in Adolescence.

Make Bihar mal-nutrition free .

Reduce slunting.


NNM Praphat feri In Sitamarhi NNM Prabhat pheri inaugration was

done by DDC sir and DPO(ICDS) sir .


Convergence meeting with all

Concern department

Executive Committee MeetingExecutive Committee MeetingExecutive Committee MeetingNational Nutrition MissionNational Nutrition MissionNational Nutrition Mission

SiddharthnagarSiddharthnagarSiddharthnagar

Dated-13-03-2018Dated-13-03-2018Dated-13-03-2018

Presented by-Presented by-

KUNAL SILKUKUNAL SILKU

District MagistrateDistrict Magistrate

SiddharthnagarSiddharthnagar

Presented by-

KUNAL SILKU

District Magistrate

Siddharthnagar

Siddharthnagar Demographic Details

Indicators under Ni� Aayog Aspira�onal District

Underweight children under 0‐5 years

Stun�ng among children under 5 years

Percentage of Infants Aged 6‐23 months Receiving an Adequate Diet.

Severe Acute Malnourishment

Percentage of women taking Supplementary Nutri�on

Children age 6‐59 months who are Anemic

Prevalence of anemia in women and girls (15‐49 years)

Strategy

Way forward/Sugges�on

CONTENT

SIDDHARTHNAGAR DEMOGRAPHIC DETAILSSIDDHARTHNAGAR DEMOGRAPHIC DETAILSSIDDHARTHNAGAR DEMOGRAPHIC DETAILSSerial No. Features Unit Value

1. Geographical area Sq. km. 2895

2. Total population Lakh 2559297

3. Sub-divisions Number 5

4. Blocks Number 14

5. Revenue Villages Number 2499

6. Gram Panchayats (Village Councils) Number 1199

7. Taluka Panchayats (Block Councils) Number 152

8.

Nagar Panchayats

(Municiple

Councils)

Number

5

9.

Aaganwadi

Centre

Number

3112

10.

Aaganwadi

Worker

Number

2732

11.

Pregnant Women

Number

39654

12.

Lactating Women

Number

35872

13.

Adolescent Girls

Number

9336

14.

Children

0-5 years

Number

375609

INDICATORS UNDER NITI AAYOG ASPIRATIONAL DISTRICT

Indicator Weightage

• Percentage of underweight children under 5 years

• Percentage of stunted children under 5 years

• Severe Acute Malnourishment

• Percentage of infants aged 6-23 months receiving an adequate diet (breastmilk + complementary feed)

• Percentage of pregnant women taking Supplementary Nutrition under the ICDS programme regularly

2.1

2.4

1.5

2.4

0.9

UNDERWEIGHT CHILDREN UNDER 0-5 YEARS

An underweight child is An underweight child is low weight for age.low weight for age.

Weightage in Health & Nutri�on Index of Ni� aayog‐2.1 Weightage in Health & Nutri�on Index of Ni� aayog‐2.1

District Status‐ 43.5% as per NFHS‐4 District Status‐ 43.5% as per NFHS‐4

35.5% underweight children as per Wajan Diwas 2017 35.5% underweight children as per Wajan Diwas 2017

1,19,608 underweight children as per Wajan Diwas 2017.1,19,608 underweight children as per Wajan Diwas 2017.

An underweight child is low weight for age.

Weightage in Health & Nutri�on Index of Ni� aayog‐2.1

District Status‐ 43.5% as per NFHS‐4

35.5% underweight children as per Wajan Diwas 2017

1,19,608 underweight children as per Wajan Diwas 2017.

35.7

39.5

35.5

33

34

35

36

37

38

39

40

In %

India U.P Siddharthnagar

STUNTING AMONG CHILDREN UNDER 5 YEARS low height for age. low height for age. A stunted child is A stunted child is

Weightage in Health & Nutri�on Index of Ni� aayog‐2.4 Weightage in Health & Nutri�on Index of Ni� aayog‐2.4

Stun�ng‐ from maternal malnutri�on, lack of knowledge on Stun�ng‐ from maternal malnutri�on, lack of knowledge on

infant young child feeding prac�ces, lack of hygiene, infant young child feeding prac�ces, lack of hygiene,

poor food security. poor food security.

low height for age. A stunted child is


Stun�ng‐ from maternal malnutri�on, lack of knowledge on

infant young child feeding prac�ces, lack of hygiene,

poor food security.

38.4

46.3

57.9

0

10

20

30

40

50

60

70

NFHS‐4

In %


PERCENTAGE OF INFANTS AGED 6-23 MONTHS RECEIVING AN ADEQUATE DIET

Adequate Diet = Breast Feeding + Complementary Feeding


9.6

5.3

1.9

0

2

4

6

8

10

12

NFHS‐4

In %


SEVERE ACUTE MALNOURISHMENT

Severe Acute malnutri�on is defined as per WHO criteria for infant 6‐59

Low Weight for height


Visible Severe was�ng and /or MUAC <11.5 cm ( 115 mm)

Children with severe acute malnutri�on have nine �mes higher risk of death.

7.5

6

4.4

0

1

2

3

4

5

6

7

8

NFHS‐4

In %


PERCENTAGE OF WOMEN TAKING SUPPLEMENTARY NUTRITION

Each pregnant women registered at AWC

is en�tled to receive a minimum 21 days of

Supplementary Nutri�on (3 packets of THR)

in a month.

Weightage in Health & Nutri�on Index‐0.9

70

30

% of Women Recived THR

Recived THR Not Received THR

CHILDREN AGE 6-59 MONTHS WHO ARE ANEMIC

58.5

63.2

65.1

54

56

58

60

62

64

66

NFHS‐4

In %


PREVALENCE OF ANEMIA IN WOMEN AND GIRLS (15-49 YEARS)

53

52.4

56.6

50

51

52

53

54

55

56

57

NFHS‐4

In %


DN ERU N OF UO RE IL SC HY MC EE NF TIL



STRATEGY FOR UNDERWEIGHT CHILDREN

Regular tracking/weighing using growth chart.

Focus on 1000 days. Early ini�a�on of breast feeding, exclusive breast

feeding and con�nued breast feeding �ll 2 years of age.

Linking of severely under weight children’s family to Antayodaya

scheme to ensure food security.

Providing job card to parents of SAM children to upgrade their

economic status.

Focus on home visit by front line workers as part of BCC (Behavior

Change Communica�on.

Rou�ne health check up, treatment and regular follow up of health

status of sever underweight children.

STRATEGY FOR MATERNAL HEALTH

100% tracking and registra�on of pregnant women by Health

and ICDS

Ensure 4 Antenatal check ups compulsorily.

Iron folic Acid supplementa�on as per norms.

Ensure 100% tracking and home visit by FLW of high risk

pregnancy cases and referral.

100% supplementary nutri�on from ICDS (THR).

STRATEGY FOR ADOLESCENT GIRLS

Weekly Iron Folic Acid supplementa�on through WIFS

programme.

Organizing Ladli Diwas for awareness genera�on among

adolescent girls related to health and hygiene.

Educa�ng adolescent girls regarding health, hygiene and

sanita�on by Health, ICDS and Educa�on departments.

Preven�ve and correc�ve measures for reducing

malnutri�on in adolescent girls.

COMMON STRATEGY1. 96 villages have been adopted by 49 district level officers to set them free from severe malnutri�on

as per State Nutri�on Mission guidelines.

2. To tackle malnutri�on effec�vely, ac�ve as well as cohesive support and convergence among

a. ICDS,

b. Health,

c. PRI,

d. Rural Development,

e. Educa�on and

f. Civil Supply departments has been ensured and regular monitoring and review is done in District

Nutri�on Commi�ee mee�ng every month.

3. Improving water and sanita�on facility, making district open defeca�on free.

4. Real �me monitoring of THR distribu�on by district and block level officials.

5. Focus on home visit by front line workers as part of BCC (Behavior Change Communica�on).

6. Promo�on of diet diversity for all, using home visit and mid media pla�orms

7. For be�er prac�ces of complementary feeding ECCE (Early Childhood Care and Educa�on) sessions are

being organized at AWC, VHND, Annaprashan and mothers mee�ngs.

WAY FORWARD / SUGGESTION In place of Panjiri as THR, THR in the form of candies, biscuits and other protein rich packaged powder products. (It will

help in preven�ng diversion in form of ca�le feed)

Development of IEC materials related to Maternal Infant and Young Child Nutri�on and Infant Young Child Feeding

prac�ces.(Should be taken up by state and center similar to Swatch Bharat Mission Scheme)

Procurement of new weighing scale where weighing scale are not func�onal. (Can be done using un�ed fund of ANM.)

Recruitment of Aaganwadi and Mukhya Sevika (State should try to get the HC stay vacated.)

Handholding required in iden�fying and preven�ng stun�ng.

a. Currently our program focusses on matnutri�on. Our FLWs are trained for iden�fica�on, measuring as well as

preven�on and cure for malnutri�on.

b. However, no such literature, tools or training has been provided for iden�fica�on, measurement, preven�on or cure

of stun�ng.

c Currently neither ASHA nor AWW are measuring stun�ung.

So as a way forward

a. Requirement of height‐weight‐age chart for tracking of stunted children (Currently only weight‐Age chart has been

provided)

b. To ensure tools and training to FLWs for iden�fica�on of stunted children.

c .Convergence with Health Department for rapid screening of 0‐5 years children and iden�fica�on of stunted children.

Ensuring home visit of severely underweight children by FLW as well as District level officials. (To be done at district level)

Training/sensi�za�on of AWW, Mukhya Sevika and CDPO on Maternal Infant and Young Child Nutri�on and Infant Young

Child Feeding prac�ces. (To be done at district level. However some training partners can be provided to us by state /

center)

Thank You.

Government of U.P.

ANALYSIS ON GAPS IN NUTRITION

SECTOR

DISTRICT- SITAPUR

Total No. of Blocks-19

Indicator Sitapur UP

Population1 4.4 million 199.8 million

Maternal mortality

ratio2, 3 311 258

Infant mortality rate2 80 68

Neonatal mortality

rate2 54 49

Under-5 mortality

rate2

116 90

Source Data :- 1Census of India, 2011 2AHS, 2012-13

DISTRICT PROFILE

Particulars Sitapur

Literacy Rate 63.38%

Number of Hospitals (District) 2

Number of community Health centers 20

Number of Primary Health Centers 60

Number of Subcenters 468

DISTRICT PROFILE- NUTRITION INDICATORS

Particulars/ Indicator Sitapur UP India

Mothers who had at least 4 antenatal care visits (%) 9.3% 26.4% 51.2%

Children age 9-59 months who received a vitamin A dose in last 6 months (%)

45.3% 39.5% 60.2%

Children under age 3 years breastfed within one hour of birth (EIBF) 34.8% 25.2% 41.6%

Children under age 6 months exclusively breastfed (%) 62.7% 41.6% 54.9%

Breastfeeding children age 6-23 months receiving an adequate diet (%) 1.9% 5.3% 8.7%

Total children age 6-23 months receiving an adequate diet (%) 1.7% 5.3% 9.6%

Mothers consumed IFA for 100 days & more during pregnancy 1.1% 12.9% 30.3%

Children age 6-59 months who are anemic (<11.0 g/dl) (%) 52.6% 63.2%

58.4%

Pregnant women age 15-49 years who are anemic (<11.0g/dl) (%) 58.4% 51% 50.3%

Data Source : NFHS-4 (2015-16)

NUTRITION STATUS OF SITAPUR

56.4

14

48.6 46.3

17.9

39.5 38.4

21

35.7

0

10

20

30

40

50

60

% children under 5 year who are stunted(height for age)

% children under 5 year who are wasted(weight for height)

% children under 5 year who areunderweight (weight for age)

Sitapur UP India

DATA SOURCE:- NFHS-4

CURRENT NUTRITION STATUS (HMIS DATA ) - MATERNAL - SITAPUR

Indicator

Status as per NFHS-4 (15-16) Achievement according to

HMIS

Target

District State-U.P. 2017-18 (Till February

Month-2018

Currently Married P.W. aged (15-49 years)

registered for ANC (%) NA NA 73% 90%

Mother Who had Antenatal checkup in first

trimester (%)I 22.7%

45.9%

40% 90%

Mother who consumed IFA for 100 days or

more (%) 1.1% 12.9% - 90%

Mother who had full Antenatal Checkup (%) 1.1% 5.9% 32% 90%

Institutional Delivery (Public facility) 57.0% 44.5% 51% 100%

Note- Indicators taken as per Kuposhan Mukt Gaon Target.

CURRENT NUTRITION STATUS (RED/YELLOW) – CHILD - SITAPUR

Particulars Total Number Status (%)

Total no. of children found malnourished as per wajan diwas report (Oct-17)-

(Red & Yellow category)

1,66,420 31.45%

Total no. of children improved in weight category – Febuary-18 18798 11.29%

DATA SOURCE:- DPO OFFICE SITAPUR- FEBUARY-2018

PERSISTANCE OF GAPS & CHALLENGES IN ACHIVEING LOW NUTRITION AMONG MATERNAL & CHILD NUTRITION.

Poor coordination in convergence in-between different departments at district and block level.

Poor quality in delivering a health services, shortage of essential drugs at block level (like - Iron-sucrose).

Not having regular & effective monitoring systems to check over program.

Poor Infrastructure & necessary equipment's (Weighing machine) of Aganwadi centers.

Lack of human resource to cater a health services (ICDS + Health Dept.)

Lack of motivation among staff.

Un utilization of funds / Lack of funds.

Health service providers (AWW ,ASHA & ANM) are in-capable to organize Health & Nutrition Education sessions at community level.

Due to long distance & geographical constraint community face problem to reach NRC for treatment of SAM children.

High load of deliveries and high prevalence of HRP cases among pregnant women.

Lack of knowledge on Health , nutrition & sanitation at community level.

Lack of participation at community level.

KEY ACTION POINTS FOR ADOPTED VILLAGES UNDER KUPOSHAN MUKT GAON – 120

Sl. No. Main Activities Time Line

1 Regular visit by officers in adopted villages & submitting of supportive

supervision reports (Parup report)

By 10th of Every month

2 Developing of Block Nutrition Committee (ICDS+Health+BSA+Panchayati Raj) &

submitting reports to district

Every Month

3 Regular effective meeting of District Nutrition committee & involvement of

officers of adopted villages and other departments.

Every Month

4 Strengthening a referral system of SAM child to NRC by Involvement of ICDS +

Health from all blocks – At least 2 Per block

Every Month

5 Involvement of Development partners (UP-TSU/ UNICEF) in DNC meeting Every Month

6 Asha Sangini , ANM & ICDS supervisor should do a joint visit and submit a report

at district level

Every Month

7 Involvement of CDPO (ICDS) to visit on VHND days in adopted village with

officers and give a feed back report on same in DNC meeting

Every Month

8 Use of Un-tide fund (VHSNC fund) for purchasing of necessary equipment's of

Aganwadi centers & sub center

-

9 Supply of essential drugs at block level (PHC/CHC) to improve maternal status –

like Iron Sucrose, IFA tablets

-

CONTINUED…..

Sl. No. Particulars Timeline

10 Strengthening a community event (Bachpan, Mamta & Ladli

Diwas-5, 15 & 25) at AWC by involvement of different

departments.

Every Month

11 Issuing a Govt. order to feed a child (3-6yrs) at AWC from BSA

dept. in order to increase PSE & nutrition status of children.

-

12 Training on Health & Nutrition topics of Aganwadi , ASHA &

Sangani

-

GOOD PRACTICES ON IMPROVING NUTRITION STATUS AT COMMUNITY LEVEL WITH DEVELOPMENT PARTNERS – UP-TSU.

Community Events

Joint visit of Development Partners (TSU- DN)

with Health & ICDS Dept. DNC Meeting BSPM Inaugration

THANK YOU….

By – Dr. Sharikha Mohan (D.M. Sitapur)

Dept. of Women & Child Development,

Govt. of Karnataka

Setting up of National Nutrition Mission (NNM)- Approved on 30.11.2017.

Budget of ₹ 9 . rore [FY -18 to FY 2019-2020]

BE for 2017-18: Rs. 1100 crore; RE: 550 crore; Released : Rs. 480 crore (as on date)

BE for 2018-19 is Rs. 3000 crore

All States and Union Territories- Targeted in a phased manner

Year States/districts to be covered

2017-18

315 common districts identified in the descending order of prevalence of

stunting from amongst 201 districts identified by NITI Aayog on the basis

of National Family Health Survey-4 data, 162 ISSNIP districts and 106 districts

of Scheme for Adolescent Girls.

2018-19

235 districts based on the status of under-nutrition in various States/UTs to be

identified generally based on prevalence of stunting.

2019-20 Remaining districts of all 36 States/UTs.

FEATURES OF NNM 1. The NNM, as an apex body, will monitor, supervise, fix targets and guide the

nutrition related interventions across the Ministries

2. The proposal consists of

• Mapping of various Schemes contributing towards addressing malnutrition

• Introducing a very robust convergence mechanism

• ICT based Real Time Monitoring system

• Incentivizing States/UTs for meeting the targets

• Incentivizing Anganwadi Workers (AWWs) for using IT based tools

• Eliminating registers used by AWWs · introducing measurement of height of

children at the Anganwadi Centres (AWCs)

• Social Audits

• Setting-up Nutrition Resource Centres, involving masses through Jan

Andolan for their participation on nutrition through various activities, among

others.

The programme through the targets will strive to

Reduction in the level of stunting

under-nutrition,

anemia and

low birth weight babies

Major impact:

one great step toward

Improving Nutrition

9 Districts

57 ICDS projects

19184 AWC

Low prevalence (<20%)

Medium Prevalence (20% to <30%)

High Prevalence (30% to <40%)

Very High Prevalence (<40%))

List of AWCs selected for Nutrition Mission

S. No District Name No. of Project No, of AWC

1 Bagalkote 6 2221

2 Ballari 8 2393

3 Bidar 5 1893

4 Davangere 6 2112

5 Haveri 7 1918

6 Koppal 5 1850

7 Yadgir 4 1386

8 Vijapur (Bijapur) 7 2313

9 Kalburgi (Gulbarga) 9 3098

Total 57 19184

National Nutrition Mission Trainers

Sl

No District DD PO CDPO ACDPO SUPERVISORS Total

1 Bagalkot 0 1 3 3 81 88

2 Bellary 0 1 6 5 64 76

3 Bidar 0 1 2 2 45 50

4 Bijapur 1 1 4 2 80 88

5

Davanage

re 0 1 4 1 66 72

6 Gulbarga 0 1 4 4 97 106

7 Yadgir 0 1 0 4 44 49

8 Haveri 1 1 2 1 70 75

9 koppal 1 1 0 0 67 69

Total 3 9 25 22 614 673

Goal of NNM The goal of NNM are to achieve improvement in nutritional status of

Children from 0-6 years, Pregnant and Lactating Mothers in a time bond manner during

the next three years, beginning 2017-18 with fixed Target as per under…..

S.No Objective Target

1 Prevent and reduce stunting in children (0-6 years By 6%

@2% p.a

2 Prevent and reduce under-nutrition (underweight prevalence) in

children (0-6 years)

By 6%

@2% p.a

3 Reduce the prevalence of anaemia among young Children (6-59months) By9%

@3% p.a

4 Reduce the prevalence od anemia among Women and Adolescent Girls

in the age group of 15-49 years

By 9%

@3% p.a

5 Reduce Low Birth Weight (L.BW) By 6%

@ 2% p.a

Targets- for the next three years, beginning 2017-18 as per under…..

Prevent and

reduce stunting in

children (0-6

years)

Prevent and reduce

under-nutrition

(underweight prevalence)

in children (0-6 years)

Reduce the

prevalence of

anemia among

young Children (6-

59months)

Reduce the prevalence

of anemia among

Women and

Adolescent Girls 15-49

years

Reduce Low

Birth Weight

(L.BW)

NNM By 6%

@2% p.a

By 6%

@2% p.a

By9%

@% p.a

By 9%

@3% p.a

By 6%

@ 2% p.a

Koppal

(59.8%)

By 53.8%

(49.9%)

By 43.9%

(68.5)

By 59.5%

(68.1%)

By 59.1%

Yadgir (55.5%)

By 49.5%

(50.3%)

By 44.3%

(74.00%)

By 65.00%

(74.00%)

By 65.00%

Kalburgi (52.2%)

By 46.2%

(56.7%)

By 50.7%

(72.4%)

By 63.4%

(72.4%)

By 63.4%

Bellari (47.3%)

By 41.2%

(39.4%)

By 33.4%

(72.3%)

By (63.3%)

(69.1%)

By 60.1%


Prevent and

reduce stunting in

children (0-6 years

Prevent and reduce

under-nutrition

(underweight prevalence)

in children (0-6 years)

Reduce the

prevalence of

anemia among

young Children (6-

59months)

Reduce the prevalence

of anemia among

Women and

Adolescent Girls 15-49

years

Reduce Low

Birth Weight

(L.BW)

Bagalkote (47.3)

By 41.3%

(44.6%)

By 38.6%

(62.9%)

By 53.9%

(66.6%)

By 57.6%

Davangere

(46.4%)

By 40.4%

(41.9%)

By 35.9%

(65.9%)

By 56.9%

(65.9%)

By 56.9%

Vijaypur (44.9 %)

By 38.9%

(38.9%)

By 32.9%

(68.00%)

By 59.00%

(68.00%)

By 59.00%

Haveri

(43.4%)

By 37.4%

(36.5%)

By 30.5%

(63.9%)

By 54.9%

(63.9%)

By 54.9%

Bidar (42.8%)

By 36.8%

(39.4%)

By 33.4%

(69.1%)

By 60.1%

(69.1%)

By 60.1%

03

06

04

05

01 02

Loan of USD 200 million being negotiated

with World Bank for NNM Phase-I

MoU to be Signed with States/UTs

Nominate Nodal Officers for NNM

Verification of Districts/Projects/AWCs

Create Budget Head for NNM

Initiate Implementation

•Procurement of Devices

•Hiring of Manpower

•Training

Convergence (CAP)

ICDS- CAS Grievance Redressal

(Call Centre)

Behavioural Change CBE, IEC Advocacy, Jan Andolan

Training & Capacity Building (ILA)

Innovations Incentives

11 Digit and LGD Codes

• Preparation of 11 Digit Code.

• LGD Code at Village Level.

• Template being forwarded

Discontinuation of Registers

10 of the 11 AWC registers to be

discontinued on stabilization of

Data Entry by AWWs.

Data Plans

• Procurement of SIM Cards.

• Data Plan for AWWs and LS.

Training of LS and AWWs

• Training of AWWs and LS

by Master Trainers

Procurement of Devices

• Smartphones & Tablets – 1 per

AWW & LS

• Growth Monitoring Devices – 1 set

per AWC-Stadiometer,

Infantometer, Weighting Scale

(Infant/Mother and Child)

Training

• 4 Master Trainers /District.

• Training of Master Trainers.

• Across 44 Locations.

• Tentatively - 19th Feb 2018

Procurement of Devices through GeM

e-ILA

• ILA modules for training on Mobile App.

• Web based application for evaluation.

Training Modules

All 21 ILA Modules will be available on

NNM Website.

Translation & Printing to be carried out at

State Level.

Guidelines Implementation Guidelines

already Issued, need to be

translated at State Level.

Training • Nominate Master Trainers.

• .Prepare Micro Training Schedule.

State Resource Group (SRG) - Quarterly

District Resource Group (DRG) - Quarterly

(3 districts together)

Block Resource Group (BRG) - Monthly

Sector Meetings - Monthly

8-10 per district DC, DPO, CDPO, RCHO/DIO

25-30 CDPO, Supervisors,

NNM Block Coordinator, Block nurse,

External Resource Persons

AWWs in Sector

Monthly

10-15

SPMU and other identified resources

Central Team (from Central CPMU and World Bank)

Facilitator

Facilitator

Facilitator

Facilitator

Cost Norm Cost ₹

State SRG

Cost Includes: Venue, Food/refreshment and TA

Frequency: 2 days every quarter

1,50,000/-

District Level DRG

Cost Includes: Food/Refreshment and TA

Frequency 2 days every quarter

30,000/-

Block Level BRG per Module

Cost Includes: Refreshment and Printing

Attendance: 8-10 people

Frequency: 1 day per Module/month

4,000/-

Sector Level per Theme

Cost I ludes: TA ₹ /- , Refresh e t ₹ /- a d Pri ti g ₹ /-) total

@ 75 per AWW Frequency: 1 per Theme/month

1,500/-

1 2 3

Community Based Events •Guidelines issued. Need to be translated at State level.

•To be conducted once in a month, on defined Themes.

•State to release funds in advance. @ ₹ 5 /- /event.

IEC and Advocacy •Print , Television, Radio.

•Social Media Campaigns.

Jan Andolan •Through involvement of Panchayati Raj.

• Institutions/Villages Organizations/SHGs etc.

•Ensure wide public participation.

District Convergence Plan

Chaired by DM/DC/Collector.

finalized by 31st Dec for the

consequent year.

[Review: 10th Jan,10th April,10th

July, 10th Oct]

Village Level VHSN Day-Every month

State Convergence Plan

Chaired by Senior most

Principle Secretary. Finalized

by end Jan. Submitted to

MWCD.

Block Convergence Plan

Chaired by SDM.

Finalized by 15th Dec for the

consequent year.

Government of India-

Executive Committee

Headed by Secretary, MWCD.

Meets quarterly.

NITI Aayog-National Council

Reports to PMO every 6

months.

For 2018-19 all Committees and CAP to be finalised at the earliest

Women &

Child

Developmen

t

Health &

Family

Welfare

Drinking

Water &

Sanitatio

n

Consumer

Affair, Food

& Public

Distribution

Rural

Development

Urban

Development

Tribal Affairs

Panchayat

i Raj

Dept. of

School

Education

& Literacy ,

HRD

Information

&

Broadcastin

g

Converge at

National

State

District

Block

Village

NITI Aayog

AWW/Supervisors

ASHA/ANM

Volunteers/SHGs

AWC as the vibrant platform for convergence of all nutrition programs/Schemes

Innovations

Based on experience

and identification of

Gaps,

earmarked

developmen

t

funds

for

and

implementation of

innovations.

Flexi -Funds

•Provided at

State Level.

• To cater for regional

peculiarities.

• Provides flexibility to

States.

Incentives

State Level

•Annually.

•Based on achievement of

goals.

•Scaled as per population

size.

Cash Award to

Frontline Functionaries

•Annually.

•Corpus of ₹ 5 Crore. •Performance based.

•Includes AWWs, LS, ASHA,

ANM

AWWs for ICT-RTM

•Monthly - ₹ 5 /-.

•Performance based.

Separate Guidelines will be issued

Position No.in each

State/UT

Mode of

Recruitment

State Project

Director 1 Ex Officio

Joint Project Coordinator

1 per 10n districts #

On deputation

Specialists 5 Contractual

Accountant 1 per 10 districts # Contractual

Project Associates 1 per 10 districts # Contractual

Secretarial

Assistant/DEO 2 Contractual

Office Messenger 2 Contractual

District

Coordinators 1 per District Contractual

Project Assistants 1 per District Contractual

Block Coordinators 1 per Block Contractual

Project Assistants 1 per Block Contractual

# (Minimum 1 per State/UT)

• 50% funding through Gross Budgetary Support as per applicable cost sharing ratio

between the Centre and the States

(i.e. 60:40 for States & UTs with legislature; 90:10 for North-Eastern States &

Himalayan States and 100% for Union Territories without legislature.

• 50% Externally Aided Project (EAP) funding through IBRD (International Bank for Re-

construction and Development/ Multi-lateral Development Banks (MDBs)- World

Bank

Year Total cost NNM

(Rs. in crore)

GOI share without

EAP.

(Rs. in crore)

2017-18 2602.75 819.87

2018-19 3526.08 1110.71

2019-20 2917.34 918.96

Total 9046.17 2849.54

Device Maximum

U it Cost ₹

Scale

Smart Phone including battery bank, phone

cover and screen guard

₹ , /- 1 per AWW (additional 5%)

Tablet ₹ , /- 1 per Lady Supervisor (additional 5%)

Growth Monitoring Devices- 4 Nos.

(Stadiometer, Infantometer, Weighing Scale

(Mother& Child) and Weighing Scale (Infant)

₹ , /- 1 set per AWC

Internet Connectivity for AWWs (4G) ₹ /- Per month per AWW

Internet Connectivity for LSs (4G) ₹ /- Per month per LS

Maintenance of Smartphones/ Tablets (10%),

after expiry of warranty period on case to case

basis

₹ /- Onetime

Training Cost for Master Trainers AWWs on

ICT RTM -Onetime

₹ /- Per AWW/Master Trainer, for entire

duration of training

Non-Recurring

SI. No. Item Unit Cost (in ₹ Lakhs)

1. Office Equipment (Computers, Printers, Scanners etc.) 12.00 (lump sum)

2. Office Furniture (Table, Chair etc.) 3.00 (lump sum) Recurring

3. Rent 1.00 per month per

State/UT

4. Travel # 1.00 per month per

State/UT

5. Office Administration (Electricity, Telephone, Internet,

Water, Stationery, Hiring of vehicles etc.)

3.00 per month per

State/UT

6. Operations Research 50.00 annual per

State/UT

# Ensure that there is no duplication of Travelling Allowance at District/State levels

Preparatory Stage

Pre-Launch Stage

Launch

Post Launch Stage

Short Term Activities

Long Term Activities 15 Days

Environment Building on Nutrition

Synergise all Line Departments

National Level State/UT Level

WCD, DWS, Health, RD, to synergise under

NNM

National Level State/UT Level

District Level Block Level Village Level

Trans-Media Campaign

District Review Meeting [ICDS, Health, DWS, PRI]

Mid-Media Activities [CDPO & MO]

Discussions on Nutrition, Health & Sanitation

[Panchayati Raj Institutions]

Participation by Elected

Representative Nutrition Awareness by Nutrition

Enablers

Organise Nutrition Rallies/Walk

Nutrition Based Activities

[Outdoor Media-Song & Drama Division, Painting Competition, Nukkad Nataks, Nutrition Pledge]

Launch Venue District & Block Level Village Level

Trans-Media Campaign

Coverage on Facebook &

Twitter Live

Live Participation of

District & Block Level Officials [Video Streaming/Webcast]

Organize VHSN Day on

Nutrition

Visit of Ho ’ le Prime

Minister to

Exhibition Area

Launch of National Nutrition

Mission e-ILA Watch Launch Event Live

Community Participation

Launch Minus 15 Days to Minus 10 Days

• District Officers (ICDS, Health, DWs, PRI) to undertake combined reiew meeting focusing on outcome monitoring and nutrtion indicators.

• Ensure Coverage in Local Media

• Post images of activities on social Media page/ handle.

• Participate in Social Media Campaign


• Participation of elected representative in events

• Nutrition Rally/Walk to be organised at District Level.

• Insure Coverage in Local Media

• Post images of activities on social Media Page/handle

• Partcipate in Social Media Campaign

• Outdoor media activation through Song and Drama Division avilable at State Level.

Launch Minus 5 Days to Launch


• District Officers (ICDS, Health, DWs, PRI) to visit

• Insure Coverage in Local Media

• Post images of activities on social Media Page/handle


• Partcipate in Social Media Campaign


Project level Village /AWC Level

CDPO with Medical officers to intiate

targeted mid-media activities and awareness

drives on institutional deliveries, WASH,

Dietary Diversification, Immunication, Food,

Fortification, Deworming, IYCF etc

All Panchayat Raj institutions to have

focused group discussions on thematic

domains of Nutrition, health and Sanitation

Post images of activities on Social Media

page/ handle.


page/ handle

Participate in Social Media Campaign.



Organise Nutrition based activities like,

painting competitions, group discussions,

competitions etc.

Organise Nukkadnataks on Nutrition,

heath and Sanitation through loca groups

Post images of activities on social Media

page/Handle

Display of NNM posters, banners and

brouchures and AWCs



page/ handle.

Spread Nutrition Awareness through

Nutrition Mascots/Enablers.



Organise Nutrition Rally/Walk

Institute a Nutrition pledge in local

Language for beneficiaries and families


page/Handle

Organise Adolescent Girls Group

Councelling on nutrition.








Institute a Nutrition pledge in local

Language for beneficiaries and families


page/Handle

Organise Adolescent Girls Group

Councelling on nutrition.





District project Village /AWC level

All officials to watch the

Launch of NNM at a central

location and live

participation through Video

Streaming.

Insure Coverage in local

Media.

Post images/ photographs

of activities on Social

Media.

Partcipate in Social Media

Campaign

All officials to watch the

Launch of NNM at a central

location and live

participation through Video

Streaming.

Post images of activities

on social Media

page/Handle.

Partcipate in Social Media

Campaign

Organise VHSN Day on

Nutrition

Watch the Launch on TV

at AWC or Community

Centre etc.


Implementation of

Coveragence Action plan.

Awareness campaigns to

continue.

Implementation of

relevant NNM Components.

Implementation of


Training of Field

functionaries for ICDS CAS.

Implementation of


Implementation of


Training of Field

functionaries for ICDS CAS

House visits.

VSHN Day

Awareness Campaigns

Implementattion of


Link :http://icds-wcd.nic.in/nnm/home.htm Document

Notifications OM for Constitution of National Council on India's Nutrition Challenges

OM for Constitution of Executive Committee of NNM

Guidelines Guidelines for implementation of Incremental Learning Approach

Guidelines for organizing Community Based Events

Release of Funds Financial Year 2017-18 - All 36 States/UTs

ICT-RTM Identifications of Master Trainers

ILA Letter to States/UTs - Guidelines for Incremental Learning Approach

CBE Letter to States/UTs - Guidelines for organizing CBE

Procurement Specifications of Smart phone, Tablet and Power bank under NNM

Specifications of Growth Monitoring Devices under NNM

NNM Districts List of 315 Districts in 36 States/UTs covered in Phase-I

Vacancies Vacancy Circular for filling up of various posts in the NNRC-CPMU

About NNM Press Release

Project Management Team NNRC-CPMU

Administrative Approval & Guidelines • Administrative Approval for setting up of National Nutrition Mission

# Manpower Norms and Administrative Guidelines being issued

shortly

http://icds-wcd.nic.in/nnm/home.htm



Status of Nutrition in

Children Arava Rajkamal

DC West Singhbhum (Jharkhand)

Profile of the district

• Population: 16 lakhs (70% STs)

• Area-wise the largest district of Jharkhand

• Total Villages: 1642

• 40% of Forest Area and many forest villages

• LWE Influence: 287 affected villages

• 18 Administrative blocks; 3 Sub-Divisions

• 15 CHCs; 5 MTCs (Bed strength = 60)

• 2330 Anganwadi Centres with total enrolment of 1,56,664 (6months to 6years)

• Sanitation coverage: 91%

• Villages with Iron contamination in water: 717

• Rural economy with nominal agriculture activity with forest-produce based livelihoods

• Villagers are also engaged in labour/transport of Iron ore mining

2

Severe Wasting by numbers & prevalence rates (%) in Jharkhand (NFHS-4)

3

Koderma

Ranchi

Garhwa

Palamu

Chatra

Latehar

Hazaribagh

Giridih

Lohardaga

Gumla

Simdega

W.Singhbhum

Khunti

Bokaro

Dhanbad

Deoghar

Jamtara

Dumka

Godda Pakur

Sahibganj

Estimated numbers Prevalence rate

>30,000

>15%

20-30,000

10-15%

<20,000

5-10%

District: West Singhbhum (Jharkhand) Nutritional status of below 5 years Children

District

Total number of Children

under 5 years who are

stunted (height-for-age)

Total number of

Children under 5 years

who are wasted

(weight-for-height)

Total number of Children

under 5 years who are

severely wasted (weight-

for-height)

Total number of

Children under 5 years

who are underweight

(weight-for-age)

West Singhbhum

142983 *

90267*

31533*

161036*

49.8 45.3

59.4

45.1 39.3

32 29

37.5

23.3

40.6

11.8 11.4 13.1 8.9

19.9

56.5

47.8

66.9

52.6 49.8

0

50

100

NFHS-3

2005-06

(Jharkhand)

NFHS-4

2015-16

(Jharkhand)

NFHS-4

2015-16

(West Singhbhum)

NFHS-4

2015-16

(Saraikela-Kharsawan)

NFHS-4

Y 2015-16

(East Singhbhum)

Children under 5 years who are stunted (height-for-age)(%) Children under 5 years who are wasted (weight-for-height) (%)

Children under 5 years who are severely wasted (weight-for-height)(%) Children under 5 years who are underweight (weight-for-age)(%)

4

Malnutrition’s strong correlation with..

• Poverty / Food insufficiency (leakages and absenteeism in ICDS/NFS/Health services in remote areas)

• Poor complimentary feeding practice (6-23 month children)

• Early marriage and teenage pregnancy

• Lack of access to safe drinking water

• Poor sanitation conditions & lack of hygiene

• Micronutrient deficiencies & Anaemia in adolescent girls

5

Understanding SAM within the community context in West Singhbhum

• Indigenous tribal community of Ho with Ho as the only language

• Very docile community with strong village institutions

• SAM has existed within the communities for generations and they have very well defined symptoms and correlation with other socioeconomic factors

• Puni – child <6 months spiritual attack

• Dehna – Child 6m-2 years spiritual and physical

Nutritional Intervention Strategy

• Intervention for short-term results: To save the malnourished children with CMAM model pilots in Khuntpani (UNICEF) and Chakradharpur (MSF) blocks. Next 3 months roll-out is planned in 6 other blocks using DMFT support

• Intervention for medium-term results: Expansion of CMAM models to entire district and strengthen the MTC infrastructure & ICDS delivery system (especially in LWE-affected/Forest villages)

• Intervention for long-term results: Address the issue of malnutrition with community-based behavioural change interventions

• Interventions supported by State Nutrition Mission (both blocks), State Health Mission (Chakradharpur) and partners – UNICEF/TATA CSR for Khuntpani and MSF (Doctors without Borders) for Chakradharpur

7

Intervention design for CMAM pilots in Khuntpani & Chakradharpur Blocks

8

Community-based Management of Acute

Malnutrition (CMAM)

Preventive Management Therapeutic Management

Community-based

treatment of

Children with severe

wasting without

complications (RUTF)

Facility based

treatment of Children

with severe wasting

and other

complications (MTCs)

Discharge

Community

mobilization

with women

SHGs for child

nutrition and

health

Promotion of WASH

practices

Behavioural change

communication through – Gram

Sabhas / Vajan Diwas / Swachhta

Diwas

Food security

through PDS

Implementation Strategy

• Extensive microplanning

• Training of stakeholders (ICDS/ANM/ASHAs)

• MUAC Screening – Identification

• RUTF Distribution

• Community-level intervention involving Gram Sabhas/SHGs

• Supervision and monitoring at multiple levels

• Quantification of results and feedback mechanism from field

• Popularizing success stories to generate demand in other blocks

• Roll-out in remaining 16 blocks

9

Sector

4

Sector

3

Sector

2

Sector

1

Massive screening activity of Mid-Upper Arm Circumference

(MUAC)

10

Community Awareness activities involving SHGs

11

RUTF (Nogod Lupu) Distribution

12

Behavioral Change & Sensitization in small groups

13

Supportive Supervision by ICDS

14

Monitoring by PRIs & Officials of District Malnutrition Task Force

15

ATFC Patient Flow

(Chakradharpur)

17

Sector-1 Sector-2 Sector-3 Sector-4 Total

Total AWCs 39 31 36 31 137

Active screening date -Septem er’17 De em er’17 O to er’17 De em er’17

Total children

(projection) 3136 2593 2793 2335 10,857

Children screened 1919 1407 1672 1626 6624 (61%)

SAM children

identified by MUAC 88 26 47 49 210 (3.1%)

SAM children enrolled

in pilot 68 21 46 41 187+8 (90%)

Children with medical

complications 9 5 1 6 21

Children enrolled in

MTC 6 2 0 3 11

Children refused MTC

treatment. 3 3 1 3 10 (8 returned to

CMAM + 2 unknown

status)

Migration/ no

information 2

Coverage & Enrolment (as on 31st Jan 2018):

Case Study of Paikera Purty (Khuntpani)

18

Age- 24 months

MUAC- 10.8 cm

Weight- 6.0kg

Age- 27 Months

MUAC- 12.8 cm

Weight- 7.8kg

Case Study of Arjun Banra (Khuntpani)

19

Age- 10 months

MUAC- 9.5 cm

Weight- 4.2kg

Age- 12 Months

MUAC- 13 cm

Weight- 6.6kg

Case Study of Shuru Banra (Khuntpani)

20

Age- 18 months

MUAC- 10.3 cm

Weight- 5.2kg

Age- 20 Months

MUAC- 12.6 cm

Weight- 7.1kg

Case Study of Jamuni Bodra (Chakradharpur)

21

Age- 21 months

MUAC- 7.8 cm

Weight- 4.35Kg

Age- 23 Months

MUAC- 12.8 cm

Weight- 6.8 Kg

Outcome indicators (Recovery rate) at 8 weeks, 12 weeks and 16 weeks.

22

Recovery rates of children at different weeks following different criteria

Recovery as per MUAC >=12.5

cm (WHO protocol) Recovery as per MUAC >=12 cm

Weeks

Total Cases

(N)

Total

recovered

cases (n) Percentage (%)

Total recovered

cases (n) Percentage (%)

At 8 weeks 103 32 31% 59 57%

At 12 weeks 56 35 63% 40 71%

At 16 weeks 34 28 82% 30 88%

Optimum cure rate by International Standards: 75%

Outcome Trends (for Khuntpani block)

23

4.19 4.47

3.52

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

Avg Weight Gain of all children btw

6-59 months at discharged

Avg Weight Gain of Children btw 6-

24 months at discharged

Avg Weight Gain of Children btw

24-59 months at discharged

Average weight gain on discharge (gm/Kg/day)

N=27 N=19 N=8

Average length of treatment: 10 weeks (Ideally 12 weeks is the Optimal period)

Optimum weight gain by international standards in community setting: 2-4gms/Kg/day

Outcome trends (for Chakradharpur Block)

Indicators Value

Number of children recovered 355

Average weight gain at discharge in ATFC 19%/3.4gm/kg

Average length of stay (days) ATFC 62 days

Total Target

N % %

Total screened ATFC (Passive screening) 2389

Total admitted ATFC (MUAC<11.5cm) 649 26.9

Total discharged ATFC 541

Total cured 355 64.6 80%

Total defaulter 120 21.8 15%

Total Non-respondents 66 12 5%

Total children screened for CMAM till now: 806 (MUAC upto 12.4cm)

24

Learnings & Way forward

• NNM – the gamechanger: HR/Financial/Monitoring support & opportunities through the newly launched National Nutrition Mission

• Instead of Anganwadi Sevika OR ANM/ASHA model – a more holistic model is expected in universal protocol of CMAM (with clearly defined roles to AWW/ASHA/ANM)

• Roll-out in 4 blocks in Phase II (April 2018); 2 more in Phase III (June 2018) and 10 more in Phase IV (September 2018)

• Distribution cum child-friendly MTC Check-up vans (Puni-Dehna Gaadi)

• Focus on using local language-based radio feed/Nukkad nataks/Swachchta Diwas/Vajan Diwas/SHG mobilization to make the fight against malnutrition a Jan Andolan

• Creating examples of cured children as brand ambassadors - Mascots

• Technology-based monitoring of ICDS delivery and mobile app for malnutrition monitoring (underdevelopment for tracking all SAM children)

• Providing safe drinking water & sanitation facilities at all Anganwadi centres from DMFT fund (Total to be covered by 2021)

• Attempt to create a Malnutrition Research & Training Centre at the District (with DMFT support)

25

Thank You

26

one great step toward

Improving Nutrition

4 ICDS projects

1386 AWC

STATUS OF ANGANWADI BUILDINGS

SL.No Name of the

block/project

No.of AWC S Arrangements of centers functioning in

Rent

BUILDI

NGS

Total Sanctioned functioning

Own

BUILDINGS

Panchayat

BUILDINGS

Community

BUILDINGS

Youth

Assitaion

BUILDING

S

Mahila

Asson

BUILDING

S

Temples

School

BUILDING

S

Make

shift

Arrangme

nt AWC Mini

AWC AWC Mini AWC

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

1 Shahapur 386 9 386 9 279 6 9 0 0 0 16 0 85 395

2 Shorapur 451 23 451 23 315 0 20 0 0 0 27 0 112 474

3 yadgir 239 4 239 4 159 4 3 0 0 0 8 0 69 243

4 Guramtakal 260 14 260 14 191 5 5 0 0 0 16 0 57 274

Dist.Total 1336 50 1336 50 944 15 37 0 0 0 67 0 323 1386

1. Gap in Infrastructure – Anganwadi Buildings

Anganwadi Basic Infrastructure Information

Sl.No ICDS Project No of

AWC

No. of

Own

Buildings

Kitchen Room

Availability Garden

Toilets

Availability

Drinking

Water Facility Electricity

Compound

Wall Play Ground

LPG Gas

Connection

Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

1 Shahapur 395 275 210 185 0 395 254 141 147 248 170 225 13 382 13 382 395 0

2 Surpur 474 315 117 357 1 473 49 425 66 408 259 215 61 413 52 422 474 0

3 Yadgir 243 157 84 159 1 242 154 89 83 160 179 64 48 195 54 189 243 0

4 Gurumatkal 274 195 186 88 5 269 171 103 81 193 171 103 37 237 54 220 274 0

Total 1386 942 597 789 7 1379 628 758 377 1009 779 607 159 1227 173 1213 1386 0

2. Gap in Infrastructure – Anganwadi Buildings –other facilities

SL. NO Name of the

Taluka

No.of.

AWCs

+mini

sanction

ed

No.of. AWCs

+mini Operated

No.of.AWCs +mini

Reporting No.of CDPOs No.of ACDPOs No.of Supervisors No.of AWWs No.of AWHs

AWC Mini

AWC AWC

Mini

AWC

Santione

d

In

Position

Santione

d

In

Position

Santion

ed

In

Position

Santione

d

In

Position

Santione

d

In

Position

1 Shahapur 395 386 9 386 9 1 0 2 2 15 13 395 384 386 366

2 shorapur 474 451 23 451 23 1 0 2 2 18 13 474 469 451 437

3 yadgir 243 239 4 239 4 1 0 1 1 11 9 243 236 239 223

4 Guramitakal 274 260 14 260 14 1 0 0 0 10 9 274 270 260 256

TOTAL 1386 1336 50 1336 50 4 0 5 5 54 44 1386 1359 1336 1282

3. Gap in Human Resources – ICDS Staff Position

• Poor Attendance in Anganwadi for Pre-School Education Activities

• Parents prefer to send their children to convent school instead of Anganwadis (Urban areas)

• Community Participation is very poor in overall Development of Anganwadi Centers

• Parents are not ready to stay in NRC for complete duration of 15 Days, in every Taluka separate NRC required

• 50% Beneficiary of ICDS do not have toilets in their houses

• All Anganwadis workers and Supervisors need periodic training

• Balavikas Committees need to be strengthened and should be trained regarding ICDS Activities

Classification of Nutritional Status

District : Yadgir `January-2018

Sl.No Name of the

Project

No. of

Children

Normal Children Children with wasting Children with Stunting Under Weight

Children

No. of

Children %

No. of

Children %

No. of

Children %

No. of

Children %

1 Shahapur 39814 19745 49.59% 9794 24.60% 19935 50.07% 11537 28.98%

2 Shorapur 41373 13668 33.04% 7571 18.30% 27705 66.96% 11026 26.65%

3 Yadgir 18440 7889 42.78% 5543 30.06% 10551 57.22% 5995 32.51%

4 Guramitakal 18852 9325 49.46% 3905 20.71% 9519 50.49% 4627 24.54%

TOTAL 118479 50627 42.73% 26813 22.63% 67710 57.15% 33185 28.01%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

Shahapur

Shorapur

Yadgir

Guramitakal

Normal Children

Wasting in Children

Stunting in Children

Under Weight Children's

Classification of Nutritional Status District : Yadgir (Month Wise)

Sl.No Month & Year

No. of

Weighed

Children

Normal Moderately Severely

No. of

Children %

No. of

Children %

No. of

Children %

1 2 3 4 5 6 7 8 9

1 Apr-17 115020 76976 66.92% 37256 32.39% 788 0.69%

2 May-17 115288 77799 67.48% 36710 31.84% 779 0.68%

3 Jun-17 119255 76953 64.53% 41532 34.83% 770 0.65%

4 Jul-17 113444 76453 67.39% 36179 31.89% 812 0.72%

5 Aug-17 115700 77268 66.78% 37613 32.51% 819 0.71%

6 Sep-17 115729 74454 64.33% 40443 34.95% 832 0.72%

7 Oct-17 112601 75698 67.23% 35985 31.96% 918 0.82%

8 Nov-17 112533 74739 66.42% 36919 32.81% 875 0.78%

9 Dec-17 115611 79022 68.35% 35766 30.94% 823 0.71%

10 Jan-18 116212 83027 71.44% 32399 27.88% 786 0.68%

National Nutrition Mission Trainers

Sl

No

Project/

Office DD PO CDPO ACDPO SUPERVISORS Total

1 District Cell 0 1 0 0 0 01

2 Shahapur 0 0 0 2 13 15

3 Surpur 0 0 0 2 13 15

4 Yadgir 0 0 0 1 9 10

5

Gurumatka

l 0 0 0 0 9 9

Total 0 1 0 5 44 50

Goal of NNM The goal of NNM are to achieve improvement in nutritional status

of Children from 0-6 years, Pregnant and Lactating Mothers in a time bond

manner during the next three years, beginning 2017-18 with fixed Target as per

under…..

S.N

o

Objective Target

1 Prevent and reduce stunting in children (0-6 years By 6%

@2% p.a

2 Prevent and reduce under-nutrition (underweight

prevalence) in children (0-6 years)

By 6%

@2% p.a

3 Reduce the prevalence of anaemia among young Children

(6-59months)

By9%

@3% p.a

4 Reduce the prevalence od anemia among Women and

Adolescent Girls in the age group of 15-49 years

By 9%

@3% p.a

5 Reduce Low Birth Weight (L.BW) By 6%

@ 2% p.a


Prevent and

reduce

stunting in

children (0-6

years)

Prevent and reduce

under-nutrition

(underweight

prevalence) in

children (0-6 years)

Reduce the

prevalence of

anemia among

young Children

(6-59months)

Reduce the

prevalence of

anemia among

Women and

Adolescent Girls

15-49 years

Reduce

Low Birth

Weight

(L.BW)

Yadgir (55.5%)

By 49.5%

(50.3%)

By 44.3%

(74.00%)

By 65.00%

(74.00%)

By 65.00%

• District Officers (ICDS, Health, DWs, PRI) to undertake combined reiew meeting focusing on outcome monitoring and nutrtion indicators.

• Ensure Coverage in Local Media

• Post images of activities on social Media page/ handle.


• Nutrition Rally/Walk to be organised at District Level.


• CDPO with Medical officers to intiate targeted mid-media activities and awareness drives on institutional deliveries, WASH, Dietary Diversification, Immunication, Food, Fortification, Deworming, IYCF etc

• All Panchayat Raj institutions to have focused group discussions on thematic domains of Nutrition, health and Sanitation

• Organise Nutrition based activities like, painting competitions, group discussions, competitions etc.

• Spread Nutrition Awareness through Nutrition Mascots/Enablers.

• Organise Adolescent Girls Group Councelling on nutrition.

• Organise Nukkadnataks on Nutrition, heath and Sanitation through loca groups


Implementation of

Coveragence Action

plan.

Awareness

campaigns to

continue.

Implementation of

relevant NNM

Components.

Implementation of

Coveragence Action

plan.

Training of Field

functionaries for ICDS

CAS.

Implementation of

relevant NNM

Components.

Implementation of

Coveragence Action

plan.

Training of Field

functionaries for ICDS

CAS

House visits.

VSHN Day

Awareness

Campaigns

Implementattion of

relevant NNM

Components.

Documents

INTERDEPARTMENTAL CONVERGENCE FOR ... - ICDS