Editorial Analysis: Project Sampoorna


Project Sampoorna


What is discussed?

The article discusses about Project Sampoorna which was conceptualised and successfully implemented in Bongaigaon district of Assam. It also discusses about how Project Sampoorna’s success in reducing child malnutrition is a model that can be easily implemented anywhere.

Background

  • Mission Sampoorna was launched by Bongaigaon district administration with the prime objective to identify acute malnutrition among the children of the district and to take necessary steps to set them free from the problem.

Malnutrition in Bongaigaon district

  • Bongaigaon has 1,116 Anganwadis with a total of 63,041 children below five.
  • The massive exercise of plotting their weights and heights in World Health Organization growth charts revealed a total of 2,416 malnourished children; 246 cases of Severe Acute Malnutrition (SAM) and 2,170 instances of Moderate Acute Malnutrition (MAM).

Challenges

  • District Nutritional Rehabilitation Centres, or NRCs, usually have up to 20 beds; and a monthly intake of 200 SAM children is not practical. Also, parents of the children who are admitted forgo their daily wages (which to an extent is compensated by the Government) and abandon their farmlands for 10 days. Back home, siblings of the SAM child are not taken care of and may become malnourished. The treated child could also slip back to a SAM state after being discharged and if not cared for.

Project Sampoorna

  • Based on the success of the community based COVID19 management model (Project Mili Juli), Project Sampoorna targeting the mothers of SAM/MAM children, the tagline being ‘Empowered Mothers, Healthy Children’ was launched
  • Under this project Mother of a healthy child of the same Anganwadi Centre (AWC) was identified and paired her with the target mother; they would be ‘Buddy Mothers’ (2,416 pairs).
  • Buddy Mothers
    • They were usually neighbours and shared similar socioeconomic backgrounds.
    • The pairs were given diet charts to indicate the daily food intake of their children;
    • They would have discussions about this on all Tuesdays at the AWC.
    • Local practices related to nutrition would also be discussed.

Hindrance to the project

  • The major hindrance to the project was patriarchy.
  • Mothers had to be empowered financially for sustained results.
  • Therefore, they were enrolled in Self Help Groups (SHGs) under the National Rural Livelihoods Mission (NRLM). Meanwhile, milk and an egg on alternate days for all 2,416 children for the first three months were arranged to their childrens, giving time for their mothers to stabilise themselves in the newly found jobs.

Why address child Nutrition?

  • The highest risk factor for high risk pregnancy is anaemia which is usually nutritional.
  • The vicious cycle of a malnourished child growing into an unhealthy adolescent, and then further into an anaemic pregnant young woman giving birth to an asphyxiated low birth weight baby; this baby then facing possible developmental delays, only to grow into a malnourished child; and this child who struggles further for nutrition and appropriate care while the world around her barely makes ends meet is the one that sucks in all possibilities of a healthy society.
  • In order to break out of this vicious cycle, the low hanging fruit had to be targeted — children’s nutrition.

Outcome of Project Sampoorna

  • After three months of Project Sampoorna, out of 246 SAM children, 27 (11%) continued to be SAM, 28 (11.4%) improved to MAM and a whooping 189 (76.8%) became normal. Out of 2,170 MAM children, 12 (0.6%) deteriorated to SAM, 132 (6.08%) stayed MAM and an unbelievable 2,015 (92.8%) became normal.
  • Result of Buddy Mothers Model and Women Empowerment Model
    • Mothers had done what institutions could not do for years.
    • By March 2021, 84.96% of SAM children and 97.3% MAM children were normal; and by September 2021, 92.3% SAM and 98.9% MAM children were normal.
  • Children who had not improved were checked and treated by doctors under the Rashtriya Bal Swasthya Karyakram (RBSK).
  • National Nutrition Mission and the State government recognised the project in the ‘Innovation Category’.
  • Project Sampoorna had prevented at least 1,200 children from becoming malnourished over the last year.
  • A real time data sheet is updated by field level doctors as and when a high risk pregnancy is identified, which is then followed up till safe delivery. The project has yielded encouraging results; maternal deaths for six months (April 1, 2020 to September 30, 2020 compared to April 1, 2021 to September 30, 2021) have fallen from 16 to three and infant deaths from 130 to 63.

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