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Nutrition Rehabilitation Centre brings hope for newborn health in India

© UNICEF India/2007/ Kumar
UNICEF and the Government of India have partnered to train auxiliary nurse-midwives and community health workers in Lalitipur.

UNICEF’s yearly flagship report, The State of the World’s Children, launched 22 January 2008, makes a call to unite for child survival. Here is one in a series of related stories.

LALITPUR, India, 19 February 2008 – Her name, ‘Abhilasha’, means ‘wish’ in Hindi. Not so long ago, she showed all the characteristic symptoms of severe undernutrition. Weighing just 4.5 kilograms, two-year-old Abhilasha had sunken eyes, a swollen belly and shriveled skin.

The toddler might have died in a matter of days if it had not been for a timely referral to the newly established Nutrition Rehabilitation Centre in her home district of Lalitpur, in the northern Indian state of Uttar Pradesh. One of the states with the highest rates of child mortality in India, Uttar Pradesh, is taking steps to improve its children’s health. 
A mother’s ‘wish’ come true

After only a week of receiving nutritional supplements and daily follow-up visits by a paediatrician and nutritionist at the centre, Abhilasha started to show promising signs of recovery. Her mother, Pukhan, was extensively counseled on how to prepare nutritious meals with readily available, low-cost ingredients. In less than a month, Abhilasha gained 35 per cent more weight. Pukhan left the centre holding her ‘wish’ in her arms, a healthy and happy Abhilasha. 

The Nutrition Rehabilitation Centre, housed within Lalitpur’s Community Health Centre, opened its doors in June 2007. Within three months, it had offered free residential and institutional care to 70 undernourished children.

The centre is only one component of a larger child survival strategy called Integrated Management of Neonatal and Childhood Illnesses (IMNCI). In October of 2005, UNICEF and the Government of India partnered to implement IMNCI in 25 districts across the country.

IMNCI aims to improve health worker skills through hands-on training, strengthen the health system to deliver interventions effectively, and promoting healthy family and community behaviours.

© UNICEF India/2007/ Kumar
The Nutrition Rehabilitation Centre in Lalitpur.
Emphasis on neonatal care

The emphasis on neonatal care was introduced because this is the most critical period for infant mortality – nationally, close to 50 per cent of newborn deaths occur within seven days of birth.

The IMNCI lays great emphasis on home visits and counseling for the mother. During home visits, mothers receive counseling on issues such as breastfeeding, maintaining body warmth, detecting danger signs in their newborn and proper hygiene.

In Lalitpur, IMNCI has trained more than 1,000 auxiliary nurse-midwives and community health workers, popularly called 'anganwadi workers'. In the past 20 months, these trained workers have reached roughly 70 per cent of all newborns in the district within 24 hours of birth.

Health managed at home

Through the anganwadi workers, minor problems have been managed at home through counselling and basic drugs.hile critical ones, such as severe undernutrition, have been referred to the nearest health centre for immediate treatment.

The Department of Health and Family Welfare of Uttar Pradesh has now decided to scale up IMNCI, adding a component on maternal health and community mobilization, in 17 of the worst-performing districts in the state.

With political support for the expansion of such initiatives, Uttar Pradesh, which presently accounts for a quarter of India’s total child deaths, may make strides towards ensuring that many more under-fives have a healthy beginning to a fulfilling life.  



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