The Union Ministry of Health and Family Welfare has recommended the adoption of standards laid down by the World Health Organisation (WHO) in dealing with nutrition for children affected by severe acute malnutrition (SAM). The Women and Child Development (WCD) ministry is currently working on a set of guidelines tackle malnutrition among children afflicted by SAM.
Currently, the Centre has no guidelines for children affected by SAM. The health ministry was asked by the WCD ministry to help with recommendations and policy prescriptions with the guidelines. As part of its guidelines, the health ministry has asked the WCD ministry to adopt WHO standards.
As per these metrics, when a child’s weight-to-height ratio is very low and lies below -3 of the standard deviation and is visible by severe wasting or by the presence of nutritional oedema, the child is considered suffering from SAM.
An official from the WCD ministry said that there are primarily two types of children affected by SAM: those whose foodpipes are constricted because of the malnourishment and cannot swallow food, and those who can. For the first kind, nutrition is provided through intravenous fluids, while fortified food is recommended for the latter.
The WHO, as per its guidelines, recommends that children affected by SAM be provided with 5000 IU vitamin A daily, in case they are not using dietary supplements which as per WHO standards is ready-to-use therapeutic (RUTF) food. Children suffering from dehydration, WHO recommends, must be rehydrated slowly with low-osmolarity oral rehydration solution.
In its guidelines, the WCD will define SAM and its parameters, the amount of food and nutrition that is recommended to combat it, and define the roles of anganwadi and ASHA workers.
Last month, on August 28, the WCD ministry issued a circular to state governments telling them that the use of RUTF food to tackle SAM is not “accepted policy” of the Centre. As a proof of that, the ministry referenced a February 2009 circular issued by the health ministry. The circular came a few days after the RSS-linked Swadeshi Jagran Manch objected the use of packet foods as RUTF because they felt that the move will only benefit corporate bodies and in states where it has been launched, RUTF have proved to be an expensive affair.
