Why Malnutrition? Building a low-cost, private-public parternship UNI Program Outreach Successful Interventions Sustainability and Scalability
Early Moments Matter
Few challenges facing the global community today match the scale of malnutrition, a condition that causes an estimated 45% of deaths of children under age five. The developmental, economic, social, and medical impacts of the global burden of malnutrition are serious and lasting, for individuals and their families, for communities and for countries. In India, nearly every third child is undernourished – underweight (35.7%) or stunted (38.4%) and 21% of children under-five years are wasted as per NFHS 4 2015-16.
It is an established fact nationally and globally, that malnutrition in the first two years of life negatively impacts the physical and cognitive development of children, eventually leading to irreversible damage. The first 1,000 days — the period during a woman’s pregnancy and the child’s first two years of life — represent a crucial window of opportunity to prevent malnutrition. Thus, with the focus on 1,000 days Urban Nutrition Initiative (UNI) was initiated in March 2015 as a low-cost, Public Private Partnership (PPP) between Rajmata Jijau Mother and Child Health and Nutrition Mission (RJMCHNM), TATA Trust and Committed Communities Development Trust (CCDT).
UNI leverages the existing government system of ICDS across eight high-burden ICDS projects, with a high prevalence of malnutrition, covering districts of Mumbai (Khar & Santacruz E), Nashik, Nagpur, Malegaon and Thane (Bhiwandi) in Maharashtra to focus specifically on reducing malnutrition. The program is based on the premise of ‘optimal results with minimum resources’ and over the last three years has reached out to 32,258 children in the age group of 0-2 years, 12,383 pregnant women and 12,338 lactating mothers.
While malnutrition can manifest in multiple ways, the path to prevention is virtually identical: building the capacity of frontline workers; enhancing uptake of service delivery; optimal breastfeeding in the first two years of life; nutritious and safe complementary foods in early childhood; anthropometric measurements and line listing babies born with low birth weight; adequate maternal nutrition before and during pregnancy and lactation; and referrals to Nutrition Rehabilitation Centers in extreme cases of undernutrition. These key ingredients [i] can deliver a world where children are free from all forms of malnutrition. UNI successfully incorporated the implementation of these interventions detailed below:
- Strengthening ICDS
- Enhancing Demand Generation for ICDS Services
- Home-Visits and Counseling for Child Rearing and Feeding
- Growth Promotion and Monitoring
- Enhancing Maternal Health and Nutrition
The UNI model ensures that the community is at the center of both demanding for services and ensuring these are effectively delivered. UNI also works together with existing government machinery and renders these services more effective. By deploying these two approaches—partnering with existing government machinery and deploying community-based monitoring mechanism—the model is rendered sustainable and low-cost.