End Malnutrition Initiative (EMI) – a novel public health concept to reduce the burden of Malnutrition was introduced by the Edward & Cynthia Institute of Public Health(ECIPH) – a unit of CHD Group & Advanced Technical Co-operation Center with Yenepoya ( Deemed to be University).
This initiative was piloted from a public health standpoint and implemented as a social responsibility programme in Yelburga Taluk of Koppal District in Karnataka state.
This initiative aimed to lower the case load to near zero levels for children under five years of age having Severe Acute Malnutrition (SAM) and also decrease the burden of Moderate Acute Malnutrition (MAM) which eventually can be brought to zero with sustained budgets. This program was implemented on ground by the CHD Group team and supported by the Department of Women and Child Development, Government of Karnataka. Due to paucity of the funding, the project was implemented in pilot mode to demonstrate proof of concept which it successfully delivered. From 31 SAM children in August 2022, the number came down to 11 in March 2023. Likewise from 1067 MAM children in September 2022, the number came down to 329 in March 2023.
The model worked on a public private partnership to end malnutrition issues. Parents of under five children, anganwadi supervisors, community elders, elected representatives, faith based leaders were engaged in uniting towards ending the burden of malnutrition. While health promotion served at the center of the intervention, low-cost nutritious dietary food, monitoring and evaluation, daily weight gain recording and weekly height records, ad-hoc supervision, involvement of retired people towards better nutrition and hand-holding parents towards preparation of food was the main turning point in achieving the success.
All Anganwadis in Yelburga taluk of Karnataka state in India were given supportive supervision and hand-holding in terms of low-cost energy rich diet that had to be provided to the children by their parents.
500 youth volunteers were identified to amplify low-cost dietary interventions to be fed to the children and nutritious diet were boosted in the localities. In anganwadis the children were fed nutritious food ranging from shenga chikki, to bele payasa, chitrana, anna sambar, sprouted green grams, godhi payasa, uppitthu and others which changed on a daily basis. At homes, the parents were taught preparation of fortified food mixtures to be given to the children under five years of age.
CHD Group social media handles and then Karnataka State Women and Child Development Minister’s social media handle also amplified the dietary interventions which had a cascading effect with greater awareness being created and which led to improvement in child health and the case load for SAM and MAM children started to drastically fall.
Speaking on this matter, Dr. Edmond Fernandes, Director, Edward & Cynthia Institute of Public Health stated that such concepts if scaled can wipe out Malnutrition from India by 2030 but needs serious political will, targeted strategy with weekly monitoring and supportive supervision and parental ownership to an extent. For parents not taking child health seriously, this could be tied to having government subsidies suspended temporarily as part of a behaviour change mechanism, besides pressure groups created locally to ensure optimum growth of the child. Dr. Edmond Fernandes has extended support to any state government willing to implement the programme as per his directions and also to any foreign governments wanting to seriously work in the end malnutrition space as this model is now tested, piloted and has delivered miraculous results with upscaling potential.