The finding reported by Sachdev, et al. [1] in a recent paper
published in Indian Pediatrics contradict the notion that
children with severe acute malnutrition (SAM) require special treatment.
However, the authors reported ‘no dedicated programme for management of
SAM’ in Meerut during their study.
Bal Swasthya Poshan Mah (BSPM), a government
initiative with support from UNICEF, was launched in 2003, and was
scaled up and implemented across the UP state, including in Meerut. The
program has its special focus on referral of undernourished children,
bi-annual supplementation of vitamin A, iodized salt consumption,
exclusive breastfeeding, and complementary feeding. The activities were
linked with outreach plans of Auxillary Nurse Midwives [2].
The authors, while observing the fate of SAM
children, did not consider the effect of the above program on the health
of the children. The apparent reduction in case fatality rate of SAM in
the study under discussion could be due to provision of referral for
malnourished children under the ongoing program activities. In fact, the
program has been appreciated for keeping synchronization with the
immunization activities and thus, not disturbing the routine of front
line health workers [3].
In this regard, it could be mentioned that National
Family Health Survey, conducted at similar time period, found 4.9%
prevalence of severe wasting from rural Meerut [4].
References
1. Sachdev HS, Sinha S, Sareen N, Pandey RM, Kapil U.
Survival and recovery in severely wasted under-five children without
community management of acute malnutrition programme. Indian Pediatr.
2017. (ahead of print)
2. Government of Uttar Pradesh and UNICEF. Mission
Poshan: Uttar Pradesh State strategy for 11th five year plan.
Directorate of ICDS and Department of Women and Child Development, Uttar
Pradesh; 2006.
3. Shaikh S, Dwivedi S. Monitoring of BSPM activities
in two intensive districts of eastern Uttar Pradesh. Indian J Prev Soc
Med. 2011;42:149-53.
4. International Institute for Population Sciences (IIPS) and Macro
International. National Family Health Survey (NFHS 4), 2015 16: Meerut.
Mumbai: IIPS; 2017.