Indian Journal of Medical Sciences Medknow Publications on behalf of Indian Journal of Medical Sciences Trust ISSN: 0019-5359 EISSN: 1998-3654 Vol. 57, Num. 7, 2003, pp. 319-320

Letter to the Editor

Efforts to improve nutritional status in rural areas of Gujarat, India

R. K. Bansal, R. K. Srivastava and V. Sharma

Municipal and Government Medical College, Surat and UNICEF, Gujarat.

Code Number: ms03007

Sir,

The Family Welfare and Education Services Project, initiated in 1992 and operational till 1998, aimed to improve the nutritional status among 73,000 people living in 30 villages of Anand and Kheda districts of Gujarat State. The project was undertaken by Charutar Arogya Mandal Trust, in co-operation with Tribhuvandas Foundation, and milk co-operatives. Prevailing poor quality of life and nutritional status, including high maternal anaemia & under-nourishment in children ¹ prompted these interventions. The project had promoted ameliorative measures as nutritional education for improvement of quality and quantity of food items; sprouted cereals use; domestic nutritional rehabilitation of children suffering from PEM using local food items; Vit. A and Iron supplementation; early weaning; supplementary feeding of children & women; prevention of diarrhoea, etc.

A mother-oriented approach was adopted for education with formation of women groups and Mother-in-law clubs. Domicilliary demonstrations of nutritious, balanced and iron and vitamin A rich recipes were performed with follow-up visits. The women and children attending the demonstrations were served these preparations to convince them that nutritious food is also tasty. Importance of low oil preparations was added in the last phase to decrease risk of CHD ² among the affluent sections of this area.

The project resulted in significant nutritional and health improvements. Infants breast-fed within 12 hours of delivery doubled from 11.2 percent to 23.5 percent. IMR decreased from 91 to 44 and under 5 mortality from 135 to 90 per 1000 live births during a three-year period. Vitamin A deficiency awareness doubled from 15.2 to 30.4 percent during a three-year period. Similarly the percentage of pregnant and lactating women taking iron and folic acid supplementation increased significantly. A KABP evaluation had documented the effectiveness of project staff in nutritional education. To combat malnutrition in under 5 children activities as ORS promotion during diarrhoea; importance of hand washing and consumption of freshly cooked food were promoted. Thus diarrhoea decreased from 7.3 percent to 5.8 percent during a three-year period. Participation of medical students and interns in program activities and case studies encouraged a sense of community responsibility and rural work. The project also sensitised the population, service providers, medical students and interns towards adoption of healthier nutritional habits. Our experiences bring out the need for sustained efforts, as behavioural change is a slow process.

Authors acknowledge assistance of UNFPA, AIDAB, ILO, TF, CAM Trust, Govt. of India, Govt. of Gujarat, Dr. D. H. Trivedi, Dr. G. K. Trivedi and Dr. Sajan Nair in the project. This work was carried out, while the authors were working at Karamsad.

R. K. Bansal, R. K. Srivastava and V. Sharma,
Municipal and Government Medical College, Surat and UNICEF, Gujarat.

REFERENCES

1. Bansal RK, Sharma V. Maternal and child health and community based problem oriented medical curriculum. Indian J Maternal and Child Health 1993;4:78-80.
2. Trivedi DH, Sharma V, Pandya H, Arya RK, Mehta R, Bansal RK, et al. Longitudinal epidemiological study of coronary heart disease in a rural population of Kheda district, Gujarat, India. Sozial- Und Praventivmedizin 1996;41:373-9.

Copyright 2003 - Indian Journal of Medical Sciences.