Bhubaneswar, May 23: The ongoing global health disaster of COVID 19 may also have local consequences on the overall health indicators of Odisha. It is very likely that with the ongoing migrant crisis and lockdown curbs, the nutritional status of lakhs of children in the state may get a jolt.
With cases of loss of wages of daily wage laourers, joblessness triggered by lockdown, loss of remittance from the incoming Odia migrants it is much likely that the state may witness a paradigm shift to the rural economy, affecting several facets of the society including health. Loss of linkage to institutional centres like Anganwadi centres and others are likely to deprive several kids from the government assistance that were earlier provided to them.
While the Odisha government has been taking special measures to bridge the gap, the future looks bleak. Several international organisations working with the state also believe that the nutritional support base especially for the kids should not get affected.
“It is important to ensure that COVID 19 does not lead to a nutritional crisis and Odisha does not lose the progress it has made over the past several years. UNICEF in Odisha is working closely with the state government to ensure a nutrition response remains at the core of the COVID 19 strategy in the state,” said Monika Nielsen, Chief, Field Office, UNICEF Odisha.
The state has already in the past hogged limelight for the national media for cases of malnourishment deaths, starvation an nutritional deficiencies like stunting, anemia and others. The burden of COVID 19 may also intensify the woes.
Odisha has made improvements in nutrition levels over the past decade and a half. Between National Family Health Survey 3 (NFHS 3) in 2005-06 and NFHS 4 in 2015-16 the proportion of malnourished children under the age of five (U-5) in the state declined to 34.4 per cent from 40.7 per cent.But wasting (low weight for height) among children continues to be quite high.
Preparedness is the key
Given the natural disasters Odisha has faced in the past years and has learnt from, the state government’s response to COVID 19 has been a comprehensive one, taking into account the geographical, social and economic diversity of Odisha.
When the state government decided to close down the anganwadi centers, alternative channels of providing nutrition were put in place to ensure the lockdown did not impact the nutrition of young children.
The WCD Dept was declared as a critical Dept of Govt. of Odisha which means it was needed to provide continued services to people even during the period of lockdown. Working in collaboration with the state government, UNICEF led the development of the Nutrition and Food Security response plans which outlines certain short-term and medium-term plans to address the situation. Some key actions by the Government of Odisha:
Zero Crowd @ Anganwadi Centre; Take Home Ration Delivered at Door Step
Even though Anganwadi Services were closed down till 30th April, 2020 State Govt. has come up with innovative idea of delivering food at the door steps of beneficiaries. Integrated Child Development Services (ICDS) has ensured Take Home Ration (THR) & eggs, as per entitlement, are supplied to children (6 months–3years) and pregnant & nursing women by the Anganwadi Workers (AWWs)/Helpers (AWHs) at household level till the month of June. All govt. advisories such as using masks, maintaining social distance was followed by AWW/AWH etc which ensured Zero Crowd at Anganwadi Centers thus reducing the chances of transmission of infection.
Substituting Dry Ration with Hot Cook Meals
With lock down in force, it was a challenge to provide regular hot cook meal to pre-school children enrolled in Anganwadi Centres. Hence, instead of providing hot cook meal and morning snacks at Anganwadi Centers, dry ration have been distributed to preschool children (3-6) years, by the AWWs/AWHs at their homes. A total of 41,27,050 beneficiaries including i.e, 17,93,896 children of the age group 6months-3 years; 16,13,775 children of the age group 3 – 6 years and 7,19,379 pregnant & nursing women have been covered in the process. Thus continued nutrition services have been established.
Community Kitchen by WSHGs for the poor and destitute
Community kitchens have been made functional through WSHG (Women Self Help Group) members particularly for the old, infirm and destitute. 7185 SHGs of Mission Shakti are involved in management of free kitchens. The guest migrant labourers at many places have been able to regularly access food because of this specific nutritional intervention.
SHGs – lend a crucial helping hand
Besides, running community kitchens, the SHGs under Mission Shakti have come forward to stitch cotton masks to cater to the surge in demand. Over 1006 SHGs have stitched over 22 lakhs face masks so far. Over 600 SHGs under Mission Shakti have registered to run dry ration and vegetable shops and 147 mobile shops in various districts of the state.
Home delivery of MDM (Mid Day Meal) ration and IFA (Iron Folic Acid tablets) for school children
With the closure of schools, the government has decided to provide Mid Day Meal (MDM) dry ration for 90 days at one go through Fair Price Shops/PDS outlets to all students. Each primary school student has been provided 3Kg of rice per month and each Upper Primary child has been given 4.5 Kg of rice per month. This is in addition to a child’s entitlement under TPDS/SFSS (Targeted Public Distribution System/State Food Security Scheme).
With support from UNICEF, the Health & Family Welfare Department and School & Mass Education Department directions have been issued for home distribution of IFA tablets for school students by the school teachers for weekly consumption.
AWW and AWH continue to provide services through Social Distancing
Efforts are being made to provide continued services to the community even during the period of lock down, so that no compromises are made on the health or nutrition front. Front line functionaries such as Anganwadi workers (AWW) and Anganwadi helper (AWH) wear a mask, follow social distance, hand hygiene practices and respiratory hygiene while on duty. Routine Immunization sessions have continued and AWW, ASHA & ANM move from door-to-door to provide ANC services and nutritional counseling.
Trainings and Capacity Building
The state government supported by UNICEF has initiated online video training programmes for all front line workers (AWW, ANM, ASHA). Where ever online training was not possible, physical training was organized at the sector level while ensuring social distancing norms were followed.
The front line workers have been oriented on COVID-19, its symptoms, social distancing, hand-hygiene measures, respiratory hygiene, care of senior citizens, nutrition during COVID-19, breast feeding practices and care for malnourished children. This added capacity is expected to help them to serve people better.
Similar trainings were organized for Odisha Livelihood Mission (OLM) staff members, NGO partners and Tribal Cooperative Marketing Development Federation of India Limited (TRIFED) functionaries on ‘COVID-19 and adaptation of healthy behaviors related to health, nutrition and hygiene’ through online platforms.
Important topics like Infant and Young Child Feeding (IYCF); Management of SAM (Severe Acute Malnutrition); Healthy eating and Village Health, Sanitation and Nutrition Day; Adolescent Health and Nutrition; Parenting and Psychological Care were covered.
With UNICEF’s support, an online training was also provided for Nutrition Rehabilitation Center (NRC) functionaries and medical officers (pediatricians) engaged at NRCs on ensuring adequate nutrition for children with severe and acute malnutrition during the COVID 19 period. They were also oriented on handling the influx of SAM cases at NRCs once restriction on movements is lifted.
With the routine reporting system (MIS) at village level getting affected during the lock down, a real-time online data collection and compilation platform has been developed by UNICEF to obtain information from independent sources like NGO partners. The results are analyzed daily and shared with the appropriate authority for taking corrective action.