Abstract of Dissertation

Keyword : Child Malnourishment Treatment Centre; CMTCs; CMTC Services; Utliztion Pattern of CMTC

Objective : To understand the utilization of CMTC services in district Amreli and factors affect the utilization pattern Objectives: i. To understand the utilization pattern of CMTC services in district Amreli ii. To understand beneficiary perspective iii. To understand frontline worker (AWW) perspective iv. To assess current status of CMTCs in terms of equipments, facilities and human resource and to identify loopholes at facility level (CMTC) v. To devise suggestions for betterment of service delivery

Background : Gujarat, despite excellent economic growth, lags behind in nutrition, being the 4th worst performing major state for under nutrition in India as per NFHS III. Underweight prevalence in the state has reduced only by one percent from 42% in 98-99 to 41% in 05-06. Integrated Child Development Services Scheme (ICDS) under Department of WCD is striving hard to combat malnutrition in India. It has also introduced new services like Child Malnutrition Treatment Centers (CMTCs) and Nutrition Rehabilitation Centers (NRCs) in coordination with other sector like Department of Health and Family welfare in order to fight against malnutrition with full vigor. District Amreli in Gujarat has 14 functional Child Malnutrition Treatment Centers (CMTCs). But the performance of these facilities is far below mark in treating severe acute malnourished (SAM) children as compared to other districts. Referrals made from Anganwadi centers (AWC) and other facilities are low. In particular, utilization of Child Malnutrition treatment Centers (CMTCs) in district Amreli, Gujarat is found to be low as compared to the performance of other districts.

Methodology : The study was a Cross-sectional, descriptive one conducted over a period of two months. Study subjects were mothers of CMTC beneficiaries (admitted and discharged) and CMTCs. Pre-tested tools used during the study were: Interview schedule for mothers of beneficiaries and check-list for CMTCs.

Findings : Among Admitted and discharged beneficiaries, most belonged to low socio-economic strata and were being referred to CMTC through Anganwadi centres via Anganwadi workers for being identified as malnourished (weight for age). Most beneficiaries’ mothers were satisfied with services but lacked knowledge regarding incentives and most children were not gaining expected weight during their stay. Anganwadi workers lacked knowledge about CMTC services and faced community-resistance. Most of the CMTCs had measuring scales and kitchen equipment, but lacked basic amenities. Also nutrition assistants were not available full-time and were sharing working hours between two CMTCs.