Abstract of Dissertation

Keyword : Child Malnutrition; Situational Assessment; AWC; Child Malnutrition Treatment

Objective : • To assess the availability of services at CMTCs in Surendra Nagar District in terms of infrastructure, human resources, and equipment according to the Operational Guidelines. • To assess the improvement in the health status of children admitted to CMTCs in the district. • To assess the functioning of CMTC treatment centers at 4 blocks. • To identify gaps and key interventions to fill up the gaps identified at the facilities.

Background : Different stages in the life cycle are interdependent and so are the aspects of where and how healthcare is provided. The district Surendra Nagar in Gujarat has 8 functional Child Malnutrition Treatment Centers (CMTCs). But the performance of these facilities is far below the 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 Surendra Nagar, Gujarat is found to be low as compared to the performance of other districts.

Methodology : This is a cross-sectional Descriptive study that analyses data collected from a population, or a representative subset, at a specific point in time- that is cross-sectional data. A facility-based cross-sectional study was conducted for 3 months at 4 CMTCs in Surendra Nagar district of Gujarat. Assessment of Infrastructure, Human resources, and equipment was done through structured checklists, drawn up in accordance with the guidelines. The data of children admitted from February to April 2018 is analyzed to assess their nutritional status at the time of discharge and after three follow-up visits. Filled interview schedule and records were checked for completeness and analysis was done in MS Excel.

Findings : 1. Discrepancies in Feeding Protocols. The guideline was not followed at all CMT, different practices were seen in different places. 2. Stock out of Multivitamin has been observed in CMTC Chuda and Lakhtar due to expiry dates. 3. In CMTCs (Chuda, Lakhtar) run under Gatisheel Gujarat, Payments of beneficiaries were not done regularly. 4. Most of the health centers have IEC material displayed for handwashing station 6. Good cleanliness and Hygiene were maintained at all CMTCs except Lakhtar.

Recommendations : The study was aimed at assessing the overall functioning of the CMAM programme and its effectiveness in improving the overall health status of SAM children. It is evident from the analysis and results that there is an underutilization of the services at CMTC centers. Moreover, the practices, are not followed the way it should be. There is still defaulted rate because of low awareness.