Results and lessons learned from UMANG program: A large scale community-managed supplementary feeding program in India

Full text: India's National Family Health Survey (2005-2006) revealed that 48% children under 5 years old were stunted while 43% were underweight. Child malnutrition is the outcome of high levels of exposure to infections, inappropriate infant and young child feeding and caring practices. It has its origins almost entirely during the first two to three years of life. Child malnutrition is responsible for 22% of India's burden of disease. According to the Lancet journal in 2013, undernutrition during pregnancy, affecting fetal growth, and the first two years of life is a major determinant of both stunting of linear growth and subsequent obesity and non-communicable diseases in adulthood. World Vision India (WVI) is a humanitarian organization working in India since 1951 and currently serving 163 districts in 25 states. The strategic directive of WVI for 2011-2014 focuses on reducing infant mortality and eliminating hunger in communities. In March 2011, a special task force Integrated Programming - Child Health (IPCH) with the key mandates to target families of malnourished children residing in program areas towards delivering fullness of life; support Government, communities and other partners in scaling up proven multisectoral interventions; leverage multi-sectoral coalitions to combat malnutrition; advocate change in system and sustainability; and set up organizational support. A generic logframe with the intervention packages was adopted by Area Development Programs (ADPs) in 96 locations, making it the biggest nutrition program ever been implemented by WVI. After doing the nutritional assessment, 83255 children were identified to be in moderate and severe malnutrition condition. Considering that even mild to moderate malnutrition greatly increases the risk of children dying from common childhood diseases, WVI decided to set up an emergency response as an ethical and critical decision to save the lives of these children. A community managed supplementary feeding program called "UMANG" (Urgent Management & Action for Nutrition Growth) was developed and implemented across 84 ADPs. Through this program a malnourished child gets an additional feeding (one full meal and healthy snack), apart from what is provided at home and through the Government run Anganwadi Centre (an Indian policy to provide free mid-day meal to the children, but recent review shows varying degree of quality and attendance). UMANG menu meets one third of the daily requirement of children using locally available low cost nutritious food provided for a period of 90 days. Through UMANG mothers were educated and trained on healthy cooking, feeding and caring practices. Within the period of October 2012 to May 2013, as many as 24,154 children were enrolled in UMANG, and 44% have graduated to normal nutritional status at the end of 90 days program. Review of the program revealed that UMANG has increased the knowledge of mothers on malnutrition, contributed to the formation of common interest groups and enhanced the co-ordination of the frontline workers in addressing malnutrition. The presentation will highlight lessons learned from the 90-day implementation of this large scale community-managed supplementary feeding program. (author)