Community-based studies on the implementation of GOI protocol (2023) for management of malnutrition in children

Objective

To document:

Ø  the ongoing growth monitoring and detection of under-nutrition in children under the existing guidelines by the health and ICDS frontline workers;

Ø  changes over the next three years in growth monitoring and detection of under-nutrition in children as envisaged in the 2023 protocol;

Ø  changes in community-based management of child malnutrition over the next three years;

Ø  changes in referral of SAM children to hospitals for management of medical complications.

Study design

NFI had been undertaking mixed longitudinal studies on nutritional status and morbidity in a well-defined urban low middle income community for over a decade.

The ongoing data collection will provide the baseline information on socio-demographic profile of the population, morbidity and nutritional status of under-five children in this community.

Over the next three years the NFI research staff will undertake data collection on changes in the:

Ø  Coverage under the monthly weighing and growth monitoring;

Ø  Detection of moderate and severe undernutrition in these communities;

Ø  Changes in the referral of children to hospitals for severe malnutrition.

The NFI research staff will undertake anthropometric measurements once a quarter to document the changes in prevalence of stunting, underweight and wasting in children over the next three years.

Sample Size:

About 2000 under-five children will be investigated at any given time point in this mixed longitudinal study. The population is largely of families of migrant labourers and about 50% shift to other areas by 12 months. At the third year about a third of the families enrolled may be available. As some families move out others with similar sociodemographic profile move in and so there will not be any problems in having an adequate sample size in this mixed longitudinal study for the entire duration of the study.

Duration of the study: Three years

Parameters for impact assessment:

Changes in the ongoing programme over three years in:

Ø  Coverage under the monthly weighing and growth monitoring;

Ø  Detection of moderate and severe under-nutrition in these communities;

Ø  Changes in the referral of children to hospitals for severe malnutrition.

Data collection by research staff on nutritional status of under-five children once in three months will provide information on the changes in prevalence of moderate and severe stunting, underweight and wasting in under-five children in this community over the three-year period.

Policy and programme implications of the study

Data from the study will provide evidence on the feasibility and impact of the implementation of the 2023 protocol for management of malnutrition in children so that appropriate mid-course corrections in the protocol can be carried out.