Bal Poshan Yojana: A Novel Approach to Facility-Based Severe Acute Malnutrition Management

Introduction Severe acute malnutrition (SAM) carries severe implications for a child's development. The survival of a child suffering from severely acute malnourishment is majorly dependent on the management of SAM, and scaling up the framework for addressing malnutrition is one of its main components. A severely malnourished child has a higher risk of mortality as compared to an ideally nourished child. Bal Poshan Yojana under the aegis of Project Tushti, a public-private partnership (PPP) model, aims at strengthening the framework of treatment for SAM children by working towards building a sustainable eco-system through engaging the government body, private practitioners and implementing bodies. Methods Bal Poshan Yojana is a novel approach implemented for the first time in the Devbhumi Dwarka district of Gujarat for the management of SAM under a PPP model. The private practitioners and centres were empanelled and trained on the treatment of SAM. SAM children with medical complications were screened through anthropometric measurements and appetite tests carried out by Rashtriya Bal Swasthya Karyakram (or RBSK, a program for child health) medical team. High-risk cases were referred to the nearest empanelled Bal Poshan Centre in the area. Children were treated for 14 days at the Bal Poshan Centre as per the protocol of the National Rehabilitation Centre and then discharged if the children fulfilled the criteria. The treatment included a 14-day treatment protocol and three follow-ups in an interval of 15 days each. The data was analyzed with appropriate statistical tests. Results Since its inception, a total of 102 severely malnourished children under five years of age have completed their treatment successfully, including three follow-ups. Around 60.79% of SAM children have been found to become normal in their nutritional status. The mean weight gain upon discharge was 0.57 kg and after three follow-ups, it was 1.051 kg. Conclusion Bal Poshan Yojana is a one of its kind initiative to tackle the growing burden of malnutrition among under-five age group children. The initiative has a focused approach. Strong referral and verification mechanisms ensure complete transparency and yielding of desired results.