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Nutrition Rehabilitation Centres (NRCs) are operational at public health facilities to exclusively cater to the under-five sick Severe Acute Malnourished (SAM) children who are admitted for clinical management of their medical complications along with nutritional management.SAM children without medical complications do not require admission to NRCs. However, sicknesses associated with any kind of malnutrition are treated at public health facilities.
Ministry of Health and Family Welfare has issued guidance notes time to time to all the States and UTs and organized webinars to understand the status of implementation of the NRC programme and to ensure the uninterrupted functioning of NRCs during and post COVID-19 lockdown.
The guidance note on “Enabling Delivery of Essential Health Services during the COVID 19 Outbreak” was issued on 14th April 2020 and on 24th May 2020, guidance note on “Provision of Reproductive, Maternal, Newborn, Child, Adolescent Health Plus Nutrition (RMNCAH+N) services during & post COVID-19 Pandemic” was further issued for ensuring RMNCAH+N services. It was advised that NRC services in the non-containment zone to be continued as per existing national guidelines, and in containment zones, medical management of sick SAM children to be ensured in the nearest NRC/health facility whereas post-discharge follow up to be conducted through teleconsultation.
During FY 2019-20, 2.25 lakh sick SAM children received treatment in 1072 NRCs and in FY 2020-21, 1.04 lakh sick SAM children received treatment in 1073 NRCs.
The details of State/UT-wise prevalence of different forms of severe malnutrition among children as per NFHS-4 (2015-16) and Comprehensive National Nutrition Survey (CNNS),2016-18 are at Annexure-I. The data indicate improvement in the various indicators of severe malnutrition among children under 5 years. The prevalence of severe malnutrition among children under 5 years has reduced for stunting from 16.3% to 13.2% , for wasting from 7.4% to 4.9% and for underweight from 11% to 10.1%.
AS Annexure-I
State/UT wise prevalence of severe malnutrition indicators as per National Family Health Survey (NFHS-4), 2015-16 and Comprehensive National Nutrition Survey, 2016-18
| S. No.
|
State/UT | Stunted (under 5 yrs) |
Underweight (under 5 yrs) |
Wasting (under 5 yrs) |
|||
| NFHS-4 | CNNS | NFHS- 4 | CNNS | NFHS-4 | CNNS | ||
| 1 | Andaman & Nicobar | 6.9 | – | 4.4 | – | 7.5 | – |
| 2 | Andhra Pradesh | 10.7 | 14.4 | 7.2 | 9.8 | 4.5 | 5.9 |
| 3 | Arunachal Pradesh | 11.9 | 10.7 | 5.7 | 3.1 | 8 | 1.7 |
| 4 | Assam | 14.3 | 15.1 | 8.1 | 11.3 | 6.2 | 7.8 |
| 5 | Bihar | 23.1 | 18.1 | 15.2 | 11.4 | 7 | 4.2 |
| 6 | Chandigarh | 7 | – | 5.8 | – | 3.9 | – |
| 7 | Chhattisgarh | 15.7 | 11.4 | 11.2 | 12 | 8.4 | 5 |
| 8 | Delhi | 10.7 | 9.7 | 6.2 | 6.2 | 4.6 | 3.2 |
| 9 | Dadra Nagar Haveli | 19.7 | – | 11.3 | – | 11.4 | – |
| 10 | Daman & Diu | 8 | – | 4.8 | – | 11.9 | – |
| 11 | Goa | 8.8 | 5.3 | 5.5 | 5.2 | 9.5 | 5.1 |
| 12 | Gujarat | 16.5 | 14.2 | 12.4 | 10.2 | 9.5 | 6.9 |
| 13 | Haryana | 14.8 | 11.7 | 8.1 | 9 | 9 | 2.1 |
| 14 | Himachal Pradesh | 7.8 | 6.7 | 4.3 | 5.4 | 3.9 | 3.1 |
| 15 | Jammu & Kashmir | 11.9 | 5.8 | 4.9 | 4.9 | 5.6 | 6.9 |
| 16 | Jharkhand | 20.2 | 14.1 | 17.4 | 15.5 | 11.4 | 6.4 |
| 17 | Karnataka | 16.6 | 12.4 | 11.6 | 9.5 | 10.5 | 4.6 |
| 18 | Kerala | 6.8 | 5.2 | 3.6 | 3.2 | 6.5 | 2.7 |
| 19 | Lakshadweep | 6.2 | – | 5.6 | – | 2.9 | – |
| 20 | Madhya Pradesh | 18.6 | 14.1 | 14.3 | 12.5 | 9.2 | 6.6 |
| 21 | Maharashtra | 12.9 | 14.3 | 10.5 | 9.8 | 9.4 | 5.2 |
| 22 | Manipur | 8.8 | 10.4 | 2.4 | 3 | 2.2 | 3 |
| 23 | Meghalaya | 18.9 | 17.2 | 6.8 | 7.9 | 6.5 | 4.9 |
| 24 | Mizoram | 8.8 | 6.8 | 2.8 | 1.5 | 2.3 | 2.2 |
| 25 | Nagaland | 10.3 | 10.8 | 4.3 | 5 | 4.2 | 5.3 |
| 26 | Odisha | 12.3 | 8 | 9.4 | 5.5 | 6.4 | 2.4 |
| 27 | Punjab | 8.3 | 8 | 5.8 | 4.8 | 5.6 | 2.3 |
| 28 | Puducherry | 11 | – | 7 | – | 7.8 | – |
| 29 | Rajasthan | 17.3 | 13.2 | 12.2 | 9.4 | 8.5 | 3.6 |
| 30 | Sikkim | 12.5 | 7.1 | 3.7 | 2.3 | 5.9 | 1.1 |
| 31 | Tamil Nadu | 10.8 | 5.8 | 6.5 | 6.5 | 7.9 | 8.1 |
| 32 | Telangana | 9.1 | 8.7 | 7.8 | 7.3 | 4.8 | 5.6 |
| 33 | Tripura | 8.1 | 13.4 | 5.3 | 7.5 | 6.3 | 5.3 |
| 34 | Uttar Pradesh | 21.2 | 15.4 | 12.2 | 12.4 | 6 | 4.7 |
| 35 | Uttarakhand | 14 | 9.8 | 7.5 | 3.4 | 9 | 1.4 |
| 36 | West Bengal | 10.3 | 7.2 | 8.8 | 7.3 | 6.5 | 4.3 |
| India | 16.3 | 13.2 | 11 | 10.1 | 7.4 | 4.9 | |
