Undernutrition is one of the most concerning health and development issues in India as in other parts of the world. Undernutrition encompasses stunting (chronic malnutrition), wasting (acute malnutrition) and deficiencies of micronutrients (essential vitamins and minerals)

Reproductive, Maternal, Newborn, Child and Adolescent Health

• Weight-for-age (underweight) – it is composite index of height-for-age and weight-for-height. Children with low weight for their age are susceptible to various infections in comparison to the children with the standard weight for age. It is a comprehensive indicator for malnutrition as it takes into account both acute and chronic malnutrition.
• Height-for-age (stunting) – this index is an indicator of linear growth retardation and cumulative growth deficits. Children who are short for their age (stunted) are chronically malnourished.
• Weight-for-height (wasting) – this index measures body mass in relation to body length and describes current nutritional status. Children considered thin (wasted) for their height are acutely malnourished.

Severe acute malnutrition is defined by very low weight-for-height/length (Z- score below -3SD of the median WHO child growth standards) or by the presence of nutritional oedema

Nutrition Rehabilitation Center (NRC) is a unit in a health facility where children with Severe Acute Malnutrition (SAM) are admitted and managed. Children are admitted as per the defined admission criteria and provided with medical and nutritional therapeutic care. Once discharged from the NRC, the child continues to be in the Nutrition Rehabilitation program till she/he attains the defined discharge criteria from the program. In addition to curative care, special focus is given on timely, adequate and appropriate feeding for children; and on improving the skills of mothers and caregivers on complete age appropriate caring and feeding practices. In addition, efforts are made to build the capacity of mothers/caregivers through counselling and support to identify the nutrition and health problems in their child.

Objectives of Facility based management of SAM

• To provide clinical management and reduce mortality among children with severe acute malnutrition, particularly among those with medical complications.
• To promote physical and psychosocial growth of children with severe acute malnutrition (SAM).
• To build the capacity of mothers and other care givers in appropriate feeding and caring practices for infants and young children
• To identify the social factors that contributed to the child slipping into severe acute malnutrition.

The services and care provided for the in-patient management of SAM children include

• 24 hour care and monitoring of the child
• Treatment of medical complications.
• Providing sensory stimulation and emotional care. Social assessment of the family to identify and address contributing factors.
• Counseling on appropriate feeding, care and hygiene.
• Demonstration and practice- by -doing on the preparation of energy dense child foods using locally available, culturally acceptable and affordable food items.
• Follow up of children discharged from the facility