Why Preventive Approach to Malnutrition?

Ayush Case Study

(An Insight to Understand Matri Sudha’s Work on Malnutrition)

(Aspect 1- Curative Care)

Ayush was acknowledged Severely Acute Malnourished with medical complications during the growth monitoring process initiated in October 2014 by Matri Sudha. Ayush was 18 months old at that time and according to weight for age, his weight was only 5.65 Kg which actually should have 8.3 Kg.

Ayush is the youngest child born to Pinto-Barkha after 2 live births. He was born to her mother after complete 9 months of pregnancy without any complications but was found low birth weight (1.5kgs) [normally a child should weighed 2.5 kg at time of birth]. The delivery was happened at home and there was lack of health and nutrition knowledge.

Ayush’s mother missed the ante-natal checkups as she met an accident which got her leg fractured. She was unaware about the location of Primary Urban Health Centre also ASHA worker never came to her for any kind of information.

Ayush was not even received the necessary vaccination which is be given to a child in the first year of life which includes the most important ‘measles’ at nine months.  The first intervention started with a counseling session where in Ayush’s mother was counseled by Matri Sudha team to visit PHC located in Lal 2014 in 2015.

Ayush`s health condition was getting worse day by day. His weight was continuously decreasing. The father of the child was found very irresponsible towards the child. After insisting many times they both did not go to PUHC.

Finally the parents were threatened by staff that their complaint will be lodge at police station if they do not take their child either to the health centre or hospital as Ayush’s health was getting deteriorated. After much persuasion they agreed to visit the primary health centre. Matri Sudha team took the child along with his parents to the health centre for preliminary check-up where the Medical Officer referred the child to Kalawati Saran hospital. The parents were hesitant to go the hospital alone. As a result Laxmi from Matri Sudha was given the responsibility to take Ayush and her mother to Kalawati Saran Hospital on 22-07-2015. In the hospital Ayush underwent 5 tests i.e. blood test, Vitamin D, Urine Test, Stool Test and X-ray of palms and legs and asked to come again for reports a week later (29-7-2015).

Second visit was made on (29-7-2015) where the child was linked with immunization process and the doctor informed that the child is having Rickets (Rickets is a skeletal disorder that’s caused by a lack of Vitamin D, Calcium or Phosphate).

Regular visits were started to take Ayush to the hospital and Laxmi used to visit Ayush’s home on regular basis to track the feeding behavior of his mother, feeding pattern of Ayush and signs of improvement in his health as suggested by the doctor. Since he was not able to walk at all, a walker was also purchased and given to Ayush so that he could be able to stand and walk a little.

Through the below given chart we would try explain what was missed in Ayush case:-

 

(An Insight to Understand Matri Sudha’s Work on Malnutrition)

(Aspect 2- Preventive Care)

Before we dwell upon the preventive work on malnutrition let us answer few questions!!

“Had Barkha given proper care during her pregnancy period by the community health worker, would she deliver the child at health institution”? ….Yes!!

“Could we prevent Ayush to born as low-birth weight”….Yes!!

“Had Ayush’s weight noted after his birth, would he be given special care at hospital?”….Yes!!

“Had Ayush’s care at home could be better taken care by his mother, would she given health and nutrition counseling by health and nutrition workers under the government programme?” …..Yes!!

The answers to all the above questions are “BIG YES”, since we find the preventive care model in these answers to prevent a child to reach to a stage where “curative care” is required.

 

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