10/09/2013

Micronutrient Initiative - India

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India The State of Health and Development

The mortality rate of children under the age of five is 64 per 1,000 live births down from 118 in 1990. 62% of pre-school children are deficient in vitamin A, leading to an annual 330,000 child deaths. 9% of children under five are affected by diarrhoeal disease. 58.7% of pregnant women, 63.2% lactating mothers and 69.5% of preschool children are anaemic. Only 71% of households currently consume adequately iodized salt.

by Nutrient by Region by Country

Our Priorities
MI is working to achieve the following priority objectives: Increase biannual administration of Vitamin A syrup to all children 9-59 months in priority states. Expand zinc supplementation along with Oral Rehydration Salts (ORS) for the treatment of childhood diarrhoea in priority states. Improve production, monitoring and consumption of iodized salt and provide technical support to salt producers. Introduce and promote the use of double fortified salt (DFS), fortified with iodine and iron, especially through programs that target the most vulnerable. Expand iron and folic acid (IFA) programs for preschool children, adolescent girls, pregnant and lactating women. Support the Indian Flour Fortification Network (IFFN) in advocating for wheat flour fortification, and continue to host its secretariat. Support the Micronutrient Initiative India Trusts (MII) growth and capacity to implement high-quality micronutrient programs in the country.

A w oman w orking in a salt factory in Gujarat.

Stories from the Field

MIs biggest zinc program is reducing diarrhoearelated deaths in India Double Fortified Salt: Smartening & strengthening a school lunch School girl turns mentor for outof-school girls to help reduce anaemia levels

Programs and Results

Child Survival: Reducing under-five mortality
Vitamin A MI is focusing on increasing coverage in hard-to-reach areas and provides technical and program support at district, state and national levels. MI continues to support twice-yearly vitamin A supplementation, delivered by state governments in the high burden states of Uttar Pradesh, Bihar, Madhya Pradesh, Chhattisgarh and Jharkhand. Zinc MI is working towards sustainable scale-up of zinc and ORS through public channels by ensuring their wide availability to healthcare providers and caregivers and by increasing awareness on the health benefits of each. MI has initiated large zinc and Oral Rehydration Salts (ORS) programs for the treatment of diarrhoea among children to improve child survival in Bihar, Gujarat and Uttar Pradesh. Lessons learned from the pilot projects in Chhattisgarh and Bihar, with support from the Department of Biotechnology; Government of India; and BIBCOL; a public sector zinc manufacturer, were useful in shaping larger programs. Field Story: Using zinc to save childrens lives in an emergency setting in India

Laxmi Salt: Adding Wisdom to a Simple Staple

District administrators innovativeness channels efforts to reduce adolescent anaemia

MI has developed first-of-its-kind training modules for healthcare workers and members of the Integrated Child Development Services (ICDS). Quarterly Newsletter on Childhood Diarrhoea Management in Bihar Issue 1, Issue 2, Issue 3,Issue 4

Child Development: Enhancing cognitive growth of young minds

Salt Iodization MI works closely with the Office of the Salt Commissioner, Government of India and other international organizations to address gaps in and improve Indias salt iodization program. This includes working with approximately 600 small and medium-scale

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gaps in and improve Indias salt iodization program. This includes working with approximately 600 small and medium-scale salt processors in Gujarat, Rajasthan, Tamil Nadu, Andhra Pradesh, Odisha and Karnataka and distributing nearly 80 crushing and iodization units to small scale salt processors. Field Story: Laxmi Salt: Adding Wisdom to a Simple Staple MIs work has contributed to the iodization of more than 25% of the total non-refined edible salt produced in India. Salt Coverage Study 2010 The Iodized Salt Coverage Study 2010, undertaken by MI and the International Council for the Control of Iodine Deficiency in 2010 in rural areas of eight states in India revealed a significant 20% increase in the use of adequately iodized salt in rural households. MI will use the survey to continue to gather support for its efforts to scale up production and consumption of adequately iodized salt in India. Double Fortified Salt To reduce iron and iodine deficiency, MI developed a way to combine iron and iodine in salt. Using the momentum of the iodized salt program, double fortified salt (DFS) could provide iron on a regular basis as well. As part of its efforts to reduce iron and iodine deficiencies in children, MI provided technical support to the Tamil Nadu Salt Corporation (TNSC), to start producing DFS. TNSC continues to provide DFS to school children as part of the Mid-Day-Meal Program in Tamil Nadu. To facilitate wider production and distribution of DFS, MI is working to ensure the premix will be included among the products approved within the Ministry of Healths Prevention of Food Adulteration/Food Safety and Standards Act. Field Story: Double Fortified Salt: Smartening and strengthening a school lunch In the News: Micronutrient Initiative President Venkatesh Mannar wins Tech Award in Health for Double Fortified Salt Report: Solutions in a Pinch: Micronutrient Initiatives Double Fortified Salt strategy tackles two problems in one go (PDF)

Micronutrient Initiative - India

Womens Health: Empowering women by improving survival and health

Iron Supplementation MI initiated pilot projects on Iron Folic Acid (IFA) supplementation targeting children, adolescent girls and pregnant women in select districts of Chhattisgarh, in partnership with the state government. By improving adherence to this proven intervention, MI and its partners are working to influence Government of India health policy-makers to include iron supplementation in national programs. Field Story: District administrators innovativeness channels efforts to reduce adolescent anaemia Brochure: Iron deficiency anaemia control for adolescent girls in Chhattisgarh, India (PDF) Flour Fortification MI continues to support wheat flour fortification with iron and folic acid in India by hosting the India Flour Fortification Network (IFFN) Secretariat. Until 2010, MI also provided technical support to the ICDS Food Fortification Program and the West Bengal Governments Wheat Flour Fortification Program. Fortified wheat is distributed under the public system and reaches 5.6M children and 1.13M pregnant and lactating women in 17 districts.

Progress and Challenges

Vitamin A syrup is now reaching 38 % of children aged 9 to 59 months in priority states, however, the supply chain needs improvement. MI recently secured new grants to support zinc and ORS programming in India and has sustained advocacy efforts. MI is also providing refresher training for health care workers and constant messaging and ongoing supportive supervision for mothers, caregivers and health care workers. The Iodized Salt Coverage Study 2010 reported a 20% increase in the use of adequately iodized salt in rural households in Gujarat, Rajasthan, Tamil Nadu, Andhra Pradesh, Orissa and Karnataka. Given that only 47.3% of these households are consuming iodized salt, much work remains to be done. More than half of women and children in India are anaemic and the current supply of iron folic acid supplements needs to be streamlined. Though 26 % diarrhoea cases in children are treated with ORS, only 0.3 % receive zinc supplements.

Contact MI in India
J K Raman Country Director 11, Zamroodpur Community Centre Kailash Colony Extension New Delhi 110048, India Tel: 91 11 46862000 Fax: 91 11 46862048

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