Question : NUTRITION REHABILITATION CENTRES

(a) the total number of Nutrition Rehabilitation Centres (NRCs) and the estimated number of children having severe/ acute malnutrition along with the total number of children enrolled at these NRCs, State/UT-wise;

(b) the mechanism put in place by NRCs to identify and improve the condition of children with severe and acute malnutrition;

(c) the total number of cases where the children enrolled at NRCs have been able to successfully recover from the above mentioned condition;

(d) whether the Government have reviewed the functioning and performance of these NRCs and if so, the details thereof; and

(e) the steps taken/proposed to be taken by the Government to make the NRCs more effective?

THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI GHULAM NABI AZAD)

(a) to (c): There are 763 Nutritional Rehabilitation Centres (NRCs) functional across 16 States and UTs. In 2012-13, 1,28,431 children have been treated and in 2013-14 (till 2nd Quarter), 73,254 children have been treated in these NRCs. The total estimated number of children having severe/acute malnutrition along with the total number of enrolled at these NRCs, State/UT-wise is annexed.

Malnourished children under the age of five years identified from health facilities and Anganwadi Centres are referred to Nutritional Rehabilitation Centres where Severe Acute Malnourished children with complications are admitted and provided nutritional rehabilitation and medical treatment. The care takers are provided daily wage compensation, food and provided nutritional counselling for proper feeding of their child.

(d) & (e): The functioning of Nutritional Rehabilitation Centres are being reviewed from time to time by undertaking monitoring visits by Central and State level teams and directed for corrective measures. The following steps are recommended to the State/UT Governments by Ministry of Health & FW to make NRCs more effective:

# Improving utilisation of NRCs by orientation of Health functionaries and Anganwadi workers for Severe Acute Malnutrition along with establishment of effective linkage between the two departments and community for referral to NRCs

# Stricter enforcement of correct admission as advocated by Government of India guidelines to ensure priority treatment to critical cases

# Ensuring accurate treatment protocols by undertaking adequate placement of staff and refresher trainings of staff of NRCs

# Discontinuing uniform length of stay, and following of discharge criteria issued by Government of India

# NRCs should be established nearer to Paediatric ward for better management of children

# Establishment of NRCs based on burden of malnutrition and prioritising Tribal Districts, Malnutrition High Burden Districts, High Priority Districts.

# Ensuring follow up of discharged children and linking them to ICDS system after discharge for complete recovery