Health System Under Strain: Malnutrition’s Ground Effect

Malnutrition.

Malnutrition is a condition in which children are deprived of essential nutrition, resulting in incomplete mental and physical development. Consequently, they may face additional health issues such as tuberculosis, typhoid, and malaria.

There are several methods to assess malnutrition. These include measuring a child’s weight, height, and the circumference of the head or arm, and then comparing these with the average measurements of healthy children of the same age.

At primary health centers, the mid-upper arm circumference (MUAC) is used to assess malnutrition. UNICEF and WHO have donated medical supplies and tools, including MUAC tapes, to all government health centers. However, this method is applicable only for children aged six months to five years.

Based on MUAC measurements, there are three possible outcomes:

1. Normal – MUAC greater than 12.5 cm

2. Moderate Acute Malnutrition (MAM) – MUAC between 11.5 cm and 12.5 cm

3. Severe Acute Malnutrition (SAM) – MUAC less than 11.5 cm

Now let’s discuss the treatment for children with the last two types of malnutrition at basic and rural health centers:

For Moderate Acute Malnutrition (MAM): Children are given multi-mineral sachets (image attached). These sachets are rich in essential minerals and vitamins, which not only help address the nutritional deficiency but also increase appetite. Each box contains 30 sachets, to be mixed daily with milk, Cerelac, or similar food. These children typically show improvement within one month and return to normal MUAC levels within three months.

For Severe Acute Malnutrition (SAM): In addition to the multi-mineral sachets, these children receive a unique, peanut butter-like paste called Plumpy’Nut or Ready-to-Use Therapeutic Food (RUTF) (image attached). This paste is imported from France and made from peanuts, vegetable fat, milk, and soy. Children suffering from SAM enjoy eating it. With regular use, they gain significant weight, and I have personally observed noticeable improvements in their MUAC measurements.

We have both systems and resources in place, yet implementation is lacking. For instance, the government and NGOs are providing valuable resources, but most people are unaware of them due to poor execution and lack of awareness. As a result, rightful beneficiaries are deprived of their rights. It's also true that the government has not provided adequate attention or resources to crucial sectors like health and education. Even the resources that are available often fall victim to mismanagement and corruption. This is the unfortunate state of most government departments, where those in power control the resources, and the public is left with nothing.