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-The Times of India
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<em>LUCKNOW: </em>The state nutrition mission, approved by the state cabinet here on Monday, will begin with 41 high-focus districts. These districts, say officials in the state C, account for high rate of malnutrition. The list includes Gorakhpur, Kushinagar, Deoria, Ballia, Siddharthnagar, Bahraich, Barabanki, Shravasti, Gonda and Balrampur besides the Bundelkhand region.
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Officials said the state may look forward to the formal launch of State Nutrition Mission anytime. The project aims at improving the standards of general health and immunity among children, adolescents and expectant mothers. As per government's own admission, of the 19 million malnourished children in India, 20% hail from UP. &quot;The blueprint for implementation of the mission is ready. It is set for launch soon,&quot; said an officer.
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 Sharing more details, a senior health department official said they had examined the model of implementation being successfully used by Maharashtra, the pioneer in this regard. &quot;The Gujarat government has also adopted the model with certain changes. Another set of officials examined the Gujarat model and compared the two to draft the version for UP. The best points have been picked up for UP,&quot; he said. Inputs given by Melinda Gates of the Bill and Melinda Gates Foundation and LG Arsenault, country head of UNICEF, which they gave in their meetings with the chief minister in February, have been incorporated into model.
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Sources in the government revealed the biggest fear of the stakeholders is inter-sectoral coordination. &quot;Effective implementation of the mission would involve coordination between health, panchyati raj, rural development, child development and nutrition and social welfare departments which is quite a tedious task,&quot; said an NGO which is also working to eliminate child malnutrition.
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Aware of the burden of responsibility, stake holders have urged the Akhilesh government to depute a senior IAS officer at the helm of affairs. In states where the mission has already started, the senior bureaucrat works as the director general of the mission. He is supported by directors representing departments of health, integrated child development scheme and monitoring and who instead have another set of officials to lead the programme to the last level.
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Another major issue before the state government is to address the issue of shortage of doctors and nurses. &quot;In Maharashtra, we found that ANMs were shouldering the programme. They were equally supported by doctors and nurses who are sparsely available in UP. Stake holders are looking at filling the gap with NGO and private sector tie-ups,&quot; said an officer.
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CM's wife and MP from Kannauj Dimple Yadav represents Uttar Pradesh in the Citizen's Alliance Against Malnutrition, a body that comprises several social workers, NGO representatives and parliamentarians working to tackle malnutrition which is at the root of many diseases and disability in the country, is taking personal interest in the mission. Several cinestars including actor Amir Khan are also a part of this body. Dimple is taking keen interest in the mission.
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A delegation of the alliance visited UP in September and stressed the need for the mission in UP. They also asserted that positive outcomes were possible with a dedicated approach. In Maharashtra, where the mission was launched in 2005, malnutrition dipped by 16% in a span of five years (2006-12). Thereafter, principal secretaries of department of medical and health, women and child development and rural development were asked to come up with a draft for the mission, which is to be submitted to the chief secretary by November 15.
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 State health department anchored the mission and its NRHM unit organised a workshop on the issue in mid-October. It was attended by nutrition mission officials from Maharashtra and Gujarat. In December, chief secretary Jawed Usmani fixed December-30 deadline for giving a final shape to the implementation plan for state nutrition mission. The draft was submitted in January.
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<strong>HEALTH UNDER THREAT</strong>
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<em>Status of malnutrition</em>
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CURRENT SITUATION: Uttar Pradesh has around 1.3 million severe acute malnourished children
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UNDER-NUTRITION FIGURES OF UTTAR PRADESH (CHILDREN UNDER-FIVE YEARS OF AGE):
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Stunted (chronic under-nutrition): 57% in UP as compared to 48% in India
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Wasted (acute under-nutrition): 15% in UP as compared to 20% in India
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Underweight (acute and chronic under-nutrition): 42% in UP as compared to 43% in India
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<strong>CONTRIBUTING FACTORS:</strong>
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LOW BREASTFEEDING:
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Only around 33% of under-3 children (1 out of every 3) being breastfed within one hour of birth
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Only around 18% of 6-35 months children (1 out of every 5) have been exclusively breastfed for at least six months
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HIGH ON MICRONUTRIENT DEFICIENCIES:
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VITAMIN-A: Only about 34% children covered for vitamin A
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HIGH PREVALENCE OF ANAEMIA IN ALL AGE-GROUPS (AS PER NFHS-3):
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85% among children (6-35 months age group)
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52% among pregnant women
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Every second adolescent girls is anaemic
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LOW COVERAGE OF USE OF IODIZED SALT: Around 42.5% households reported adequate iodized salt consumption
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