Bottleneck analysis of community-based management of severe acute malnutrition program in the tribal state Jharkhand
- 1Department of Community Medicine, RIMS, Ranchi, Jharkhand, India
Abstract
Background:: Throughout the world, the majority of deaths among under-five children are accredited to malnutrition. Malnutrition is a serious condition for children in India; it makes the diseases more fatal and increases the severity of the disease also. Malnutrition is the intrinsic cause of 68% of child deaths in India. Community-based management of acute malnutrition (CMAM) is a line of action focusing on the treatment and prevention of malnutrition. CMAM has been introduced in over 60 countries throughout the world and is an important part of community mobilization pivotal to the prevention of malnutrition. This paper emphasizes the place of CMAM in India in addition to treatment and the bottlenecks faced in its utilization by beneficiaries as well as service providers.
Methods:: The study was conducted from April 2021 to December 2021. The study was conducted by purposive random sampling covering 305 AWCs and 16500 children of two blocks of West Singhbhum district, Jharkhand. Of these, 28 Anganwadis were visited and 1985 children were screened by monitors taken from SCOE (State Centre of Excellence for SAM management), PSM Dept, RIMS
Results:: One of the important findings of the study is that only 2.5% of children were suffering from severe acute malnutrition, which means that regardless of bottlenecks faced, the prevalence of malnutrition declined. Our analysis had shown bottlenecks over the four determining factors for the treatment of SAM. The main supply-side bottlenecks identified were the stock-outs of commodities (THR and medicines), nonfunctional instruments, and improperly trained health workers. The support of ANMs and the Lady Supervisor was also lacking, resulting in ineffective counseling, irregular and low-quality SAM treatment, and delivery of services.
Conclusion:: This study explains different bottlenecks coming in the delivery of CMAM services and provides a detailed understanding of factors guiding the application of the CMAM program for the betterment of severely malnourished children. The AWWs need to be trained more efficiently. A basic exam can be introduced to assess their functional standard. However, working conditions and remuneration of AWC workers need to be improved to bring it to par with the work given. The findings of the study are expected to help policymakers take appropriate corrective measures to make the CMAM more effective and easily applicable, thereby bringing down the rate of malnutrition.
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BibTeX
@article{kiran2026bottleneck,
title = {{Bottleneck analysis of community-based management of severe acute malnutrition program in the tribal state Jharkhand}},
author = {Kumari Asha Kiran and Neha Priya and Manisha Kujur and Anit Kujur and Vidya Sagar and Shalini Sunderam and Reema Kumari},
journal = {Journal of family medicine and primary care},
year = {2026},
month = jul,
doi = {10.4103/jfmpc.jfmpc_1315_25},
url = {https://europepmc.org/article/PMC/PMC13722256},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Bottleneck analysis of community-based management of severe acute malnutrition program in the tribal state Jharkhand
AU - Kumari Asha Kiran
AU - Neha Priya
AU - Manisha Kujur
AU - Anit Kujur
AU - Vidya Sagar
AU - Shalini Sunderam
AU - Reema Kumari
PY - 2026
DA - 2026/07/01
JO - Journal of family medicine and primary care
DO - 10.4103/jfmpc.jfmpc_1315_25
UR - https://europepmc.org/article/PMC/PMC13722256
AB - Background:: Throughout the world, the majority of deaths among under-five children are accredited to malnutrition. Malnutrition is a serious condition for children in India; it makes the diseases more fatal and increases the severity of the disease also. Malnutrition is the intrinsic cause of 68% of child deaths in India. Community-based management of acute malnutrition (CMAM) is a line of action focusing on the treatment and prevention of malnutrition. CMAM has been introduced in over 60 countries throughout the world and is an important part of community mobilization pivotal to the prevention of malnutrition. This paper emphasizes the place of CMAM in India in addition to treatment and the bottlenecks faced in its utilization by beneficiaries as well as service providers. Methods:: The study was conducted from April 2021 to December 2021. The study was conducted by purposive random sampling covering 305 AWCs and 16500 children of two blocks of West Singhbhum district, Jharkhand. Of these, 28 Anganwadis were visited and 1985 children were screened by monitors taken from SCOE (State Centre of Excellence for SAM management), PSM Dept, RIMS Results:: One of the important findings of the study is that only 2.5% of children were suffering from severe acute malnutrition, which means that regardless of bottlenecks faced, the prevalence of malnutrition declined. Our analysis had shown bottlenecks over the four determining factors for the treatment of SAM. The main supply-side bottlenecks identified were the stock-outs of commodities (THR and medicines), nonfunctional instruments, and improperly trained health workers. The support of ANMs and the Lady Supervisor was also lacking, resulting in ineffective counseling, irregular and low-quality SAM treatment, and delivery of services. Conclusion:: This study explains different bottlenecks coming in the delivery of CMAM services and provides a detailed understanding of factors guiding the application of the CMAM program for the betterment of severely malnourished children. The AWWs need to be trained more efficiently. A basic exam can be introduced to assess their functional standard. However, working conditions and remuneration of AWC workers need to be improved to bring it to par with the work given. The findings of the study are expected to help policymakers take appropriate corrective measures to make the CMAM more effective and easily applicable, thereby bringing down the rate of malnutrition.
SN - 2249-4863
SN - 2278-7135
ER -