Radha was overjoyed when a video call, dialled by her Anganwadi didi, connected her to a nutritionist who told her simple tips about feeding her 2 year old child Ankit, whose stagnant weight was a growing cause of concern for his mother. A feedback call was received by her a week later confirming the improvement in weight of the child.

Over 400 such satisfied families have received nutrition related consultation for their malnutritioned children within 15 days of launch of Telenutrition facility in district Pilibhit of Uttar Pradesh. Founded by newly joined young district magistrate, telenutrition facility in the district is solving nutrition based issues of families with ease in the tough times of Covid-19.

"If telemedicine can deliver medical advise of expert doctors to remote rural corners through virtual medium, why not telenutrition for much needed nutritional guidance. This thought set the ball rolling", says Pulkit Khare, DM Pilibhit. A team of counsellors led by nutritionists was then selected. Telephone lines were arranged at the Districts Nutritional Rehabilitation Centre (NRC). A dedicated video calling number for each block of the district was circulated to the Asha-ANM-Anganwadi, the frontline workers of the block, through block level watsapp groups. Hoardings were put up at prominent places in the city to disseminate the numbers to carry the new initiative forward. A weekly feedback mechanism regarding the effectiveness of advice given was also incorporated by making weekly return calls to check the status of the malnourished child.

"Nutrition is often an ignored agenda especially in rural areas even during the redgular days. With the outbreak of Covid-19 pandemic, the challenge for district administration was magnified. Families were reluctant to get their malnourished child admitted to the Nutritional Rehabilitation Center at the District Hospital. With Telenutrition, we have used simple technology to reach directly to such children and track the improvement in their growth", says Khare. With telenutrition facility in place, mothers are voluntarily calling up at the publicized video call numbers to seek expert nutritionist's advice. Also, the frontline workers during their home visits follow all Covid related protocols, and emphasize focus on severe acute malnutrition (S.A.M) children and ensures that they get timely nutritional advice on video calls from the experts sitting daily shiftwise at the telenutrition centre. The initiative, first of its kind in the state, is proving highly effective in times of pandemic as the home bound children are examined on video calls, their basic parameters like age, height, weight and symptoms are queried and simple dietary interventions are immediately advised. The details of each caller are noted and a unique case ID is allocated, which is used a week later to make return calls and track the growth status.

Frontline workers during their home visits after following all Covid related protocols

The Prime Minister's Overarching Scheme for Holistic Nutrition or POSHAN Abhiyan is Government of India's flagship program to improve nutritional status for children, pregnant women and lactating mothers. Launched in March 2018, it directs the attention of the society towards the problem of malnutrition to address it a mission mode. Each year, the month of September is celebrated as Poshan Maah followed-up by intensive set of activities to address the curse of malnutrition. With the prevalent Covid spread, carrying out the message of Poshan Maah was a difficult challenge for the district administration.

Pilibhit district in Uttar Pradesh planned inter-departmental coordination and activities conforming to the Covid protocols. Telenutrition was a district level innovation which gained momentum in no time. Webinars - Poshan Panchayats - were also conducted throughout the month involving all the possible stakeholders. 11 families with children suffering from severe acute malnutrition were also given cows from the state run gaushalas to supplement the dietary requirements of the children. Over 288 Poshan Vatikas or nurseries were established in the premises of the Anganwadi centres to provide nutritional fruits and vegetables to the malnutrition children.

Digital poshan consultation service

Intensive drive to measure accurate height and weight of children below 5 years of age was done throughout the district in this month covering over 1,80,000 children. All above activities were registered on the Poshan Abhiyan portal of Government of India where at the end of PoshanMaah, district Pilibhit topped the state with 2602825 activities, followed by Meerut (2046399) and Jaunpur (1172883). Though, there is still a long way to go before the district or the state can claim to be free from malnutrition, but these small steps of delivering nutritional support by digital medium in the pandemic, spread positivity for the flagship scheme and the nutritional status of children in Pilibhit.

(Author is the district magistrate (DM) of Pilibhit)