Just a few months back, two-year-old Vartika was unable to walk and weighed a mere 7.1 kg. Her fragile condition brought her to a Mini Nutritional Rehabilitation Centre (NRC) in Cholapur of Varanasi, Uttar Pradesh. About 15 days later, Vartika emerged from the centre with newfound vitality — walking, running, and even dancing.
“Her weight increased to 7.6 kg, but more importantly, she left with a smile on her face,” IAS officer Himanshu Nagpal tells The Better India.
A couple of years earlier, the crisis was clear: According to the 2019 National Family Health Survey (NFHS-5), Varanasi had one of the highest rates of Severe Acute Malnutrition (SAM) in the state. With 13.3 percent of its children aged zero to six classified as SAM, the gravity of the situation demanded urgent action.
Rising to the challenge, the district magistrate S Rajalingam and chief development officer Himanshu Nagpal spearheaded a ‘10-Point Kashi Strategy’ to tackle the crisis from multiple fronts.
Varanasi’s 10-point strategy
While the administration was already working to tackle malnutrition in the district, Himanshu would still see many malnourished children in Anganwadi centres during his field visits. “When the child is malnourished, their learning levels are low and leads to poor performance in schools and colleges throughout their lives. We accordingly found shortcomings and tried to work upon them,” he explains.
- Firstly, the district administration ensured that Anganwadi centres opened on time and were habitable enough for kids to come daily. “Our interventions would not have been effective if children did not come to these centres. So, we renovated 2,200 Anganwadi centres and built 600 new centres, which were earlier in rented spaces,” he says.
- To improve children’s nutritional absorption capacity, the district started providing daily iron and multivitamin supplementation as part of its extensive nutritional supplementation programme, ‘Abhinav Pehel’, which was initially started by Himanshu’s predecessor, Abhishek Goyal.
- Along with this, millet-based supplements and plant-produced fortified foods also ensured a nutritious boost for both children and mothers.
“Every day, the malnourished children were given millet bars and ragi laddoos at the Anganwadis. This played a crucial role in improving attendance and retention. Earlier, only daal (pulses), chana (grams), refined oil, and wheat were given to these families. Instead, we started distributing ready-to-eat items like barfi (milk based sweet) and daliya (broken wheat) for the use of children. Almost one lakh SAM and MAM (moderate acute malnutrition) children are given these daily,” he says.
- “We also replaced manual scales with digital measurement equipment to Anganwadi centres for accurate measurement of children’s weight and height [a critical component to measure the scale of malnourishment],” he adds.
- Core to the strategy was improving data accuracy through the POSHAN Tracker, ensuring near-complete coverage and accurate assessment of children’s nutritional status.
- Equally groundbreaking was the establishment of 2,700 nutritional gardens and the advent of decentralised mini-NRCs, which solved the limitations posed by earlier centralised efforts. “Parents, who are mostly daily wagers, could not afford to leave their children at the district level NRC for two weeks in fear of leaving their income source. We opened block-level mini NRCs, which helped improve the numbers,” says Himanshu.
These initiatives allowed an astonishing tenfold increase in children treated per month — from 20 to 130 SAM and MAM children.
- To address low birth weight in newborns, the administration set up 12 Mother and Newborn Care Units (MNCUs), along with Special Newborn Care Units (SNCUs) and Newborn Care Units (NBCUs). These facilities ensured newborns achieved healthy weight through methods like Kangaroo Care – a skin-to-skin care technique for holding a baby directly against the mother’s chest.
- The administration also promoted exclusive breastfeeding and saw a 30 percent increase in participation, driven by daai (elderly women). “Buddy mothers lent their voices and experiences, offering guidance and companionship to families on similar journeys toward health,” Himanshu says.
- A transformative aspect of this mission was the engagement of over 3,914 Anganwadi workers, helpers, and supervisors. “These dedicated individuals formed the backbone of this effort, making daily life-altering impact that brought the rate of SAM cases plummeting from 13.7 per cent in 2020 to an extraordinary 0.22 per cent by mid-2024,” he highlights.
- Most importantly, regular monitoring and accountability were prioritised. “We randomly call families from our database, and our senior officials also make surprise visits to check the progress of the work. Personally, I also supervise the success of the programme every 15 days,” the IAS officer adds.
Between 2021 and the end of 2024, there has been a massive drop in the number of SAM children from 24,820 to 316, whereas MAM children saw a drop from 46,478 to 6,936 in the same period.
Behind these impressive numbers lie stories of renewed potential and hope like Vartika’s — stories that echo through the lanes of Varanasi, reminding us of the power of collective action and dedicated leadership.
Commenting on the recent drive to combat malnutrition, Neelam Singh, an Anganwadi worker from Rasulpur village, shares, “We now have digital weight-measuring devices, and our centre has been recently repainted. We regularly receive take-home rations, including daliya, pulses, refined oil, and fruits like apples, oranges, and bananas.”
Adding that the initiative has also boosted attendance at the centre, she continues, “Remarkably, we’ve been able to provide our children with nutritious millet laddoos every day. Currently, we have no malnourished children here. Recently, a child named Kanak, born prematurely, was admitted to the NRC, where she received nutritious meals and fruits. She was discharged in early February, having gained weight from 4.5 kg to 5.19 kg. The mother and daughter left with smiles,” she adds.
Because of this endeavour, thousands of children like Kanak and Vartika in rural areas of Varanasi are now growing up healthier, more vibrant, and poised to reach their full potential, leaving behind the shadows of malnutrition.
“This initiative isn’t just about food and nutrition; it’s about turning the tide towards a future where every child has the right to thrive,” Himanshu smiles.
Edited by Arunava Banerjee; All images courtesy Himanshu Nagpal
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