Abstract:
Background: Child malnutrition remains a pressing public health issue in India, especially in urban slums where socioeconomic challenges exacerbate nutritional deficits. In 2014, SNEH Foundation, in partnership with Tata Motors Limited, launched the “Addressing Malnutrition” project in Pimpri-Chinchwad Municipal Corporation (PCMC), Pune. The initiative adopted the Community-based Management of Acute Malnutrition (CMAM) model to identify, treat, and prevent malnutrition in vulnerable children. The COVID-19 pandemic heightened the urgency of such interventions due to disrupted health services and increased food insecurity.
Objective: To assess the preventive and curative impact of the CMAM-based intervention on acute malnutrition among children under five in PCMC slums over a 10-year period (2014–2024).
Methods: A total of 2,808 unique children under five were assessed through annual sampling from various urban slums to reflect the communities' mobility. Nutritional status was categorized as Severe Acute Malnutrition (SAM), Moderate Acute Malnutrition (MAM), or Healthy. Improvement and transition to healthier zones were key outcomes.
Intervention: A door-to-door survey identified SAM/MAM children using standard anthropometry. Medical camps screened for comorbidities, followed by deworming and antibiotics as needed. Appetite tests determined eligibility for Ready-to-Use Therapeutic Food (RUTF) or Supplementary Food (RUSF), depending on severity. Micronutrient supplements (iron, calcium, multivitamins) addressed deficiencies. Sustainability was ensured through Poshan Sahelies, Health Management Committees, peer support, and caregiver training.
Results: On average, 93% of enrolled children showed annual improvement. Full health zone transition occurred in 2015, 2016, 2017, 2018, and 2022. Highest transition rates were in 2017 (98.86%), 2021 (98.71%), and 2023 (98.32%). In 2024, 92.52% improved, with 89.41% reaching healthy status. A Social Return on Investment (SROI) analysis (2016–2018) showed ?1.85 gained per ?1 invested.
Conclusion: The CMAM-based intervention is a sustainable, scalable solution for tackling acute malnutrition in urban slums. Its integrated clinical and community-driven approach offers a replicable model for broader malnutrition programs.
Keywords: CMAM, Malnutrition, RUTF, RUSF, Community Health, SNEH Foundation, Tata Motors, Urban Slums, PCMC, SROI, Child Nutrition, COVID-19
