Abstract of Dissertation

Keyword : CMAM Program; KAP Study; National Health Mission; Malnutrition; ASHA

Objective : • To assess the knowledge and practice of parents regarding malnutrition and the CMAM programme. • To assess the knowledge and practice of ASHA’s regarding the CMAM project. • To review the secondary data to know the extent of CMAM program outcome.

Background : The CMAM approach includes community outreach (for community sensitisation and community involvement, active case finding and home follow-up of problem cases), outpatient management of MAM (depending on the context), outpatient management of SAM without medical complications and inpatient management for the stabilisation of SAM with medical complications. CMAM is closely linked with preventive and other curative health and nutrition interventions and social safety nets. This study is done to assess the functioning of CMAM programme through primary data collection by rapid situational analysis on knowledge and practice of ASHAs and beneficiaries, in Surendranagar district of Gujarat undertaken by NHM Gujarat. Rationale of the study: The present study is aimed to assess the knowledge and practices of ASHA and beneficiaries regarding malnutrition and CMAM program. Research question: What is the existing knowledge and practices of ASHA and beneficiaries regarding CMAM program in Surendranagar district of Gujarat?

Methodology : Research Methodology •Research Design: Quantitative Design. •Study Design: observational cross-sectional study. •Study Location: village khodu, nagara, katuda, prangadh, dedadara and kharva of Wadhwan block of Surendranagar district. •Sample size: 20 Parents of enrolled children in CMAM programme,30 ASHAs •Sampling Method: Non-Probability, Convenience Sampling. •Study Duration: Three month •Study Respondents: Parents of Enrolled Children in CMAM and ASHA workers of that area. Methodology: •For Primary Data collection: According to convenience sampling village khodu, nagara, katuda, prangadh, dedadara and kharva were visited. A rapid situational analysis tool was prepared for ASHA and the parents of SAM children enrolled, at their home setting in these village the questions were asked, and the responses were recorded. The questions were close ended as to explore whether the target population falls into that range of responses, with an Intent to find probable reasons. •For secondary Data collection: From the State monitors the figures for indicators of CMAM Project were collected and recorded as to analyze the SAM load and What is the success rate. •Data analysis: Data was interpreted through coding in MS-Excel.

Findings : There were gaps in the knowledge of ASHA and beneficiaries about the CMAM program. The major cause of delay in the treatment was found to be low awareness among population in about 60% cases. Only 60% of the ASHA workers knew about how to measure MUAC. 65% of parents responded positively about improvement in health of their children. 70% of parents were counseled by ASHA.

Recommendations : The study aimed to assess the overall functioning of CMAM programme and its effectiveness in improving overall health status of SAM children. It is evident from the results and discussion that there is a lack of awareness about the problem and inefficient utilization of resources. There are gaps in the knowledge of ASHA workers about the program which is a big concern. Moreover, the practices are not followed the way they should be. There is a high dropout rate which is because of low awareness.