Abstract
Background: Childhood under-nutrition is a major public health problem and developmental challenge in India. In this context, Government of Gujarat has launched Mission Balam Sukham to improve the nutrition status of child at anganwadi level, but there were children who did not improve after 30 days of enrollment.

Objectives: The objectives of this study were (i) to compare respondent and non-respondent children who enrolled in Mission Balam Sukham in terms of their care taker’s knowledge, attitude behavior and practices, their hygienic habits, and facilities provided by anganwadi and (ii) to find out reasons for failure to respond among those who treated under Mission Balam Sukham at anganwadi level.

Materials and Methods: A case-control study was conducted at anganwadi center of Surat city. Sample size of 190 (cases 95 and controls 95) using the prevalence of those who improved from severe undernourishment (control) which is 50% and prevalence of those who did not improve at all (case) which is 30% based on results of pilot study of anganwadi. Odds ratio (OR) with 95% confidence interval was calculated.

Results: Cases were found to have significant association with mother accompanied child at anganwadi (OR: 29.2 [11.53-73.99]), literacy (OR: 5.67 [2.79-11.55]), working status of mother (OR: 30.62 [12.07-77.71]), clean water supply at home (OR: 12.44 [6.267-24.71]), hand washing practices of child (OR: 106.9 [38.89-293.6]), contact with tuberculosis patient (OR: 3.037 [1.592-5.795]), having siblings (OR: 6.37 [2.86-14.18]) and cleanliness of anganwadi (OR: 4.73 [1.831-12.26]).

Conclusions: At anganwadi under Mission Balam Sukham, improvement in child’s nutrition is positively correlated with mother’s care, hygienic practices, environment of home and anganwadi.

Key words: Anganwadi; Mission Balam Sukham; Nutrition