There has been a shortage of 'F 75' and 'F 100' (powdered milk powder) for children with severe malnutrition since 6 months. Treatment of such children has become more complicated due to lack of effective alternative foods. Their lives are also in danger.

According to the data of the Department of Health Services, there are about 40,000 acutely (severely) malnourished children across the country. Last year, 52 people died due to malnutrition. Both the situation and the data point to a dire situation. But even after reaching the end of the current financial year, the department has not been able to proceed with the procurement process of many essential medicines including 'F 75' and 'F 100'.

This is not because of lack of budget. In the current financial year, 41 lakh 55 thousand rupees are available for purchase of nutrients. Instead, it could not be purchased due to price disputes in the tender. In such a situation, the state should show its presence to untie the knots of problems in the procurement process.

The nutritional rehabilitation center in Butwal has been affected by the lack of 'F 75' and 'F 100' since February. Due to the lack of those medicines, nutritious food such as milk, jaulo, litho, dalbhat etc. made by themselves is being fed. The Center says that since February, 75 people have been sent home for treatment by feeding them nutrients. Children from West Nawalparasi, Palpa, Gulmi, Rupandehi, Arghakhanchi and Kapilvastu come for treatment at the

center. Similarly, in the center under Gajendra Narayan Singh Hospital located in Rajviraj, due to lack of medicine, attempts have been made to 'purify' dairy milk and make it similar to F-75 and F-100 for seven months.

However, 'F 75' and 'F 100' contain high levels of nutrients including vitamins, zinc, and other minerals. Therefore, solid food is effective for malnourished children. As an alternative, home-made nutritional supplements are not as effective as medications. So the only option is to supply the popular medicine. 

Even though the shortage is increasing, the Department of Health Services has not yet called for a tender to purchase medicines such as nutrients F 75 and F 100 for feeding malnourished children with other physical diseases. The reason for this is different. In collusion of suppliers, only one company tendering more than the cost price, not inviting tenders on time, lack of communication between employees and suppliers are the main reasons.

The delay in procurement is due to the fact that the past cost cannot be kept higher than the price when tendering for the purchase of medicine. However, an option may be used to prepare the cost price by making a market assessment of the price of the required medicine without being illegal or irregular. On the other hand, officials say that there is a delay in taking forward the file as there is frequent turnover of decision-making staff from the top to the bottom. Although transfer-promotion is considered a regular process in the administrative sector, one should be aware that it does not affect other regular work.

There may be many short-term and long-term strategies, but for now the focus should be on supply as soon as possible. Searching for a donor agency can also be an option. At the same time, the officials who did not assess the shortage in time and did not care to initiate the procurement process should also be held accountable. Because, there is a budget to buy, medicines are also produced all over the world, but due to not buying them on time, there is a shortage of medicines and the treatment of children is affected without accountability  Can't happen.

Equal access to health care is a constitutional right. Therefore, it is the government's responsibility to create an environment where children suffering from malnutrition can get the necessary medical treatment. However, preventing health problems from occurring is more important than the right to receive treatment for any health problem.

The same formula should be followed in the case of malnutrition. In general: access to education is low, there is a lack of health awareness, the poverty rate is high, the problem of malnutrition is seen in relatively remote areas. Because mothers in such an environment are more likely to not eat enough nutrients during pregnancy, so the baby born is more likely to be malnourished. Similarly, the possibility of malnutrition increases due to lack of awareness and access to nutritious food, consumption of inedible items, and lack of easy treatment and care for other types of common illnesses.