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Child Health and Nutrition

Tackling malnutrition by empowering systems and promoting community ownership of child nutrition


Mumbai (Dharavi, Wadala)
Panchmahal, Gujarat

The Problem


India is home to one-third of the world’s malnourished children. Among children under five years of age in urban Maharashtra:


are stunted
(low height-for-age)

are wasted
(low weight-for-height)

are underweight
(low weight-for-age)

Malnutrition remains a silent crisis among urban low income communities. Government programmes that address this issue face challenges in quality of service delivery and implementation. Many target beneficiaries are also unaware of how to avail these government services.

Source: National Health Family Survey 4 (NHFS 4) 2015-16

How can we equip communities to prevent malnutrition and increase quality of public health services to tackle child malnutrition?

Our Work


We believe that strong engagement with both communities and public health systems can lead to improved health-seeking behavior and higher quality services.

Our flagship nutrition programme, Aahar, works to prevent and treat malnutrition in children less than 3 years of age. We partner with the Integrated Child Development Services (ICDS), a government welfare scheme that provides health and nutrition services. Our work covers 150 anganwadis (child care centres) across vulnerable settlements in Dharavi and Wadala.

Building awareness and mobilizing communities


In our commitment to building a strong volunteer-driven culture, we work on forming Community Action Groups and a cadre of community residents who will hold anganwadis accountable for service delivery. We conduct public awareness activities to improve uptake of ICDS services, while promoting good health practices.

Strengthening ICDS implementation


We focus on training and building capacity of anganwadi sevikas (government-employed community health workers who deliver ICDS services) to improve nutrition service delivery in our intervention areas.

Reach


1,50,000

population reached in Mumbai (2018-2019)

10,967

children under 6 years
of age weighed per month
on an average (2018-2019)

1,162

pregnant women served in
partnership with ICDS per
month on an average (2018-2019)

30,233

participants mobilized through
community awareness campaigns
(2018-2019)

A shift from direct to indirect intervention: Phase II of Aahar


In April 2016, the mode of the AAHAR program shifted from direct implementation to a more hand-holding and capacity-building role, where SNEHA gradually started increasing the responsibility of ICDS to deliver 6 mandated services, facilitate positive interaction between ICDS and community for child health and nutrition. SNEHA also started building capacity of the community to expect, demand and negotiate availability and improved quality services from ICDS, thus, empowering them to act as a catalyst for sustained change.

During April 2018- March 2019, the program served an average of 14149 children and 1662 pregnant women per month. Furthermore, the program achieved a 29% net reduction in wasting levels, and significantly contributed to a 158% increase in weighing of children aged 0-2 years from baseline to endline survey period (Dec 2015- Mar 2019). To increase community ownership and weave in a sustainability framework, 744 female volunteers (Aug 2016- Mar 2019) and 247 male volunteers (June 2017- Mar 2019) have been identified and recruited under Aahar program.

Read the endline report: 2012-2015

Impact



29%

reduction in wasting levels
among children (Dec 2015-Mar 2019)

158%

improved coverage of weighing
done by ICDS for 0-2 year old
children in last one month (Dec 2015-Mar 2019)

37%

increase in registeration of
pregnant women for antenatal
care in first trimester (Dec 2015-Mar 2019)

55%

improvement in introduction of
solid and semi-solid food - infant
and young child feeding practices
(Dec 2015-Mar 2019)

Notes from the field:
Learnings by volunteers
for resolving reluctant cases


Handling reluctant cases and their queries pertaining to ICDS mandated services can be challenging for the volunteers. Therefore, imparting timely, updated information on ICDS services through volunteers’ training sessions helps them deal with community queries with confidence.

It was the time when Maharashtra government kick-started six-week measles-rubella vaccination drive across all schools. SNEHA’s volunteer Bina Qureshi* came to know that some parents were reluctant towards administration of measles and rubella vaccine in their children at the community school where her 6-year-old daughter Sarah* was studying.

During this critical time, the school teachers requested Sarah’s mother Bina to speak to the reluctant parents on measles and rubella vaccine. Bina responsibly nodded yes to the challenge and recollected as much information as possible from her recent measles and rubella volunteers’ training conducted by SNEHA’s Community Organizer. She brought into the limelight the fact that more than 1.3 million children acquired measles infection and around 49,000 infected children died each year in India.

Moreover, she also shared that rubella infection in pregnant women may cause fetal death or congenital defects; it led to the development of birth defects in almost 40 000 children annually in the country. Hearing this, the reluctant parents understood the seriousness of measles-rubella vaccination and allowed doctors to vaccinate their children.

Volunteer Hina’s presence of mind and strenuous efforts in tackling reluctant cases received a huge round of applause and appreciation from her daughter’s school authorities, Sevika and Community Organizer.

*Name changed

Scaling Our Model


Our partnerships help us scale our models and exchange best practices with other organizations in child health and nutrition.

Learn more about how we work.


We are collaborating with SETCO Foundation (the CSR wing of SETCO Group of Companies) to improve maternal and child health and nutrition across 18 anganwadis (child care centres) in Panchmahal district, Gujarat. We support SETCO in developing protocols, monitoring and evaluation frameworks, and communication materials. We aim to build capacity of SETCO’s core and field teams, and support them in building partnerships with communities and other health institutions.

Partners


Integrated Child Development Services

Municipal Corporation of Greater Mumbai

SETCO Foundation

HDB Financial Services

Julius Baer

DSP BlackRock Mutual Fund

Mommy's Bliss Fund of Tides Foundation

M

Mariwala