REPORT ON POSHAN - icds-wcd.nic.in · Common Application Software Capacity Building (Incremental Learning Approach) Incentives ... Adolescent Girls, SHG women, and Pregnant Women

REPORT ON

POSHAN ABHIYAAN POSHAN MAAHAND

(SEPTEMBER 2018)

SWASTH BHARAT PRERAKS

TATA TRUSTS

MINISTRY OF WOMEN AND CHILD DEVELOPMENTGOVERNMENT OF INDIA

List of AbbreviationsAAA ANGANWADI WORKER - ASHA - ANMANC ANTENATAL CAREANM AUXILIARY NURSE MIDWIFEASHA ACCREDITED SOCIAL HEALTH ACTIVISTAWC ANGANWADI CENTREAWW ANGANWADI WORKERECCE EARLY CHILDHOOD CARE AND EDUCATIONICDS INTEGRATED CHILD DEVELOPMENT SERVICESIFA IRON AND FOLIC ACIDILA INCREMENTAL LEARNING APPROACHMOW&CD MINISTRY OF WOMEN AND CHILD DEVELOPMENTNRC NUTRITION REHABILITATION CENTRESAM SEVERE ACUTE MALNUTRITIONSHG SELF HELP GROUPUP UTTAR PRADESHVHSND VILLAGE HEALTH SANITATION AND NUTRITION DAY

Rakesh Srivastava SECRETARYMINISTRY OF WOMEN & CHILD DEVELOPMENTGOVERNMENT OF INDIA

Dr. Rajesh Kumar JOINT SECRETARYMINISTRY OF WOMEN & CHILD DEVELOPMENTGOVERNMENT OF INDIA

SWASTH BHARAT PRERAKS

ACTIVITIES BY THE

7ACTIVITIES BY THE SWASTH BHAR AT PRER AKS

The POSHAN Abhiyaan (National Nutrition Mission) was launched by the Honourable Prime Minister on March 8, 2018 at Jhunjhunu in Rajasthan. The Mission is multi sectoral with a targeted approach to reduce stunting, undernutrition, anaemia, and low birth weight. The Key focus areas of the Mission include:

POSHAN ABHIYAAN

Convergence

Behavioural Change & Jan Andolan

Innovations

Common Application Software

Capacity Building (Incremental Learning Approach)

Incentives


Convergence

Behaviour Change

Capacity Building

Innovation

Incentive


Convergence

Behaviour Change

Capacity Building

Innovation

Incentive


Convergence

Behaviour Change

Capacity Building

Innovation

Incentive


Convergence

Behaviour Change

Capacity Building

Innovation

Incentive


Convergence

Behaviour Change

Capacity Building

Innovation

Incentive


Convergence

Behaviour Change

Capacity Building

Innovation

Incentive

ABOUT

8 ACTIVITIES BY THE SWASTH BHAR AT PRER AKS

Through the Swasth Bharat Preraks program, The Tata Trusts supports the Ministry of Women and Child Development (MoW&CD) in POSHAN Abhiyaan. The program covers 315 districts in the first phase and 235 districts in the second. This is a nation-building initiative wherein Preraks undergo a rigorous training and are deployed to work as catalysts at the ground level and provide management support to their respective District Magistrate/ Collector and the line departments in effective and efficient implementation of the Abhiyaan. The initiative captures innovations for scale-up to strengthen delivery of services linked to nutrition and the scheme. Presently, there are 220 Preraks on the ground across 26 states. The Trusts aims to deploy 550 Preraks in the near future.

SWASTH BHARAT PRERAKSA NATION BUILDING INITIATIVE

PRERAKS GENDER AND EDUCATION PROFILE

77 Female Preraks143 Male Preraks

~40% Engineers ~30% Management graduates ~30% Social Sciences graduates & others

From 32 Preraks in May

To 220 Preraks in September


10 Andhra Pradesh6 Assam17 Bihar8 Chhattisgarh8 Gujarat3 Haryana4 Himachal Pradesh1 Jammu and Kashmir14 Jharkhand1 Karnataka1 Kerala26 Madhya Pradesh18 Maharashtra

2 Manipur3 Meghalaya1 Mizoram1 Odisha4 Punjab23 Rajasthan1 Sikkim5 Tamil Nadu5 Telangana1 Tripura5 Uttarakhand54 Uttar Pradesh

PRERAKS DISTRIBUTION ACROSS STATES

1

1

1

12

3

6

17

14

8

1

44

5

54

3

1

1

5

5

18

10

826

23

10

September 2018 was observed as Poshan Maah across the country with activities focussing on awareness generation on access to better nutrition, health, and hygiene for all. The 4 Hafte 4 Charche campaign, supported by the Swasth Bharat Preraks Program was implemented to leverage the network of more than 200 Preraks on the ground. The initiative brought together key stakeholders on nutrition. It was envisaged that the four weeks of Poshan Maah would provide four messages to key stakeholder groups namely: the Panchayati Sarpanches, Adolescent Girls, SHG women, and Pregnant Women and Nursing Mothers. The 4 charche included:

4 HAFTE 4 CHARCHE

ACTIVITIES BY THE SWASTH BHAR AT PRER AKS

PANCHAYATI PANCHASUTRAUrging sarpanches to pledge to take ownership of key parameters in Anganwadi services

POSHITH KISHORIEmphasising on diverse and healthy diet, menstrual hygiene, and use of IFA to prevent anaemia

MAHILA POSHAN SAMELANEducating the women in SHGs about the nutrition and health services provided by the Anganwaadi and ASHA workers to increase the reach of these services in the community.

POORN POSHANFocussing on the importance of a diverse complementary diet for children over six months of age


4 POSTERS IN 11 LANGUAGES WERE DISTRIBUTED IN OVER 200 DISTRICTS

KEY HIGHLIGHTS FROM

HafteCharche

13KEY HIGHLIGHTS FROM 4 HAFTE 4 CHARCHE

CASE STUDY

SCALING UP IMPACTFUL INITIATIVESGARGI KAULAlwar, RajasthanPA NCH AYATI PA NCH A S UTR A

The Sarpanch is the head of all functions in the village machinery. He or she is vested with powers to support local governance. Our Swasth Bharat Prerak, Gargi supported a workshop in the Alwar district of Rajasthan for 500 sarpanchs (in convergence with the Swachh Bharat Mission team) to sensitise them on the issue of malnutrition, POSHAN Abhiyaan and the importance of hygiene in better nutrition status.On September 12th, Team Alwar utilised the concept of Panchayati Panchasutra and conducted a pilot named Goonj in the Neemrana block of the district. The objective behind Goonj was to:

Sensitise the Panchayati Raj functionaries to key concepts of malnutrition

Support development of a village action plan to identify key challenges in reducing malnutrition

Develop mitigating strategies and, Implement and follow-up on the action plan to

ensure improvement in nutrition status of the beneficiary groupsAlwar will be scaling up this project in the entire district with the aim of developing an action plan for every village, enabling POSHAN Abhiyaan to become a Jan Andolan.

14 KEY HIGHLIGHTS FROM 4 HAFTE 4 CHARCHE

CASE STUDY

CONVERGENCE AS CORNERSTONE FOR NUTRITION AGENDA

SOUNDARYADindigul, Tamil NaduSelf-help Groups (SHGs) play a vital role in improving the reach of services in the hinterlands of India. Therefore, their inclusion in POSHAN Abhiyaan, through nutrition agenda for SHGs, would ensure greater reach of important nutrition-related messages. Aligned with this vision, a joint orientation of SHG members on National Nutrition Mission and ‘Swachhata Hi Sewa’ movement was conducted on September 17, 2018. The District Collector presided over the meeting which was attended by officials from various departments like DRDA, WCD (ICDS), and the Department of Education, Health and Social welfare. Our Swasth Bharat Prerak, Soundarya, took this opportunity to discuss the targets to be achieved under the Abhiyaan, and the undernutrition and anaemia prevalence in the district. Soundarya addressed almost 300 SHG members reinforcing the importance of including nutrition in the SHG agenda, with a special emphasis on growth monitoring of children as a strategy for timely identification and mitigation of malnutrition.

NAVYA MSWest SikkimAs part of ‘4 Hafte 4 Charche’ campaign in Mangalbari Primary Health Centre, Soreng Block, West Sikkim, a ‘Mahila Samelan’ program was conducted on September 19, 2018. The CDPO, Block Development Officer, SDM Soreng & Gyalshing, Gram Panchayat President and Vice President were among the dignitaries present at the program. The program was a convergence activity conducted with the support of frontline workers from Health and ICDS. Overall 70 participants attended the program including SHG members, lady supervisors, anganwadi workers, ASHA, ANM, medical officer. Our Swasth Bharath Prerak, Navya M S, screened a video on POSHAN Abhiyaan and delivered a talk on the ‘Role of SHGs in POSHAN Abhiyaan’. The event concluded with a rally against malnutrition with a strong message to eat healthy and reduce malnutrition.


PRAMEET CHOPRAKhandwa (East Nimar), Madhya PradeshThe key activities envisaged under the ‘4 Hafte 4 Charche’ campaign were implemented by the Swasth Bharat Prerak, Prameet Chopra, under the guidance of the District Collector Khandwa (East Nimar), Madhya Pradesh. Through the four weeks, Prameet leveraged the network of key stakeholders to communicate the messages of ‘4 Hafte 4 Charche’. The activities included:

Discussion with all Sarpanchs and local leaders about the Anganwadi centre services and their role in improving nutrition-related service delivery

Leveraging the community-based events at every AWC in the district. Key concepts such as adequate nutrition for all target beneficiaries and right age to get married for adolescent girls were reinforced

Kishori Balika Diwas was observed across the district where issues related to adolescent girls, such as menstrual hygiene, anaemia, need for nutritional and balanced diet, and importance of consumption of IFA were deliberated

Convergence with DAY-NRLM to bring together around 350 SHG women to highlight the importance of nutrition and setting up Poshan Vatika in the community were deliberated and key action points were identified.

16 KEY HIGHLIGHTS FROM 4 HAFTE 4 CHARCHE

CASE STUDY

ADDRESSING THE NEEDS OF ADOLESCENT GIRLS

RUTU TEKWANINarmada, GujaratAs part of the 4 Athvadiya (hafte) 4 Charche initiative by the Swasth Bharat Preraks, Poshit Kishori was celebrated in Narmada (an Aspirational district), Gujarat on September 15, 2018 across all 952 Anganwadi Centres. The Swasth Bharat Prerak, Rutu Tekwani, was actively involved in the planning and implementation of the event. She supported the training of CDPOs on key messages to be disseminated to the AWWs and, in-turn, to adolescent girls.Rutu also actively contributed to other activities including counselling sessions to Kishoris on the importance of an iron-rich diet, proper way to take IFA tablets, and the importance of menstrual hygiene and sanitation. The program saw a significant number of adolescent girls participating in the event in the Aspirational District. The adolescent girls applied mehendi on their hands conveying messages such as ‘Yogya Poshan, Desh Roshan’ and ‘Darek Ghare Poshan Tyohar’, pledging a healthy future.


ARPITA SAHAChubri, AssamThe Swasth Bharat Prerak in Assam coordinated and implemented the Poshith Kishori event under the 4 Hafte 4 Charche campaign. The event was aimed at generating awareness on the right age for marriage and the importance of higher education for girl child with adolescents, supervisors, Anganwadi workers and community members in the audience. She discussed menstrual hygiene, use of sanitary pads, and balanced diet. She also conducted home visits in the cases of teenage pregnancy and provided counselling. She emphasised that adolescent girls will become the community leaders of future and it was imperative to educate the girl child, and seek out access to basic health, nutrition, and hygiene practices. The event was conducted in the open community ground to attract wider participation. The event soon grew from a small convention of young girls to a mass congress of adult women and onlookers who joined in the discussion increasing the reach threefold than was anticipated.

52,253 AWCS WERE COVERED

UNDER THE INITIATIVE ACROSS

211 DISTRICTS OVER THE COURSE

OF 4 WEEKS REACHING

~27 LAKH TARGET POPULATION

SUPPORT EXTENDED IN

POSHAN ABHIYAAN AND

POSHAN MAAH ACTIVITIES

19SUPPORT EXTENDED IN POSHAN ABHIYA AN AND POSHAN MA AH ACTIVITIES

Within only five months of the program, the Swasth

Bharat Preraks have contributed significantly to the

POSHAN Abhiyaan and Poshan Maah activities.

The MoW&CD spearheaded the Poshan Maah activities

leveraging 12 line departments on 11 key themes. All

220 Preraks were trained on the expectations from the

Ministry in the planning, implementation, and data

sharing of activities for their respective districts. The

Preraks were also instrumental in social media and

outreach of nutrition initiatives.

1. Adolescent education, age at marriage, and nutrition

2. Anaemia

3. ANC

4. Breastfeeding

5. Complementary feeding

6. Diarrhoea

7. ECCE

8. Food fortification

9. Growth monitoring

10. Hygiene, water, and sanitation

11. Immunization

12. Overall nutrition

Assisting district office in effective roll out POOJA VERULKAR CHADRAPUR, MAHARASHTRA

Pooja was instrumental in supporting her district office

in planning and organising Poshan Maah activities. She

brought together key stakeholders to orient them on the

events and the expectations from the State, undertook

extensive visits during September to provide on-the-

ground support to frontline functionaries and uploaded

data on the dashboard.

She also supported the district office in formation of the

District Convergence Committee, and in developing the

Convergence Action Plan. Pooja is being acknowledged

by the MoW&CD for Individual Excellence on the field

in supporting the Abhiyaan and Poshan Maah initiatives.

Identifying effective innovations for scale-upARUSHI PANDEY VARANASI, UTTAR PRADESH

Arushi has been supporting the Supervisor and

Anganwadi workers of the Kakarmatta block in their

efforts to improve services to adolescent girls. The

centres in this block now see participation of more than

40 adolescent girls, every month. According to Sector

Supervisor Lalima Pandey, the promise of games and fun

brought the girls to these centres initially, but the free and

safe space to discuss the problems, which they could not

discuss at home, makes them come every month. A few

techniques they used to achieve this outcome include:

1. KISHORI KA PITARA: Adolescent girls can write and

drop their problems in a box (pitara). The anganwadi

worker, then, discusses and strives to solve the problems

while maintaining anonymity of the girl.

2. NUTRITION SASHES: Girls who come for Laadli

Divas (a day to bring adolescent girls to discuss anaemia)

are regularly given sashes with nutrition messages

on them. Wearing the sashes instils a sense of pride

motivating them further to campaign for their own needs

at home.

3. QUIZ COMPETITION: Questions on nutrition,

menstruation care, anaemia and general hygiene are

given to the girls. Each girl, then, reads out her question

and answers it. This has improved their ability to

confidently answer questions about their health and

hygiene. Take 19-year-old Mamta for example - Mamta’s

parents refused to let her study after the 10th grade. A

few months after she started coming to the Anganwadi

for Kishori Diwas, she put in a question into the kishori ka

pitara about how to convince her parents to let her study

further. This led to intensive counselling of her parents

by the Supervisor and Anganwadi worker. Mamta is now

in the 11th grade, and plans to opt for a graduation degree

after school.

20 SUPPORT EXTENDED IN POSHAN ABHIYA AN AND POSHAN MA AH ACTIVITIES

Navigating difficult terrains: Snippets from the North East StatesDEEPTAPRAN SONOWAL DARRAN, ASSAM

Apart from supporting maximum Poshan Maah events

in the district, the journey for #RightNutrition took

Deeptapran to one of the remotest parts of the district

where the primary connectivity is through boats.

These ‘water economies’ of Assam are famed for their

highly shifting landholdings and hard to reach migrant

population. For the first time, a meeting on Poshan was

held where all village leaders, members of different

administrative bodies, school administration, gram

panchayat and villages participated. Nutrition counsellor

was also invited to provide advice about right diet and

child care. The discussions touched upon key aspects

such as key nutrition services available for the community

and the need to support AAA in spreading the message of

eradicating malnutrition.

DEARSON MARING TAMENGLONG, MANIPUR

During the Poshan Maah, Dearson Maring, the Prerak

at Tamenglong organised awareness and sensitisation

programs at schools and villages advocating for

balance diet, adequate complimentary food/feeding,

and prevention of anaemia through VHSND. The event

was organised in collaboration with the District Health

Society and Zila Swachh Bharat Prerak. A total of 65

VHSND were conducted in September, impacting more

than 100 villages in Tamenglong District. A special

session was carried out by Dearson with 146 students

from class VIII to X at Tousem high school. The session

covered the relation between health, nutrition and

economic development.

KUSHANKUR DUTTA DHALAI, TRIPURA

Kushankur supported in organising Poshan quiz for 250

students of Class VI to XII across 26 schools in Dhalai.

The event was attended by the District Magistrate &

Collector Dhalai, and officials from the Social Welfare

and Education department. The quiz focused on various

aspects of healthy eating and right nutrition. The winners

of this quiz were nominated as the ‘Child Ambassadors’

of POSHAN Abhiyaan to spread awareness about right

nutrition.

GEORGE LALNEIKUNG CHANDEL, MANIPUR

George joined as a Prerak in April 2018 in Chandel. A

management graduate, George has been instrumental

in the roll out of POSHAN Abhiyaan components in his

district. A few instances of his work till date include:

1. Orientation of frontline functionaries in POSHAN

Abhiyaan.

2. Roll out and supportive supervision of VHSND as a

convergence community level activity.

3. Convergent efforts for 100% weighing of all

beneficiaries during the Poshan Maah in collaboration

with AAAs, RBSK team, and community members.

4. Conducting Poshan Melas and Poshan Rallies across

the district with ~750 participants.

POSHAN Abhiyaan activities in RajasthanTata Trusts has been supporting the refurbishment of

100 Anganwadi centres (AWCs) into model AWCs across

Rajasthan. Out of these refurbished AWCs, 86 centres were

inaugurated during the Poshan Maah by the village leaders.

During September, a weekly Poshan quiz was organized

for AWWs in the Dainik Bhaskar daily newspaper, and

60 winners were identified and felicitated in an award

ceremony. The ceremony was attended by Prof. Vinod

Paul, Member NITI Aayog and Smt Anita Bhadel,

Hon’ble Minister, MWCD Rajasthan, Smt Roli Singh,

Principal Secretary, MWCD Rajasthan, along with the

key state officials of MWCD, Rajasthan. Other initiatives

undertaken by our Preraks in Rajasthan include:

1. Natasha Khurana supported in organising Free Anaemia

check up camps under the supervision of 244 sarpanchs.

2. Manisha Khanna, our Prerak in Chittorgarh, has been

instrumental in bringing together key functionaries from

line departments not just for Poshan Maah activities but

for the key Abhiyaan initiatives as well.

Social media and outreach The Preraks across all districts have been actively

involved in social media communication of activities

carried out by their districts. Further, some of our

Preraks leveraged community radio, Akashwani, and

other platforms with greater rural penetration to spread

the message on nutrition, health, and sanitation. These

Preraks include:

1. Juhi Kumari from Garhwa, Jharkhand organised two

sessions on Swasthya

Charcha in collabo-

ration with the All

India Radio. The first

session focused on

talks with the district

officials on POSHAN

Abhiyaan and PM-

MVY. Juhi identified

two AWWs for the

2nd session. They had written and performed folk songs

on nutrition and health messages. These AWWs were re-

quested to perform the folk songs which were aired on

radio.

2. About 50 Preraks in UP, under the guidance of our State

Lead Ravi Shankar Giri, had taken up the responsibility

of periodically updating the social media page of their

districts on Poshan Maah activities. The efforts paid off

when UP was awarded the best performing state under

the social media and outreach category.

Activities during the International Breastfeeding Awareness WeekThe first week of August is observed as the Breastfeeding

Awareness Week across the world. Our Preraks, freshly

deployed in their districts, have shown keen interest in

conducting large scale BCC campaigns to spread the

message of early initiation and exclusive breastfeeding of

children. These include:

1. Rajiv Suman from Muzaffarpur, Bihar spearheaded the

oath taking and signature campaign for early initiation

and exclusive breastfeeding. The activity reached over

11,000 women in their reproductive age who took the oath

to exclusively breastfeed their new born for six months.

2. Sumit Bharti, our Prerak in Baran, Rajasthan has been

instrumental in designing activities for the National

Breastfeeding Awareness week in August. The activities

reached over 98,000 beneficiaries during week.

3. Manisha Khanna from Chittorgarh undertook

an extensive breastfeeding awareness campaign in

the district reaching over 2,00,000 beneficiaries over

the week.

22 KEY HIGHLIGHTS

Key highlights of the program thus farAlthough, the Preraks have been on the field for a

short span, there have been significant impetus on

system strengthening, infrastructure improvement, and

in the roll out of POSHAN Abhiyaan components. We

are delighted to showcase the following milestones of

our Preraks:

1. SYSTEM STRENGTHENINGA. Mayank Joshi from Buxar, Bihar, supported the

frontline functionaries to streamline and upload data on

ICDS CAS. This ensured budgetary allocation alignment

with the number of beneficiaries.

B. Hassan Pandher in Faridkot, Punjab, was instrumental

in strengthening the supply chain for SNP in his district.

C. Amit Kumar from Lohardaga, Jharkhand has been

actively involved in Project Alanka, wherein all officers

from Health and ICDS department would be assigned as

guardians of undernourished children in their district.

Every officer is expected to meet the families, counsel

them, and follow up on the child’s health regularly.

2. INFRASTRUCTURE IMPROVEMENTA. Kartheek has been instrumental in the ISO certification

of model Anganwadi centres in the Chittoor district of

Andhra Pradesh. It helped in standardising and creating

a professional outlook of Anganwadis, thereby, increasing

registration and attendance of children. This innovation

was well appreciated by the district administration. The

district plans to get ~5 Anganwadis across all blocks to be

converted into model centers. Chittoor will be the first

district in Andhra Pradesh to issue ISO certificates to

Anganwadi centres.

B. Mayank Joshi from Buxar has worked towards

improving NRC infrastructure. This was followed by

mass awareness campaign on the services available at

the NRCs. The intensive endeavour has seen an increase

in bed occupancy from 35% to over 95% in the past three

months.

3. ROLL OUT OF POSHAN ABHIYAAN COMPONENTSA. Preraks in UP have been extending their support in

the roll out of CAS through various activities including

core 12-digit coding of all AWCs in the state, and being

part of the master trainers to train field functionaries in

the use of the application.

B. Our Prerak from Rehasi, J&K, Ravish Singh Rana,

observed that VHSNDs were not regularly observed in

the district. With support from his district office, he

brought together the key stakeholders at the district and

block level and oriented them on the need for VHSND

and the supervision formats to ensure action across all

villages. Through Ravish’s efforts, monthly convergent

VHSNDs now happen across the district .

C. Sowbhagya Pentacota, our Prerak from Vizianagaram,

Andhra Pradesh has been instrumental in ensuring

completion of all ILA module training in the district. She

has also worked extensively in strengthening community-

level engagement to counsel families with SAM children

to avail facility-based care at the NRCs. She has also been

instrumental in streamlining VHSND. As of September,

90% of all villages in the district were observing VHSND

every month.

D. All our Preraks are involved in bringing together key

stakeholders for the convergent committees and drafting

Convergent Action Plans at the block and district level.

Further, the Preraks are geared up towards realising the

vision of nutrition becoming a people’s movement.

In summary, the Swasth Bharat Preraks, as a district

level resource for POSHAN Abhiyaan have shown

significant impact in moving the agenda forward. In the

past few four months, the 211 districts have witnessed

a 68% increase in community-based events and 16%

increase in VHSNDs.

The Way ForwardThe program is envisaged as a nation-building activity

wherein young professionals would support the district

administration towards improving its nutritional

outcomes for children, women, and adolescent girls. It

was envisioned that the program would be an enabler for

a lot of these youngsters from urban areas and provide

them an opportunity to make a meaningful impact. The

Preraks have shown great enthusiasm, integrity, and

commitment to the cause, and are cognizant of their

responsibilities.

We are truly humbled and overwhelmed by the warm

response that we have received from the Centre, State,

and District officials, and the frontline functionaries.

With such a wonderful start, we are hopeful that the

Swasth Bharat Preraks would significantly contribute to

achieve the overall goals of the Abhiyaan.

TATA TRUSTS

MINISTRY OF WOMEN AND CHILD DEVELOPMENTGOVERNMENT OF INDIA

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REPORT ON POSHAN - icds-wcd.nic.in · Common Application Software Capacity Building (Incremental Learning Approach) Incentives ... Adolescent Girls, SHG women, and Pregnant Women