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Dear friends,
Greetings from the Swasth Bharat Prerak (SBP) program.
In early 2018, we set-up the SBP program to support the government in the effective implementation of the path-breaking POSHAN (Prime Minister’s Overarching Scheme for Holistic Nutrition) Abhiyaan or the National Nutrition Mission. A partnership between the Ministry of Woman & Child Development (MoWCD) and Tata Trusts, the SBP program is a unique fellowship, which deputes young professionals as a district-level managerial and administrative resource to the state machinery.
At its core, the program is guided by the goal of Tata Trusts to contribute meaningfully to better nutrition outcomes for children and pregnant women in the country as the Chairman of Tata Trusts, Mr Ratan Tata put is so
eloquently: “My most visible goal is to do something in nutrition to children in India and pregnant mothers. Because that would change the mental and physical health of our population in years to come.”
The core mandate of the SBP program is fully aligned with POSHAN
Abhiyaan. It has supported the effective implementation of the five key pillars - convergence, capacity-building, communication and behaviour change, innovation and technology.
In over two and half years, the program has contributed substantially to
achieving the goals of the POSHAN Abhiyaan. Committed and dedicated, the Swasth Bharat Preraks have taken forward the agenda of kuposhan- mukt India to the grassroots level. At any given point, around 300 Preraks, one in each district, are fully immersed in deepening the impact of POSHAN Abhiyaan. Innovative in their approach and equipped with strong command over technology, their enthusiasm, contagious energy and ‘can do’ spirit has truly made a difference.
I have great pleasure in sharing a few examples of some of the replicable and scalable initiatives implemented by Preraks. I do hope that you will find these initiatives inspiring and of value.
Thank you for your continued support. We look forward to your feedback and suggestions.
Warm regards, Dr Rajan Sankar Senior Advisor, TINI
CONVERGENCE
Superfood power: Jhangora laddoo in Take Home Ration
Vishwa Mohini, Pauri Garhwal, Uttarakhand
In the Himalayan region of Pauri Garhwal in Uttarakhand, grows a lesser-known
superfood - jhangora or
barnyard millet. High in protein, calcium, iron, minerals and vitamin B complex, jhangora is also gluten-free. The district has a high prevalence of anaemia among women and adolescent girls, and women are not too keen on take home ration (THR).
The solution?
“Innovation of jhangora laddoo is one of the best practices in the
district. It is rich in iron, proteins and minerals. It was put into action by Swasth Bharat Prerak, Vishwa Mohini. She worked on its taste and quality. The district will provide these laddoos across anganwadi centres to mitigate malnutrition and we look forward to better health outcomes of people.” - Dhiraj Singh Garbyal, District Magistrate, Pauri Garhwal
A tasty and healthy ‘jhangora laddoo’.
Swasth Bharat Prerak Vishwa Mohini recognised the value that this locally grown millet could bring to the lives of women, and children and developed a recipe - adding jaggery, coconut powder, cardamom, ghee and fennel seeds to jhangora. Since jhangora is widely grown in the region, Vishwa roped in self-help groups (SHGs) to set-up manufacturing units, thus providing a source of livelihood to women. With the full support from the district team, she was able to train SHGs in the Pauri cluster to make these delicious laddoos.
The Hon’ble Chief Minister of Uttarakhand, Mr Trivendra Singh Rawat launched these laddoos in November 2019.
CAPACITY-BUILDING
Correcting data discrepancy by training frontline workers
Rutu Tekwani, Narmada, Gujarat
Inaccurate data on malnutrition can lead to beneficiaries being excluded from schemes that benefit them. Rutu Tekwani, from Narmada district of Gujarat, noticed a discrepancy between the data on underweight children recorded in the monthly progress reports (MPR) of the district and the National Family Health Survey 4 (NFHS-4).
The Women & Child Development Commissioner in Gujarat entrusted her with conducting a verification exercise of Baal Tula reports (or growth monitoring registers) of select anganwadi centres. The results revealed that in the sample 10 anganwadis, the proportion of underweight children was approximately 50%. It was substantially higher than the figure of 15.24%, as reflected in the MPR.
To address this data discrepancy, along with support from the Program Officer, Mr Ramesh Bhabhor, Rutu provided intensive growth monitoring training to the anganwadi workers. The team also demonstrated how to correctly record weight and the use of digital weighing machines.
As a result, after only four months, the percentage of underweight children reported increased from 15.24% to 40%, thereby substantially bridging the gap between MPR and NFHS-4 data. This ensured that all malnourished children continue to receive the due services.
This endeavour has been appreciated at various levels. Rutu remains
grateful for the faith the district officers reposed in her. “It has enabled me to make this vital contribution towards accurately mapping data,” she says.
COMMUNICATION AND BEHAVIOUR CHANGE
Snakes and ladders – engaging with adolescent girls on health and nutrition
Nida Fatima, Lakhimpur Kheri district, Uttar Pradesh
Saanp seedhi ka khel - the game of snakes and ladders - evokes fond images and memories of childhood. Nida used the game of snakes and ladders as a tool to engage with young girls on the themes of health, nutrition, and appropriate hygiene practices.
“I have seen an increase in the number of girls participating in Kishori Diwas; they are eager to be a part of the game,” shares Nida.
Reflecting on the success of this initiative, an anganwadi worker said that conversations through the game are much more engaging. “The game also creates a platform to discuss difficult topics with greater ease.”
Group games are an ideal platform to bring young people together. They are interactive and subtly help break the ice to get conversations going.
No one knows it better than Nida, who has her formal education and training in development communications. With the objective of increasing adolescent participation in the efforts to improve health and nutrition, Nida looked for group activities, which are a part of our socio-cultural traditions. After several rounds of discussions with the Child Development Project Officers (CDPOs), the age-old game of snakes and ladders with questions on health, nutrition, and personal hygiene was developed. How does the game work?
A traditional snakes and ladders mat with questions on health, nutrition, and personal hygiene at every snake-head or ladder is mapped. A right answer ensures safe passage while a wrong response at the snake-head pulls you down in the game. The questions are designed to initiate a two-way
conversation between the anganwadi worker/teacher and the participants.
“The best part of this game is that it can be tailor-made for any participant group, since people of all ages can relate to the game,” says Nida.
Preraks in Uttar Pradesh also leveraged the folklore of Ram Leela to disseminate messages about good nutrition, using humour and
designing characters such as Suposhit Ram, Iron Laxman and Bharat Vitamin C, who fight against Kuposhan ka Ravan and Anaemia
Srupnakha. The first performance of Suposhan ki Leela was attended by more than 500 people. It received enthusiastic response prompting the district administration to request for video recording of the play so that it could be used as an information, education and communication (IEC) aid. The full video is available here
INNOVATION
Amla candies: cost-effective strategy for anaemia control
Ronica Devarshi, Hailakandi, Assam
Learning from the experiences of fellow Preraks on cost-effective strategies to combat iron deficiency, Ronica Devarshi, the Prerak in Hailakandi, Assam devised an intervention to encourage women to consume iron-rich foods during pregnancy. “This initiative is an add-on to the Iron and Folic Acid (IFA) supplementation program and not a replacement of the government
strategy,” says Ronica. She observed that despite receiving IFA tablets, women were not consuming them due to the taste or not knowing how to consume them. Poshan Maah 2019 provided Ronica the platform to make a tangible difference to this situation.
She met the Deputy Commissioner and presented an innovative initiative - amla candies to fight anaemia. She wanted to train the women in the district to make amla gud candy, a homemade candy made from gooseberries and jaggery. Gooseberry, commonly known as amla is a rich source of iron and vitamin C, while gud (jaggery) is an important source of iron, potassium and other minerals. These are both locally available, cost-effective and
sustainable options for iron supplementation.
Post the go-ahead from the Deputy Commissioner, Ronica organized a district-level training on preparation of amla candy. Altogether 24 anganwadi supervisors participated in the program. This was followed by a three-day program in all the anganwadis across the district. On the first day, lady supervisors trained the anganwadi workers and other interested women to prepare amla candy. Days two and three were devoted to sensitising them on the causes and effects of anaemia and the distribution of amla candies.
The Deputy Commissioner also visited one of the anganwadis in Hailakandi to motivate the participants.
The campaign distributed amla candies to almost 7000 women, adolescent girls and children across Hailakandi district. “The response has been most encouraging and I am grateful to the Deputy Commissioner for making this possible,” says a happy Ronica. Anganwadi supervisors shared that the beneficiaries like the taste of the candies, and the workers are motivated to make this innovation a part of the diet provided to the beneficiaries. To prepare amla candies at a commercial scale, 30 SHG members were trained.
TECHNOLOGY
ICDS-CAS for data driven monitoring
Srishti Bhattacharya, Burhanpur, Madhya Pradesh
Srishti from district Burhanpur, Madhya Pradesh has played a crucial role in the effective use of Integrated Child Development Services-Common
Application Software (ICDS-CAS) and statistical improvement under the guidance of the District Program Officer (DPO) and the Early Childhood Care and Education (ECCE) coordinators. Burhanpur consistently ranked poorly when it came to ICDS-CAS rollout and service delivery reporting. After detailed analysis, Shristi identified lack of technically sound human resources as the main reason.
“ICDS-CAS is an effective tool for real time monitoring of anganwadis.
The performance of Burhanpur district was very poor. There were no DC, Project Assistant, Block Coordinator or other staff posted to look after the program. With support of the team, Srishti has done a
remarkable job. She monitored the program very well and now the district’s ranking for open anganwadi centres has moved from bottom to the top three performing districts in the state.” - Mr Suman Kumar Pillai, DPO, WCD Burhanpur
Working closely with district officials, she started resolving queries relating to operational aspects of the software, as well as designing online IEC
materials for frontline workers. She also developed a new model of
monitoring and evaluation, which directly involved the DPO and the CDPO.
This ensured that ICDS-CAS was an important agenda in departmental meetings involving field functionaries.
The results have been encouraging. In less than one year of the intervention, there is a distinct improvement in the number of active anganwadi centres in the district. The overall rank of Burhanpur in the state’s monthly report of ICDS-CAS activities has also shown consistent improvement. The ICDS- CAS reach has been impressive – above 90% for December 2019- February 2020.
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