Optimal nutrition is essential for a child’s growth and development in the first two years of life. Exclusive breastfeeding for six months and continued breastfeeding with age-appropriate, nutritionally adequate complementary feed is essential for a child after six months up to two years of age. This helps prevent stunting and prevents the child from entering the undernutrition cycle. Once the child is six months of age, the body and brain require more nutrients which breastmilk alone cannot provide. Hence, appropriate complementary feeding becomes essential. Appropriate nutrition ensures a robust immune system and the realisation of full potential for the child. Healthier children will surely be more productive and will be able to create opportunities for themselves, their families and communities to eventually break the cycle of poverty and hunger.

Sara (name changed), residing in Sabarkantha district of Gujarat, is a mother of three, preoccupied with household chores. Her father, a brick labourer, is frequently out for work. Being an informed mother, Sara did not compromise on introducing healthy food groups as part of Zarine’s (name changed) complementary feed. Earlier, Sara used to let Zarine have market-available biscuits and other snack packets, and chips, among others, to save time when she was too busy with household chores or managing the other two children.

When an Anganwadi worker from Project Vruddhi met Sara, she was advised on better food practices for Zarine. “I was aware that market-available packet food is not good for Zarine, but it was sometimes very convenient. Managing a home with three children can be difficult, especially when the other two children demand packaged foods such as cold drinks, chips, and sweets. So, I used to let Zarine eat just to manage and get some time to complete my pending chores.” said Sara. “But when I was made aware that this casual approach might cost me Zarine’s changed behaviour towards homecooked food, and may result in her weight loss, or restrict her optimal growth, I became very conscious about what I was feeding my youngest child” she added.

Zarine is now breastfed along with homemade semi-solids such as porridge, mashed vegetables, and fruits, among others, with no packaged food at all. This counselling on the mother’s feeding practice was critical in ensuring that the child does not lose adequate nutrition, fall ill, or become malnourished. This positive impact was enabled by ongoing engagement with families and their trust in Front-Line Workers and Project Vruddhi’s Field Coordinators (FCs) to guide them, and their children towards better healthy food practices

Sunil Patil works as a community mobilizer for Action Against Hunger India, and during his field visit to Chinchutara, he came across a newborn baby’s lactating mother, Sudheshna Vargi (name changed), who was visiting from another village. Sunil later visited Sudeshna’s home as part of his work and spoke with her about a variety of topics during his initial visit. During the conversation, Sunil learned that Sudeshna had given birth to a baby boy in a rural hospital in Mokhada, and that the baby weighed only 1.8 kg. Sudeshna expressed her concern about her baby’s low weight. It was established that the baby’s health was in poor condition, and there was a risk of further deterioration if his condition remained unaddressed.

Sunil and the Anganwadi workers attempted to persuade the baby’s mother and grandmother to take the newborn to the district hospital for a health checkup, where the SDH had a Special Newborn Care Unit (SNCU). But the family refused to take the child to Jawhar. Sunil then advised the caregivers to go to Morhanda Primary Health Centre (PHC) at the very least. This was when Sunil discovered that Sudeshna was to visit the Morhanda PHC a day before his visit. However, she had to wait for a vehicle for more than three hours and ultimately missed the appointment. However, caregivers were willing to carry the newborn to Morhanda PHC, the following day. On returning from the field, Sunil inquired about an ambulance. However, none was available. This was when the Action Against Hunger field officer arranged for a private vehicle, enabling the caregivers to take the newborn to the hospital.

The medical officer examined the newborn and advised the caregivers to take the child to Jawhar SDH. The following day, an ambulance was arranged from Aase PHC by the field supervisor, field officer, and ASHA worker. The newborn was admitted to SNCU in Jawhar sub-district hospital. The baby’s father was also present at the time of admission. The child was admitted to Jawhar SDH’s SNCU for three days. Every day, Sunil diligently followed up with the caregivers. On the day of discharge, the field officer urged Jawhar SDH staff to provide an ambulance so that the caregivers could safely travel to their home in Chinchutara – more than 40 km away. For three months, AAH provided food baskets to caregivers. Sunil also visited their home and counselled them on breastfeeding, hygiene, and other newborn care practices.

Later on, Sunil recorded the baby’s weight and it improved to reach 6.0 kg. The case story demonstrates the impact of strong convergence and local coordination between our organisation and the Government functionaries. It was a successful attempt that eventually saved a newborn’s life and restored caregiver’s confidence in improving the health and nutrition of a newborn.

Sheila (name changed) gave birth to a baby boy at Sadrabadi Primary Health Centre (PHC). Both the mother and the child were healthy. Sheila was discharged from the hospital just three days after delivery. However, the child’s weight at birth was 2 kgs only. A fortnight after the discharge, Sheila’s breast milk abruptly stopped flowing. This is when Sheila sought treatment at Sadrabadi PHC, from where she was referred to the Dharni rural hospital. However, Sheila received no benefit from the treatment. Because of the lack of mother’s milk, the child’s weight began to fall, and his health began to deteriorate. During a field visit, one of the Anganwadi workers briefed the Community Mobiliser on Sheila’s condition.

Our CM visited Sheila and, after a critical analysis of her health, discovered a lump in her breast. This eventually helped understand the primary reason why Sheila’s breast wasn’t producing milk. In the meantime, she started feeding her baby bottled milk, which could have been more dangerous for the baby. The Community Mobiliser and Anganwadi workers counselled Sheila about the importance of exclusive breastfeeding until the baby was six months old. Sheila was also counselled on the potential harm to the baby if he was not breastfed.

Sheila’s mother-in-law was advised to massage Sheila’s back once a day. Our CM explained to Sheila and her mother-in-law that massaging the back causes milk to be produced in the breast. Sheila’s mother-in-law began to follow the process diligently. After five to six days Sheila was able to produce breast milk and gradually the lump disappears. Sheila was then able to breastfeed her child. The child’s health and weight eventually improved. The family was extremely happy with Action Against Hunger’s intervention and rigorous counselling that saved the child’s life.

Kirtiratna Kharat is working with Action Against Hunger as a Community Mobiliser (CM). During one of her home visits, she found Usmana Shaikh (name changed), who was 4-months pregnant that time. Her LMP was 28.3.21 and EDD was 4.12.21, but she was not doing her pregnancy registration at any private or municipal hospital or in a nearby health post. When Kirtiratna inquired about this, she said she was not going there out of fear. The CM counselled her that there was no need to be afraid of the corona virus, and one should follow safety measurements like wearing a mask, face shield, washing hands in regular intervals, while visiting hospitals or health posts. In addition, one can wear hand gloves; and if all the all-safety measurements are followed, then no need to be afraid.

The CM advised her to register her name in any hospital as soon as possible. She also talked about ante-natal care, rest and nutrition. In the interaction, the CM felt that she is concerned with the subject of nutrition. The lady gradually opened to the CM and told that she was living in her husband’s home, and she is not comfortable there. She is not eating as per her habits and feels shy to eat. Then the CM asked her about her husband, father-in-law and mother-in-law’s behaviour. She said there was no problem from their side. She felt shy because this house was not hers. She felt that at her own home, there is freedom.

The CM was shocked when she heard her story but quickly understood that this was her personal thought, and there was no problem with the in-laws. She started to counsel her again by saying that if she does not eat properly, then her child’s health would be affected. The child may be malnourished and the baby’s weight may be decreased. Growth may be hampered if the child will not get proper nutrition from the mother. She needs to eat the balanced-diet in lunch and dinner, and take medicines like iron, folic acid and calcium tablets and other medicines and supplements as per doctor’s prescription. Finally, she was convinced; and she also agreed to eat properly, so that her child would be healthy.

She promised the CM that she would go to her mother’s home very soon and follow whatever has been suggested to her. Now she has registered her name in the hospital, received a second T.T. injection; furthermore, she is also eating enough.

Rupa Seth (name changed), 22, resides in Nehru Nagar, Andheri, Mumbai. Her husband is the sole breadwinner in the family and works for a private company. Roshni Shinde, our Community Mobiliser (CM), identified and enrolled Rupa as a pregnant woman when she was expecting her third child. Roshni did not know about Rupa’s third pregnancy initially. During one of the visits to Rupa’s home, Roshni found out that Rupa had lost both her new borns within a week of birth.

Back then, the doctors could not identify the reason behind the mishap. On knowing about this, Roshni advised Rupa to get admitted to a hospital for proper care and treatment. This was when Rupa informed the CM about her plans to deliver her third child in her hometown. Roshni tried counselling Rupa and asked her to register at Cooper Hospital in Mumbai instead, keeping her health in mind. On her second follow-up visit, when our CM prodded Rupa further, she registered herself at the Cooper hospital for all Ante-Natal Care (ANC) services.

Doctors even recommended a C-Section delivery during Rupa’s third trimester. However, she declined due to fear. But our CM didn’t give up and counselled Rupa once more, whereafter she agreed to a C-Section. Eventually, Rupa gave birth to a healthy baby. During the doctors’ investigation, it was found that her previous borns had suffered from the nuchal cord (An umbilical cord that is wrapped around a baby’s neck in utero), which resulted in their deaths. Due to our Community Mobiliser’s hard work and perseverance, Rupa overcame her fears. She could identify the cause behind the deaths of her newborns and eventually received the needed help to deliver a healthy baby.

Prema (name changed), a married woman, lives in Keshvi, Dhudhiya village, with her five children and husband. The remote location and lack of transportation in her region have been a major reason behind the underdevelopment of the village.

Prema’s husband works as a truck driver and frequently spends time away from home. He spends most of his earnings on alcohol, leaving the family’s needs unmet. Prema’s four children belong to the same age group. While Prema struggled to find enough nutritious food while pregnant with her fifth child, and her husband’s alcohol consumption put a strain on their finances. After learning about Prema’s pregnancy, an Anganwadi and AAH Community Mobiliser (CM) discovered that the child she was pregnant with was very weak and was anemic. This stressed Prema for obvious reasons, as it could have led to her losing the child.

Under such scenario, when Prema needed a good amount of care, there was no one else at home to look after her or even take her to the health centre regularly for check-ups. This is when Action Against Hunger team devised a plan to take care of Prema. They took her to the health facility and also visited her home regularly. Prema’s neighbours assisted in providing nutritious food comprising of pulses, vegetables, fruits, and milk. In the seventh month of her pregnancy, Prema suffered stomach aches. Following an investigation, it was determined that the child’s life was in danger, and Prema needed complete bed rest. For two months, Anganwadi health workers and Prema’s neighbours worked together to look after her. Eventually, things went well and Prema was blessed with a healthy newborn.

Suwans Panchayat is the largest panchayat in Kishanganj block of Baran district in Rajasthan. It covers around 14 villages and is situated 36 km from the sub-district headquarters in Kishanganj, and 50 km from the district headquarters, in Baran. Raji Bai Sehriya is the lady Sarpanch of the Panchayat and is truly a commendable leader. She is a strong individual and motivated to work with the community. Raji Bai firmly believes that her ambition and dedication shall bring about a transformation in her Panchayat.

For Raji Bai Sehriya, it was not an easy task to embark upon this transformational journey. First, she lacked education and actual experience of working with rural local governance. Despite being aware of the Anganwadi centres in her village and surrounding areas, Raji Bai was initially uncomfortable communicating with Government officials as the head of her Gram Panchayat. This was because she had never visited these centres. However, she gradually became aware of the problems confronting her village, such as lack of potable water and non-functional hand pumps, poor communication and road connectivity, malnutrition, lack of awareness on health and nutrition, sanitation and hygiene, and infrastructure and proper housing.

Further, the Covid-19 pandemic struck during her tenure, making things more difficult for her. However, she received assistance and support from one of her ward leaders during the lockdown. She connected with the representatives at Action Against Hunger through phone calls. Even though she initially relied on the Ward Panch for information, she gradually learned to communicate independently. As her Ward Panch and Action Against Hunger team continued to motivate her, she became more interested in Panchayat affairs.

Despite all the challenges stemming from her illiteracy and lack of knowledge, Raji Bai remained motivated to adapt and learn constantly. She proactively set up meetings with other Panchayat members and Panchayat Samiti officials and was always ready to take a stand. Her ability to take the initiative and learn by observing her surroundings enabled her to develop a well-thought-out strategy for her Panchayat. Raji Bai’s strategy covered all the critical areas like water, sanitation, electrification, and construction of roads and streets in the village.

She became more involved in organising events to spread awareness, such as celebrating World Breastfeeding Week, with the help of Action Against Hunger. Her eagerness to learn more about nutrition led her to participate in commemorating various other days and events. After the pandemic, she visited MCHND with our field team to ensure that Covid-19 protocols were being followed. Raji Bai was keen to establish POSHAN Vatikas and plant trees, so she initiated a planting drive in her Panchayat’s villages. During Nutrition Month, hosted in September, she organised POSHAN Panchayat and raised awareness about ‘POSHAN Thali’, ‘The first 1,000 days of a child’s life’, ‘Child malnutrition’, and ‘Importance of MTC’ in the treatment of Severely Acutely Malnourished (SAM) children with health complications. After receiving information from the Action Against Hunger representative, Raji Bai and the Anganwadi workers visited homes of pregnant women and began to counsel them on the importance of a healthy diet during pregnancy.

At present, Raji Bai is all set to resolve the concern of electricity shortage. She has been meeting and visiting electricity officials and her local area MLAs, because the solution to this problem was beyond the scope of Sarpanch or other Panchayat officials. Apart from these efforts, Raji Bai believes that women’s reservation in the panchayat system can empower village women to take a stand for themselves. She is aware that even though it will take time for women to achieve the needed confidence, the Panchayat encourages them to speak up about their concerns. Raji Bai has received recognition from her community members, officials, and development organisations for her relentless efforts towards bringing about a positive change in her Panchayat.