Anshula’s Journey: Navigating Health Challenges and Empowering Families

In August 2023, at Anganwadi in Govandi, Maharashtra, 11-month-old Anshula Shaikh (name changed) was assessed and found to have low weight compared to her height by a Community Mobilizer (CM) from Action Against Hunger. Anshula weighed 7 kg, measured 65.5 cm in height, had a MUAC of 120 mm, and a WHZ score of -2. The CM informed Anshula’s mother that a Moderate Acute Malnutrition (MAM) card would be created for her daughter from Action Against Hunger, and her weight would be monitored every 15 days by the CM. Anshula’s mother mentioned that the child had experienced vomiting and a fever in the past 15 days but was currently fine. The CM advised her to provide boiled water, avoid open food, and feed Anshula freshly cooked meals.

However, after another 15 days, Anshula’s weight had decreased. Upon inquiry, the CM discovered that Anshula was only breastfed and not given complementary food. The CM educated the mother on introducing complementary food, emphasizing diet diversity, quantity, and frequency.

Despite a slight improvement in weight after 15 days, Anshula’s weight was still 200 grams less than her admission weight. The CM sought the assistance of a counselor who found out that the mother struggled financially because the father had dual marriages and was reluctant to spend on Anshula’s health. The CM and counselor jointly ensured that Anshula’s mother received Take Home Ration (THR) from the Anganwadi Center (AWC) and provided guidance on using THR ingredients like moong dal, toor dal, rice, and semolina to prepare nutritious meals.

With consistent follow-ups and home visits, Anshula’s health improved, leading to her discharge in March 2024. Her seven-month journey included 13 Out Patient Treatment (OTP) follow-ups and 7 home visits, resulting in Anshula weighing 7.6 kg, measuring 68.3 cm in height, with a MUAC of 126 mm, and a WHZ score of -1. The goal extended beyond Anshula’s recovery to empowering her mother for the family’s future well-being.

 

Empowering Communities: Poshan Chaupals Driving Nutrition Change in Sabarkantha, Gujarat

The Social and Behavior Change (SBC) intervention by Project Vruddhi, an initiative by Action Against Hunger, is a key pillar in strengthening the Nutrition Infrastructure in Sabarkantha, Gujarat. Through this intervention, Project Vruddhi aims to technically equip the staff of the Health and Women & Child Development Department (WCD) within the Government of Gujarat towards improved service delivery. Beyond the system-level intervention, for both direct and indirect beneficiaries at the community level, Project Vruddhi focuses on enhancing service utilization through SBC.

Solely focusing on pregnant and lactating mothers for SBC through Mother’s Meetings, organized jointly by the Health and ICDS – WCD Department staff along with the Project Vruddhi team, wasn’t enough. To build a robust support system, the inclusion of key influencers in a family – husbands, mothers-in-law, fathers-in-law, and other family members, as well as key community-level influencers to reinforce the messages for improved Maternal, Infant, and Young Child Nutrition (MIYCN), was necessary. Hence, Project Vruddhi’s team, in consultation with the Chief District Health Officer (CDHO), Sabarkantha, initiated Poshan Chaupals(Nutrition Meets).

To ensure effectiveness and engagement, the Project Vruddhi team strategically designed two strategies for the Poshan Chaupal:

  1. Involvement of community-level influencers to sensitize the communities
  2. Participation of husbands and other family members in such Chaupals

Poshan Chaupals were conceived to holistically address and improve maternal and child health and nutrition. To enhance the impact of the Chaupal, Project Vruddhi’s team takes proactive steps for community mobilization to ensure active participation of family members of pregnant women and children under 2 years of age.

The community influencers, often the Sarpanch, Panchayat member, social worker, teacher, or community leader, communicate about the prevention of maternal anemia, appropriate breastfeeding, and complementary feeding practices. Family members actively participate and recognize their roles in supporting the well-being of both mother and child, thereby creating an enabling environment that fosters better nutrition outcomes for them.

Poshan Chaupals have been organized on a monthly basis in each of the eight blocks of Sabarkantha district since September 2023.