A Journey of Hope and Resilience

In Malpur village of Vadali block in Sabarkantha, a Community Based Event (CBE) called “Mamta Divas” was taking place, dedicated to maternal and child health. Alongside Community Health Officers (CHO) and Frontline Workers (FLWs), the team from Project Vruddhi — an initiative of Action Against Hunger — participated in supportive supervision during this event.

Fanika Panchal (name changed), a pregnant woman, attended the event. During the counseling session, the team identified that Fanika, who was three months pregnant, weighed only 32 kg. Alarmed by her low weight, the Accredited Social Health Activist (ASHA) explained the importance of a balanced diet and proper medication to her. They planned a joint home visit with the Project Vruddhi team to provide further support and guidance.

When the team visited Fanika at her home, she was hesitant. “I eat enough; I don’t want to increase my weight,” she said defensively. She mentioned eating home-cooked food, including vegetables, but seemed unconvinced about the necessity of weight gain. Despite her reluctance, the team left, hoping to build trust over time. During the next visit, it was discovered that she had been taking calcium and iron tablets together, unaware that this could hinder their absorption. The team advised her to take them at different times, with a gap of four hours, and to include Vitamin C-rich foods to enhance absorption.

During a subsequent home visit, Fanika opened up more. She shared a heartbreaking story: a year after her marriage, she had lost a child. At that time, her weight had not significantly increased, and she feared a similar outcome in this pregnancy. Her fear consumed her, casting a shadow over her hopes. The team comforted her and motivated her to follow a balanced diet and medication regimen. Initially, Fanika’s hemoglobin (HB) level was low at 8.5 g/dl in her first trimester. However, with the support and guidance she received, she gained a glimmer of hope that her HB could improve. This newfound confidence fueled her commitment to follow health advice diligently.

To provide additional support, Fanika was invited to participate in breastfeeding awareness week by Project Vruddhi in August 2022. The FLWs and Project Vruddhi team also invited her to an Anganwadi Center (AWC) to celebrate her baby shower during ‘Suposhan Divas’, marking the start of her seventh month of pregnancy.

When the time came for her delivery, Fanika’s hemoglobin had improved to 11 g/dl, and her weight had increased to 43.2 kg. However, when she delivered a girl child on 18/12/2022, the baby weighed 1.9 kg, categorized as Low Birth Weight (LBW) and a Severely Acuta Malnourished(SAM) child. Despite these challenges, with improved hemoglobin levels, increased weight, and continuous support, Fanika developed trust in the Project Vruddhi team and FLWs.

Post-delivery, she took the initiative to call the ASHA for help with her newborn- Chandni (name changed). The ASHA worker informed Project Vruddhi’s team. Both the ASHA worker and Anganwadi Worker (AWW), along with the Female Health Worker (FHW) in their catchment, have received technical support from Project Vruddhi and participated in trainings on maternal anemia, breastfeeding, and complementary feeding under the first 1000 days of life model.

The FLWs and Project Vruddhi team sensitized Fanika on Exclusive Breastfeeding (EBF), providing demonstrations on positioning and latching, as she expressed concerns about the baby’s ability to suckle well.

The team also explained and motivated Fanika and her family members on Kangaroo Mother Care (KMC). They provided continuous support to her family. When the child was six months old, they also helped Fanika and her family initiate Complementary Feeding (CF). The family was guided on diet diversity, quantity, and consistency. The Anganwadi Worker (AWW) also gave Fanika Baalshakti – THR (Take Home Ration) and shared different recipes that could be made from it. Her family was invited to attend a Poshan Chaupal, a nutrition meeting for the community involving husbands and other family caretakers, in September 2023. These meetings, along with several home visits, were designed to educate and empower families about maternal and child health.

 

L to R: Asha Nayi, Accredited Social Health Activist (ASHA), Bhumika Limbachiya, Block Coordinator, Project VruddhiMegha Parmar, Auxiliary Nurse and Midwife (ANM), Fanika and her mother-in-law and  Bindu Parmar, Anganwadi Worker(AWW) counseling Fanika on complementary feeding at her home.
Fanika feeding Chandni at home. A glimpse of her meal.

Through persistent efforts and dedicated care, Fanika’s daughter Chandni, who once a SAM child, began to thrive. When Chandni was 4 months old, she weighed 4.8 kg, which means she progressed from SAM to Moderately Acute Malnourished (MAM) status. By the time she turned seven months old, she had progressed to being a healthy child, weighing 6.2 kg. Currently, Chandni is one and a half years old and weighs a healthy 9.600 kg. This transformation has brought immense relief and joy to Fanika and her family.

Reflecting on her journey, Fanika felt empowered and more knowledgeable about maternal and child health. She was determined to take even better care during her next pregnancy, armed with the confidence and experience she had gained.

Fanika’s story is a testament to the power of community support, proper counseling, and the unwavering dedication of health workers. It highlights the impact of initiatives like Project Vruddhi in transforming lives and fostering hope in the face of adversity.

Sanand, Gujarat

Project Trupti launched in Sanand, Gujarat is supported by Baxter Pharmaceutical India Pvt. Ltd. and implemented by Action Against Hunger India. The project adopts a comprehensive life cycle approach, seamlessly integrating health and integrated Child Development Services (ICDS) to provide holistic support to the community.

This project aims to significantly enhance the health and well-being of mothers and children up to 5 years old by providing timely referrals and treatment, ensuring every child receives the essential care for a healthy start in life. Improve Infant and young child breastfeeding practices in the community, and improve awareness of safe drinking water, and personnel hygiene through various approaches of social and behavioral change communication strategies.



Exclusive Breastfeeding: Ensuring Healthy Growth of a Child

On October 30, 2023, a dedicated team from Project Vruddhi, an initiative by Action Against Hunger, alongwith Frontline Workers (FLWs) conducted joint home visits of identified families in Dedhrota village of Himmatnagar in Sabarkantha.

L to R: Rupangi, Atit, Divya, Harsha Chamar an Accredited Social Health Activist (ASHA) worker, Kinjal Goswami, Field Coordinator and Amit Suthar, Block Coordinator of Project Vruddhi during joint home visit.

 

They visited the home of Rupangi (name changed) and her husband Atit (name changed), where they met their newborn daughter, Divya (name changed), who was just three days old. As they approached the house, they found Rupangi was bathing little Divya. The team observed that the baby was shivering, which prompted immediate concern from the team and FLWs. The Field Coordinator of Project Vruddhi realizing that the baby is going into hypothermia, quickly wrapped Divya in towels to warm her up. Then asked the mother gently the reason for bathing the baby in cold weather. Rupangi explained that they had just returned from the hospital, and wanted to clean the baby. Then the mother was taught Kangaroo Mother Care (KMC) and explained the importance that skin-to-skin contact was vital to keep Divya warm and help her thrive. Demonstrating the technique, they placed Divya on Rupangi’s chest and ensured she was comfortable. They then guided the family on Kangaroo Family Care (KFC) practices to be followed at home.

Divya weighed just 2.4 kg at birth. When Block Coordinator Amit Suthar asked Atit about their feeding practices, he revealed they had been giving Divya packaged milk as she struggled to breastfeed. Recognizing the need for proper guidance, the team and FLWs demonstrated correct positioning and latching techniques to help with breastfeeding. They emphasized the importance of Exclusive Breastfeeding (EBF), explaining that a mother’s milk contains all the nutrients essential for a child’s growth and development.

Over the next few months, the team continued to visit and support Rupangi. They provided further demonstrations on breastfeeding, ensuring that Rupangi was confident and comfortable. By the time Divya was six months old, they assisted in introducing complementary foods, ensuring her nutritional needs were met.

At eight months, Divya gained a healthy weight of 7 kg. The combined efforts of Project Vruddhi and the dedicated FLWs saved her from malnutrition and set her on a path to thriving health.

The success story of Divya in Dedhrota village stands as a testament to the power of joint and consistent efforts in community health initiatives. It brought immense relief and joy to Rupangi, Atit, and their family, showcasing the profound impact of targeted interventions and compassionate care.

State-level scale up: SBC package and Digital training on Breastfeeding techniques during WBW24




A Social and Behavior Change (SBC) package  produced by Action Against Hunger is scaled up at State-level by the Women and Child Development Department (WCD), Gujarat for breastfeeding awareness during World Breastfeeding Week 2024 (WBW2024). Another initiative of Action Against Hunger,  which is scaled up by WCD, Gujarat is a digital training on Maternal, Infant, and Young Child Nutrition (MIYCN), with a particular emphasis  on breastfeeding.

Project Vruddhi, an initiative by Action Against Hunger, produced 1-minute jingles and videos using an infotainment approach. These media pieces aim to educate about various aspects of the first 1,000 days model, specifically focusing on breastfeeding awareness, as part of the Social and Behavior Change (SBC) package. The package is titled “Jaagta Rehjo,” with a tagline, “ane bija ne pan jagadjo” translating which means: “stay aware and spread awareness among others.” The tagline is used several times hinting a call-to-action, to spread awareness. The videos, feature dialogues in regional language – Gujarati and incorporates singing, dancing, illustrations, and text to reinforce key messages, for better recall. The lead characters, dressed as ‘Ranglo’ and ‘Rangli’ are conceptualized from the popular Gujarati folk art form ‘Bhavai’. By blending traditional folk messaging with modern filmmaking techniques,  including regional dance forms like  ‘sanedo’ and ‘timli’, the approach ensures greater relatability and acceptance by government staff and local communities in Gujarat. These media pieces are catchy, concise, and entertaining.

The MIYCN training includes an introductory session and five pre-recorded sessions covering seven different breastfeeding topics which will be disseminated to all Frontline Workers (FLWs) across Gujarat via Satellite Communication (SATCOM) and the YouTube channels of the Women and Child Development Department, Gujarat. These pre-recorded sessions highlight key learnings from the 5-day MIYCN workshop conducted in Sabarkantha in May 2024, where 50 champions from the ICDS-WCD and Health Departments were trained. The workshop was led by Dr. Rupal Dalal, Director of Maternal and Child Health (SMDT), and her team. As a technical partner, Action Against Hunger is pleased that these training sessions will enhance awareness about effective breastfeeding positioning and latching techniques, contributing to optimal weight gain in newborn infant.

 

Check Action Against Hunger – India’s youtube page for the SBC videos and MIYCN training videos. 

 


 

 

 

 

 

 

 

 

 


 

Enhancing MIYCN: A 5-Day Intensive Breastfeeding Workshop in Himmatnagar

A 5 day District Level Workshop on Maternal, Infant and Young Child Nutrition (MIYCN) with special emphasis on Breast Feeding techniques was organized for sensitizing and training the Health and ICDS-WCD officials in collaboration by the technical support from Project Vruddhi – an initiative by Action Against Hunger at Star City, Himmatnagar from May 28 to June 1, 2024. 

The workshop was attended by 50 identified master trainers from the HFWD and ICDS-WCD. The workshop was complimented by the presence of members on the dais namely Shri Harshad M. Vora IAS – District Development Officer (DDO) Sabarkantha, Dr. B. H. Patel – Chief District Medical Officer (CDMO) Sabarkantha, Dr. Raj B. Sutariya – Chief District Health Officer (CDHO)  Sabarkantha, Dr. K. S. Charan, In-charge Programme Officer (PO)-ICDS & Additional District Health Officer (ADHO) – Sabarkantha, Dr.Jayesh Katira, Regional Deputy Director (RDD) – Gandhinagar, Dr,Rajesh Gopal, Liasoning Officer – Sabarkantha & Director Gujarat State AIDS Control Society (GSACS), Dr. A.I.Malik, District Quality Assurance Medical Officer (DQAMO), and Dr.Pravin Damor, Epidemic Medical Officer(EMO) .  Dr. Rupal Dalal – Director – Maternal and Child Health (SMDT), Ms. Deepali Kedarnath Fargade – Manager CSR – Health and Nutrition – Tilaknagar Industries Ltd., Shital Mohan Hiwale – Project Director – Shrimati Malati Dahanukar Trust facilitated the training. 

The workshop began with the representation of NFHS data and evidences gathered from the field followed by discussions on other MIYCN topics. A special session on effective Breast-feeding techniques was addressed by Dr. Rupal Dalal. A session on importance of weight gain with breastfeeding, Latching and feeding positions for effective breast-feeding, manual expression of breast milk and its storage was also done. During the workshop, reasons for ineffective breastfeeding due to nipple and breast conditions was also discussed along with the importance of skin-to-skin contact after C-section, Kangaroo Mother Care(KMC), making of KMC bag and basics of newborn care. Later during the workshop, a discussion on the importance of first 1000 days, complimentary feeding, various types of essential nutrients and demonstration of protein-rich recipes were done. A special visit was done to GMERS Himmatnagar where all the participants along with the facilitators visited all  mothers of new born babies were educated for breast feeding positions and techniques, that helped them to achieve effective breastfeeding of the newborns.   

A pre-test and a post-test was conducted for all participants to ensure that effective MIYCN Training was imparted.  

 



Supporting Mothers: Bansi Offers Fish at 50% Discount to Pregnant and Lactating Women

In the heart of Dharni Block, Maharashtra, Bansi Sawalkar’s (name changed) journey with pisciculture not only transformed her family’s livelihood but also became a beacon of community support. For six years, Action Against Hunger has been dedicated to uplifting 39 villages, focusing on nutrition, health, food security, and education. In February 2023, they introduced a Fish Farming Project in collaboration with Jaljeevika, aiming to bolster Food Security and Livelihoods (FSL) in the region.

Bansi, a registered beneficiary immersed in maternal and child nutrition education, caught the attention of the ACF field team with her 20×20 meter farm pond. Initially hesitant due to childcare duties, Bansi entrusted her husband and father-in-law to attend training at the Titamba Aqua school. Equipped with knowledge of pond preparation, fish species, and management techniques, they returned to kickstart the project.

The journey wasn’t without challenges. After meticulous pond cleaning and embankment leveling, Bansi and her family embraced integrated farming, planting papayas, lemons, custard apples, guavas, and vegetables like drumsticks around the pond. Their dedication saw the pond stocked with fish by September, though heavy rains later caused losses, testing their resilience.

With support from Action Against Hunger, Bansi rebounded in March 2024 by releasing 200 Pangasius fish hatchlings. Diligently adhering to water quality checks and integrating pond water for crop irrigation, she optimized their agricultural yield. By June 2024, their efforts bore fruit—literally and figuratively—as the fish grew to 400-500 grams, ready for market.

Bansi demonstrated her entrepreneurial spirit by initiating fish sales in Salai and nearby villages at Rs 200 per kg. Showing her community-focused approach, she provided a 50% discount to 8 pregnant and lactating women, creating a supportive network.

For Bansi Sawalkar (name changed) and her family, the income from fish farming has not only complemented their farming but has also brought a sense of fulfillment and stability. Their journey underscores how empowerment and perseverance can ripple through communities, igniting hope and prosperity where it’s needed most.

Sharda’s Journey: Triumph Over Malnutrition in Sathe Nagar

In the heart of Sathe Nagar, during a routine check-up at Anganwadi 148, a young girl named Sharda Kamble(name changed) was assessed for her nutritional status. Her measurements indicated she was suffering from moderate acute malnutrition (MAM). The community mobilizer attempted to explain MAM to Sharda’s mother, who did not understand Hindi. Fortunately, Sharda’s aunt, fluent in the language, conveyed the information effectively.

Sharda’s family had recently relocated from their village to Mumbai, marking this as her inaugural weight assessment. The community mobilizer inquired about Sharda’s low weight, to which the aunt confessed ignorance, attributing it to their recent move. An MAM card was issued to Sharda’s mother, detailing the necessary follow-ups and dietary advice.

A subsequent home visit revealed Sharda’s limited diet, consisting mainly of paratha, tea, and dal rice, sometimes skipping dinner altogether. The community mobilizer educated the family on healthier alternatives and the adverse effects of tea on children.

After 15 days, a noticeable improvement in Sharda’s weight was observed, thanks to her mother’s adherence to the new dietary regimen. Despite the family’s resistance to change, particularly from the elder members, the community mobilizer persisted, bringing a counselor on the next visit to address the family’s reliance on outside food.

The counselor engaged in a thoughtful dialogue with Sharda’s father and grandmother, drawing parallels between the girl’s diet and the grandmother’s own nutritional needs. This comparison sparked a realization within the family, leading to a shift towards more nutritious, homemade snacks.

As a result of these concerted efforts, Sharda’s health improved significantly. She was admitted to the program on January 31st and, by April 10th, was discharged with a healthy weight gain from 12.8 kg to 14 kg, a testament to the power of community support and proper nutrition.

Our commitment remains unwavering: to transform harmful habits and ensure that every child in our community, aged six months to five years, can break free from malnutrition, just like Sharda.

Empowering Future Care-givers: Intensive KMC Training by Action Against Hunger.

Action Against Hunger, India, in collaboration with the Department of Pediatrics, Obstetrics and Gynecology, and Community Medicine at HBT Medical College, along with Dr. R. N. Cooper Municipal General Hospital, conducted a three-day training program on Kangaroo Mother Care (KMC) at HBT Medical College. 

The training was inaugurated by Dr. Manisha Khare, the Dean of Academics, in the presence of department heads, professors, house officers, nurses, the vice-principal of the School of Nursing, and the Action Against Hunger India team. 

Over 40 participants, including third-year Nursing Students, Medical College students, and Nursing Staff from the Pediatrics and Gynecology departments, took part in the interactive and participatory sessions organized during the training. 

Dignitaries highlighted that HBTMC and Dr. R N Cooper Hospital are pioneers in establishing a dedicated KMC Unit among all major civic hospitals and teaching institutions under MCGM. Additionally, they emphasized that HBTMC and Copper Hospital are among the first institutes to introduce KMC Training in tertiary healthcare facilities. 

 

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.