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

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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

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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

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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.

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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

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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

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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.


Strengthening of Nutrition Infrastructure in Sabarkantha, Gujarat

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Project Vruddhi- an initiative by Action Against Hunger, is committed to supporting the efforts of the Health and Women & Child Development Department (WCD) within the Government of Gujarat to support the accelerated realization of the goals outlined under Poshan Abhiyan. With a focus on enhancing health and nutrition service delivery systems, the project aims to lend technical assistance to the taskforce overseeing Maternal, Infant and Young Child Nutrition (MIYCN) under the Health and ICDS scheme.  Additionally, it strives to equip the district officials with leadership acumen and Supervisory cadre with supportive supervision skills, thereby fostering sustainable progress.

In alignment with this vision, a two-day training workshop was organized for Sabarkantha district officials across both the departments in collaboration with the Department of Health and ICDS – WCD, Zilla Panchayat, Sabarkantha between December and February 2024.

Dr. Raj Sutaria, CDHO Sabarkantha, Dr. S. H. Dedhrotiya, RCHO Sabarkantha, and Manisha Brahmbhatt, Program Officer, ICDS, were the key guests at these workshops.

 1.Leadership Excellence: Igniting Potential, Inspiring Action 

The Leadership Excellence workshop, organized in December 2023, aimed to equip participants such as Programme Officers and Taluka Health Officers with essential leadership skills, enhance their strategic thinking, and inspire them to lead with authenticity and impact. The workshop incorporated theoretical knowledge, interactive activities, and practical applications to provide participants with a comprehensive understanding of leadership essentials.

 2.Empowering Health and ICDS Supervisors: A Workshop on Leadership and Enhancing Supportive Supervision 

Empowering Health and ICDS Supervisors workshop, organized in February 2024, aimed to equip participants such as Female Health Workers (FHS), Multi-purpose Health Workers (MPHW) from the Health Department, and Lady Supervisors from the ICDS – WCD Department with knowledge, skills, and tools to become effective leaders and supportive supervisors within their organizations. This workshop served as a platform to share experiences and network.



From Despair to Hope: Kishan’s Journey in Gram Chaurakhadi, Madhya Pradesh

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Gram Chaurakhadi is nestled along the banks of a river, near the border of Madhya Pradesh, and is surrounded by mountains on all sides. The village is predominantly inhabited by the Sahariya community. While the primary health center is located 15 kilometers away, the sub-health center is closer, situated 5 kilometers away in Bil Kheda Dang.

On June 14, 2019, during a screening session, Kishan was identified as severely malnourished, with a MUAC (Mid Upper Arm Circumference) of 94. His mother passed away when he was just 5 months old, and since then, he has been under the care of his grandmother, Dulari Bai Sahariya, and his grandfather, Mohanlal. When Kishan developed diarrhea and fever, his family sought help from practitioners of witchcraft, but his condition did not improve. As part of these rituals, a goat was sacrificed twice, costing them more than 10,000 rupees. Despite visiting a private doctor in Devri, Kishan’s health continued to deteriorate.

Following a screening conducted by our community mobilizer, it was evident that Kishan’s condition was critical. His grandparents and father were immediately informed about the Malnutrition Treatment Center (MTC), and Kishan was admitted on the same day.

After some initial improvement, Kishan’s grandmother brought him back to the village without consulting the doctor, staying at the MTC for only 5 days. Since Kishan was still unwell, he was sent to the Baran MTC for further treatment through the Anganwadi worker and our community mobilizer. After a noticeable improvement, Kishan’s grandmother brought him back home, following the doctor’s advice. Subsequently, our community mobilizer made regular follow-up visits to Kishan’s home, guiding his grandmother on preparing nutritious meals and providing nutritional support from the Anganwadi. The visits emphasized the importance of nutrition and a balanced diet. The Anganwadi worker was also instructed to visit Kishan’s home regularly.

Through persistent efforts, Kishan’s condition gradually improved. Today, seeing him smile and play, we are immensely gratified.

Empowering Baran: Project Navodaya’s District Workshop in Rajasthan

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Action Against Hunger (ACF) India organized a two-day workshop to share the learning and experiences of Project Navodaya, supported by the SBI Life Insurance, in Baran, Rajasthan, which is an aspirational district. As this was the exit year of the project, ACF also used the opportunity to hand-over the project to the district administration which was represented by the District Medical Health Officer, Dr. Sampath Raj Nagar.

Dr. Nagar appreciated the efforts of ACF in helping administration upgrade the skills of ASHA and Aanganwadi workers (AWWs) as well reaching out to beneficiaries with targeted interventions for pregnant and lactating mother, low-birth babies, and malnourished children under the age of 5. He also emphasized the contribution that ACF made in the most backward tribal areas of the district namely Kishanganj and Shahbad.

Dr. Nagar also highlighted that while earlier there were issues with the record keeping and proper documentation of ANC & PNC check-ups as well as screening data by ASHA and Aanganwadi workers, the same saw major improvements thanks to ACF field and technical staff who for almost around five years provided day to day support to ASHAs and AWWs, monitoring and supervision assistance to the administration, and timely reporting of crucial data to the top district officials.

While handing over the project to the Baran administration, ACF India’s Chief Operations Officer Dr. Ulhas Vasave hoped that ACF’s prioritization of maternal and child health in Baran as per 1000 days approach will remain relevant for the district administration to execute their programs and plans. He further said that the learning and experiences of ACF’s work in Baran will help the organization to further its agenda eradicating malnutrition from the areas where we work.

Project Navodaya, that was a five-year grant from the SBI Life Insurance, comes to an end in Baran and Dhar districts of Rajasthan and Madhya Pradesh where it targeted pregnant & lactating mothers and malnourished children. Project’s emphasis on system strengthening and behavioral change through community engagement saw some high impact outcomes. ACF team feels confident that the improvements that the project saw in these two districts are of sustainable nature as the focus of Project Navodaya was always on empowering frontline workers and communities rather than treating them just as some service recipients or beneficiaries.



Ankleshwar, Gujarat

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Project Sampurna launched in Ankleshwar, Gujarat is supported by Glenmark Life Sciences 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.

As part of the initiative, Project Sampurna will conduct a robust baseline assessment, anemia screening in adolescent girls and screening for malnutrition amongst children. Our commitment extends from the pre-conception stage in girls through adolescence, incorporating Social and Behavior Change Communication (SBCC) interventions aligned with a 1000-day approach.

This project is poised to make a significant impact on the health and well-being of mothers and children up to 5 years old. We ensure timely referrals for facility interventions when necessary, ensuring that every child receives the care they need for a healthy start in life.

Our goal is to sculpt a robust, anemia-free India with a focus on nurturing a healthier nation.