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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.



Project Shubharambh: Empowering Adolescent Girls Against Anaemia

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India’s National Family and Health Survey – 5 (2019-21) highlights a concerning rise in the prevalence of anaemia among women of reproductive age, with an alarming 57%. This signifies a 7.3% increase from NFHS 4, indicating a pressing need for targeted interventions. In the adolescent demographic, the increase is even more pronounced at 9.2%, escalating from 54.1% to 59.1%.

In response to this health crisis, Action Against Hunger India has launched Project Shubharambh, a pilot initiative in Sanand, strategically aimed at mitigating the burden of anaemia among adolescent girls.

Objectives:

  • Proactive Anaemia Testing and enhancing the quality of T3 (Test, Talk, Treat camps)
    • Strengthening T3 (Test, Talk and treat) camps to facilitate early identification and testing of anemia amongst adolescent girls.
  • Alleviating Burden on Specific Adolescent Girls:
    • Targeting high-prevalence areas in Sanand to focus resources on those most in need.
  • Nutrition Health Education sessions: Organizing nutrition and health education sessions and guiding adolescent girls on the basics of anaemia, its prevention, and treatment.
  • Community Engagement and leveraging festivals
    • Integrating community engagement and awareness programs by leveraging festivities of the traditional dance, Garba organized during and after the festival of Navratri to raise awareness on anaemia at the school and community settings.

Capacity & Ecosystem Strengthening:

In parallel, Action Against Hunger India is committed to strengthening the healthcare ecosystem. The organization will provide:

  • Capacity-Strengthening Training:
    • Focused capacity building of frontline functionaries of health and ICDS department by strengthening the current practices of identification, prevention, and treatment of anaemia.
  • Sustainability Measures:
    • Promoting sustainable practices of consuming locally and traditionally available iron rich foods in anaemia management to ensure long-term impact.
    • Establishing partnerships with local authorities and stakeholders to integrate anaemia prevention into routine healthcare services.
    • Promoting awareness among family members and adolescent girls to recognize the initial visible signs of anemia, encouraging adolescent girls to undergo testing, and facilitating early identification, prevention and treatment. This initiative not only aims to sensitize the community but also strives to promote the utilization of government-provided programs and facilities under anemia control initiatives such as free distribution of IFA tablets at schools and community settings and ensuring its consumption

Project Shubharambh is a holistic initiative designed to combat the rising numbers of anaemia among adolescent girls in Sanand. By combining targeted interventions, community engagement, and capacity-building efforts, Action Against Hunger India aims to create a sustainable model that can be scaled up to address anaemia challenges nationwide. Together, we strive for a healthier and brighter future for the adolescent girls of Sanand.



An Action Taken For Nutrition: Read Mayawati’s resilient story towards a Healthier Tomorrow.

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In the remote village of Doondabar, Rajasthan lies a close-knit community of the Shahariya tribe, heavily reliant on the forest, agriculture, and daily labor for their sustenance. Amongst them, 10-month-old Mayawati’s (name changed) family struggled to make ends meet, with her parents working as daily wage laborers, earning a meager income of INR 25000/- per year.

During a routine screening, Mayawati was identified as severely acute malnourished (SAM), weighing only 5kg with a Z-Score of <-3SD. Our dedicated team, determined to help Mayawati, engaged in extensive counseling efforts to convince her mother to admit her to the nearest malnutrition treatment center. Although Mayawati’s mother agreed initially, the celebration of festivals led her parents to reconsider, and they brought Mayawati back home after two days of admission.

Undeterred by the setback, we enrolled Mayawati into the ‘Naya Savera Programme,’ a government initiative to combat malnutrition at the community level through energy-dense nutrition supplements. Despite facing challenges of inaccessibility due to heavy rainfall and adverse weather conditions, our team ensured that Mayawati received regular EDNS supplies through the Anganwadi Worker and ANM.

Monitoring her health and growth was not easy, but our team persevered. We provided the family with extensive orientation on health practices, nutrition, WASH practices, and even cooking demonstrations, ensuring they were equipped to care for Mayawati effectively.

Her health condition had left her unable to walk and visibly irritated, but with constant efforts and regular support, Mayawati began to show signs of recovery. A few moths later, her measurements were truly heartening, with her weight at 8.1kg, height at 74.5 cm, MUAC at 125 mm, and Z-Score at 1SD

Mayawati’s transformation was astounding. From a SAM child to a normal, happy, and active little one, she even began walking, much to the joy of her family and the entire community. This inspiring journey of recovery exemplifies the power of dedicated efforts, timely interventions, and community support in combating malnutrition, even in the most challenging environments. Mayawati’s story is a testament to the impact that proactive and caring organizations like ours can make in the lives of vulnerable children and their families.

From Despair to Recovery: The Inspiring Journey of Prema – A Tale of Community Mobilization, Collaboration, and Triumph Over Malnutrition

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The case story of Hiral (name changed) is a testament to the dedication and effectiveness of community mobilizers like Tejas Korada, and the collaborative efforts of Action Against Hunger India, ICDS, the health department of Jawhar P.S., and local NGOs.

In the Katkari hamlets of Nandgaon village, Tejas our community mobilizer was conducting routine screening activities when he came across Hiral (name changed) and her daughter Prema (name changed). Immediately recognizing the signs of malnutrition in the 22-month-old child, Tejas decided to screen her for further evaluation. The screening revealed that Prema’s weight-for-height Z score was -3SD, indicating severe acute malnutrition (SAM).

Tejas wasted no time and, together with an Aanganwadi worker, visited Prema’s household to inform her caregivers about the seriousness of malnutrition and the need for immediate treatment. The caregivers were counseled on various aspects of malnutrition and convinced to admit Prema to the Nutrition Rehabilitation Centre (NRC) at the sub-district hospital in Jawhar.

On the same evening, Prema was admitted to the NRC, where she stayed for 14 days undergoing treatment as per protocol. Tejas provided continuous follow-up during her stay, ensuring she received the care and attention she needed to recover. However, upon discharge, it was observed that Prema had only gained 0.2 Kg of weight during her time at the NRC, which was not sufficient for her full recovery.

Recognizing the need for further intervention, Action Against Hunger India, ICDS, the health department of Jawhar P.S., and a local NGO jointly organized a health check-up camp for SAM and MAM children who were not showing progress despite treatment. Prema was referred to this camp, and transport arrangements were made to ensure her attendance.

During the camp, Prema underwent a thorough examination, and her blood and sputum samples were sent for testing. The results revealed that her hemoglobin levels were dangerously low, necessitating a blood transfusion. Additionally, it was discovered that Prema had developed a pediatric tuberculosis infection, and she was immediately put on medications to begin her treatment.

Throughout this challenging period, Mr. Tejas Korada continued to provide unwavering support. He conducted home visits to ensure Prema was receiving proper medication as directed by the medical officer.

In November, as part of routine follow-up, Prema was screened again, and the results were heartening. Her weight had increased to 8.00 Kg, and her height remained at 71 cm. Her weight-for-height Z score was now at -1SD, indicating that she had successfully overcome malnutrition and was on the path to recovery.

The success of Prema’s treatment was not only due to the efforts of the healthcare professionals and the community mobilizer but also because of the accountability and dedication shown by Prema’s caregivers. The timely and effective referral to institutional services played a vital role in ensuring Prema received the necessary medical attention and recovered from malnutrition.

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