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.

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.

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.

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.

The launch of Project Sampurna in Ankleshwar, Gujarat, supported by Glenmark Life Sciences and implemented by Action Against Hunger India, marks a pivotal moment in our collective journey. 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 shared goal is to sculpt a robust, anemia-free India by addressing health challenges at their roots. The project is a testament to the transformative power of unity, illustrating how collaboration can pave the way for a healthier and brighter future for all.

This initiative is not just about addressing immediate health concerns but is a long-term commitment to fostering a community that thrives. Join us in this journey as we work together to create a meaningful and lasting impact on the lives of the mothers and children we aim to serve. Together, we can build a healthier, brighter tomorrow.