Project Vruddhi by Action Against Hunger is dedicatedly working towards enhancing nutrition outcomes in Sabarkantha, Gujarat, through collaboration with the ICDS – WCD and Health departments.

Vankar’s extensive community knowledge proves invaluable, particularly in identifying community-level influencers for initiatives like Poshan Chaupal – an initiative by Project Vruddhi aimed at improving nutrition outcomes for both mothers and children.

We commend Vankar for his enthusiasm and valuable contributions. Offering training and development opportunities to personnel in the Health and ICDS departments, represented by Vankar, is a significant stride towards bolstering the system and fostering a sustainable model.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Shaneen Sheikh’s (name changed) journey in Nehru Nagar slum became an inspiring case study for the dedicated team working on maternal and child healthcare. At 27 years old, Shaneen lived a modest life with her husband and children in a rented house, with her husband being the sole breadwinner for the family. It was during her second pregnancy that she enrolled with us in our healthcare program aimed at supporting pregnant women and new mothers in the slum.

Throughout her pregnancy, the healthcare team diligently visited Shaneen’s house, providing her with essential prenatal care and educating her about the significance of exclusive breastfeeding for her newborn. Shaneen seemed committed and assured the team that she was following their instructions carefully.

In November, Shaneen gave birth to her baby, and the team continued their regular visits. However, during one visit in April, Shaneen informed the team that she had visited Cooper Hospital and obtained the necessary medicine for her baby’s condition. However, she also revealed that her family had started giving complementary feeding to the baby, contrary to their earlier advice on exclusive breastfeeding.

The team didn’t lose hope and persisted in educating Shaneen about the significance of exclusive breastfeeding until the baby reached six months of age. They explained the potential risks of introducing solid foods too early and the benefits of breast milk for the baby’s overall health and development. Shaneen, despite her family’s pressure, promised the team that she would not initiate any complementary feeding until her baby completed six months.

Shaneen’s determination to prioritize her baby’s health and follow the team’s guidance even amidst familial pressures impressed the healthcare workers. Her willingness to embrace change and learn about better healthcare practices made her a role model for other mothers in the community.

The success story of Shaneen Sheikh and her baby became an example of how education, persistence, and genuine care can make a significant difference in the lives of vulnerable families. The healthcare program in Nehru Nagar slum continued its mission, inspired by Shaneen’s journey, to improve maternal and child healthcare outcomes in the community.