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.

Optimal nutrition is essential for a child’s growth and development in the first two years of life. Exclusive breastfeeding for six months and continued breastfeeding with age-appropriate, nutritionally adequate complementary feed is essential for a child after six months up to two years of age. This helps prevent stunting and prevents the child from entering the undernutrition cycle. Once the child is six months of age, the body and brain require more nutrients which breastmilk alone cannot provide. Hence, appropriate complementary feeding becomes essential. Appropriate nutrition ensures a robust immune system and the realisation of full potential for the child. Healthier children will surely be more productive and will be able to create opportunities for themselves, their families and communities to eventually break the cycle of poverty and hunger.

Sara (name changed), residing in Sabarkantha district of Gujarat, is a mother of three, preoccupied with household chores. Her father, a brick labourer, is frequently out for work. Being an informed mother, Sara did not compromise on introducing healthy food groups as part of Zarine’s (name changed) complementary feed. Earlier, Sara used to let Zarine have market-available biscuits and other snack packets, and chips, among others, to save time when she was too busy with household chores or managing the other two children.

When an Anganwadi worker from Project Vruddhi met Sara, she was advised on better food practices for Zarine. “I was aware that market-available packet food is not good for Zarine, but it was sometimes very convenient. Managing a home with three children can be difficult, especially when the other two children demand packaged foods such as cold drinks, chips, and sweets. So, I used to let Zarine eat just to manage and get some time to complete my pending chores.” said Sara. “But when I was made aware that this casual approach might cost me Zarine’s changed behaviour towards homecooked food, and may result in her weight loss, or restrict her optimal growth, I became very conscious about what I was feeding my youngest child” she added.

Zarine is now breastfed along with homemade semi-solids such as porridge, mashed vegetables, and fruits, among others, with no packaged food at all. This counselling on the mother’s feeding practice was critical in ensuring that the child does not lose adequate nutrition, fall ill, or become malnourished. This positive impact was enabled by ongoing engagement with families and their trust in Front-Line Workers and Project Vruddhi’s Field Coordinators (FCs) to guide them, and their children towards better healthy food practices

Sunil Patil works as a community mobilizer for Action Against Hunger India, and during his field visit to Chinchutara, he came across a newborn baby’s lactating mother, Sudheshna Vargi (name changed), who was visiting from another village. Sunil later visited Sudeshna’s home as part of his work and spoke with her about a variety of topics during his initial visit. During the conversation, Sunil learned that Sudeshna had given birth to a baby boy in a rural hospital in Mokhada, and that the baby weighed only 1.8 kg. Sudeshna expressed her concern about her baby’s low weight. It was established that the baby’s health was in poor condition, and there was a risk of further deterioration if his condition remained unaddressed.

Sunil and the Anganwadi workers attempted to persuade the baby’s mother and grandmother to take the newborn to the district hospital for a health checkup, where the SDH had a Special Newborn Care Unit (SNCU). But the family refused to take the child to Jawhar. Sunil then advised the caregivers to go to Morhanda Primary Health Centre (PHC) at the very least. This was when Sunil discovered that Sudeshna was to visit the Morhanda PHC a day before his visit. However, she had to wait for a vehicle for more than three hours and ultimately missed the appointment. However, caregivers were willing to carry the newborn to Morhanda PHC, the following day. On returning from the field, Sunil inquired about an ambulance. However, none was available. This was when the Action Against Hunger field officer arranged for a private vehicle, enabling the caregivers to take the newborn to the hospital.

The medical officer examined the newborn and advised the caregivers to take the child to Jawhar SDH. The following day, an ambulance was arranged from Aase PHC by the field supervisor, field officer, and ASHA worker. The newborn was admitted to SNCU in Jawhar sub-district hospital. The baby’s father was also present at the time of admission. The child was admitted to Jawhar SDH’s SNCU for three days. Every day, Sunil diligently followed up with the caregivers. On the day of discharge, the field officer urged Jawhar SDH staff to provide an ambulance so that the caregivers could safely travel to their home in Chinchutara – more than 40 km away. For three months, AAH provided food baskets to caregivers. Sunil also visited their home and counselled them on breastfeeding, hygiene, and other newborn care practices.

Later on, Sunil recorded the baby’s weight and it improved to reach 6.0 kg. The case story demonstrates the impact of strong convergence and local coordination between our organisation and the Government functionaries. It was a successful attempt that eventually saved a newborn’s life and restored caregiver’s confidence in improving the health and nutrition of a newborn.

Sheila (name changed) gave birth to a baby boy at Sadrabadi Primary Health Centre (PHC). Both the mother and the child were healthy. Sheila was discharged from the hospital just three days after delivery. However, the child’s weight at birth was 2 kgs only. A fortnight after the discharge, Sheila’s breast milk abruptly stopped flowing. This is when Sheila sought treatment at Sadrabadi PHC, from where she was referred to the Dharni rural hospital. However, Sheila received no benefit from the treatment. Because of the lack of mother’s milk, the child’s weight began to fall, and his health began to deteriorate. During a field visit, one of the Anganwadi workers briefed the Community Mobiliser on Sheila’s condition.

Our CM visited Sheila and, after a critical analysis of her health, discovered a lump in her breast. This eventually helped understand the primary reason why Sheila’s breast wasn’t producing milk. In the meantime, she started feeding her baby bottled milk, which could have been more dangerous for the baby. The Community Mobiliser and Anganwadi workers counselled Sheila about the importance of exclusive breastfeeding until the baby was six months old. Sheila was also counselled on the potential harm to the baby if he was not breastfed.

Sheila’s mother-in-law was advised to massage Sheila’s back once a day. Our CM explained to Sheila and her mother-in-law that massaging the back causes milk to be produced in the breast. Sheila’s mother-in-law began to follow the process diligently. After five to six days Sheila was able to produce breast milk and gradually the lump disappears. Sheila was then able to breastfeed her child. The child’s health and weight eventually improved. The family was extremely happy with Action Against Hunger’s intervention and rigorous counselling that saved the child’s life.

Kirtiratna Kharat is working with Action Against Hunger as a Community Mobiliser (CM). During one of her home visits, she found Usmana Shaikh (name changed), who was 4-months pregnant that time. Her LMP was 28.3.21 and EDD was 4.12.21, but she was not doing her pregnancy registration at any private or municipal hospital or in a nearby health post. When Kirtiratna inquired about this, she said she was not going there out of fear. The CM counselled her that there was no need to be afraid of the corona virus, and one should follow safety measurements like wearing a mask, face shield, washing hands in regular intervals, while visiting hospitals or health posts. In addition, one can wear hand gloves; and if all the all-safety measurements are followed, then no need to be afraid.

The CM advised her to register her name in any hospital as soon as possible. She also talked about ante-natal care, rest and nutrition. In the interaction, the CM felt that she is concerned with the subject of nutrition. The lady gradually opened to the CM and told that she was living in her husband’s home, and she is not comfortable there. She is not eating as per her habits and feels shy to eat. Then the CM asked her about her husband, father-in-law and mother-in-law’s behaviour. She said there was no problem from their side. She felt shy because this house was not hers. She felt that at her own home, there is freedom.

The CM was shocked when she heard her story but quickly understood that this was her personal thought, and there was no problem with the in-laws. She started to counsel her again by saying that if she does not eat properly, then her child’s health would be affected. The child may be malnourished and the baby’s weight may be decreased. Growth may be hampered if the child will not get proper nutrition from the mother. She needs to eat the balanced-diet in lunch and dinner, and take medicines like iron, folic acid and calcium tablets and other medicines and supplements as per doctor’s prescription. Finally, she was convinced; and she also agreed to eat properly, so that her child would be healthy.

She promised the CM that she would go to her mother’s home very soon and follow whatever has been suggested to her. Now she has registered her name in the hospital, received a second T.T. injection; furthermore, she is also eating enough.

Rupa Seth (name changed), 22, resides in Nehru Nagar, Andheri, Mumbai. Her husband is the sole breadwinner in the family and works for a private company. Roshni Shinde, our Community Mobiliser (CM), identified and enrolled Rupa as a pregnant woman when she was expecting her third child. Roshni did not know about Rupa’s third pregnancy initially. During one of the visits to Rupa’s home, Roshni found out that Rupa had lost both her new borns within a week of birth.

Back then, the doctors could not identify the reason behind the mishap. On knowing about this, Roshni advised Rupa to get admitted to a hospital for proper care and treatment. This was when Rupa informed the CM about her plans to deliver her third child in her hometown. Roshni tried counselling Rupa and asked her to register at Cooper Hospital in Mumbai instead, keeping her health in mind. On her second follow-up visit, when our CM prodded Rupa further, she registered herself at the Cooper hospital for all Ante-Natal Care (ANC) services.

Doctors even recommended a C-Section delivery during Rupa’s third trimester. However, she declined due to fear. But our CM didn’t give up and counselled Rupa once more, whereafter she agreed to a C-Section. Eventually, Rupa gave birth to a healthy baby. During the doctors’ investigation, it was found that her previous borns had suffered from the nuchal cord (An umbilical cord that is wrapped around a baby’s neck in utero), which resulted in their deaths. Due to our Community Mobiliser’s hard work and perseverance, Rupa overcame her fears. She could identify the cause behind the deaths of her newborns and eventually received the needed help to deliver a healthy baby.

Prema (name changed), a married woman, lives in Keshvi, Dhudhiya village, with her five children and husband. The remote location and lack of transportation in her region have been a major reason behind the underdevelopment of the village.

Prema’s husband works as a truck driver and frequently spends time away from home. He spends most of his earnings on alcohol, leaving the family’s needs unmet. Prema’s four children belong to the same age group. While Prema struggled to find enough nutritious food while pregnant with her fifth child, and her husband’s alcohol consumption put a strain on their finances. After learning about Prema’s pregnancy, an Anganwadi and AAH Community Mobiliser (CM) discovered that the child she was pregnant with was very weak and was anemic. This stressed Prema for obvious reasons, as it could have led to her losing the child.

Under such scenario, when Prema needed a good amount of care, there was no one else at home to look after her or even take her to the health centre regularly for check-ups. This is when Action Against Hunger team devised a plan to take care of Prema. They took her to the health facility and also visited her home regularly. Prema’s neighbours assisted in providing nutritious food comprising of pulses, vegetables, fruits, and milk. In the seventh month of her pregnancy, Prema suffered stomach aches. Following an investigation, it was determined that the child’s life was in danger, and Prema needed complete bed rest. For two months, Anganwadi health workers and Prema’s neighbours worked together to look after her. Eventually, things went well and Prema was blessed with a healthy newborn.