Malnutrition in children has emerged as a silent national emergency and accounts for 68% of all infant mortality in India. Malnutrition adversely affects a child’s chance of survival and learning ability, and increases susceptibility to illness. Considering these, Nutrition India Programme has been launched by Plan India with support from Reckitt Benckiser in tribal districts – Nandurbar and Amravati – of Maharashtra.
Improve the nutritional status of children during the first 1,000 days of birth by:
- 40% reduction in the number of children under-5 who are stunted
- Reduce and maintain childhood wasting to less than 5%
To achieve its outcomes in a period of 5 years (2018-2023), the project has adopted an integrated, multi-sectoral approach which involves communities, civil society organisations (CSOs) and government agencies. Its design employs distinct features like ethnographic research which seeks to understand the gaps, needs and on-ground realities of the lives of the families. Similarly, interventions were designed with a human-centred design which involved talking to the community to capture socio-cultural insights before designing the programme. This research informed decisions such as the location and timings of centres, which resulted in enhanced adoption and social acceptability of the programme outreach and engaging first-of-its-kind female-only cadre of Community Nutrition Workers (CNWs).
CNWs are sensitized and rigorously trained by renowned public health experts, paediatricians, gynaecologists and community development specialists. They identify vulnerable pregnant women and children to deliver home-based, tailor-made, focussed healthcare and interventions on environmental sanitation and hygiene. They also help in skill-building of frontline workers specifically to overcome breastfeeding failures, counselling on infant and young-child feeding practices and safe water and hygiene practices.
To promote behaviour change within communities, the project has crafted standard messaging to generate behavioural nudges to drive the awareness and demand for nutrition and hygiene. These messages are delivered using specially designed games, nutrition kits, multimedia stimuli, and community festivals. In addition, the project launched conditional cash transfer to enable the families of high-risk pregnant women and malnourished children to use services offered by the public health system. Plan India also worked with the government and state government authorities through its facilitation and advocacy work to renovate, update and strengthen nutritional rehabilitation centres (NRCs). Work is also in progress to address gaps in establishing and regularising the functioning of village health and nutrition days (VHNDs).
The project is also a first in utilising blockchain-enabled digital technology for providing real-time data monitoring and service verification to track and enable conditional cash transfers to women. Geo-tagged and real-time dashboards help project teams and government officials access accurate, Real-time monitoring of project progress on various outcome indicators. In the five year duration, the programme aims to:
Reach out to 177,000 mothers of malnourished children and influenced village-level functionaries, religious leaders, traditional healers in communities to address child malnutrition
Influence at least 50 NGOs to engage actively on mother and child malnutrition
Influence government health personnel in 1000 villages through lobbying with the state and national governments to replicate best practices in 6 states
Establish Center of Excellence to exited techno-managerial support to the deprived regions of the country
The project is able to earn the trust of the district level officials (medical and ICDS), frontline workers, panchayats and most importantly the community specifically the pregnant and lactating women. The entire programme hinges on its synchronisation with local health cultures and close collaboration with a network of traditional health providers and the communities who are not passive beneficiaries but key actors in the process of transformation. The project has started showing early trends, lives of about 6,500 under-five children have been saved in first year. The social return of investment of the project was carried out by an independent global evaluation agency, the results show that every ₹1 invested in the institution of Nutrition India Programme delivers ₹36.90 of social value, which is encouraging.
In the last one year the programme has
- Reached 32,900 under five children
- Supported 805 women with institutional deliveries
- Supported 1268 households to start kitchen gardens to ensure adequate and diversified diet
- Ensured well-being of 3900 pregnant women