One thing that differentiates humans from animals is the ability to think intelligently. And, yet, this gift can turn into a nightmare with overthinking, as it may make a simple problem seem like a complicated one.
A similar situation was witnessed in a Chhattisgarh district. Although the people in Bemetera were quite well off and even rich compared to some of the backward tribal and naxal affected districts of the state, malnutrition was a recurring health issue, leaving the district administration puzzled as to why children from well-to-do families were malnourished.
When a young IAS officer arrived in this district as SDM, in her first posting, she also started wondering on similar lines. She started looking for the root cause, and on finding it, all it took was the implementation of a simple measure to solve it.
Indian Masterminds spoke to this 2020 batch IAS officer of Chhattisgarh cadre, Ms. Suruchi Singh, to find out from her what was the simple solution she came up with.
A SIMPLE SOLUTION
In this case, something as simple as counselling people on eating and feeding practices and, thereafter, monitoring their progress proved to be the game-changer.
The people of Bemetera district had the resources to provide balanced meals to their children, but lacked knowledge on proper eating and feeding practices. Existing myths around food and increased accessibility to highly processed food had further compounded the problem.
Ms. Singh realised that nutrition counselling can be a solution to this problem. “Experience has taught us that simple things may not always be easy, but are often the most effective solutions,” she said.
The concept of nutrition counselling is yet to be properly institutionalized and uniformly implemented across states, although the POSHAN Abhiyaan Progress Report 2018 clearly mentions: “A focused and coherent SBCC Action Plan is essential to take the work of POSHAN Abhiyaan forward.”
Potth Laika Abhiyaan
Thus, Ms. Singh decided that the need of the hour was for the field staff to be properly trained in nutritional counselling, and for it to be mandatorily and uniformly implemented in the district.
The inhabitants of Bemetara are relatively affluent. The district is in the fertile plains of Chhattisgarh and, hence, agriculturally rich. Furthermore, it is not naxal affected.
However, the number of Severe Acute Malnutritioned children (SAM) was as high as 3299 in December 2022. This figure bears striking resemblance to tribal dominated and naxal affected districts such as Bastar.
“It pointed towards the lack of proper knowledge about feeding practices. The problem is not access but improper knowledge around when, how and what to eat. This is why nutrition counselling coupled with robust monitoring was chosen as the modus operandi for this area,” Ms. Singh said.
And, so, a nutrition counselling programme was launched in the district under the name ‘Potth Laika Abhiyaan’. The name literally translates to ‘Healthy Child Mission’ in Chhattisgarhi language. The initiative is being implemented in 72 most affected AWCs in Bemetara sub-division of Bemetara district.
HOW IT WORKS
With technical support from UNICEF Chhattisgarh, ground level staff of Health and Women and Child development departments were thoroughly trained on how to provide nutrition counselling to families.
Every Friday, parents of the targeted SAM and Medium Acute Malnutritoned (MAM) children were called and counselled. They were taught in simple Chhattisgarhi language the importance and constituents of ‘Tiranga Bhojan’, which is a balanced diet consisting of food items of the three colours in our national flag. Orange items like carrots, white items like rice, eggs, milk, and green items like vegetables.
The parents were also told about the importance of washing hands regularly and were taught many other similar tips for leading a healthy lifestyle. Many harmful dietary myths and superstitions were dispelled as well. Local leaders such as Sarpanchs, Panchayat Sachivs and religious heads were also involved during the counselling sessions.
At the same time, the progress of the targeted children was closely monitored. Door-to-door visits to houses of targeted children were regularly conducted for the purpose of monitoring their progress.
SIGNIFICANT RESULTS
And this simple ‘mantra’ worked! With nutrition counselling coupled with regular monitoring and evaluation, 53.77% targeted children, that is 599 out of 1114 children, were brought out of malnutrition in a period of nine months, from December 2022 to July 2023. Similarly, 61.5% MAM children and 14.67% SAM children were brought out of malnutrition.
“These figures are highly encouraging and statistically significant. Comparing this with a random control group of 20 AWCs where this mission was not being implemented, a total of only 30.6% children were taken out of malnutrition,” Ms. Singh said.
That is, 33.8% MAM children were taken out of malnutrition and zero SAM children were taken out of malnutrition. This reveals a total increase of 23% over and above the control group, which is very encouraging, according to the officer.
ZERO COST
The initiative proved to be cost effective as well. Ms. Singh explained: “While providing meals requires elaborate budgets and eventual risk of leakages, this mission is a zero cost one, requiring no more than a few training sessions and regular monitoring.”
Children receive mid-day-meals at their schools and families receive monthly rations through the public distribution system. Ready-to-eat packets and hot meals are served to mothers and children at the Anganwadi Centres (AWCs) under the Prime Minister’s POSHAN Abhiyaan. Further, various add-ons such as eggs, bananas, protein powders, peanut chikkis and jaggery are also distributed under various state-specific schemes such as Mukhya Mantri Suposhan Yojana in Chhattisgarh.
But, the fact of the matter is, nutrition has to start from homes. “Parents let their children eat whatever they fancy, rather than see them go hungry. If kids insist on chips or biscuits, parents buy these for them. I’d suggest not to give in. When kids go without eating for a while, they start feeling hungry, and then they eat any food laid out before them. And, it is the parents’ duty then to give them a balanced diet,” Ms. Singh said.
MODEL CAN BE REPLICATED
She also pointed out that ‘Jan Andolan’ or social and behavior change communication (SBCC) has been a facet of the POSHAN Abhiyaan. This includes bicycle rallies, plantation of Poshan Vatikas, celebration of Poshan Maah, Poshan Pakhwaras, Godh Bharaais, etc., which are implemented by the states through various awareness programmes.
And, ‘Potth Laika Abhiyaan’ is doing just that – bringing about social and behavioural change through effective communication. Ms. Singh said, “Learning from our experience, I can say that if this model is replicated on a larger scale across districts and states, it will yield good results. Providing food to the poor needs to be supported with nutrition counselling and monitoring in order to truly accelerate the eradication of malnutrition.”
Indeed, going by its positive impact in Bemetera, this simple strategy of nutrition counselling can go a long way in helping to achieve the dream of a ‘Kuposhan Mukt Bharat’.
