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Lessons from Bemetara: Bridging the malnutrition gap
- Government has made efforts to ensure food security by implementing various schemes and programmes.
- Mid-day-meals in schools to provide nutritional meals to children and distributing monthly rations to people through a robust Public Distribution System.
- Ready-to-eat packets and hot meals are being served to mothers and children at Anganwadi Centres (AWCs), under Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN) Abhiyaan.
- Add-ons such as egg, banana, protein powders, peanut chikki and jaggery are being distributed under various State-specific schemes like Mukhyamantri Suposhan Yojana in Chhattisgarh.
- Despite government efforts, nutritional security remains unachieved goal.
Why is nutritional security still a distant dream?
- People lack knowledge of proper eating and feeding practices.
- Myths around food and increased accessibility to highly processed food have added to the problem of malnutrition.
- Nutrition counselling and creating awareness among people can be the answer to this problem.
Concept of Nutrition Counselling:
- Under POSHAN Abhiyaan “Jan Andolan”, or social and behaviour change communication (SBCC), has been one of its main facet.
- Under Jan Andolan several activities like bicycle rallies, plantation of Poshan Vatikas, celebration of Poshan Maah, Poshan Pakhwaras and Godh Bharaais takes place to spread awareness among the people.
- Different States have held various awareness programmes under the SBCC.
- Even after so many efforts made by the government the concept of nutrition counselling has yet to be properly institutionalised and implemented uniformly across States
- According to the POSHAN Abhiyaan Progress Report, 2018, “A focused and coherent SBCC Action Plan is essential to take the work of POSHAN Abhiyaan forward”.
- There is a need for field staff to be properly trained in nutritional counselling and there is a need for it to be implemented, mandatorily and uniformly, by States.
Case study of Bemetara
- Bemetara is district situated in the fertile plains of Chhattisgarh, it is unaffected by Naxalite activities and is agriculturally rich.
- The inhabitants of the districts are also relatively affluent.
- Even after so many positives the number of Severe Acute Malnutritioned (SAM) children in the district was as high as 3,299 in 2022 which is very similar to the situation in tribal-dominated and Naxal-affected districts such as Bastar.
Reason behind number of SAM children being so high:
- The problem is not about access to food but lack of proper knowledge of when, how and what to eat.
- This is why nutrition counselling combined with robust monitoring was chosen as the way to address the problem of Malnutrition for this area.
Potth Laika Abhiyaan (Healthy Child Mission)
- It is a nutrition counselling programme that is being implemented in 72 of the most affected AWCs in the Bemetara sub-division, receiving technical support from UNICEF, Chhattisgarh.
- Ground-level staff from the Health and Women and Child Development departments have been well trained on how to provide nutrition counselling in the region.
- Every Friday, the parents of the targeted SAM and Medium Acute Malnutritioned (MAM) children are counselled.
- Parents are taught in simple Chhattisgarhi language about the importance and the constituents of “Tiranga Bhojan” (a balanced diet), the need to wash hands regularly and many other tips in order to lead a healthy lifestyle.
- Many harmful dietary myths and superstitions are dismissed.
- Local leaders like sarpanchs, panchayat sachivs and religious heads have participated in the counselling sessions.
- Door-to-door visits to the houses of targeted children are done to monitor their progress.
Tiranga bhojan
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Benefit:
- Providing meals requires elaborate budgeting and there is risk of leakages, whereas Potth Laika Abhiyaan''s mission is a zero-cost mission, requiring few training sessions and regular monitoring.
Progress under the Scheme:
- 53.77% of targeted children were brought out of malnutrition by the Potth Laika Abhiyaan, in nine months.
- 61.5% of MAM children and 14.67% of SAM children have been brought out of malnutrition.
- All these were achieved just by providing nutrition counselling along with regular monitoring and evaluation.
- Potth Laika Abhiyaan results when compared with a random control group of 20 AWCs where this mission was not being implemented, only 30.6% children were taken out of malnutrition.
- That is, 33.8% MAM children and zero SAM children were taken out of malnutrition.
Providing food to the poor needs to be supported with nutrition counselling and monitoring to truly accelerate the eradication of malnutrition. It is only when this simple but impactful strategy of nutrition counselling is followed both in letter and spirit, that India can move closer towards achieving the ambitious yet noble dream of a “Kuposhan Mukt Bharat”.