There was a time when people in Ganaur Tehsil of the Sonipat district in Haryana hardly felt any need to take special care of a pregnant woman in their family. Following the tradition, they relied on the life experience and wisdom of elderly women in the family. For all medical assistance, they engaged a ‘daai’, a local midwife who was not qualified to offer her services. People hardly took pregnant women for regular medical check-ups at nearby public health centres. They did not even go for the immunization of pregnant women and babies. In most cases, babies were delivered at home with the help of the ‘daai’. People consulted a qualified doctor at a public health clinic or a hospital only in case of any serious complication or medical emergency.
Every village in the Tehsil did have one Anganwadi centre to provide the necessary support, medical assistance and guidance to pregnant women and their family members during pregnancy and post-delivery of the baby. But, people preferred not to consult Anganwadi centres.
- Datauli village Anganwadi worker Ranu Goswami
“They would not even tell us that someone in the family is pregnant during our visits. They used to hide this information from us as they carried several misconceptions about immunization and other medical interventions. Sometimes when we came to know that someone was pregnant in a family, it was already too late. Right nutrition and health intervention should start from the day a woman conceives,” Ranu Goswami, an Anganwadi worker in Datauli village, recalls.
Over the last 10 years, however, a lot has changed in the region.
People in Ganaur Tehsil ( a block) now understand the necessity and significance of maternal and child health care, even those who are uneducated and poor. There is hardly any case of a baby delivered at home. Pregnant women undergo regular medical check-ups and accept required medical interventions including immunization without any apprehension.
People now remain in touch with the Anganwadi centres in their locality for all medical help and other support provided under the National Nutrition Mission schemes or ‘Poshan Abhiyan’ implemented across the country to improve the nutritional outcomes for children, pregnant women and lactating mothers by holistically addressing the multiple determinants of malnutrition.
Thanks to the tireless efforts of the Anganwadi workers and the officials of the women and child development department.
“We gradually won the trust of the people, managed to develop a relationship with them. We educated them on various aspects of the child and mother’s nutrition and health. We explained to them why a regular medical check-up, immunization and right nutrition strategy were necessary for the well-being of both the mother and the child. They now look up to us. They inform us if someone is pregnant in their family, and seek support. There is a lot of awareness now,” Goswami adds.
Breastfeeding practices have changed. Newborn babies are breastfed within an hour of birth. Beneficiaries follow the guidelines of Anganwadi workers on breastfeeding practices, post-delivery medical interventions, tips of good health and nutrition strategy.
“Earlier, they (lactating mothers) used to administer ‘ghutti’ (a thick mix of sugar and water) to newborn babies on the instructions of elderly women in the family or ‘daai’. They now breastfeed the babies within an hour of birth and continue the practice. They do not administer ‘ghutti’ to babies anymore, even if their ‘daadis’ insist on it. We educated them, told them about the benefits of colostrum and exclusive breastfeeding till six months,” Goswami tells
With the increase of the penetration of Anganwadi workers, families have started following the instructions of the Anganwadi workers on the nutritional needs and well-being of the mother and the child. Those, who cannot afford adequate nutrition, collect healthy food items from Anganwadi centres under the supplementary nutrition programme
The Anganwadi centres provide various recipes of age-appropriate hot cooked meal to pregnant women, lactating mothers and children below 6-years. This provision, however, has been suspended since March last year following the outbreak of the Covid-19. At present, beneficiaries are provided take-home-ration (THR).
- WCDPO Parveen Kumari in her office
“Under the THR provision, we are providing them ration every month. They do not visit Anganwadi centres. They cook at home and eat. We will switch back to the hot cooked meal provision once the pandemic situation improves and the restrictions are lifted. Some cases of Covid-19 still keep coming up now and then,” Ganaur tehsil Women and Child Development Project Officer (WCDPO) Parveen Kumari told Outlook Poshan.
- Savita with her eight month oldgirl child at home in Datauli village
For Savita who gave birth to a girl child six months ago when the Covid-19 pandemic crisis was at its peak, the services of Anganwadi centre in Datauli village were no less than a boon.
“The kind of support and services that they have been providing to me and my baby was unaffordable for us. Our nutritional needs would have remained unfulfilled if they had not given us (supplementary) food (items). From regular health check-ups, immunization, medicines to hospitalisation for the delivery, they arranged everything. They even arranged an ambulance to take me to the hospital. We did not have to pay for any of these,” she tells.
Right nutrition and medical care were perhaps impossible for Savita as her husband works as a daily wage labourer. With his little earnings, he is barely meeting his family expenses. Besides an eight-month-old daughter, the couple has a seven-year-old son, who studies in a primary school in the village.
- Anganwadi team visitinga beneficiary's home in Datauli village
The community-based events, organized by the WCD department in the villages twice a month under the Poshan Abhiyan, have yielded positive results. Such events have helped educate the beneficiaries on various issues of nutrition and healthcare of women and children, sanitization and hygiene. They have also turned out to help increase community support in the fight against malnutrition in the region.
“In Mahila Gosthi (Women's seminar), we organize various activities to increase awareness of our beneficiaries. We give them nutrition and health tips. As part of the community outreach programme, our department has decided to organize a special Mahila Gosthi event every six months from this year. We will organize various activities in this half-yearly event as well. Participants will be asked to cook healthy recopies and the best three of all entries will get a cash prize,” WCDPO said.
- Anganwadi team visitinga beneficiary's home in Datauli village
Ganaur Tehsil has a total of 74 villages and 251 Anganwadi centres to cater to the nutritional and health needs of pregnant women, lactating mothers and children below 6-years. They also run pre-schools for children and also target adolescent girls to educate them on various aspects of nutrition, health and hygiene. A large number of villages have very poor households in the Tehsil.
“We keep a special focus on low-income households and provide benefits under the Poshan Abhiyan. We organize camps in such areas and hold various activities to educate them on various aspects of nutrition and health,” the WCDPO says.