In March 2018, the Government of India launched its ambitious Poshan Abhiyaan to tackle the issue of malnutrition. However, despite various flagship programmes of the Government, the threat of widespread child malnutrition still remains. Worldwide too, the 2018 Global Nutrition Report lists malnutrition as a severe problem, once again. Half the deaths in children are linked to malnutrition (Lancet maternal and child nutrition, June, 2013). Therefore, a multi-pronged approach is necessary to tackle the scourge.
The Child in Need Institute (CINI), a top national NGO based out of West Bengal, partnered with UNICEF, Save the Children, DFID, Oracle, HCL and Johnson & Johnson to address this issue, under its first 1000 days care project. The community-led project for the care of malnourished children was designed on the premise that well-informed and motivated mothers, ably supported by equally aware neighbourhood communities, can effectively improve the nutritional status of their children. With the CINI method as the guiding principle, the project aimed to create sustainable models of community practices. The project was carried out across several districts of West Bengal: South 24 Parganas, Uttar Dinajpur, Malda and Kolkata
How children are being fed
The key components of the project were setting up Anganwadi-based feeding demonstration and counselling sessions to promote optimal infant and young child feeding practices and encourage community-based care of under-weight children without medical complications.
In CINI’s current project locations in West Bengal several pockets still remain unserved and under-served under the ICDS services. These pockets have many young children who are moderate to severely under-nourished and remain undetected even with the ICDS programme mechanism for screening and management.
The project conducted Participatory Learning and Action (PLA) exercises to identify the current practices of feeding behaviours of infant and young children in the community as were the good practices.
Lessons to learn
The project threw up two vital clues on feeding behaviour:
1) That the majority of mothers and caregivers were not aware of age appropriate complementary feeding.
2) Most children, after completion of six months, didn’t get the age-appropriate complementary foods with right quantity, quality, frequency and consistency.
Based on this learning, the existing recipes given to young children were modified adding the locally available nutritious foods from family food basket (oil, seasonal green leafy vegetables, red and yellow vegetables, pulses, seasonal fruits, dairy, eggs and iodised salt). The point was to make the food more calorie-dense and rich in micro-nutrients.
Caring at home
Demonstrating visible impact in combating malnutrition, the project proved that a well-implemented project with a combination of homebased care of malnourished children without medical complications is more cost-effective and successful than institutional care. For the success of homebased interventions, dietary counselling and basic personal hygiene were outlined as an integral part of the programme. This successful project is now a replicable model for the rest of West Bengal and other Indian states.
Dr Samir Narayan Chaudhuri is the Founder-Director of the Child In Need Institute (CINI). Swapan Bikash Saha is Project Director—Nutrition of CINI. To know more about CINI’s work, please visit: https://www.cini-india.org/