As stories of change across India show, it is critical to empower frontline health workers who are driving maternal and child nutritional and developmental outcomes in the last mile.
As stories of change across India show, it is critical to empower frontline health workers who are driving maternal and child nutritional and developmental outcomes in the last mile.
Addressing malnutrition is critical to building a strong foundation for human development. Optimal maternal nutrition and infant and young child diets represent the most effective set of interventions to reduce child mortality and illness, prevent malnutrition, determine cognitive development and ultimately enable productive adult life. is. Specifically, her first 1,000 days of life, from conception to the first two years of her child’s life, are critical. This stage provides a critical opportunity to ensure optimal growth, development, child survival, and lifelong health and nutrition. In fact, 80% of brain development occurs during the first 1,000 days of life.
To address the persistently high burden of malnutrition, India has embarked on several policy and programmatic initiatives, including its flagship program, the Prime Minister’s Comprehensive for Holistic Nutrition. Includes initiatives under the Ministry of Women and Child Development, including the Plan (POSHAN) Abhiyaan (launched in April 2018). (MWCD). Its overarching goal is to improve nutrition outcomes by focusing on capacity building, improved service delivery, community mobilization and participation, technology use, and interagency/intersectoral convergence planning and review. is. In addition, there is greater emphasis on documenting intervention coverage during her first 1,000 days, including pregnancy registration, antenatal check-ups, and exclusive breastfeeding, compared to the situation in 2015–16.
Evidence-based interventions matter
Evidence suggests that to effect change in nutrition outcomes, evidence-based interventions must be implemented with high coverage, continuity (over 1,000 days of life and across delivery channels), intensity (multiple interactions), quality and equity. must be provided in A woman’s health and nutritional status, including weight and hemoglobin levels, age of conception, and levels of multiple micronutrients before and after conception, are important determinants of child health.
The importance of preconception care, or care before conception, is recognized. In 2018, the Ministry of Health and Family Welfare, in collaboration with the State of Maharashtra and UNICEF, launched the first primary healthcare innovation program to promote pre-conception women’s health in Peth and Sina Districts, Nashik District, Maharashtra. Completed in 27 months, the program found that improving the health of adolescent girls and women not only improves newborn health, but also prevents low birth weight, premature birth and neonatal death. I understand. Its success has resulted in expansion across several districts in the state.
All such interventions are delivered to the last mile by a network of frontline workforces. Health planning and action. In many areas they are the only access point to basic nutrition and other health services. They are critical in promoting healthy practices, providing on-the-ground support, and raising awareness.
in Uttar Pradesh
For example, during Poshan Pakhwdaa in March 2022, in a remote village in Uttar Pradesh, all families with children under the age of 2 will overcome long-standing fears and misunderstandings and bring their children to the Anganwadi Center. We were able to measure our weight. AWW supported by a female supervisor. Relatives such as mothers, grandmothers and fathers were enlightened about the benefits of regular weighing. Men, especially fathers, play a very important role in ensuring maternal and neonatal health (MNH). They can influence her MNH behavior and good practices within the home and community. Studies have shown that a mother is 1.5 times more likely to receive prenatal care early in pregnancy than she is if the father is involved during pregnancy.
Back to the topic. AWW and female supervisors enlisted the assistance of Panchayat Her Pradhan, who organized a community-level meeting the day before the start of Porthan Her Pakwada. Engage all men, women, AWW, ASHA, school teachers, and community elders to ensure the benefits of weighing, early detection of undernourished children, and weighing of all eligible infants Did.
Also read: How to fight malnutrition
Similarly, a female supervisor of a block in Unao district (Uttar Pradesh) confirmed that AWW not only received growth monitoring devices, but were also trained to accurately measure and record body weight. . A community mobilization meeting was also organized to ensure that all eligible children were covered.
These stories of change from Uttar Pradesh, driven by frontline workers and their supervisors, resonate with the joint efforts of AWW and ASHA workers living in remote villages bordering Nepal. I’m here. .
Momentum to strengthen the nutrition system is focused on regular skills, supportive supervision and motivating frontline workers to deliver tailored, targeted and quality nutrition and health services. is guessing. These should be prioritized and maintained at the program level, along with data-driven reviews. Their deep understanding of issues and needs at the grassroots level makes their contribution to community health much greater. It’s important to empower frontline employees who are driving change in the last mile.
Dr. Dinesh Baswal is the MNCH Leader and Chief of the Party Saksham MNCH Accelerator supported by USAID (South Asia Hub). He is also the former Undersecretary of Maternal and Child Health for the Department of Health and Family Welfare.
