Yasodha, mother of a 19-month-old girl and five months pregnant with her second child, is happy that due to the combined efforts of Front-line workers (FLWs) and POSHAN Champions, she is more aware of what food and nutrition supplements she needs to ensure better health for herself and her unborn child.
Living in a tiny village Saleda, around 10 kms away from the block headquarter of Bhinder, in Udaipur district, with her family of 6 members, Yasodha had relied completely on knowledge of her mother-in-law and family members during her first pregnancy and delivery. Though she delivered a healthy baby, but she faced many complications during her first pregnancy.
“I appreciate the way they have informed me about my health and are guiding me for proper weight gain - what nutritious food to eat during pregnancy,” says Yasodha. “Now not only me but my husband and mother-in-law also know about this. Nowadays my husband accompanies me for my ANC check-ups.”
Yasodha has received the counselling at AWC, at community level during PLA (Participatory Learning Action) meetings and at home. When unable to go to the Anganwadi Centre (AWC), AWW or ASHA along with POSHAN Champions visit her at home.
Today Yasodha is among many pregnant and lactating women (PLW) in the village who are benefiting from the intensive nutrition counselling provided by a FLWs and POSHAN Champions. There is awareness about how much weight they should gain during pregnancy, what should be eaten during times when they don’t feel like eating, what will happen if they don’t take iron and calcium supplements regularly, etc.
Intense interpersonal counselling (IPC) by the FLWs has increased awareness amongst PLWs but has also motivated family members to openly support them.
Since the time POSHAN Abhiyaan was launched, efforts have been made by stakeholders to spread the messages of nutrition. In its effort to intensify its initiatives to improve the status of undernutrition in the state, Government of Rajasthan has started implementing a state level ‘Social and Behaviour Change Communication Strategy’.
The first state to do so, Rajasthan has stepped up efforts to improve the nutrition status in the state. In some pockets these efforts are bearing encouraging results, though these are too few
and too scattered. Udaipur district in Rajasthan has few such good examples
In Udaipur, FLWs have joined hands with community POSHAN champions trained under RajPusht program to impart specific counselling to every pregnant and lactating woman. A layered approach has been adopted where message is being imparted to the pregnant and lactating women through multiple channels at multiple level – an Anganwadi worker counselling at Anganwadi centres, ASHA during community level meetings, ANM on the MCHN days and the POSHAN champions supplementing the AWWs and ASHA during the home visits.
Home visit counselling is not restricted to PLWs but also other family members. Orientation of doctors have also been done to ensure that these messages get imparted during the hospital visits and post-delivery by the hospital staff. The entire attempt is to maximise the touchpoints for a PLW thus increasing the opportunity for her to get her queries addressed and make her more empowered with knowledge. A recently organised POSHAN Pakhwada, a combined force of 6866 ANM, ASHA, AWW and Community POSHAN champions visited the homes of all PLWs in Udaipur district to spread the nutrition and child care message.
Repeated training of the FLWs along with specific counselling tools like JobAids have been undertaken to support this entire process. In these training sessions specific information on nutrition is imparted besides skills of counselling using various information tools. The process though long is starting to show impact on the ground.
(The writers are part of the IPE Global project on maternal and child nutrition being implemented in Rajasthan).