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Nutrition in Banjar block, Himachal Pradesh – can we strengthen the District Health system?

Nutrition in Banjar block, Himachal Pradesh – can we strengthen the District Health system?. Over view . Situation summary – why nutrition campaign? Actions for intervention Achievements Lessons for learning. Nutrition programme. Nutrition in under 5’s – Tandi Panchayat, HP, INDIA.

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Nutrition in Banjar block, Himachal Pradesh – can we strengthen the District Health system?

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  1. Nutrition in Banjar block, Himachal Pradesh – can we strengthen the District Health system?

  2. Over view • Situation summary – why nutrition campaign? • Actions for intervention • Achievements • Lessons for learning

  3. Nutrition programme

  4. Nutrition in under 5’s – Tandi Panchayat, HP, INDIA

  5. ICDS programme – Integrated Child Development Scheme Largest programme in India • 780 000 across India • Anganwaddi – each with ‘madam’ and helper • Growth monitoring • Pre-school 3-6y (3hrs) • Rations for children and mothers • Support to ANMs and immunisation/ antenatal (primary sub-centre)

  6. Initial analysis – Banjar block ICDS programme October – Dec 06 Survey of 15 anganwaddis 90% centres staffed 50% no utilisation of meds 100% have completed growth monitoring 60% under supplied rations 50% of mother’s don’t attend

  7. ICDS programme Banjar Programme not accessible to over 50% of population (more than 1 hour walk) Growth monitoring limited (lack of scales and inaccurate) Lack of training to workers Financial disincentive if reporting malnutriton

  8. Our strategy to support and work with ICDS programme Banjar, HP

  9. Build relationships with Government Project Officer and District officials Support anganwaddi with child health clinics for all malnourished children on 15th dates Training each month to ICDS staff Train Nutrition promoters based in communities to work with anganwaddi workers Outreach work – rations/ growth monitoring by NPs to more remote villages Register 30 children each Share all growth monitoring data with ICDS Advocates with communities on nutrition/ ICDS Strategy

  10. How are we going so far?

  11. District health programme • District and block project officers very supportive and gives us teaching of all of anganwaddi • Uses our information to give feedback • Keen to work together further • Anganwaddi staff very glad for support – use our scales and data, refer children • Medical doctor (PHC) disinterested

  12. Nutrition promoters • Growing in confidence with communities • Speaking at Gram panchayat and women’s gatherings • Working with families • Need to increase political action

  13. What we are doing right • Identifying need and priority of community • Develop programme iteratively • Evidence based • Take small steps • Frequent meetings with Govt officers • Asking communities for participation and evaluation (Jibhi CHAI and Govt workers) Working in partnership and not parallel

  14. What we would change next time… • Nutrition promoter selection- Difficulty mixing high and low caste/ • Some girls without leadership ability • TALK to others BEFORE STARTING • How to get Govt Doctors onside? • Take longer with everything - increase community participation and make more a People’s programme

  15. Thoughts?

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