Nutrition

Nutritious feeding programme gives hope to tribal mothers in Orissa

© UNICEF/India/2007

Women monitoring feeding

Sarada Lahangir

Koraput, Orissa: "Amar pila amar dhan, aame amar pilake nekhaiki mari ne deun, aame raan neichu amar pilake aame banchabu. "(Our children are our wealth, we won't let our children die of malnutrition, we have taken an oath to save our children).

Eighteen-year-old Raibali Durua, who has a malnourished child, took this oath with total solemnity. Raibali has already lost two children due to malnutrition and her eight-month-old child was in the Grade III category of malnourishment till a month back.

Thanks to an enigmatically named nutritional feeding programme called “Positive Deviance” in Hardoli village, Raibali's son has now improved up to Grade I. This has instilled confidence in Raibali as well as other mothers in the village. Now each and every tribal woman articulates this slogan in Hardoli village, Kotpad block of Koraput district.

Malnutrition: a reality in Orissa
Subhadra Batra, just 14, has a nine-month-old child in her lap. Subhadra got married at the age of 10 and it was very difficult to save both mother and child at the time of delivery. "My baby was very weak, because I hardly had any milk for him. The Anganwadi didi (community-based Early Child Care Worker) told us in a meeting about this feeding programme and I decided to follow her advice. I am happy to see that my child is now recovering," she says.

Malnutrition is widely prevalent in Orissa and particularly severe among children under three years of age.  In Koraput 27 percent of children in this age group are either in Grade II, III or IV of malnutrition.

Ninety percent of girls in this tribal area marry at an early age (between 10 to 14) and get pregnant soon after. This is one of the causes of their poor health as well as that of their children. Secondly, a majority of the tribals live below the poverty line and solely depend on wage labour for survival. Most of the mothers work as wage labourers, leaving their young children under the care of older siblings.

Keeping these factors in mind, UNICEF, along with the Department of Women and Child Development launched the Positive Deviance Programme also known as Ame bi Paribu (We Too Can).

It is called Positive Deviance (PD) because it looks at the positive side of an otherwise very grim picture. Aimed at reducing malnutrition among children less than three years of age the initiative emphasizes behavioural change through participatory learning and community mobilisation.

© UNICEF/India/2007

Feeding session in progress

Explains K Parvati, an Anganwadi worker, "the idea is to share and learn the best feeding and caring practices that exist within the community."

PD's unique feature is that it focuses on the inherent strengths of the community and draws from the untapped resources available within the community.

The guardians of the children bring food including vegetables, rice, dal and pulses to the Anganwadi centre and place them in the 'Akshya patra', a common receptacle.

"Today the programme is implemented in 326 Integrated Child Development Services (ICDS) centres and 2,000 Anganwadi centres and reaches out to cover approximately 40,000 children. In Koraput district, the programme was launched this year in 50 Anganwadi centres, covering around 1,000 children. The target is to cover 400 centres in the district by December-end.

A joint effort of ICDS and UNICEF
The government’s ICDS programme provides the Anganwadi Centre with rice and dal. The women of the community jointly participate in the cooking and feeding exercise that takes place once in a day. Mothers with undernourished children follow this regime for 12 days in a month. For the rest of the month, caregivers practice the desired feeding practices at home and record their child’s progress. Every month the malnourished child is weighed. A weight gain of 100-600 gm is a great morale booster for the mothers.

The whole village is mapped and charts are drawn to indicate the nutritional status of each child as well as the village.

Subasini Panda, one of the ANM workers associated with the PD in the Kotpad block, says that the programme has made a major impact in tackling malnutrition in the villages.
The maps use colour coding to grade the child - the colour red indicates severe malnutrition, yellow moderate malnourishment and green normal. The charts stating the health status of each child are prominently displayed at the anganwadi centres, stirring the mothers into improving the status of their children. Plotted with the help of panchayat members, the maps also show the location of the feeding centres in the village.