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Location

Jamui district, Bihar, India
Thematic Intervention: Nutrition & Participation


Project Context

Samagra Seva was registered in the year 2001 in Jamui District and works within the district itself in Bihar state. The project holder, Mr. Makeswar Rawat has worked with WHO and UNICEF as a consultant supporting the immunization drives in the state of Bihar. The inhabitants in the intervention villages of Jamui Sadar and Jhajha block belong to schedule caste, schedule tribe and other backward caste communities. Samagra Seva has focused its work on referring severely Acute Malnourished (SAM) children to Nutritional Rehabilitation Centers (NRCs), ensuring growth monitoring in all the 19 ICDS centers and institutionalizing practices like hand washing in 6 ICDS center.

Problem Statement

As per the Census data 2011 prevalence of wasting & stunting in Jamui is higher than the state average of Bihar. This needs to be seen in the context that Bihar has the highest incidence of malnutrition in India.

As per census -2011 Jamui’s nutritional status as below:

Indicators Bihar Jamui

Below -2 SD Wasting( Weight for height) %

19.2

35.4

Below -2 SD Stunting ( Height for Age ) %

52.0

63.1

Below -3 SD Stunting ( Height for Age ) %

25.3

47.0

Below -2 SD Underweight ( Weight for Age ) %

40.3

65.7

Below -3 SD Underweight ( Weight for Age ) %

15.8

35.6


The recent published NFHS-IV (2015-16) data shows that:

Indicators Bihar Jamui

Children under 5 years who are stunted (height-for-age)

48.3%

45.9%

Children under 5 years who are wasted (weight-for-height)

20.8%

29.4%

Children under 5 years who are severely wasted (weight-for-height)

7%

10.9%

Children under 5 years who are underweight (weight-for-age)

43.9%

47.2%

Children with less than 2500 gm birth weight

9.5%

7.7%


Malnutrition is an inter-generational issue with gender discrimination playing a lethal role in this cycle. There is lack of AWC, no universal coverage of children and AWW/ASHA workers do not record Growth chart of children. There is a lack of awareness among families on malnutrition, importance of Breastfeeding, importance of spacing between two children, effects of early child marriage. Early marriage of girls less than 18 years is highly prevalent, early marriage is related to poor health and nutrition outcomes for mothers and babies. Child marriage prevalence is alarming and access to skilled health personnel and Sub-Health Centres is very limited. Another important player are the AWWs who don’t regularly monitor each child and also unable to identify a SAM child. The NRC also is situated in Jamui district head quarters and therefore there is issue of accessibility. Even mothers are not willing to stay in the NRC since they have to take care of their other children.

Achievements & Impact


The current focus (Nutrition) in the district is as per the CRY criticality mapping (program deepening strategy). However, Samagra Seva as a CRY partner has been working on various aspects of child protection issues, especially child labor and child marriage. In this context, the key child protection issues like child labor and child marriage has been a focus in the last couple of years. In the reporting period, the organization has built the capacities of the Block level Child Protection Committee and Gram Panchayat in collaboration with the District Child Protection Unit (DCPU) for logical conclusion of the program on protection. Going forward the partner will focus on Nutrition.


Key Result Areas: Reduction in child labor in 30 Tolas (habitations) in 2 blocks of Jamui district through strengthening child protection units.

Program Activities Planned Progress and Achievements

* Collaboration with District Child Protection Unit (DCPU) for formation of village and Panchayat level Child Protection Committees (CPC).
* Conduct capacity building of village, Panchayat and Block level CPC members and extend handholding support in actions on child protection issues including child labor in project areas.

* 2 capacity building programs have been organized for the Child Protection Committees (CPC) in the Gram Panchayat Level and Block level on their roles and responsibility.
* 9 Gram Panchayat Level Child Protection Committee (GPLCPC) and 24 Village Level Child Protection Committee (VLCPC) were formed.
* 47 Block Level Child Protection Committee (BLCPC) members have undergone orientation workshop on their roles and responsibilities in Jhajha.
* 38 child labor (6-14 years), and 25 child labor (15-18 yrs) were contacted and mainstreamed into schools.


Key Result Areas: Reduce malnutrition among children and pregnant and lactating mothers in the project intervention area.

Program Activities Planned Progress and Achievements

* Tracking low birth weight babies and dialogue with the ICDS workers to ensure weighing of newborn within 24 hours in case of non-institutional birth.
* Linking the children who are out of ICDS Anganwadi tracking, for take home ration (THR) for mothers under supplementary nutrition program(SNP), and growth monitoring.
* Identification of the severely acute malnourished (SAM) children & referral to Nutrition and Rehabilitation Center (NRC).
* Discussion with young adults on the issue of early marriage, early motherhood as trigger for malnutrition.

* 296 children received complete immunization.
* Out of 249 newborns, 199 children were ensured colostrums feeding.
* Total 2,013 children in the age group of 0-5 years were mapped on the Growth Monitoring Chart (GMC) chart out of which, 561 children were out of the ICDS.
* Height measurement flex were installed in all 24 ICDS centers and is now being used.
* Out of 404 identified mothers, 296 mothers had received full vaccination.
* 23 ICDS centers out of 27 centers have organized the BACHPAN DIVAS (Children’s day).


Program Activities Planned Progress and Achievements

* Capacity building session with adolescent on different health & hygiene practices.
* Identification and tracking of pregnant mothers.
* Capacity building of mothers on nutrition and dietary counseling during pregnancy and lactation in the community & promotion of diversified diet, early initiation of breastfeeding (within 30 minutes), exclusive breastfeeding for 6 months and continuation till 2 years.

* In 6 ICDS centers, the workers have been ensuring hand wash practices before serving the hot cooked meal for children.
* 40 SAM (severely acute malnourished) children were referred to the Nutrition Rehabilitation Center (NRC) and one child was referred to the Sick Newborn Care Unit (SNCU).


Key Result Areas: Children are raising their voices on the issues affecting their lives.

Program Activities Planned Progress and Achievements

* Conduct regular meeting with Children Collectives emphasizing on aims, objectives and task to be undertaken (monthly). Focus to include more girl children in the Children collectives.
* Conduct capacity building sessions with children collectives’ members.
* Setting up digital literacy center equipped with information related to personal hygiene, healthy life practices, nutrition, reproductive health etc.
* Ensure engagement of community in the activities undertaken by the children collectives and vice versa.

* 168 girls were capacitated on different health and nutrition issues.
* A total of 20 meetings were organized with ‘Kishori Manch’ and another 43 meetings were organized with ‘Bal Manch’.

Update on major events /campaigns that may have taken place on ground:


* Adolescent workshop on health and nutrition: - Samagra Seva conducted a two - day adolescent workshop in which the objective was to sensitize the children on good health, hygiene practices and major health schemes currently provided by the state government. A total of 27 children participated in the workshops.
* Mission Bal Poshan: - This program was conducted in two phases. In the first phase Samagra Seva did various activities viz. wall painting, slogan writing, demonstration on nutrition through community meeting. A total of 598 people participated in the first phase of the event and the emphasis was given more on Growth Monitoring Chart. Whereas in the second phase the campaign continued for one month. Samagra Seva liaised with the government officials to carry on this month long event. The District Magistrate, District Program Officer, and Child Development Project Officer (CDPO) etc. were present during the launch of the event. During the event, nutritious local food was demonstrated and the community was actively involved.

Knowledge and Capacity Building workshops:


* A capacity building workshop for the animators was organized on plotting Growth Monitoring Charts (GMC). Age vs. Weight remains the criteria of mapping Growth Monitoring Chart (GMC) and thus concept of plotting the respective lines needs to be done with caution otherwise the it may show wrong results. As an outcome, participants understood the way plotting needs ot be done and in turn they have taken a session with the ICDS workers in their respective project areas.

Plans


Key Result Areas Program Activities Planned

Reduction in Malnutrition level

* Tracking of nutritional status of (6 months to 3 yrs) all children through Growth Monitoring campaign by ICDS centres on a quarterly basis.
* Identification of the Severely Acute Malnourished (SAM) children & referral to Nutrition Rehabilitation Centre (NRC).
* Capacity building session with adolescent on different health & hygiene practices, food intake, gender discrimination etc.
* Checking of anaemic condition for 200 Adolescent girls through VHSND (Village Health, Sanitation and Nutrition Day) platform. Baseline and endline data of anaemia result would be compared and strategies to be prepared for improving of the condition.
* Activation of 5 VHSNC (Village Health, Sanitation and Nutrition Committee) in the operational area.
* Developing community kitchen gardens in 5 villages.
* Block level capacity building workshop for ICDS workers on ‘how to prepare nutritious food at ICDS centres and on Growth Monitoring Chart (GMC) and Mother and Child Protection (MCP) card’.

Plans


Key Result Areas Program Activities Planned

Children are raising their voices on the issues affecting their lives

* Regular meeting with Children Collectives emphasizing on aims, objectives and task to be undertaken (monthly). Focus to include more girl children in the activities of Children Collectives.
* Capacity building of children group on CRY’s child centre module.
* Setting up digital literacy centre equipped with information’s pertaining to reproductive health, nutrition etc.
* Meeting with parents/ guardians for promoting children participation in the children’s collective process.

Financial Summary: January to December 2019


Budget Breakup 2019

Nutrition

11,416

68%

Participation

1,517

9%

Administration

3,949

23%

Total Grant Approved

16,882

100%