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Location

30 villages/habitations of Lamptaput block of Koraput district of Odisha.
Thematic Intervention: Health and Nutrition

Background

SPREAD was founded by Mr. Bidyut Mohanty along with some like minded people in 1989 with a commitment to work for the betterment of underprivileged population with focus on development of tribals in Koraput district of Orissa. In initial years of intervention, the project team focused on the problems of the displaced tribal population, those who have been deprived of their homes and livelihood due to loss of land and common property to make way for a major hydro-electric project, Damanjodi by NALCO. SPREAD became a CRY supported partner from 2005-06. Mr. Bidyut Mohanty, the Project Holder has been working in the development sector for the last 15 years on the issues of gender, participatory approach, advocacy and program Monitoring and Evaluation. He started work with Dalit children of slums in Bhubaneswar and has been associated with ‘Agragami’ on the issues of tribals.

Problem Statement:

Koraput district is located in the backward Koraput- Bolangir- Kalahandi (KBK) region of Odisha. The district is predominantly populated by scheduled tribes and falls under the Scheduled Area. All the blocks are Integrated Tribal Development Agency (ITDA) blocks. The tribes which pre-dominantly populate the Koraput region are Kandhas, Sauras, Sabras, Bhottoda, Bhumiyas, Parajs, and Gadabas. Literacy rates are below the state and National averages. The predominant issues in health are as follows –
•Late pregnancy registration-The community has a strong belief against the registration of the first born. They believe that the medication will harm the child.
•Women health is not prioritized – women health is accorded low priority as male are considered to be more productive & contributing in family earning.
•Irregularity in the consumption of IFA Tablets- ignorance on the benefits of iron tablets result in the irregularity of its consumption.
•Physical work during pregnancy & lactation period- Throughout the pregnancy period women are engaged in their regular household & field job. After the delivery the woman is back to her usual work in one month, which takes a high toll on women’s health and debars children from exclusive breast feeding.
•Irregular health check up of the children: Pre-school health program (RBSK) not working properly and children in school are irregularly screened for their health.
•Change in the food plates over years: The change in the food plates over the years by the market rules have taken a toll on the health of the community and made the locally available food unpopular. Behavioural change on locally available food and nutritional values of such food materials is required for the revival of community health.

The community monitoring of ICDS[1] by Mata Committee/Janch Committee (mothers’ collectives) members has been a great success in Koraput operational area in the previous years and to carry the same enthusiasm, a campaign was much needed to engage the community on nutrition and reduce malnutrition in the area. The project team closely facilitated the process of growth monitoring along with the community and ICDS workers. NRC[2] was too taken into consideration to accept the referrals being made at the VHND[3] and manage the number of malnourished children being referred. A package with other components like health hygiene, hand wash practices and kitchen garden has created a vibration in the community and on the other hand the health workers at the village level too have been enthusiastic about the campaign. Over the years of CRY intervention, there has been a change in the food habits of the community owing to lack of knowledge of balanced diet, availability and affordability. Intervention on potable and safe drinking water has been one of the focal areas of the project. Arrangements have been made to supply water to the areas, wherein the tube wells are closed.
SPREAD has been implementing in-depth programming on health and nutrition themes in the intervention villages. The project conducted activities with children, communities and stakeholders to streamline the processes on health and nutrition in the operational area. Community meetings were held in all villages; with training of PRI[4] members, they took initiative and a female staff appointed in the sub centre; lactating and pregnant mothers were linked with schemes; institutional deliveries increased and all have practices exclusive breastfeeding; all the sub health centres have ANMs ; kitchen garden played important role in shifting of Severely Acute Malnourished (SAM)children to yellow category ; attendance in the VHND has been increased; all ICDS centres plotting growth chart. Discussion of nutrition food was held among children groups, Anganwadi centres and schools; Children collectives are functional in the project area; child cell training was imparted with children groups; adolescent groups strengthened in all villages. Use of the Mobile Vaani Technology has helped in spreading awareness amongst the community about the various issues and the schemes hence demand from the community for services increasing.
The following are the changes observed in the location throughout the years of intervention of SPREAD:-
• Over the years the ANM[5] visits have been regular in the revenue villages and the hamlets adjacent to the revenue villages, which have enhanced the immunization completion.
• The number of Institutional deliveries have increased owing to the schemes and follow up by the team.
• The VHND processes have been regular and the ICDS has been functional with the increase in the enrolment in the ICDS.
• Participation of the children have increased and children are taking interest in games and gatherings. Adolescents have been contributing to the processes of meetings and other activities.

Plans:


Key Result Areas programs Planned

Access to free, primary health care in the intervention area

• Identify all pregnant and lactating mothers; registration of women with AWCs; ensure 90% of women avail MAMTA and JSY scheme;
• To ensure 90% women that delivered their baby at an institution
• To ensure 100% villages organise VHNDs during the year.
• Have community meetings in at least all 28 villages and conduct 1 breastfeeding week celebration and 1 food demonstration event in all the villages.
• Organize village community meetings; Ensure participation of Panchayati Raj Institution (PRI) members in the community meetings; Train PRI members to design Village Development Plans (VDP); Make VDP in at least 14 villages.
• To ensure 90% adolescents provided with IFA[6] tablets.
• Training to be organized for grass root functionaries (ASHA[7], AWW[8] and ANM) on health service delivery.
• All children in the age group of 0-1 year to be immunized and vaccinated completely.


Key Result Areas programs Planned

Reduction of child malnutrition in operational areas from 0 to 6 years

• Create awareness among the community on the importance of breastfeeding through breastfeeding week observation.
• Conduct situation analysis, including wealth ranking; weighing all children under 5 to determine who is malnourished; focus group discussions; transect walk and community mapping; market survey and seasonal calendar.
• Address basic health needs for all children through de-worming, updating immunisations, providing micronutrient supplements if needed etc.
• Develop charts on nutrient-rich foods which are locally available and affordable.
• Ensure 100% of Anganwadi workers can plot the weight of a child on a growth chart to identify malnourishment conditions of children.
• Conduct 4-5 days of sessions with small groups of malnourished children and their caregivers, preparing and feeding through the chart prepared and discussing the positive deviant practices.
• Conduct regular growth monitoring to track children’s progress and identify new cases of malnutrition.
• Promotion of Kitchen garden in household and ICDS centres.
• Create adolescence girls group as a model in 5 villages.
• Ensure 100 % of the existing Anganwadi have the provision of Take Home Ration (THR)

Financial Summary: January to December 2021


Budget Breakup 2021

Health

4,296

40%

Nutrition

4,296

40%

Administration

2,148

20%

Total Grant Approved

10,741

100%