Nutrition in banjar block himachal pradesh can we strengthen the district health system
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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

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


Over view
Over view strengthen the District Health system?

  • Situation summary – why nutrition campaign?

  • Actions for intervention

  • Achievements

  • Lessons for learning


Nutrition programme
Nutrition programme strengthen the District Health system?


Nutrition in under 5 s tandi panchayat hp india
Nutrition in under 5’s – Tandi Panchayat, HP, INDIA strengthen the District Health system?


Icds programme integrated child development scheme
ICDS programme – Integrated Child Development Scheme strengthen the District Health system?

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)


Initial analysis banjar block icds programme
Initial analysis – Banjar block ICDS programme strengthen the District Health system?

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


Icds programme banjar
ICDS programme Banjar strengthen the District Health system?

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



Strategy

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


How are we going so far
How are we going so far? District officials


District health programme
District health programme District officials

  • 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


Nutrition promoters
Nutrition promoters District officials

  • Growing in confidence with communities

  • Speaking at Gram panchayat and women’s gatherings

  • Working with families

  • Need to increase political action


What we are doing right
What we are doing right District officials

  • 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


What we would change next time
What we would change next time… District officials

  • 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


Thoughts
Thoughts? District officials