Malnutrition is a serious issue in many parts of India and nearly every third child under 5 years is malnourished NFHS 4 (2015-16). The first 1000 days is considered crucial— the period during a woman’s pregnancy and the child’s first 2 years of life is termed as critical in preventing malnutrition. It was with this focus that Urban Nutrition Initiative (UNI) was started in March 2015 as a Public-Private-Partnership between TATA Trust, Rajmata Jijau Mother & Child Health and Nutrition Mission (RJMCHNM) and a consortium of NGOs led by Committed Communities Development Trust (CCDT) with technical support from UNICEF. Under the UNI project 8 high burden ICDS projects, with a high incidence of malnutrition, across 4 districts of Maharashtra namely Mumbai, Thane, Nashik and Nagpur were covered.
As this three-year Urban Nutrition Initiative comes to a close, a dissemination meet was held on June 21st at the Marine Plaza hotel, Mumbai. The dissemination meet, facilitated by CCDT was attended by all project implementing partners and non-profits, including Tata Trusts, UNICEF, Nutrition Mission, SNDT, Amhi Amchya Arogyasathi, VACHAN, FMCH and ISSUE—as well as CDPOs and the ICDS Commissioner.
Key dignitaries at the dissemination meet included Ms. Vinita Singal (IAS, Secretary, DWCD), Ms. Indra Mallo (IAS, Commissioner, ICDS), Ms. Suprabha Agarwala (Director, Raj Mata Nutrition Mission), Ms. Rajeshwari Chandrasekar, Chief of Field Officer (UNICEF Maharashtra), Ms. Debasmita Pani (Manager Nutrition, Tata Trusts), Dr. Shobha Udipi (Ex Professor and Director of Department of Post-Graduate Studies and Research in Home Science, SNDT University), Ms. Chhaya Rade (COO, CCDT) and Mr. Ninad Phatarphekar (CEO, CCDT).
Tata Trusts representative, Ms. Debasmita Pani, welcomed the audience and introduced the key dignitaries. She shared why Tata Trusts had supported the Urban Nutrition Initiative (UNI) and how proud the Trust was to partner with CCDT and implementing organizations. She particularly talked about how nutrition demonstrations, mothers’ groups and home-visits were exemplary strategies that other organizations working in the space could emulate and replicate.
Key Note speaker, Ms. Vinita Singal, IAS, Secretary, DWCD set the tone of the event by emphasizing how malnutrition was a health condition that—just like HIV, Polio and other endemic diseases—required consolidated efforts across all stakeholders to eradicate. She optimistically declared that malnutrition could be eradicated within one generation, if only we were able to focus on to-be adolescent mothers and enhance their own levels of nutrition and health. Emphasizing that efforts must begin even before a child is born, Ms. Singal talked about the various dimensions of malnutrition and how it wasn’t merely a factor of poverty—but instead is related to knowledge, information and practices. She, therefore, cautioned that a one-size-fits-all approach couldn’t be used to eradicate malnutrition and that the issue varied depending on the terrain where people lived. Ms. Singal talked about how urban children were at a bigger disadvantage than their rural counterparts, because of complex urban issues of water and sanitation, space and time constraints of the caregiver and high mobility on account of migration that makes it difficult for health functionaries to track children.
Representing the Government’s Nutrition Mission and ICDS program were Ms. Suprabha Agarwala (Director, Raj Mata Nutrition Mission) and Ms. Indra Mallo (IAS, Commissioner, ICDS) respectively. Ms. Agarwal shared that the unique selling proposition of the UNI program was that it did not set up a parallel system or duplicate efforts—but instead leveraged existing government systems and supported the department to give its best. It was this approach that rendered the program sustainable, allowing initiatives to continue through government functionaries post the program’s three-year period. Moreover, it allowed the program to be implemented ‘using minimal resources for optimal results.’ Ms. Mallo talked about the National Nutrition Mission launched early this year by the government, and how ICDS is at the forefront of this initiative—screening, weighing and identifying SAM/MAM children.
Setting the context of the program and the situation on-the-ground prior to implementation, Dr. Shobha Udipi (Ex-Professor and Director of Department of Post-Graduate Studies and Research in Home Science) SNDT University, presented key findings from a ‘Feeding Practices and Nutrition Intake survey’ conducted within the program area. These findings reiterated the need for intervention, given poor nutrition levels and dietary practices among the target population.
Presenting the impact of the program, key interventions employed and lessons learned, Ms. Chhaya Rade, COO, CCDT said, “We implemented six key interventions to reduce malnutrition in high-burden districts across Maharashtra including Strengthening ICDS, Enhancing Demand Generation for ICDS Services, Home Visits and Counseling for Child Rearing and Feeding, Growth Promotion and Monitoring, Referrals and Enhancing Maternal Health and Nutrition. The data indicates that malnutrition rates reduced on account of the program—specifically, the percentage of children Severely Acutely Malnourished reduced by 3.36% and those Moderately Acutely Malnourished reduced by 7.3%. The UNI model ensures that the community is at the centre of both demanding for services and ensuring these are effectively delivered. UNI also works together with existing government machinery and renders these services more effective. By deploying these two approaches—partnering with existing government machinery and leveraging community-based monitoring mechanisms—the model is rendered sustainable and low-cost.”
Touching upon the way forward, UNICEF Chief of Field Office (Maharashtra), Ms. Rajeshwari Chandrasekar emphasized the need to learn from challenges experienced in implementing UNI over the last three years and incorporating these insights when designing future programs. She noted how UNICEF’s new five-year program plan for Maharashtra heavily focuses on urban-health, given the poor health indicators in urban slums. She urged participants working on health programs to customize different interventions and strategies for urban settings, as opposed to rural and tribal areas. Ms. Chandrasekar emphasized the need to focus on the second window of opportunity: Adolescent Girls, whose health prior to child rearing, was a key determinant factor in the health and nutrition of infants.
Mr. Ninad Phatarphekar, CEO, CCDT closed the day’s proceedings with a vote of thanks to all those present, especially those who had contributed by way of presentations and keynote addresses.
To read more about the findings of the Urban Nutrition Initiative click here.