on the details of
Motihari district, East Champaran, Bihar
Thematic Intervention: Health and Nutrition
CHARDS is implementing CRY project in 17 Hamlets of Two Panchayat namely Madhubani Ghat and Vardaha situated in Motihari Sadar. These villages are mostly inhabited by Dalit, Mahadalit, Other Backward Castes (OBC), Minority and having total of 3776 Household. The intervention villages are also prone to floods. Landlessness is a major cause of poverty among Dalits/Mahadalits and Minority. The benefits of government poverty alleviation and social security schemes hardly reach to beneficiaries owing to corruption.
CHARDS started working with the Dalit and backward community especially with women, children and farmers in the year 2004. The project holder is Mr Sashi Prasad, who has closely worked with women and children of the area on the issue of malnourishment. CHARDS as an organisation started organizing health camp in one Panchayat of Motihari and also organized training for the small and marginal farmers on Vermin compost and Nutritional Garden.
The primary issue which is been addressed in the operational area is health and nutrition. In the project area the existing health care facility is not easy to access by all, due to several factors. The main barrier of accessibility is distances from the villages and poor quality. Due to inaccessibility of health services the burden of home delivery is still prevalent. The other underlying reasons behind the high burden of non-institutional childbirth are: poor birth planning, absence of male person in the family as male person migrated for their livelihood to the other states,unavailability of ambulance and lack of available finance. Due to several reasons the child death rate is also high in the project area. From January to June 2016, 11 children deaths were reported from the project area. Parents and community are unaware on preventive measures/symptoms of illness and it has been observed that in case of minor illness or onset of any illness they do not take proper care. It was observed that considerable numbers of women still believe in old unscientific practices and taboos, stories which lead to higher rate of mortality and morbidity.
Malnutrition is yet another issue which needs to be addressed in the operational area. There is scarcity of adequate numbers of ICDS (Integrated Child Development Services) centers in the operational area and thus a large numbers of children are out of services. The regular growth monitoring rarely happens thus the growth of the children is not known and malnutrition is not arrested at the early stage. The problem of colostrums feeding is a significant challenge in the community, due social belief and age old practices the colostrums is not provided to the newborn. At the time that women become pregnant, they are often expected to keep quiet, work hard and eat little. Lack of proper infant feeding practices and lack of knowledge on health, hygiene & sanitation facilities for mother & child in the area also make the situation alarming. Infections can cause malnutrition through decreased nutrient absorption, decreased intake of food, and direct nutrient loss. The diseases are caused due to lack of hygiene and sanitation among children. Another cause of malnutrition among children is high burden of child marriage, which results in early motherhood and birth of early child.
- To enhance the health seeking behavior of the community
- To reduce the child mortality & morbidity in the community.
- To increase institutional delivery in the project area through community sensitization and strengthening of health institutions.
- To reduce the burden of malnutrition in the project areas.
Achievements & Impact in the Review Period
CHARDS as an organization took up the strategy of building awareness through organizing village level meetings, Self Help Group (SHG) meetings, adolescent group meetings, women group meetings and targeted beneficiaries meetings and ensured the participation of health service provider like AWW (Anganwadi Workers), ASHA (Accredited Social Health Activists) and ANM (Auxiliary Nursing Midwifery) in the meetings. This year the organization also roped in authority from ICDS, public health centres, district hospital, Nutrition and Health Management department, Nutrition and Rehabilitation Center(NRC) and agency working in health for capacity building, health linkages, NRC linkages and empowering beneficiaries. This overall gave momentum to vaccination, institutional birth, and linkages to ICDS centers and Severely Acute Malnourished (SAM) children rehabilitation.
On the other hand the organization continued tracking of children, Pregnant and lactating women for vaccination, Antenatal and Postnatal care, institutional birth and rehabilitation of malnourished children. Based on tracking, household counselling was also done which led to building knowledge of the beneficiaries on health and nutrition issues affecting them.
The organization made a step forward in strengthening the ICDS development committees, making ICDS functional and demand generation for health sub enter, facilities in additional primary health centres and new ICDS centre. In the process the organization engaged community, Panchayati Raj Institutions (PRI) members and local leaders and also did signature campaign for demand generation from Health Minister – Bihar. The organization got overwhelming response from health minister and assurance for referring it to chief secretary- Motihari and district magistrate.
Overall following were the achievements of 2016:
- Tracking of Pregnant women has resulted in antenatal centers of 367 pregnant women.
- There is also an increase in complete immunization. This year the complete immunization is 77%.
- Perceiving the benefit of institutional delivery, there has been increase in same (108 institutional delivery out of 213). In 2015 it was 30% and now it is 51%)
- Pregnant women and lactating women are gradually getting adequate care from family members.
- Adolescent girls coming out of their boundaries and seeking information from health service provider.
- 1564 children are being covered for regular tracking. Tracking has resulted in linkages of children to AWC (Anganwadi Centre)/NRC and counselling of parents
- With the support of ICDS centers 56 SAM children has been identified and 13 children referred to NRC which after treatment are back to normal.
- Adolescent girls are now more confident and seeking health related info from health service provider.
- School intervention through wall magazine has been also instrumental in making child aware on nutrition issue
Focus 1 : Reduction of Child Malnutrition in 17 Hamlet of 2 Panchayat. Community started to address the underlying causes of malnutrition.
- Identification and tracking of children (SAM/Malnourished) and their follow up.
- Linking children to ICDS centers. Ensuring Growth Chart Plotting for each child in ICDS.
- Community level awareness building on available resources, food diversity and initiation of supplementary nutrition after six months
- Celebration of breast feeding week in collaboration with ICDS dept (campaign for exclusive breastfeeding till six months
- Mobilizing the women to demand for regular growth monitoring chart (GMC) and sharing the data with them by the ICDS workers.
- Capacity building of pregnant/lactating/ newly married women on feeding practices, nutritional supplement and locally available resources.
Focus 2: In 17 Interventional tolas ICDS, NRCs, PDS are fully functional.Government acknowledge the demand for new ICDS and started taking action to ensure ICDS for all habitat Child Development Project Officer(CDPO) takes action to institutionalized weight machine and growth monitoring charts(GMC) in all operational ICDS centre.
- Self Help Groups/Mata Samiti meeting for their participation in strengthening ICDS centers.
- Capacity building session for proper functioning and monitoring of ICDS centre.
- Meeting with Child Development Project Officer (CDPO) and letter writing for continuation of demand for 5 new ICDS centre.
- Submission of demand for establishment of Nutrition and Rehabilitation Centre (NRC) at block level.
- Working towards building of 5 model ICDS in 2 Panchayats.
Focus 3: Children's views represented in significant policy engagements at different levels. Children raising their voice and sharing their point of views in the community.
- Regular meeting with adolescent girls group
- Regular inputs on health and nutrition issues in this process
- Empowering adolescent group in decision making process at family and community level
- Inclusion of new adolescent girls in the groups
- Support CC members in publication of Annual Magazine
- Mobilizing the parents to participate in the adolescent process.
- Work with community to help them to understand the Participation issues.
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