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Location

30 villages under Sahabad block of Baran district in Rajasthan, India


Background

Prayatn Sansthan founded in 1992 with an objective of empowerment of communities to respond to changes and enable them to change their situation of inequality and injustice. However, over a period of time it has also developed expertise on child rights issues like declining sex ratio, child education, child marriage etc and at present, most of the interventions of Prayatn across the states of U.P., M.P., Rajasthan & Orissa have specific child rights focus as per child rights situational analysis of the intervention area. Prayatn is recognized as a leading organization in the state which is working on child rights issues and is equipped with the ability to work directly at grassroots with added competency of conducting research, networking with stakeholders and lobbying & advocacy with government. The Project Holder is Mr. Malay Kumar, whose major area of expertise has been on child rights, specifically protection related issues; He has a wide experience on pre-conception and pre-natal Diagnostic Techniques (PCPNDT) Act, trafficking issue, research etc.

Situation

The CRY supported project of Prayatn Sansthan is spread over 30 villages/hamlets of Saharia tribe under Shahabad block of Baran district in Rajasthan. The district of Baran borders Rajasthan and Madhya Pradesh. The reference community predominantly belongs to the Sahariya tribe, identified as a primitive tribe by the Government of India on the basis of low growth rate, pre-agricultural level of technology and extremely low level of literacy. Baran is one of 22 districts in Rajasthan designated as ‘food insecure’. The Saharia population is particularly vulnerable to malnutrition because of its geographical isolation, uncertainty of food supply and lack of adequate health care facilities. Children are the ultimate victims of this state of food insecurity and malnourishment. Due to exclusion, extreme poverty, inappropriate development programs; children are not provided with the necessary growth and development opportunities. As far as the status of ICDS services actually available to children in coverage area is concerned, the recent study conducted by Prayatn Sanstha on Food security program for Saharia community reflected that out of total children in 0-6 years, only about 42% of the total children avail services of Anganwadi centre (AWC).

The prime reason for the high malnutrition status is lack of awareness in the community and failure of the government machinery in extending awareness and services related to water and sanitation, nutrition and health care and bringing in behavioural change in the community. There is discrimination with Saharia children in the public institutions including schools in villages with mixed population of General, (Other Backward Castes) OBCs, (Schedule Castes) SCs and Saharia tribals. Saharia community realize this discrimination and therefore they hesitate in sending their children to schools situated in the village, thus restricting their access to the limited schooling facilities available. Child marriage is highly prevalent among Sahariyas.

Objectives

  • Strengthening communities on the issue of health and nutrition. Increased adoption of community based management of malnutrition
  • Reduction in IMR (Infant Mortality Rate) and CMR (Child Mortality Rate) at least by 10%. At least 75% children in the age group of 0-6 years to be covered under regular growth monitoring. At least 20% (Severely Acute Malnourished) SAM & 35 % (Moderately Acute Malnourished) MAM children to show positive grade movement.
  • In at least 50% of the villages, regular and quality services in terms of immunization, food and nutrition from government institutions and schools are available.
  • Strengthening of evidence based advocacy initiatives.
  • Increase in quality nutritious and health services in the coverage area through government institutions.

Achievements & Impact in the Review Period


The CRY supported intervention of Prayatn Sansthan focused on addressing food security and nutrition issues and on bringing about a positive change in the lives of Sahariya children. During the period, the program at Saharia dominated block Shahbad of Baran has shown some significant outcomes and impact. The organisation leadership has shown its commitment on the issue and guided the team to bring out malnourished children from the death trap. It catered to the urgent needs of 101 children through referral services of ICDS centers in the villages and more than 50 children were brought from malnourished status to normal category. During its rapport building activity, the team has also been able to develop trust among the Saharia community with their daily needs like drinking water facility, payment of Mahatma Gandhi National Rural Employment Guarantee Act (MNREGA), immunization of children, etc were ensured through efforts of the team. Moreover, the limited understanding of the team about the Saharia tribe, its culture, and occupation has also been overcome as the team’s engagement with the community grew significantly during the period. Community level confidence has also grown, as the hesitant Saharia members are now able to visit block offices by themselves. Most importantly, good rapport with the youth and children of the Saharia community also encourages the team to take up tougher issues in the coming years. Some significant socio-cultural changes have taken place like, girls are now allowed to take admission in residential schools and parents feel proud of their girl child’s education, which simply indicates the gradual change in attitude of the Saharia parents. Major achievements in the year include:

  • 33 boys and 22 girls were linked and registered with ICDS Centres.
  • 143 nursing mothers were linked with ICDS service.
  • Growth monitoring of children has been undertaken in intervention areas as per WHO norms.
  • 29 SAM (Severely Acute Malnourished) children were followed up through home based management of nutrition. Efforts first made to refer children to the malnutrition tracking centre.
  • Community meetings regularly done to discuss feeding practices in cases of (Severely Acute Malnourished) SAM children.
  • One sub-centre has been approved for Chaurakhadi village and a plot of land for construction of building has been allotted through support of PRIs and Bal Surakshya Samiti
  • 16 village level meetings were organised to discuss importance & early initiation of breastfeeding, best use of locally available food and its nutritional values etc.
  • Discussions were held with Bal Manch [children’s groups] on child rights with focus on education, mid-day-meals, health and hygiene.
  • In all the 30 villages, children’s collectives have been formed and the process of strengthening the groups is ongoing. A total of 226 children have been organised into Bal Manch.

Success story


Young Buddho lives with her parents, Ginni and Santosh and her grandmother, Kashi in Shahbad Tehsil of Baran district in Rajasthan, India. When Prayatn foundation came to know of Buddho’s family, she was severely malnourished with the family barely able to make ends meet. Her father was working as a bonded laborer and her mother was unable to work since she was pregnant. The diet of salt, chilli powder and millet bread that they fed Buddho had caused her to become underweight with severe dysentery which further deteriorated her condition. The family could not afford to get private medical treatment for her. The team counselled the family and taught them how they could take better care of Buddho. They noticed that Buddha remained unclean and her body was prone to itching. She was provided with Oral Rehydration Salts to help her regain strength and local medicines were suggested for the body itch. It was revealed that Buddho had fallen into the habit of eating mud, a free but dangerous option to satisfy her hunger. Her parents were advised to closely monitor her eating habits. The close monitoring and medicines paid off, and in two days the team observed that her itching had subsided. But a few days later, when the team visited again, they saw that Buddho’s health was not improving. When they learnt that the family could not afford the nutritious food and milk that they were advised to provide for the baby they took the responsibility upon themselves. As part of the consecutive follow up visits, Buddho was administered with de-worming medicine and food packets were made available to her from the Anganwadi.

Simple and affordable food recipes were shared with her mother so that the children could eat simple, healthy and nutritious food. With time Buddho’s weight continued to increase considerably. Even when her parents had to migrate to other villages for work, they followed up with the team and it was seen to that Buddho received food packets regularly including administrations of Calcium medicine. Now, Buddho has crossed the levels of malnutrition and is at a healthy 13.6 kgs.

Plans


Prayatn is working in the high critical state on Child rights. The district of Baran has been mapped as critical on nutrition and protection and moderately critical on health. Prayatn is intervening to address food security and nutrition issues of Saharia children thereby enhancing institutional capacities of Saharia community and developing a local movement. A 3 year roadmap is prepared towards in-depth intervention on health and nutrition in the 30 villages. The plans are as follows:


Focus 1: Communities start demonstrating positive shift in behaviour towards best mother and child care practices.

  • Community meetings to develop, understand and document prevailing beliefs and practices related to health & nutrition of children as well as women.
  • Village level orientation meeting of pregnant women and nursing mothers related to safe delivery, early initiation of breastfeeding, exclusive breastfeeding, nutritional aspect of various food items.
  • Meetings with ICDS workers, ANM(Auxiliary Nurse Midwifery) and ASHA(Accredited Social Health Activist) to understand the problems faced by them in delivering services due to beliefs and practices related to health and nutrition amongst the community.

Focus 2: Strengthen communities to address issues of health and nutrition and adopt home based management of malnutrition.

  • Capacity building workshop for Child Protection Committees (CPC) members on Community based Management of Malnutrition.
  • Village level orientation meetings on safe delivery, care of pregnant women, early initiation of breastfeeding, first colostrum to child, exclusive breast feeding, dietary charts and use of locally available nutritious food with special focus on consumption of protein rich food.
  • Community awareness on food security, nutritional values of locally available food items, multi-cropping pattern and its importance; documentation of locally available food and its nutritional values/importance.
  • Growth monitoring of children under 0-5 years and monthly growth monitoring of severely acute malnourished children in all intervention villages.
  • Undertake home visits for family level counselling/meeting and facilitate referral service to malnourishment Treatment Center in case of medical complication.

Focus 3: Reduction in under 5 mortality rate in intervention areas by 10% and improvement in positive grade movement of malnourished children.

  • Orientation of pregnant women and lactating mothers on child health and nutrition with focus on exclusive breastfeeding.
  • Listing of all children in the age group of 0-6 years, pregnant women, adolescent girls and nursing mothers. Regular updation of the lists.
  • In coordination with the ICDS workers, linking children in the age group of 6 months to 6 years, pregnant women, and adolescent girls and nursing mothers to ICDS.

Focus 4: Evidence based advocacy on child health and nutrition strengthened.

  • Stakeholders mapping on issues related to child health and nutrition; Identification of strategic areas for engagement with stakeholder.
  • Sharing of assessment report/survey report data on maternal and child health with concerned department through meeting /interface with stakeholders etc.
  • To organize district level interface on health and nutrition among children of Sahariya community.

ANNUAL FINANCIAL SUMMARY

  • Right to Survival
    $40,318
  • Administration
    $21,413
  • Total Grant Approved
    $61,731