1. Initiative by DWCD With technical support from MPTAST
Process Documentation of Initiatives/Innovations under ABM
Initiative by DWCD
With technical support from MPTAST

2. Background

3. Atal Bal Arogya Evam Poshan Mission
Atal Bal Mission was established to strengthen and fill the gaps in the existing Integrated Child Development Scheme (ICDS).
The objective of this mission is to work in an integrated and coordinated manner to bring an improvement in the nutrition and health status of children in Madhya Pradesh State thus addressing the problem of child malnutrition in the state.

4. District Action Plan
The districts had immense scope in utilizing the funds to implement need based activities, take initiatives and apply innovative approaches to address malnutrition.

5. Initial Review Review meeting held from 17th – 26th September 2012
Based on the presentations made by the District officials, thematic areas were identified for documentation and eighteen districts were identified for process documentation.

6. Thematic areas
Third / additional meal to beneficiaries (pregnant women/lactating women/malnourished children) under ABM
Web-based tracking / monitoring
Strengthening nutrition counseling modalities / community participation
Periodic tests for assessment of AWWs skills/knowledge followed by need-based capacity building.
Other specific theme/s

7. Process Documentation

8. Objective
Identify and document the initiatives/innovations that can be scaled up across the state of Madhya Pradesh.
To assess the impact / change after implementing the initiative/innovation in the selected district/s.
Inclusion of successful initiative/innovation into the districts’ Annual plan ( ) for implementation and scale-up across the state.

9. Methodology
Finalization of list of Initiatives/Innovations and districts
Field-Assessments by a combined team of officials from DWCD, DoH&FW and MPTAST
Compilation and Screening
Inclusion in upcoming Annual Planning ( )
Implementation and Scale-up

10. Template for field-assessments
Defining the Initiative/Innovation
Name of the Initiative/Innovation
Goal/Aim
Objective
Target Population/Group
Extent of Intervention (no. of village/AWC/sector/cluster etc.)
Areas of Intervention (specify the names)
Duration (start and end date) of Intervention
What was the need for this initiative/innovation beyond ICDS SNP program already being provided at AWCs?
Describe the intervention

11. Template for field-assessments
Describing the various components / elements of Initiative/Innovation
Components of initiatives being provided Ex. Tiffin meal, pockets etc.
Constituents of food being provided
Ingredients Quantity of Ration per bens
Rationale behind using these ingredients
Anybody from the state directorate visited to see this intervention
Basis of the selection of ingredients (RDA/technical advice/local conditions/implemented in other areas)
Are the ingredients locally available?
Seasonal variations in the availability of any of the ingredients
Is there a rotational menu? Frequency of rotation of menu.
Procurement procedure and quality assurance

12. Template for field-assessments
Storage facility
Place of storage
Prevention of dust/rodents/moisture infiltration
Pilferation issues
Distribution modalities
Quantity per beneficiary
Transportation and quality assurance
Place of distribution
Frequency of distribution
Containers for distribution

13. Template for field-assessments
Consumption by the beneficiary (monitoring mechanism)
Preparation (Cooked)
Is hygiene ensured (Based on the field visit and observation)
Availability of water (running or stored)
Washing of ingredients and washing area
Cooking area
Cooking process
Storage
Others (Utensils, hands etc.)
Staff involved in this activity (Regular or additional staff)
Community involvement in this initiative
Describe various stages of community involvement

14. Template for field-assessments
Monitoring and Financial aspects of implementation of the Initiative/Innovation
Monitoring mechanism and formats used?
Impact of this intervention
In the words of DPO, AWW, Community etc. What are their indicators for the impact
Any pre post assessment done to measure the impact (what is the change - mention numerator and denominator)
Data from the MIS available for analysis
Records available of the DPO for assessment
No. of beneficiaries till date
Monthly and annual expenditure on this activity?
No. of beneficiaries per month and year based on the above mentioned cost.
Cost per beneficiary
Did any of the beneficiaries drop out of the program?

15. Template for field-assessments
Before summing up the detailed and collated information; value-add on by the field assessment team/evaluators based on the objectives of the assessment
Observations
Comments/Suggestions
Do you consider it as an innovation or initiative
Is it fit to be scaled up across the state
Do you think the intervention is in line with the set objectives if so, how and why. if not, why not.
It there a possibility that this initiative will also lead to achievement of other outcomes besides those that were envisaged. If so how and why.
Any other questions which have not been addressed above.
Conclusions.

16. Template for field-assessments
Feedback by the community and summarizing the interactions with them
Please interact with at least three beneficiaries.
What is the profile of the beneficiaries?
age group literacy status assumed Socio economic status
Do the beneficiaries have an overview of the objectives of initiative/innovation?
Are they accessing the services of the initiative/innovation regularly, if not why?
Do they think the initiative/innovation has benefited them?
Describe how it has benefited them?
Any general comments about the initiative/innovation?

17. List of Innovations S.No Component District Innovation 1. MIS Betul
Web Based Monitoring / Atal Betul mix 2.
Counselling
Vidisha
Baal Chaupal Karyakram
Neemuch
Ujjawala Abhiyan
(Nutrition / Health)
Dewas
Elderly women (badi maa) for counselling to the families of undernourished
Barwani
Breast feeding counselors appointed by Health under ABM
Dindori
Project Protsahan 3.
Training
Mandsaur
Dakshata Parikshan

18. List of Innovations S.No Component District Innovation 4. Nutrition
Shajapur
Pocket stitched in dresses
Satna
Nutri-corner
Khandwa
Akshay patra yojna
Dhar
Vatsalya Kendra
Jhabua
Aanchal Kendra
Indore
Booster Meal
Gwalior
Dugdh Sanjivani
Datia
One additional meal to pregnant women
Guna
Tiffin System 5.
Health
Dindori
Mor Dubaliya
Chhindwara
Identification & Management of Anemia in P/L women and MCTS Tracking
(Nutrition & MIS)
Hoshangabad
Project Samarpan / Vatsalya software

19. Team S.No. Cluster of districts Innovation / Initiative Component
Documentation Team
Visiting Officials (DWCD) 1
Hoshangabad
Vatsalya Software
MIS, Nutrition and Health
Sreenivasan Kallam, Richa Som and Dr. Archana Mishra
Mr. Mahendra Dwivedi-Deputy Director (MIS) + Team
Project Samarpan
Betul
Web-based Monitoring
Atal-Bal Mix
Chhindwara
MCTS Tracking
Day-Care Centre
Identification & Management of Anemia in P/L women

20. Team S.No. Cluster of districts Innovation / Initiative Component
Documentation Team
Visiting Officials (DWCD) 2
Vidisha
Bal Chaupal Karyakram
Nutrition and Health
Naresh Ramnani and Pooja Madan Kohli
Mr. Akshay Srivastava - Joint Director (ICDS)
Satna
Nutricorner
Dindori
Project Protsahan
Mor Dubaliya 3
Neemuch
Ujjwala Abhiyan
Capacity Building, Nutrition and Health
Risha Kushwaha and Kavita Chauhan
Mr. Vishal Meda – Asst. Director (ABM)
Mandsaur
Dakshata Parikshan
Shajapur
Pocket stitched in children’s dresses

21. Team S.No. Cluster of districts Innovation / Initiative Component
Documentation Team
Visiting Officials (DWCD) 4
Gwalior
Dugdha Sanjivani
Nutrition
Rajesh Shrivastav and Deepika
  Mr. Govind Raghuvanshi – Asst. Director
Guna
Tiffin System
Datia
Additional Meal to Pregnant Women 5
Dewas
Badi-maa to families of under-nourished
Counseling and Nutrition
Pragnya Das and Hamza
Mr. Sanjay Sisodia – Deputy Director (ABM)
Indore
Booster Meal
Dhar
Vatsalya Kendra 6
Barwani
Breast-feeding counselors appointed by Health dept. under ABM
Dr. Ajay Khare, Ajay Reddy/Dr. Aboli Gore
Jhabua
Aanchal Kendra

22. Reflections
From
Field-Assessments

23. Third/Additional Meal to Pregnant Women, Lactating Mothers and Malnourished Children

24. Eight children (SUW) identified for booster meal
120 gms / child provided in the evening slot of 5-7 PM by AWW and AWH.
Weight monitoring every week and recorded.
Corn-soya-wheat (salty)
Corn-soya-wheat (sweet)
Groundnut-soya-wheat
Indore

25. Complete meal to Pregnant women
Providing one complete meal to Pregnant women from 2nd trimester till delivery of the child.
Meal prepared by SHG based on day-to-day meal chart.
Datia

26. 13574 SUW children identified and made to stay at AWC from 9 AM to 4 PM.
The meals included:
Morning snack
Hot cooked meal
Rajgir ladoo- third meal
THR- fourth meal
Atal bal ladoo- fifth meal
October
March
November
Day Care Center
Chhindwara

27. Transparent box containing food ingredients based on weekly menu is kept in an identified corner in the AWC.
Nutri Corner
Satna

28. Stitched Pockets Shajapur
Children have the habit of eating packet snacks available locally.
Pocket stitched in two dresses of identified SUW children and filled with roasted gram/groundnut and jaggery for three days. For 6 months to 3 yrs children powdered form in polythene packs provided to their mothers.
Stitched Pockets
Shajapur

29. Tiffin System
Food was given to SUW children through tiffin. Managed through the SHGs. Timing: 3-4 PM
Atal Bal Mitr- link between AWW and households.
Meetha dalia
Namkin dalia khichdi
Chawal kheer
9419 SUW children number has reduced to 4274 in November 2012
Guna

30. Adoption of underweight children
Community leaders like MLA, ward member, businessmen etc played a pivotal role in adopting the SUW/MUW children of the AWCs of their areas.
Sattu, Aid (multivitamin and half a spoon of coconut oil mixed in food) provided
Adoption of underweight children
Ratlam

31. Periodic tests for assessment of AWWs skills/knowledge followed by need-based capacity building.

32. Dakshata Parikshan Mandsaur Shajapur
A test was conducted to assess the skills of the AWWs.
Based on results, AWWs who secured grade C&D were given training to refresh their knowledge.
An examination was first conducted for 1256 AWWs of the district.
Second examination for AWWs including mini-AWCs was conducted (follow-up of) after imparting training. Year gap.

33. Blood transfusion to P/L mothers
Pregnant and lactating mothers who were anemic were referred to the district hospital for blood transfusion.
Main objective was to address LBW children and anemia in women
14 bedded ward exclusively dedicated for anemic P&L mothers set up.
Blood transfusion to P/L mothers
Chhindwara

34. Ujjwala Abhiyaan
Increase awareness among adolescent girls who are either school-going or are drop-outs on proper nutrition, hygiene, reducing anemia and increasing age of marriage.
Neemuch

35. Samarpan Also called as “early intervention clinic”.
Is an initiative for early identification, screening, treatment and rehabilitation of children with developmental delay or physical disability.
Convergence of WCD, NRHM and DDRC
IPGMER developed questionnaire for screening.
Samarpan
Hoshangabad

36. Breastfeeding Counselor
Facility based counseling to the mother for colostrum feeding.
Addresses issues of newborn care practices, kangaroo care and institutional deliveries.
Breastfeeding Counselor
Barwani
Job chart of breast feeding counsellors
ANC counselling at the time of admission
PNC counselling
Breast feeding counsellor must be present at the time of labour
Educate mother about the advantages of Kangaroo care and ensure the thermal care
Counselling on attachment between mother and new-born baby
Ensure early and exclusive breast feeding practices
Ensure colostrum feeding

37. Mor Dubaliya
Dindori
731 pregnant mothers have been felicitated with the kit that comprises relevant information and materials related to pregnancy care.

38. Vatsalya Software
Software was developed with financial support from Red Cross Society.
Completely online. Has lots of data.
Has won e-global award
Hoshangabad

39. Counseling Vidisha Bal Sanskar- Vidisha
Inviting parents to AWC quarterly and educating the parents on growth and development of child
Vidisha

40. THANK YOU