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Initiative by DWCD With technical support from MPTAST

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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


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