In Rural India: Empowering Women’s Collectives to be Champions of Nutrition

In Rural India: Empowering Women’s Collectives to be Champions of Nutrition

 Good Nutrition is fundamental to both individual and national development, THE LANCET {2013} and Vision 2022 of National Nutrition Strategy, GoI committed to “ensuring that every child, adolescent girls and women attains optimal nutritional status especially those from the most vulnerable communities”. This has brought Nutrition centre stage on India’s national development agenda. From NFHS 3 {2005-2006} to NFHS 4 {2015-2016}, India has made significant improvements in most of the essential nutrition interventions outcome with exception to iron deficiency anaemia in women and children.Overall there has been decline in IMR[1],MMR[2] and U5MR[3].

However the most critical insights by Menon et al{2017}on national positive trend stated as “masks wide variation among the India states”. Several interventions still reach only 50% of the target population and NFHS-4 data reveals substantial rural – urban gap. Similarlyfindings of RSoC[4]{2013-2014} on disparities across geographic regions, socio economic classes and demographic groups concludes vulnerable pockets of rural India bear the lion’s share of nutrition deprivation.It also highlighted the limited awareness of families regarding the health and nutrition education services available at the AWC[5]and fewer women given advice on breast feeding and nutrition.

Transform Rural India Foundation’s (TRIF)Community Needs Assessments (CNA) study conducted in select vulnerable pockets in 17-districts of rural central and eastern India reveals combination of factors that compromise maternal and children’s nutrition status. The most noted ones are practices embedded community traditional culturee.g, dietary habits, early marriage, hygiene practises, gender based power asymmetries, etc. These perpetuate the cycle of under nutrition, poverty and inequities. Therefore unless nutrition moves in the hands of those who need the most, it will be challenge to meet the World Health Assembly’s global nutrition targets that India is signatory.

Over the last decade, evidence based research has dramatically expanded our understanding of how to improve the nutrition in women and children. Importantly THE LANCET {2013} executive summaryfigure 2 emphasizes on community delivery platformsfor nutrition education and promotion, crucial to achieving nutrition specific interventions and reaching populations in need. In addition UN Decade of Action on Nutrition {2016-2025}focuses on women and girls as key stakeholders of achieving nutrition equity.

WINGS[6] program implemented by IFPRI[7]andPRADAN{a TRIF Partner} interestingly demonstrates nutrition intensification activities with Self Help Groups (SHG)acts as double edge sword, affects women’s empowerment and this in turn impacts on the nutritional status of women and children under two.

Similarly women’s collectives[8]under National Rural Livelihoods Mission (NRLM) GoI, and ‘Mission Shakti’ of State Government of Odisha have proved to be potential to strengthen the last mile delivery of essential nutrition services.Similar results have been demonstrated in the Bill & Melinda Gates Foundation’s work with JEVEEKA promoted SHG in Bihar.

Building on these evidences,“community participation, ownership and leadership” are at the heart of TRIF’s health and nutrition engagement on the ground. In pilot phase, since 2016 TRIF selected1000 potential women as ‘Change-Vectors[9]’(CV) from within the target communities (select geographies of Jharkhand and Madhya Pradesh) whoare local “influencers” and have social sensitivity to take lead on triggering a process of change. CV’s focus is on “practice adoption” within the community, using the SHGs are a platform for “action-reflection”. They are trained by TRIF’s partners organisationshaving long thematic expertise. The technical knowledge imparted is around 21 jointly identified micro modules (based on continuum of care with nutrition as cross cutting) and soft-skilltraining is provided around interpersonal skills. The capacitybuilding model is a mix of both in class-training and on-field handholding support. The third layer of peer-engagement and peer-support mechanism are built to have a non-threatening environment for continued growth and development of CVs.

As of date the trained CVs in turn, areleading 1-2 hrs discussionin approximately 2000 women’s collectives[10]that coincides in their regular meetings to trigger reflection on issues and practises pertaining to IYCF[11], farming, nutrition, hygiene and sanitation, discriminatory practices around gender and caste, access to schemes and govt. entitlements, etc. The entire community driven process based on the spirit of volunteerism and a strong need in women’s collectives to transform the situation within household and habitations.

The process to trigger change on the ground begins with a visioning process around ‘aspirations’ (hope for a better future) with leadership of women’s collectives. They helps each woman internalise the need for change and come to a stage where they are ready to make personal commitments to make the change happen. Women then identify issues and attempt to start “collective action” leveraging the social mobilisation and the network of hundreds of primary women collectives in a compact geography i.e.Block.The strong Women’s Collectives engage with the public systems using the social accountability framework, presenting a strong demand system on the ground. TRIF has also facilitated formal relationships with state governments to support the ground efforts being done by the Women’s Collectives and the Thematic Partner.

The findings of evaluation study whether women’s collectives have been able to sustain its quality and impact will further deepen our understandings and sharing with wider audience.

 

Ms Runa Shamim

 Manager Health and Nutrition

&

 Mr Anirban Ghose 

Joint Managing Director 

Transform Rural India Foundation

[1] Infant Mortality Rate

[2] Maternal Mortality rate

[3] Under five mortality Rate

[4] Rapid Survey on Children

[5]Aganwadi centre

[6]Available on https://www.ifpri.org/project/women-improving-nutrition-through-group-based-strategies-wings

[7] International Food Policy Research Institute

[8] Also known as Self Help Groups at village level(tier-1), voluntary organisation at cluster of villages (tier 2)and federations at block level (tier 3)

[9]Carriers of new scientific knowledge around practices in the villages

[10]Covering a population of ~120,000

[11]Infant and young adult feeding practices

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