Dr Munjpara Mahendrabhai
The clarion call of Prime Minister Narendra Modi for a Suposhit Bharatha found resonance in Prime Minister’s Overarching Scheme for Holistic Nutrition or Poshan Abhiyan – Government of India’s flagship programme to improve nutritional outcomes among children, pregnant women and lactating mothers. A critical part of the programme has been to mobilize communities at the grassroots to combat misinformed or uninformed practices that lead to persistent malnutrition through generations. Some of the ways in which the programme has sought to bring about behaviour change includes organization of Community Based Events (CBE); Information, Education and Communication (IEC) and advocacy and Jan Andolan (or people’s movement) through convergence and ensuring wide public participation. Focusing on the aims of POSHAN Abhiyan, Mission Poshan 2.0 (Saksham Anganwadi and Poshan 2.0) was announced in Budget 2021-2022 as an integrated nutrition support programme to strengthen nutritional content, delivery, outreach and outcomes with focus on developing practices that nurture health, wellness and immunity to disease and malnutrition. The programme leverages social and behaviour change communication (SBCC) as one of its strategic pillars to build a Jan Andolan. The Abhiyan concentrates on creating awareness drives and conducting activities with the objective of improving nutritional outcomes and aims to address the challenge of malnutrition in a mission-mode. In order to ensure community mobilisation and bolster people’s participation, the Abhiyan has made sustained efforts to push for behaviour change throughout the year with focused campaigns. These campaigns have disseminated various nutrition-related messages leveraging different platforms. Along with community based events, these intensive campaigns include yearly organization of Poshan Maahs and Poshan Pakhwadas with the aim of motivating mothers and communities to practice healthier nutrition behaviour.
Under the Abhiyan, Community Based Events (CBEs) are being organized twice in a month on a fixed day of week by each Anganwadi Centre. Under Community Based Events, Annaprashan Diwas, Suposan Diwas (specifically focused on orienting husbands), celebrating coming of age, getting ready for pre-school at AWC, messages related to public health for improvement of nutrition, importance of hand-wash and sanitation, prevention of anemia, importance of nutritious food, diet diversity etc. are covered. Since the launch of the Abhiyan more than to.3.70 crore CBEs have been conducted at AWCs across the country. To focus on nutrition, increase awareness on good nutrition practices and behaviours, two major outreach and social and behaviour change campaigns are undertaken under the Jan Andolan component of POSHAN Abhiyaan. Since the launch of the Abhiyaan, four ‘Rashtriya Poshan Maahs’, a month-long campaign held in September and four ‘Poshan Pakhwadas’, a fortnight-long campaign held in March, have been held with high reach and results. Key activities which include Poshan Melas, Prabhat Pheree, sessions on nutrition at schools, Self-Help Group meetings, Anemia camps, growth monitoring of children, home visits by ASHA/AWW, Village Health, Sanitation and Nutrition Days (VHSND), etc. are carried out. The Poshan Maah and Pakhwada celebrated so far have witnessed wide participation and enthusiasm from convergent Ministries, States/UTs and field functionaries. Frontline workers, community groups, PRIs, staff at Block and District level, State departments and Ministries had exemplified diligent work towards triggering a Jan Andolan for Poshan Abhiyan. The fourth Rashtriya Poshan Maah 2021 witnessed 20.32 crore activities, while during the recently held Poshan Pakhwada from 21st March -4th April, 2022, 2.96 crore Jan Andolan-based activities were conducted. Besides nutrition, awareness of general good health and hygiene practices are also imparted to the beneficiaries of POSHAN Abhiyaan through monthly sessions. Village Health and Nutrition Day (VHND) was conceptualized under the National Health Mission (NHM). It is being implemented across the country since 2007 as a community platform, connecting the community and health systems and facilitating convergent actions. It attempts to bring health, early childhood development and nutrition and sanitation services to the doorstep and promote community engagement for improved health and wellbeing. Most importantly, in order to improve and create awareness about diet diversity in the community and provide different food groups to malnourished children, Poshan Vatikas or Nutrition Gardens have been developed to encourage local, seasonal produce for use by the community. The main objective of Poshan Vatika is to ensure supply of nutrition through organically grown vegetables and fruits. It is worth highlighting that under the plantation drive supported by MoAYUSH, 1.10 lakh saplings of medicinal plants were planted in 21 districts. Additionally, 4.37 lakh AWCs are equipped with their own Poshan Vatikas. The fifth edition of Rashtriya Poshan Maah is underway with an aim to convert Jan Andolan into Jan Bhagidari. It seeks to address the challenge of malnutrition by spreading the message through Gram Panchayats acting as Poshan Panchayats. In the Poshan Panchayats, the key focus is on “Mahilaaur Swasthya” and “Bacha aur Shiksha”.The Rashtriya Poshan Maah serves as a platform to bring focus on the discourse of nutrition and good health and intends to achieve the holistic goals of Poshan Abhiyaan in a harmonized manner. As per the recently released report of the National Family Health Survey-5 (NFHS-5), (2019-21), conducted by Ministry of Health & Family Welfare, India has improved on various nutrition indicators as compared to National Family Health Survey-4 (NFHS-4), (2015-16). According to the NFHS-5 data, Stunting among children has reduced from 38.4 percent to 35.5 percent. Wasting has reduced from 21.0 percent to 19.3 percent and Underweight prevalence has reduced from 35.8 percent to 32.1 percent. Further, the percentage of women aged (15-49 years) whose Body Mass Index is below normal has reduced from 22.9 percent in NFHS-4 to 18.7 percent in NFHS-5. Launched with a noble and holistic goal, Poshan Abhiyan intends to bring about behaviour change and increase nutritional awareness among mothers of young children, adolescent girls, pregnant and lactating women, family members including husbands, father, mothers-in-law and community members, health care providers (ANM, ASHA, Anganwadi worker) about vital nutrition behaviours with a strong focus on community level interventions and community participation. Behaviour change communication is a potent tool for promoting positive health behavior among populations. Success of Poshan Abhiyan lies in the achievement of bringing the agenda of nutrition to the centre-stage of public discourse.
(The author is Union Minister of State for Women, Child
Development & AYUSH).