-c LA S'~:rr Fi (i{,~YI6i j . PROJECT EVALUATION SUMMARY (PES) - PART I flu,""1 Symbul U·4" 7 1. PRl1JE:C tii-rL-"-: - •• ------.------.----"i:'j; Fil ;:ii:Ei' NljMii·ifr--~lif.!ii(iN/AiiJTv;-I'jj:Fia-- ._...... 4~f!:O~5!._ ... _1. JJ!3..l1[J?LNE;W _De@ ______A COtllY'lsite Program for Worn:n & Ij. r.V.1.I.Ui\1I(J~~ NlJMIlEA IL,.lar thO/,".".I,,,, rnol"IolnfJrj Ily tna i~ '"~""IIIlO unll ".u .• CO..lntrv or AIOrw I\dmlnl,~:otl,. Code, Preschoolers in KeraliJ.) India F I." "I Y nar. Sf" 101 No. b"lllllnlnil with • Ie.. 1 ,,"eh t' Y) .. _ •.. 8~.=9.. .. (aJ~E OpG # AID-386-2.l57) I3l F1HiIJLA" EVALUATIOCJ [1 SPEC II\!. £;V/,LUATION ~:-KE Y ·P·RO-jfCTi"MPL:l~Mi,NT ATION- O"·~(;~;------I!i:- ~~~J'~~t'F0'pi'(' J~·c.r-"" ----· .. I:-Pi~HIO. U-Co.V[A~D.i~~;~.U"{9L86 .- ~ Int U. I 1", .. 1 C. F In,,1 ] 55 405 I rOIl1 (monthlvr.) ---..- ... 11"',,"'''1'- PHO.AG "' Obligation Inp", II. Tutal SO .• :_ .... r...... IT . r-la.rc .1.98 Equlvelont bqh'ctl>d OfJl/very .' <' 62, 500 .. ~~~ont~_~r~_..:=.:.~~::.:.:.:.:.::_.:::;~._. ____ .. _.I~.~=-~. __ .____ ~~.::~O f Y.81._ .. _... . ~~ ..~~ __ .= ... = '... ~.. ~~.:-~.. !l;!~~·~l.~~. t; v '~'~r~~~~r' .. .Fel:;?DJa,pL-&~9.8l a. I\CTION DECISI("~$ tlPI'ROVEO flY MIf,SI('~1 UII I\ln .....' 01 FIC!: OlfH,<:T,')' ---;,-~~t~~~·~~~~~·~;:.'Uf =~Iv~d IC'UI'~ ~jro :,~~~. ;:~:-;:~,,;~g fV;'~~'I -.-", .'~." ."- .. jr--"Bor~Jf\:,1~"f'~ ... -- '-T ~·:';:::-::~~-rJ- (N 0'1 E: Min"'" ;Jocltlll'U which "ntlc/Pbt~ A I C/I'J ur rllGI(lnnl III, ;';e O"I!Oil . ",,,.1 d rn' ~ :'0 ,~!ill: 1.1 I . r· ~ !~.r: . ~~)t>C I~' ~~ po ~~_~~c:~~~~~~_~~' ~.:~ s p_~~~~~,hIC~~~::~~~~O~~:~_ "~'lll U.L ~)____ .. _ _. _ . ~ 1\ (. ~.'~~.~ _ .J_ ~ __~:~1~~.~~l~ __•
Subnission by CARE of an Evaluation Report on t.i Ie 1 I impact of the programs on ilTproving nutritional stattLS lawrence Flymt March 1982 of preschJol children including plugress tCMc::trd achievrnent of other purp<:)ses of the project, i. e. increased protein and calorj e intake, improved dietary practices, and reduced incidence of cannrunicable diseases among program beneficiaries
_. ______.. __ ", ... _. _..... ____.w ____. 10. ALl EIHIA',IVI 1', ';I:;I()N!i UN r-1J1Ui\!: or PIlOJECr 1",ph'Hru'nt~tll'" "InrI Projllct f'/lfl8r o > 0 U.g •• C!'I NDtW,HK D O:lltl (:;IJII.-Ify) A. 0 Conti,. .... 1'11,1·],.1 W"hc,u\ Ch""QtI 0 r-jllftllclnl Plnn o PIOiT -...... _...... _ .. O. 0 ChenQ') I',aluet f.JJlI~n .IId/o, D Cflftr"l\,lll I,,",plomunt:JIIIJfl Plull 0 Louicnl F Ift'nDw(lrk o PIO/C [J o It',.. (!;III"lIyl -_ ..... _.-- .. _...... __ ._._- c. "'o/ue' 0 P,o/act Allre.,".nt D PIO/P ~ Di~cl)"II""u ___ ~_4 __ .. _.. ____ ._. ______...... _..... _...... ___ ...... __ . ___ .' ___ .. ___ ... ___ .______.__ ._. '. PFlOJECT OFFICER AND HO COUN' OR Ofd'i...f:;9 ry.)HlKINO rl,nTICII'>\t •. ~; 12. Mlulnn/AID/W Ollie,' Dlro<:\ol AI-lIHOVftl ~;l:p~~;;;'Dn~n d ~r ~~~Fm~Vu~i~Pdia " ./ Sig-;';i~e-'z;;:n~~---- Mary Ann Anderson, Health, Populatlon Nutrltlon·, .. 6,.L.J>t '. -... ---.---.-...... -... ---.----.- ,', I ). Typl),1 Nu':1 . . (,./(\.-' . US~D/India I ~J~l.s?illa. M. Boughton John Westl,y, Program Offl.cer, USAID/Indl.ai.i;;i-;;------·MiSS1.0fl--Dl:reotDr--.--.. [x:)\~las A'b.a:ld, Director, CARE/India 7/U:/fl 1\10 1330-1!,) (:1.701 ---_._------. "',", 'O:"'''L ,.lllt,.. '-10.10 Lf-C(gOol.51 0 3/50 I 'DS ]J)I~ ~ .. '" '"" lIorriON (;$" ",.Pot" (41 CP'ft) ,Ot-II,' LINITED STATES GOVERNMENT Pb-~A-6 -g'~1-- l.l1emorandum CD TO lvIO/PAV, Room B-930 NS - AID/W Di\TJ~: -Tul y 16, 19H1 (/:/1'7""''- FROM Richard M. Brown - USAID/Ncw Delhi
SUDJEC'1': Project Evaluation Summary (PES) # 81-4: A Composite Program for Women 8: Pre s~huule l'S in Kerala, India - CARE OPG # AID-386-2l57.
Attached are the original PES face sheet, 16 page of narrative part, and one annex of seven pages (list of 100 day care c(!nters or 13alwadis), on the subject OPG projl:'ct.
Transmitted for reproduction and standard distribution in AID/W.
End: PES
cc: ASIA/BI ASIA/DP /' DS/DJUV PDC PVC ·FFD
Buy U.S. SntJings Bonds Rrgulnr/)· Oil the p,.oro/t Snvill,gs Pilm PES - PART II
Fegul.ar Evaluation
Project No. Title: AID-386-2157 OPG to CARE for CCtTfOsite. Program for Vbren and Preschoolers, Keralu, India
13. Smmary
'Ihtough a one yeat· Operational Program Grant (OPG) signed
on March 11, 1980, USAID provided mRE $62,500 to assist the State
Govemment of Kerala (OOK) India to accele.rate its on-going OJmposite
Program for Waren and Preschoolers (Cl'WP) by establishing one hundred ljalwadis (day-care centers :'.:or preschool children). The CPWP scherre
is designed to reduce malnutrition arrong children 0-6 years of age by providing an integrated package of services to preschool children and pregnant and lactatmg w.::m?l1 including Title II food, health care, prescrool education, and nutrition education for nothers. The balwacli unit serves as a nucleus to integrate the efforts of CARE, the OOK Departments of Health and Develoruent and the local camn.mities.
Mahilasarraj ams (Noren's Clubs) representing the local cx:mnuni ty manage the CPWP projram at village level. 'I're awareness kindled in the oomnunity by the Nahilasarrajam gene>.rates ~tun for carmunity involverent.
The CPWP schene is a \vell established, popLllar program which
CCIt1['[eI1ced in 1976. By 1980 when USAID assistance was first requested,
1601 balwadis had already been ronstructed and were fully operational in all 144 Blocks and 12 districts of Kerala. During 1980 - 1981, in addition to the 100 units oonstructed with OPG funds, another :2:
250 units were built with flU1ds fran CARE and other donors, bring-ing the total nUl1ber constl.'ucted to 1951 by March 1981. CARE and the Goverrnrent of Kerala plan to construct another 210 mits in 1981 -
1982.
Title II foods are a signific.ant resource to the program. other cb11ar inputs fran USAID represent a small proportion of the total resourres required for the CIWP.
In the ba1wadis constructed under the OPG (fewer than 5% of the total nunber of centers built) USAID funds covered less than 45% of the total constnlction costs. 'l'he ranaining costs of construction have been Iret by the Government of Kera1a, C!\HE, (]nu. the Mahi1a Samajams.
A sizuble invest:rrent has L"'€Cn made by these groups and UNICEF in equipping the centers, training bahrcldi teachers and paying their salaries.
All 100 balwadis scheduled to be constructec. under the OPG agreement had been completed and ;vere fully operational by r-1arch 1981, delivering an integrated package of health, nutrition and education services. The health services CCIn!X)nent is the weakest part of the program and needs to be improved to assure rronth1y visits to the ba1wadis by Auxiliary Nurse Midwives (Al'lrvls). Balwadi teachers have been provided a basic dru;J kit but need to be trained in how to use it. l\Teighing scales purchased for the program are not durable for field use and many are broken. A rrore suitable scale needs to he fOlU1d 1::ecause accurate rronth1y weighing is an essential part of the program. : 3:
The salaries of the balwadi teachers and length of their training ha.ve had to be increased to assure proper motivation ru~d preparation for their jobs.
The food provided to children who attend the h.1.lwadi cente:r for six hours of preschool education daily may be iI1c.'1dequate to canpensate for n-eals they \\Ould nonnally receive at hCITl!? during these hours. It is suggested that a ration be provided to these children which rreets half their daily nutrient requirerrents.
Beyond the est.c1blishrrent of an integrated program in 100 netvly built balwadi units no informatioll was available on the success of
CPWP in a~11ishing its oti1er purposes: increasing caloric and protein intake, ilnproving dietary practices, Clnd rEducing incidence of ccmmmicable diseases. E\1rthenrore, no data were available on progress of ti1e project toward accomplishing its final goal: improverre1t in nutritional status of preschool children. CARE is required by the OPG agrc.,:i-:'.'~nt to provide
USAID with an evaluation report by March 1982, describing the impact of the project on the goals and pllrJ.Xlses. ('.ARE has already collected the necessary data and is in the pL-ocess of analysing the results to rreet this requirexrent.
14. Evaluation MethocblogZ
The purpose of the evah:lation \'las a final review of project accanplishments under the OPGto CARE \,lmch expired March 10, 1981. 'l'he evaluation is based on nurrerous field inspection visits, revie\vs of ClillE' s records oonnected with project oonstruction and di.scussions with CAHE officials.
In addition a final review was conduc;;.ed at thr:> end of the grant through: :4 :
1) UnannOl.mced visits to nine randauly selected balwadis
in three districts and five blocks in Feb::.llary and Ma.y 1981.
2) Revievl of individual file folders at CARE/,l'rivcmdruIn
for six rancbmly selected balwaGis not visited in seven districts
and seven blocks (May 1981) •
3) Interviews in May 1981 with:
a) CAREVKerala Staff
b) Medical Officer in Prim:u:y Health Center (forIret"1y CARE's
Health Advisor for CPWP)
c) Balwadi Teachers
d) Balwadi Teachers' Training Staff at Extension Training Center
e) Auxiliary Nurse l\1id."i ves
f) Program I'bthers
g) Block Development Officers
h) Wcrren' s 'Welfare Extension Officers
i) r~dy Village Extension Officers
j) CARE's cOlmterpart in Cormnmi ty Developrent Deparbrent
Though tl:e field visits, interviews anel review of the files it was possible to get the ~'equired infomation on program irrplem?...ntation
(Le. inputs and outputs). HC1Never, no information was available on the brpact of the program on achieving its stated goal of inproving nutritional status of children. It was possible to determine progress toward achieving purpose one of the crwP program and the OPG, i. e. establishrrent :5:
of an infrastructure in 100 Kerala villages which adequately delivers
an integrated package of food, preschool erlucation, health services and adult nutrition education to 13,000 beneficiaries. Hovl'ever, little
infonnation was available on progress tavard achieving the other purposes of the CFWP i. e. increased protein and calorie intake, improved dietary practices I and reduced incidence of cornnunicable di seases arrong program beneficiaries.
The USAID grant agreerrent and CARE's project proposal stipulate that CARE \.n.ll evaluate the irrq:1act of the program on the stated final goal and purposes (interrrediate goals) through an in-depth study. Five oopies of this evaluation report are to be su1::rnitted to USAID by t-brch 1982.
To meet this requirerrent CARE plans to use the results of a detailed survey on the Cl:wP oonductec1 in December 1979. The data are being analyzed and a report will be sul:m:i.tted to USAID bef(!)re thE.l March 1982 deadline.
15. External Factors
- The only major change in the project setting during the life of the grant was the ever increasing oost of building balwadis and securing donated land. The OPG provided eJir-t: 45% of the cost of building a balwadi or Rs. 4,500 ($563) to be matched by a 55% contribution fran the
Government of Kerala and the r.:ahila Samajams to a total cost of Rs. 10,000
($1,250). Although the costs of balwadi construction and land increased :6:
during the grant period to a total of at least Rs. 14, 000 ($ 1,750),
the .USAID/CARE and Government of Kerala contributions rerrained constant
at Rs. 4,500 cmd Rs. 1,500 respectively. 'I'he difference was rrac1c up
by the Mahila Samajams. The Mahila Samajams alone net over 50%
of the cost of balwadi construction includlnq the donated land. The
('~emment of Kerala contributed another 13%, b:r.inging the ·JSl\ID/CZ\.J.~
input down to less than 37%. 'rherefore, the project was able to
complete the construction of 100 balwadis as originally planned despite
increasing costs. It was fortunate that the OPG ~ollowed four years of successful balwadi construction experience in which a d::Jnand for bah-Jadis had been ~ll established in the carrnunities and the people themselves \oJere willing t.o neet rrost of the costs involved.
16. Inputs
The grant inputs for construction of 100 balwadis at $563 per balt,omcli have been provided acoording to the stipulation in the grant agrecIrent.
The balwadis have been built on land owned by the Mahilil Samajams and
CARE has verified this by reviewing the land titles. Plans and specifications for the buildings ar..d eqllipnent were approved by CARE before commencement of construction. Written understandings f~um each of the co-operating Mahila Sarrajams hav8 been obtained by CAHE in which the ~'s clubs agreed to implement the prcxJram as specified, to maintain the bahoJadi for ten years and to use the building only for CPt'1P. :7:
CARE rontinues to IOOni tor the program to assure that the Mahila
Samaj arns are carrying out their duties as 2greed. At all stages of balwadi
constnlction CARE actively participated and sur;ervised the work, releasing
f\IDds in the prescribed manner after each phase of construction was
a::rnpleted.
Several problems with ot.her inputs were experienced. ~~eighing
scales purchased by CARE for the program were found to be tmreliable
and not sufficiently durable to : lction accurately after repeated use
in the balwadis. Three out of four scales seen during the final review were broken. Prototype scales should have been field tested, before large
purchases \-Jere made. The Ironthly, accurate weighing of children is an
essential part of the CPiVP illld new scales will have to be purchased that are
Irore durable and reliable for field use.
M:mthly salaries of Rs. 50 (..,6.25) for balwadi teachers paid by t.he
Government of Kerala proved to be too low to sustain adequate rrotivation by
the workers. Ftmctionaries doing similar work ju_other GovernIl'.d1t programs such as
the Integrated Child D:!velopl.'ent Services Scherre (IeC6) are paid three
times as much. 'l'he balwadi teachers protested and their rronthly salary has now been raised to Rs. 125/- ($15.63).
The one-m::mth training program for bahvadi teachers f\IDded by
UNICEF was too short to cover the necessary subject matter and it has now been increased to three Ironths. The capacity of the extension training centers has been strained to meet the demands for balwadi :8:
teachers and class size had to be increased hun 50 to 80, IQl,o.Jering the quality of the training. UNICEF plans to assist the trainlng centers to expand their facilities to rope with the derll/·md.
A mini Drug and Dietet.ic Supply Kit: (DIX» was provided to each balwadi by UNICEF. Interv:i ews wit.h relwacli teachers revealed that
they had not been adequately trained in ho.v to u.se the kit. For the
ITDst part the kits were unutilizcd in the balwuc1i beciluse the workers ... Jere rightfully afraid of making a mistake by nrescribjng the wrong drug or dosage. Three different de-\·.orrning prepcl.rations were found in some centers and the workers \>.~re oon~used arout the proper use of each.
UNICEF and CARE are planning to strengthen the balwadi teacher's training in the use of the DDS kit and simplify the number of chugs provided.
The health services to be provided through the Government of Kerala' s
Health Department are the weakest OOIrq?Onent of the project. Auxiliary Nurse
Midwives (ANMs) are supp::>sed to visit the ba.lwadis once a week and
Medical Officers (MJs) from PriITary Health Center are to visit. once a nonth.
In actuality, ANMs visit the balwadis onc..'C eVe1Y few nont113 and M=rlical
Officers visit at rrost once a year. CARP. admits that the planned mnllber of visits was realistic when there \AJere only a fet:} aWl? mits in anyone block. The health staff cannot visit vlith this frequency nON that there are 1951 CPVJP balwadis in the .'3tate, an avera(Jc of 14 per block. l\ccording1y I
CARE new feels that a visit by the ANM once a nonth would be adequate. :9 :
Children needing medical attention should be referred. by the ANM
tD the Priroary Health Center for treatrrent by the Medical Officer.
Health services to the balwadi should be provided not only by the
nearest Primary Health center (1:100,000 lXlpulation) but by the closest
sub-center, General Dispensary (GO) or Govel"t'1lrel1t Rural Dispensary (GRD)
Despite these revisions it is likely that the health c:x:xnponent
of the crwP will oontinlE to be weak unless proj ect ftmds ore invested
in strengthening the existing health system to maet the demands.
In Kerala there is an average of one ANM per 10,000 population. It has
been found elsewhere that unless that ratio is reduced to one per 5,000
it is unrealistic to expect a.Ci9:Iuate delivery of services to programs
like CP'i'VP at the village level. Acoordingly, a proposal is currently
under discussion in which UNICEF \>'uuld assist the Health Depa.rtrrent to
strengthen the health servioos for CPWP areas. A critical limiting input not
provided in the ~ program was funds for transport of health staff,
including vehicles and gasoline. '!he existing annual gasoline allowance
per Medical Officer of 200 liters is enough for only three roonths of
visitations to sub-centers and villages, if perforrred. as scheduled.
All other inputs to be delivered by CARE, UNICEF', and the Government
of Kerala were provided as planned.
17.; outputs
Progress a~t each of the OWP's project activity targets (outputs) has been good with a f~ exceptions. During the one year grant period,
100 balwadis were constructed (see list ill Annex I). Latrines were to be construc ted at each balwadi site, but in several bah.,aclis latrine construction had :10: not teen canpleted although the bc'1lwadi building was in use.
CARE plans to insure carpletion of latrine construction at each
l:alwadi. Wells have been installed at IIDSt balwadis \'litJ1 Governm:mt of Kerala funds.
Ti tIe II foods: bulgur, oil, corn soy milk, and non-fat dry mi.1k
have teen provided to 10,000 children and 3,000 pregnant and lactating
\o.O'Ilel1 six days a week I for 300 days a year .in the specified arrounts.
AI though the CfWP allONS for a special second feeding each day for
severely malnourished children, 3-5 year old children who attend the l:alwadi class for six oours a day are the only children fed twice. How'ever, the ration size is inadequate to meet the requirE!TleI1ts of these older children who spend rrost of the day at the balwadi. They should receive at least half of their daily nutrient requirem:mts (101R) at the balwadi or 750 calories and 11 gms. protein. The ration they currently receive provides a IraXinUlm of 574 calories and 25 grams protein (CSM, NFCM, and oil) or 546 calories and 22 grams protein when bulgur is used insteaCl of CSM.
At least 100 kitchen gardens and 100 poultry or goat raising units have been established in the OPG villages through UNICEF and State gove.rnrrent assistance. Eggs and goats produced under this part of the scheme
~e readily visible in all villages visited.
'lWo nutrition education training camps per year have been
OItJanized for nothers in the villages in 1,olhich the balwadis have been :11:
built. Observation of one of these camps during the final reviE".• revealed active participation by the mothers who seerred very knowledgeable about beneficial dietary practices. IIowever, nutrition education classes for nothers should be held rrore frequently than twice a year, if significant inlprovezrents in dietary practices are to be nade.
All the balwadi teachers had received one nonth of training as planned. ~st children had been imm.m.ized but few other health services had been provided.
18. l'u.rp?se
The purpose or intermediate goals stated in CARE's OPG project Proposal are:
1. To establish an infrastructure in 100 villages of
Kerala which adequately <1elivers an integrated puckage of
services to 13, 000 beneficiaries.
2. To increase daily intake by 275 calories and 12 grams protein
(assuning that 75% of the food is a supplE'lT'flJ1t) by 13,000
beneficiaries for 300 days a year.
3. To irrprove dietary practices arrong beneficiary fmnilies.
4. To reduce the incidence of ccmnunicable diseases arrong
the 10, 000 preschool children enrolled in the program.
Purpose 1 has been achieved. As stated previously, no I inform:l.tion exists on whether purposes 2, 3, and 4 have been achieved. C'l\IU~ :12:
has c.. ~.lected cmd is curre.ntly analyzing data which will p~"dvide info:rmation on the acco!1iijl.dlurent of tht:;ce purp'Jses. A report on the findings will l:€ made Clvc1il;:ble to USt'\ID by l-1arch 1982 as stipulated in the OPG.
Based on field observations, and review of project design conducted as part of the current evaluation, sore speculations on achieverrent of project purroses can be made. 'n1e ration 1l"Ic3y be rrore likely to result in the desired increase in caloric inQ"1ke arrong the si:-,ty chilc1r~ who attend the center for an hour a day for feeding only than for the forty 3-5 year old children \.mo !?anain at the balwadi for six hours of preschool education. The children ...!ho ccrne for feeding only receive a maximun of 468 calories whereas the children who stay five adchtional oours receive only 100 rrore calories.
It is likely that the food received at the balwndi for the fort.y children who spend nost of the day there is a substitute for !Tost of the focx:1 they would have received at hc:rre during the day and not Ll supplerrent. Furtherrrore, diet surveys ccnducted by the National
Nutrition r.~:>nitoring Bureau in tp...n mljor states .in India fOUIlO tile
r calorie intake of Kerala children to b2 the lowest. Only 9 {. of 1-·4 year old
Kerala children had an adeql..1r'lte calorie and protein intake catlI.:,ared to an all-India average of 37%. Increased ration size a:lUld lead to greater nutritional impact. :13:
'!he awp shows considerable p::>tential for ir.lproving the dietary practices of the beneficiaries, both through bi-annual nutrition education camps, and incare generating foo::1 production activities such as p:>ultry and goat recrring and kitchen gardens.
However, impact could be enhcmced by holdinc] classes at least monthly and not just twice a year ~
If health services were delivered in the project as planned, and drugs used as intended, the project could significantly reduce the incidence of carmun.icable disease arrong children. Howeve.t' I since health check-ups are being provided infrequently by ANMs and drugs supplied to the balwadi teacher are not being used regularly, this impact is doubtful. However, the program's lll'nnunization ooverage for tubelculosis, r:olio, dipthed.a, pertussis and tetanus is good ;md therefore should significantly reduce the incidence of these diseases.
19. Goal
The final goal of the CPWP as stated in Ci\HE' s OPG Proposal is improvBncnt in the nutritional status of 10, 000 preschool children living in the villages of Kerala.
No data are currently available on acccmplishment of this goal but the results of CARE's in-depth evaltation of (~NP should reveal the impact of the program on the nutritional status of the children enrolled. If the beneficiaries conSt.Im3 the ration primarily as a supplement and not as a substitute for their hOlle diet, its health :14:
services are adequate and nutrition eduaation effective, a significant nutritional impact oould be expected. The incaoo generating and focx1 production activities for the rrothers could also enhance the impact of the project on the nutritional status of duldren.
Hot-.'ever, nutritional impact may be less than expected due to irregular health services, and substitution of the ration for the home diet. Furtherrrore, the program is enrolling primarily children over three years old who are not severely rralnourished. l'1a1nutrition and rrortality rates are much higher arrong children below three years of age. Severely malnourished children show the rrost benefit from supplementary feeding, but feN of these c1uldren are being readied by rn'1P. Nutritional impact of CFWP oould be enhanced by enrolling rrore dUldren \moor three years old especially the severely malnourished.
20. Beneficiaries
The direct beneficiaries of the program are 3,000 pregnant and lactating nothers and 10,000 preschool children from };COr rural families who receive focd, health services, preschool education and nutrition education. At least 1,000 rural families have been given a l1'eans to increase their inCC1l'eS and improve their diets throUJh raising poultry and goats and establishing kitchen gardens.
Wells oonstructed at the 100 village balwadis provide drinking water for many menbers of the camrunity • :15:
. The CPWP rreets a fundcurental need of the hard-pressed ~rking
\\allen of the laver socio-econanic group for day care services for her preschool children.
The entire ronrnunity benefits from the program in one way or another. The balwadi has bec:are a CO'I111tlI1i ty center for all types of social activities. At.vareness of the health ilI1d nutritional needs of the yound child has increased in the cam1U!lities. The Mahila Sarrajams have organized rural \\OllEJl and given them an opportunity to mmage their own program at a balwadi which they own. These \A.OTien recruit the balwadi teacher, supervise her and pay her honorariun. The CEWP is an excellent example of involving WClT'en jn solving the health and nutrition problems of their community.
21. Unplanned Effects
In addition to tackling health and nutrition problens directly, the CEWP has enhanced the eoonomic growth of the a::mnunities. Side by side with kitchen gardens, poultry and goat keeping in hares there is strong ccmpetition anong the Mahila Samajams to set up industries of their ~-m, including handloan units, basket rraking units, printing presses and focx1 preservation tmits with state support. 'Ibis is very positive result of the program in which wanen are getting nore involved in the developrent process. :16:
22. Lessons warned
Cl~1j.J is a genuine example of a program co~ducted by the
. 7,'" .'.' Ie.' :>r' "("''',. • C'1lp'I~l"'.. "-'1 fJl'-r>T;11;"~.LI...J.:d dI1<> d U"i'\If.:Jr . .J ,.I.": ,~C'.' .• .I ....(.~.' ,.11"1:J ~ tj'_ h:. =. cc.rnn.lOlclc...> \11:t.,'1-" tj"0',.t.. nL.~L'.J",iJl) outsi(l~! resources. rfL1e re::llization 01 \:h2 l·ic1.h.ilil Samc1jarns thClt: they can nln such a p'ccgrarn for their. Citm lx'l1e"Eit is a h."lsic factor behind the SUCC8SS c·f the prog.n:ml.
I'lithout stl."engthe..'1inq the eY.i!::;b.ll<] health d(:lillC:rr.y systa~l, it is not realistic to eXl~ct tl-:e }\.!'!~1s and M)s who are already oVel.v~')rJ(ed to add on tho extra duties required t.o service the m\fp balwadi.s. If t.he health call1:onent of the projeGt is to fWlction adequately thi..':l'1 project rcsou.r.c('s ITn.lSt: lx; providc-ii to stren':lt.hen the existinq health system.
\V.~:i.gh.lng scales should h'! exte.nsively field tested for accuracy and durabiH.1:y before large scale purchases are TIede.
NLlt:ci tional .i.mr.:ect of the pl.v9ram o')ulc1 b2 enhvl1()3d by USil'KJ nut.rition status criteria (v.'eight fc.)~ <:lC:l~) to pi.ck the TIost
TIalll011rished beneficii.lriE!~; vJho \.. ~)lJl(l l:enf.'!fit lWJSt. fran food supplementation.
23. Special COrrrrents or Pe.Il"2~ks
A. No additional faliey or p:rogrClJll 1\l'::lIlagem:~nt cC.mrents need
to be included.
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Pallom Kairalt Vanitha r,ontro PuthuppC1.:I.l~r Panr.hayat. OPG/I<:11/7/80/1 51. Vazhoor D9sasevin i Wl.hilns:;tl'laja!:l Va7.hoor panclhayat. OPG/Kl1jl1/80/1 1-:0Z!IIKODE DIS'l'P.ICT- 52. Dnclagara Er:1!na la 1Jclny3. 11ahi 1::t!::a!13.j a!!l Era!~ala P1.nchn.~!:lt. OPG/KZ/1/80/1 53. Koduv.qlly U(l.1.YFl l·lahilasa!!18. j a::1 . Nam!1anda Pane haya t. OPG/KZ/G/80/1 54. II lla!nalloor Bahilasa!13ja!!1 Kakl-::ur Panchayat. OPG/KZ/G/80/2 55. Kl1nna!~angala!!1 Ponna!!]ktLyar!1 l~ah i.l::1 sn!!"!D.j a!!1 ThiruvB!.!!}13.dy panchaY:lt. OPG/K2/7/80/1 5G. 11 ~rchana l1ah i.laS[ll'la ,j rl!'! I'.arass orry. Paneha·{~.l. t. OPG/l~~1./7 /80/2 57. Kunm.1!~!!e I Lceba !,1nhilas::!.!:![L.ia::l Vela!!1 Panehaya t. OFG/r~~/8/80/1 58. l1elady Havatte HahtlaSCl!~!a;ia!!1 .l\riklllF.l1!! Pam~hayat. OPG/KZ/9/80/1 59. " T ld.rllvangayur 1'!Rh-j l::tsamajam I\ril~l.ll('.r.: Panch'n'·Lt. OPG/K7./n/~~o/2 GO. Sultan Battery Grmnod hrtr.-:mn 11a}d 1 !1 S 't ~~.'l j a!:'1 SuI t'111 B~ttter:r f'::tnehcl:r:lt. OPG/KZ/12/80/1 61. T hod'lnnl1r o PG / 1':2/ 13/80/1 ...... 5/- qfST AVAILABLE DOCUMENT - 5 - ------.-.. -...... ------1 2 3 4 ------HALAPPunAH DISTRICT 62. Kondotty Kuz 11 :l.P1aD na 11<111 t la :~n!~!:l j rt!~1 Kuzhh:::mna Pane ll~l:la t. OPG/J.!/2/B0/1 63. II 1'1 av a j ~ro t 11 t j·ra. }l"i. J. -1..:-; .'l:~n j rtH! VaZ:layoor panCll:lj':.lt. OPG/H/2/30/2 64. " Pulari, l·la'nilas1.:~rl.ia:!! Chclel;;hr::, Prtnehay1.t.. OPG/11/2/80/3 65. I 66. Kllnn1.th Wl1li.11.SR!'!i1j:1!!1 OOT'1.k'1!!l Panch-1.Y1.t. OPG/l1j4/80jl 67. Hanjeri Val'J-:a looT' l·la:l i l:-t ~:;!] :':nj m:l i(avanoor Panch~'l.:,r.1. t. OPG/11/G/80/1 68. P or int ha 11!1a nnn 1-101 at t ur 11.1. 11 i ]..1. s·'1 !'I.1..i a!!'! Hol.1.ttllr I'nnchayat. OPG/!-!/7/80/1 69. II Pallikllth Santht iW Vottathur panelnynt. OPG/H/7/80/2 70. II Choruk3.ra Ha.hilas!1!!1C1..ial!1 Elar.lk111a.m. Panehay:; t. OPG/H/7/80/3 71. V,Tandoor SharJ~lla Hrthi1a::;[l:~.1.jru'l Mlilmvu Pnnch:tynt. OPG/rVl:~/80/2 P fI W III\T DIS1'nICT 72. I,jan narc lln t U(~~wn I:!ah ilas·'1:::.~t;ia Pl l'~ot topn:Hl:'t!;1 Panr. }nya t. OPG/P /G/80/1 II 73. TIas!'ll Uahil.1.sC1.!::·1.j::l!~ Kl1r.l.?rn!~put hur r~me \l!l ':a t . OPG/F /6/80/2 74. Ottappalam i';l.lnd.nnattukarn HR hi.ln srlr.vljam {lnnnClJnarli P;:tnr.ln::rat. OPG/P/8/80/1 7.5. Sreekrishnapnrar.l Po;:!'hr::t /-1[l.hil::lsll.!1.\ j:l!'l K1.ri!!lpUzln Prl.ne1nytl t. OPG/p/ll/aO/l II 76. Pook]mt. r, 'lk1.vU lin}: ;.1 '1 Sl!:1.J.j al~l Pooklmt.t.'1kavu Pflndl::t::at. OPG/P/ll/80/2 ...... G/- qEST AVAILABLE DOCUMENT G ------_ .•. _---_ .... _------._----- 1 2 3 ------77. Thrithaln Ka 11'Ql eo I,lahili1 ~~:I.:;·l j "l!~ l'ln[; 11ns ~~erry P::lncl:nYTt. OPG/P/J.2/80/1 78. " Dc ~~ 'I S cv 1n t nrt 11 ill :::1 !!1I.1 j n!'! 'l'hrithala Prtncl::l~/lt. OPG/P/l~j80/;~ II 1Jda:,rn I'b 11'11 ar.rt 1,!."'lj.1 !'j Chal'lsser:r Panc'l:l.':,rtt. OPG/P/ 1 ;·~/['.O/3 80. " Bhav~'\nn Hahi 11 :.::l::Flj Rl1 1\.1 rUT Pn nc 1\.1 Y:'1 t • 81. II Knnll i 1'n t llan~.r I'~'lli 'l1:1 ~;·1::n j al'1 Kal1})Ur PanclJ·'lv1t. OPG/ r: /1;'2/::~O/5 ~ v Qurr.oN DIS"TnICT 82. C haclayamangalam Gra!::od 1m rn nn l,lahi l"'\S;'\!~lajr.t!:1 V81inallaor Panclnyat. 83. " S isul';.she!:1a Van Lt lla:;a:'1aj atl Kn(lnckal f'rtnc}j.'\Y-lt. 8,1. ITaly 11ahil.a~,:1::!aj."l!·! " Clr.l\',hnra. Fmlch:1Ttt. 85. II DOSClsovini lIa r'ijan HS Cha(by::t!!;angal~l::! Pnnchayr.l t. OPG/Q/3/Sf)/1 I"~ ~) .~ 8G. ChittLU:1ala K('ral'-l ilahi l:l~_::l::;'.l:j:ll'! EanJ'oc I~1[lnrl FanchaYTt. OPG/Q/S/BO/l '" 87. l:att.araJr.kara GrCl:~lOr11l1.rnn:l 1;:\1, i l.:l;,.''i:~l,:l.i;:l!:'! r. ~ huY.'onc P:-\1'1'': In:/ It-.. 88. II " D0\" i. \T:t n i. U lrl !3"1 :!'''1 i i'. :'1 fh:ll.l\,:'1t.hul' rClnch:~:·at.. j 'J. :~ OPG/QjD/80/3 " ... Pi. (1:1V 001' J.-!::l hi '1 :1':l !'!:\ j '-1::1 'l'l!';'\l.':lv()(')r P,:mr.11·t:/:lt: II ...... 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