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Proposal on Improvement of Nutrition and Health Situations in Sonua, Chakradharpur and Bandgaon Blocks of Jharkhand

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Proposal on Improvement of Nutrition and Health Situations in Sonua, Chakradharpur and Bandgaon Blocks of Jharkhand Proposal on Improvement of Nutrition and Health Situations in Sonua, Chakradharpur and Bandgaon blocks of Jharkhand Background: Good health is an integral component of human wellbeing. It is a fundamental human capacity that enables every individual to achieve her/his potential to actively participate in social economic and political processes. In particular, a growing body of evidence highlights the importance of the early years in the development of individual potential. Therefore, optimum care, nutrition and protection of children from infection, at birth and during their first 1000 days of life, not only to ensure survival but importantly form the foundation for lifelong development. Overall, improving the health of its large population, especially among the most economically and socially vulnerable sections of the society, is central to the achievement of human development of the any nation. The entire approach of socio- economic development is human based. Thus, importance of health sector is vital. In this way Jharkhand state is one of the potential areas to work on nutrition, diet diversity, infant and young child feeding and hygiene. Some data of health and nutrition status of Jharkhand. Particular % of Underweight children % of stunted children Jharkhand 56.5 49.5 National (India) 42.5 48 https://www.indiastat.com/table/health-data/16/nutrition/192/647664/data.aspx Immunization status Particulars Jharkhand coverage National coverage (%) (%) Bacillus calmette Guerin (BCG) 92 84.9 Diphtheria and tetanus (DT) 34.3 58.8 Diphtheria, Pertussis and tetanus (DPT) 0.2 0.3 Tetanus Toxoid (10 yrs) 38.4 52.6 Tetanus Toxoid (16 yrs) 37.2 46.5 Source: ministry of family welfare and women health, Govt. of India:2018-19 (https://www.indiastat.com/jharkhand-state/35/health-data/16/immunization/128/stats.aspx) Child (Aged 0-4 Years) and Infant Mortality Indicators in Jharkhand (2015 to 2017) 2015 2016 2017 Indicators Total Rural Urban Total Rural Urban Total Rural Urban Child Mortality Rate 9 10 6 8 8 7 8 8 7 Under-Five Mortality Rate 39 43 26 33 35 26 34 35 28 Infant Mortality Rate 32 35 22 29 31 21 29 30 24 Neo-natal Mortality Rate 23 25 15 21 23 13 20 21 13 Early Neo-natal Mortality Rate 19 22 9 17 19 9 16 18 9 Late Neo-natal Mortality Rate 4 4 6 4 3 4 3 3 4 Post Neo-natal Mortality Rate 9 10 7 8 8 8 9 9 11 Peri-natal Mortality Rate 20 22 11 17 19 9 17 19 9 https://www.indiastat.com/table/health-data/16/vital-statistics/291/1003098/data.aspx Concept Note: Proposal on nutrition and health in Podahat Cluster 1 In this context, one of the poorest blocks in the Jharkhand is West Sighbhum district especially Sonua, Bandgaon and Chakradharpur blocks where nutrition intervention is critical for the survival and betterment of the community About West Singhbhum West Singhbhum district came into existence when the undivided Singhbhum District bifurcated in 1990. The district was still large in size with 23 blocks. In 2001 West Singhbhum was again divided to give birth to Saraikela- Kharsawan district. At present West Singhbhum remains with 15 blocks, two administrative Sub-divisions, 204 Panchayats and 1645 villages. West Singhbhum district is situated in the southern part of Jharkhand falling under the eastern plateau and hill region. It is between 21058' N to 23056' N latitude and 850 E to 860 E longitudes. The district is at an elevation of 244 mt. above MSL. The total geographical area of this district is 5198.25 Sq. Kms. The topography of the region is very undulating in places and 52% of the area is covered with forests. The district is full of steep hills alternating with valleys, and deep forests on the hill slopes. The district contains one of the best Sal forests; SARANDA (seven hundred hills) forest is known the world over. In West Singhbhum district the challenges of health and nutrition are mentioned below. • Substantial gaps in primary health care infrastructure • Shortage of person power, drugs and equipment necessary for primary health care • Lack of training facilities • Low institutional deliveries and maternal death (21.4 and lifetime risk 0.7%) • Under-nourishment among children and women • Very low coverage of full immunization • Low level of female literacy rate (46.25 as per census 2011) PRADAN’s intervention on Nutrition in Sonua block: Currently PRADAN is engaged in nutrition activity with 31 intensive & 40 non intensive villages with 3000 families in the Sonua block through a pilot project funded by BMGF. Based on our engagement we could know there is inadequate and improper food practices along with poor hygiene which has led to 80% anaemia among women and almost 90% malnutrition condition in children. For food intake the major focus would be adequate diversified food production with increased intake of protein rich food. Additionally hygiene factors would be looked upon to avoid unwanted expenditures. The objective behind initiating this activity was looking at the stark reality of malnutrition in the area. At the outset of initiating the interventions of nutrition when C N A (Community Need Assessment) was done, some factors that were found contributing to malnutrition are: Concept Note: Proposal on nutrition and health in Podahat Cluster • Traditional practices related to pregnancy and childbirth for e.g. lactating mothers having just one meal a day (only rice and garlic), throwing away colostrum etc. • Local food consumption pattern which mostly comprises of carbohydrates and very little protein vitamin/mineral content food • Due to various reasons pregnant women not registering self with AWC • Service delivery (Institutional Delivery & JSY) system not functioning in a desired manner So, to overcome such a state, six buckets of interventions were planned and short modules were designed and developed accordingly to achieve the state of reduction in malnutrition and growth in the nutritional status of people of the area. Those 6 Buckets were. • Diet Diversity • Sanitation & Hygiene • Infant and Young Child Feeding • Adequate Food Production • Accessing Entitlements • Women Empowerment Some glimpse of Success and achievement throughout our journey in the pilot program through which major impact on behavioural change and access the health schemes program were mentioned below. Self/family Community Public systems • At least once in a day Tri colour food • Action was taken against • Access of different consumption increased Child marriage as there service around Angan • IFA tablets consumption increased are serious implication Wadi Centre, Village • Kitchen garden has been adopted by on reproductive health Health Nutrition Day, 505 households • Women’s say increase on Take Home Ration, • Women Contraceptive was used by Birth space & Family Mid-Day Meal, Public 219 households Planning after discussion Distribution System • 224 family initiated using Iron in SHG meeting • Cash assistance and vessels • Women as farmer institutional delivery • Complementary feeding practices identity helped them and though Janani Suraksha enhanced in a considerable level contributed in decision Yojana (JSY) • Using mosquito net has increased making • Awareness about • A major shift observed in • Colostrum feeding Matritya Bandana Institutional delivery practice adopted at large • Exclusive breast feeding now in scale regular practice with 90% Project synopsis: There is a pressing need to intensify and expand nutrition sensitive interventions in three nearby blocks e.g. Sonua, Bandgaon and Chakradharpur block of Jharkhand. The major interventions that we are planning are described below. ▪ Nutrition-sensitive programs in agriculture have enormous potential to increase nutritious food consumption and effectiveness of nutrition-specific actions like kitchen garden to fulfil the need of vegetable and fruit for family. Concept Note: Proposal on nutrition and health in Podahat Cluster ▪ Women become empowered on access their entitlements on Health & Nutrition. Special focus on First 1000 days care of every children in village for their brain development, proper growth ▪ Improving adolescent health and support them to choose a better livelihood opportunities, reduce child marriage by introducing Life Cycle approach and clarity on future planning. Encourage Self Help group and Village Organization to take charge of rural youth, guide them on fixing life goal, helping them to choose proper career opportunities. Intervention Area: We are planning to cover 8000 households (HH) from 25 panchayat of 3 remote blocks of West Singbhum district which are given below: Name of Block Total HH Total Village Panchayat Total SHG Block level Federation Sonua 4000 50 9 300 1 Chakradharpur 2500 40 10 200 1 Bandgaon 1500 30 6 125 1 Total 8000 120 25 625 3 Outcomes of proposed intervention The project will have benefit on behavioural change on community regarding daily nutritious food consumption, proper care and nurturing children and adolescents with adequate healthy food intake, hygienic practices and guide. Some of the benefit can be captured as: • To reach 120 villages of 3 block and encourage community on daily nutritious food intake. • Adequate knowledge and accessibility on healthy diversified diet intake. • To reach 8000 poor families in proper Kitchen garden with 12 different vegetable and at least 3 fruit plant cultivation. • Family consumes locally available nutritious food like vegetable and seasonal fruits. • Adolescent having adequate knowledge regarding proper diet & nutrition which help them to grow up properly. • At least 70% of girls adopted
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