J U L Y 2 0 2 1 | I S S U E 5 In This Issue Read about our study on Infant & Young Child Feeding practices in Rajasthan Learn about teenage pregnancy and how to manage risks Revealed: The answers to our nutrition quiz In the Learning from the Community news Community members in Banswara we talked to for our qualitative study “He only eats tanatan (a packaged Patriarchal expectations remain rife. Article on local foods of Rajasthan While most people gave lip service to published in Rajasthan Patrika. snack) and biscuits,” says Lali Bai*, a RajPusht promotes local, seasonal young mother in Digodpaar, Baran the fact that girls and boys are equal, foods to ensure dietary diversity and 1 CORINfoToHd sIeAcuNritSy. 15:58 District. Her 7-month old son refuses their expressions suggested otherwise. to have home-cooked food. But he is not the only one. Many parents A mother of two daughters teared up initiate complementary feeding of after a perfunctory answer to a infants with junk foods. Cheap, question about gender equality and convenient and easily available, they following a heavy silence, said that are the go-to for some mothers if her mother-in-law didn’t want their child does not take to another girl. Such is the desire for a boy among families that according to Sunil Kumar, Deputy Team Leader, homemade foods after six months of RajPusht, shared insights on childhood Rama, a staff nurse in one of the diarrhoea management and Poshan exclusive breastfeeding. Abhiyaan with the Health Department, districts, many mothers refuse to Bhilwara District, in a webinar on July 14. Several newspapers published reports This is a finding from RajPusht’s breastfeed their second or third about this event. qualitative study of Infant & Young daughter. Child Feeding (IYCF) practices in five project districts—Baran, Banswara, Most mothers are compelled to Dungarpur, Pratapgarh and Udaipur. return to household chores or paid Our conversations with 206 work immediately after delivery. respondents—mothers, fathers, Entire families migrate for work. grandmothers and frontline workers Often, they are too fatigued to even —helped us learn about the prevalent breastfeed. Yet, they try their best to notions, practices and challenges. feed their child, frequently taking Training of RajPusht’s Poshan Champions in Baran featured in Dainik Bhaskar them along to their worksite. RajPusht is a project commissioned by the Children’s Investment Fund Foundation to reduce instances of low birth weight and wasting. Read more about us here. 0 1 R A J P U S H T I K A | I S S U E 5 Those who live in nuclear families have they had gone to their maternal homes to manage everything on their own. during their pregnancy, a common RajPusht The 9-month-old son of Ramrati*, practice in the region. Yet, they knew Reels another young mother from Digodpaar, all about the recommended IYCF subsists mostly on breast milk. She practices. Kaushalya said, “Most believes that she can feed cereals and people in my maternal village say that fruits to the child only once he has you should feed a newborn water, but I teeth. Her husband is out for work had received phone calls and during the day and there are no in-laws messages from a doctor who told me to guide her. to feed only mother’s milk for the first six months.” Her face lit up as she Like Ramrati, many others live in a recalled the doctor’s advice. Similarly, Quarterly Review of PMMVY knowledge vacuum. Manju Bai*, a Sunita learnt about exclusive and IGMPY in Dungarpur by grandmother in Bhabhuka village, breastfeeding from a TV ad. the District Collector, 26 July Baran District said during our interaction that it was the first time Lesson from such discussions inform anybody was talking to her family the behaviour change strategy pursued about nutrition and childcare. by RajPusht. We hope to fill the information vacuum and reach In this vacuum, there were bright spots mothers through a mix of innovative too. Kaushalya Prajapat* and Sunita and traditional approaches. 1 CORINTHIANS 15:58 Meghwal* of Baran District were 1 C TrainingORIN ofT PoshanHIAN SChampions 15:58 in Banswara on interpersonal unable to go to the Anganwadi Centre *All names have been changed to counselling , 28 July and receive nutrition counselling as protect the respondents' privacy Breaking the Cycle of Krishna Singh Gohil, District Program Undernutrition Manager, Udaipur, Rajasthan During a visit to observe an MCHN Day, I saw a mother who had come with her Virtual orientation and review of IGMPY by malnourished infant for routine Dungarpur Chief Medical immunisation. On discussing with the & Health Officer, 10 July ASHA and ANM, I realised that the baby had low birth weight and his mother was not even 16 years old. She did not receive any government maternity cash transfers as her family did not want to disclose her age. Dhariyawad BCMO Dr S.K. Jain inspecting a Digital Weighing According to NFHS-4, 40% of the Machine with Pratapgarh DPM Gyanendra women aged 20-24 years in Udaipur Vishwakarma, 13 July get married before the legal minimum (Representative Photo) Monthly ante-natal age of 18. Early marriage usually check-ups can help assess and manage the risks pregnant teens face translates into early motherhood, 0 2 R A J P U S H T I K A | I S S U E 5 which poses an increased risk of pregnant teenage girls and encourage RajPusht infant mortality and low birth weight. them to: Reels Children's Investment Fund Seek ante-natal care: Monthly Foundation-funded projects, UDAAN ante-natal visits can help assess and MANZIL, are working to prevent risk factors and improve health. child marriages by helping girls The care provider should monitor continue their education and learn in- foetal growth and suggest demand skills. RajPusht aims to appropriate action. reduce instances of low birth weight Get tested for sexually and provides technical assistance to transmitted infections (STIs): BPM Divakar Jharbade the Department of Women & Child counselling pregnant women Pregnant teens are at a on PMSMA Day at PHC Seriya, Development in implementing two Salumber, Udaipur heightened risk of STIs and should cash transfer schemes (PMMVY & IGMPY) and the Department of be tested and treated accordingly. Medical, Health & Family Welfare in Get adequate supplements: strengthening ante-natal care During pregnancy, a teenage girl services. requires more folic acid, calcium, iron, and other nutrients. ANMs 1 CORINTHIANS 15:58 A National Commission for Protection should provide supplements in of Child Rights (NCPCR) report in 2008 1 CPCO HariRIN OmT HBairwaIAN Scounselling 15:58 sufficient quantities. a mother during a home visit in found that poorer households marry Kishanganj Block, Baran off girls early. Teenage mothers face a Eat well and gain weight: Diverse financial crunch and are highly foods from five or more food dependent on services offered by the groups and meals at regular government. However, the risk of intervals can help the mother gain excluding such beneficiaries remains the right amount of weight during high as their documents are often pregnancy. incomplete or their families want to Choose wisely: They should avoid Poshan Champion Yugal avoid the government's oversight. alcohol, tobacco and pan masala, Panchal counselling a pregnant They largely access ante-natal care at woman in, Talwara, Banswara and deliver at a medical facility. the Anganwadi Centre on MCHN days. “Post-natal care,” emphasies Dr Aditi, An expecting teenager is at an “is equally important as teenage increased risk of high blood pressure, mothers faces issues in breasfeeding. anaemia, premature birth and They don’t know the techniques and delivering low birth weight babies. Dr their body is often not ready. Aditi Mourya, a gynaecologist at Hormonal changes and social Anganwadi Worker Government Maharana Bhupal Hos- Rameshwari of Ward No. 14, pressures make them vulnerable to Salumber, Udaipur, celebrating pital, Udaipur, deals with these cases Pregnancy Counselling Day mental illnesses such as depression, regularly. She suggests that ANMs anxiety, and eating disorders.” should pay more attention to 0 3 R A J P U S H T I K A | I S S U E 5 Know Your Nutrition Winners! We are delighted with readers’ responses to the nutrition quiz in RajPushtika’s June edition. Of the numerous entries, four got all the answers right! These were sent in by Poshan Champions, Mr Lalit Meghwal of Pratapgarh, Mr Narayan Lal Meghwal, and Ms Sapana Jain of Udaipur Banswara’s Mr Prakash Katara. We extend the heartiest congratulations to these nutrition warriors! Here are the answers to the quiz questions: Mr. Lalit Meghwal, Pratapgarh 1. If the haemoglobin of a pregnant women is 10 g/dl, how many iron tablets should she eat? A3. Daily 2 tablets: Pregnant women with haemoglobin below 11g/dl should eat two iron-folic acid tablets (100 mg elemental iron and 500 mcg folic acid) daily for six months. This can help them beat anaemia. Q2. If the MUAC reading of a child is 12.8cm, what is her nutritional status? A1. Normal: A MUAC reading above 12.5 cm, that is, in the green range, is normal. In children of ages 6-59 months, a reading below 11 cm indicates severe acute Mr. Prakash Katara, Banswara malnutrition and readings between 11-12.5 cm indicate moderate acute malnutrition. Q3. If a child has diarrhoea, for many days should he have zinc tablets? A3.14 Days: A child suffering from diarrhoea should have zinc tablets for 14 days. Zinc treatment can considerably reduce the duration and severity of diarrhoeal episodes, decrease stool output, and lessen the need for hospitalisation.