Partner with Integrated Child Development Scheme (ICDS) to improve nutrition for all in Bihar

We engage with health and ICDS programs of the state government to improve the coverage of a range of RMNCHN (Reproductive, Maternal, Newborn Child plus Adolescent Health) interventions at scale, using creative yet replicable ways of improving frontline worker performance, appropriate to the challenging context: sharply defined intervention priorities, better tools, and job aids, skill-building, improved last-mile supervision.

Our Activities

In addition to direct technical assistance at frontline operational levels, the sustainable change required that we catalytically engage the two programs to:

  • Improve public health leadership and managerial skills.
  • Sharpen focus on outcomes and gain the ability to use data and be driven by evidence and strengthened internal accountability.
  • Strengthen core systems within both programs to provide an enabling environment for effective implementation of RMNCHN interventions.

The interventions include:

  • Weak Newborn Tracking: Including mechanisms of mentoring, supervising, and supporting FLWs to focus on delivering services and support equitably to all families, robust name-based tracking systems, logistics for ensuring supplies at the last mile.
  • ICT/mobile app: The Ministry of Women and Child Development has pushed an ambitious plan to scale up the CAS-ICT-RTM mobile app across the country, beginning with using World Bank assistance funds to provide smartphones to AWW in 8 states (including Bihar), with CARE supporting the rollout in all states.
  • VHSND platform: The TSU, under a smaller separate grant, attempted to explore another channel to promote FLW-family interactions, besides home visits, since FLWs could not be persuaded to increase home visits.
  • Incremental Learning Approach (ILA): ILA continues to be the main approach for FLW capacity building in the state.
  • Weekly CF Practice-together Days (Upari Aahar Abhyas Diwas): TSU nutrition team has been able to conceptualise and get rolled out at scale the new initiative for more frequent contacts between 7 to 9 months to enable establishing of appropriate CF and feeding norm for each child.

Impact

  • The proportion of very low birth weight babies identified at the facility receiving KMC at home has gone from 4% to 29% by 2019.
  • First-month mortality among identified preterm/ low birth weight babies has reduced from 20.8% to 15.5% by 2019.
  • The initiation of complementary feeding has increased from 47% in 2014 to 56% in 2019. The frequency of complementary feeding has increased from 38% in 2014 to 57% in 2019.
  • Timely initiation of breastfeeding (within one hour) has gone from 73% in 2014 to 86% in 2019.
  • Exclusive breastfeeding among 0-2 months has increased from 68% in 2014 to 80% in 2019.
  • Home visits showed an increase after several years and more AWWs were reported to have visited mothers at home.

Programmes

Khushi Project

One of our flagship projects, KHUSHI works towards strengthening the functionality and quality of service delivery of government’s Integrated Child Development Services (ICDS) Program to improve the health and well-being of children below 6 years of age with a focus from marginalised communities in Chittorgarh district of Rajasthan.

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