India: The POSHAN Abhiyaan improves the nutrition of pregnant women and young children

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Survey findings show that the services delivered through the POSHAN Abhiyaan were associated with better nutrition practices among pregnant and lactating mothers and their children.
Survey findings show that the services delivered through the POSHAN Abhiyaan were associated with better nutrition practices among pregnant and lactating mothers and their children.

Amrita Kumari, a pregnant mother from Muzaffarpur district of Bihar, recalls how a frontline worker under India’s nationwide nutrition program - the POSHAN Abhiyaan – continued to support her, even during the COVID-19 pandemic.

“When I was pregnant,” she said,  “the anganwadi didi periodically visited my house to advise me about the importance of ante-natal checkups, regularly taking iron and folic acid tablets and consuming a variety of foods. She also delivered rice, pulses and soyabean to supplement my nutrition. And, since I was pregnant, she alerted the local health team in case I needed support.” For this, Amrita remains ever grateful.

Amrita’s story is one of the innumerable examples of how the POSHAN Abhiyaan reached out to pregnant women, lactating mothers and those with young children, even during the most difficult times. 

The program, launched by the Ministry of Women and Child Development in 2018, seeks to ramp up the impact of India’s long-standing Integrated Child Development Services (ICDS) scheme by placing special focus on pregnant women and children below two years of age.   

 

Services delivered through the POSHAN Abhiyaan lead to improved nutrition behaviour.
Services delivered through the POSHAN Abhiyaan lead to improved nutrition behaviour.

Since 2018, the World Bank has supported the POSHAN Abhiyan in 11 priority states – Andhra Pradesh, Bihar, Chhattisgarh, Gujarat, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Rajasthan, Tamil Nadu and Uttar Pradesh. 

In March and April 2021, the Bank conducted a survey to assess the program’s delivery of nutrition services, whether the nutritional knowledge of beneficiaries had improved and if  they had adopted more appropriate nutrition and feeding practices - the key desired outcomes.

The findings demonstrated that the services delivered through the POSHAN Abhiyaan – the receipt of relevant messages, home visits by the anganwadi worker, and attendance at community based events – were associated with improved nutrition behaviors.

 

During the pandemic, the anganwadi workers went from house to house to distribute rations (supplementary nutrition) and messages on appropriate nutrition practices.
During the pandemic, the anganwadi workers went from house to house to distribute rations (supplementary nutrition) and messages on appropriate nutrition practices.

The survey also found that:

Some key findings were:

 

    Frontline anganwadi workers visit homes to advise pregnant women about the importance of ante-natal checkups, regularly taking iron and folic acid tablets and consuming a variety of foods.
    Frontline anganwadi workers visit homes to advise pregnant women about the importance of ante-natal checkups, regularly taking iron and folic acid tablets and consuming a variety of foods.

    The Poshan Abhiyan strengthens India’s longstanding nutrition program

    The POSHAN Abhiyan incorporates learnings from earlier efforts to fill the gaps in the ICDS, in operation for the past 40 years, and strengthens it by and introducing five new approaches:

    First, it  reduces the endless burden of paper-work on the frontline anganwadi workers (AWW) by providing them with smartphones that enable them to prioritize what they need to do, review what they have done and take action where necessary. 

    Second, it helps boost the knowledge and skills of these workers by giving them bite-size courses on the nutrition of mothers and children and how to counsel them, in addition to instituting performance-based incentives.  

    Third, it uses Behaviour Change Communication through a variety of media and public meetings to create awareness about the right way to care for mothers during pregnancy, and what and when to feed the children. Communities were  also mobilized to celebrate critical milestones in the lives of pregnant women and children.

    Finally, given the multisectoral nature of the challenge, it promotes coordination between all critical line departments that contribute to nutrition, such as health and family welfare, water and sanitation and rural development.

    The program offers learnings for the next phase of the Government of India’s program - POSHAN 2.0. Going forward, more intensive focus will be required on strengthening service delivery, improving appropriate complementary feeding and nutrition practices among pregnant  mothers and focusing on the nutrition and health of adolescent girls.  

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    Authors

    Deepika Chaudhery

    Senior Health, Nutrition, and Population Specialist

    Rahul Pandey

    Sr. Operations Officer

    Mohini Kak

    Senior Health Specialist

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