Nutrition Centers for Pregnant and Lactating Women
During this Nutrition Month, sharing a good practice..
The criticality of proper nutrition for pregnant and lactating women is undisputed. Equally undisputed is that their nutritional status in India is extremely worrisome. Of course the government through its Anganwadi program does supply day rations for this stage of life. But in the field, what we found was that these rations were taken home, added to the general pool of foodstuffs in the household, and consumed by all. So probably the men or the children ended up getting a little more food, but very little extra went to the target women. It was not considered at all OK for the daughter-in-law of the house to keep aside the rations that she had received for herself! So in reality, these pregnant women got very little supplementary nutrition.
Based on some state government experiences, we at GMR Varalakshmi Foundation decided to reverse the equation. Rather than the food going to homes, we thought it might work if the women came to the food. We set up small community-based Nutrition Centers which pregnant/lactating women could easily access. They had to come into the Centers at a certain fixed time every day for about half an hour. We worked out a menu of supplementary nutrition in discussion with an eminent national institution working on the subject. The menu was not a complete meal but a list of items worked out to plug the commonly found gaps in this group. Some criteria we had was that it should involve minimum cooking, and should to the extent possible, be based on seasonally available local foods. Women coming to the Centers continue to avail the Anganwaadi rations.
So women come to our centers every day and it is like a little kitty party. They eat the snack, chat together, share notes on their pregnancy. There are organized activities—from a talk by a health worker on immunization and family spacing, to games related to food, nutrition and childcare, to screening of films on health, sanitation, etc. Records are kept of their weight, hemoglobin, and doctor advice. Special care is paid to vulnerable cases.
The Centers have been in operation for almost a decade now, and have almost 100% track record of institutional deliveries and of baby weight above 2.5 kg. And the cost? The snack costs Rs. 15 per woman per day. And the program is for 12 months for each member—from roughly 3rd month of pregnancy to 6th month after delivery, with home delivery of the food during the weeks when the mother is not able to come to the Center. That is a cost of about Rs. 5500 per woman for ensuring her health and to lay the foundation for a healthy life for a baby. Extremely scalable for organizations. Not difficult even for individuals to support.
There may be many, many other such simple ideas tried by innovative NGOs and others across the country. The key is to share, learn and multiply the good practices!