Food Nutrition Health and WASH (FNHW)


SWABHIMAAN

(2016-2020)

Swabhimaan is a multi-sector integrated programme designed for, and implemented by women collectives (promoted by Aajeevika) to improve the nutritional status of women and girls.

It aims to demonstrate how village organizations promoted by Aajevika can be treated as equal and accountable partners in improving nutrition indicators, by receiving and managing community cash grants in DAY- NRLM resource blocks. The programme is currently running in Bihar, Chhattisgarh and Odisha

Background-from sewa to service

Engagement of self help groups to improve last mile delivery of health services through activities like community mobilisation, counselling, and record keeping have largely been treated as honorary work. Budgeting for these services as service costs however, will ensure better efficiency by transforming into nutrition investments.

DAY-NRLM provides an opportunity to do this via a community cash grant mechanism, where self help groups with active bank accounts can directly receive and manage money as per need-based plans developed by the community. These plans are created to improve service delivery and address nutri specific and sensitive issues in keeping with DAY- NRLM’s dashasutra strategy. Funds are disbursed by higher federated institutions that function as grantees after approving of their plans.

Improving nutrition indicators in women and girls

Swabhimaan tests the delivery of 18 nutrition specific and sensitive interventions under these five thematic categories to nutritional outcomes before conception, during pregnancy and after birth:

  • Improving food and nutrient intake

  • Preventing micronutrient deficiencies and anaemia

  • Increasing access to health services and provision of special care to nutritionally at risk women

  • Increasing access to education about water and sanitation as well as WASH commodities

  • Preventing early, poorly spaced or unwanted pregnancies

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The Swabhimaan Programme

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Components of Swabhimaan

Swabhimaan is designed to simultaneously push improved service delivery and create a demand for nutritional services in the community.


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Strengthening service delivery

Strengthening systems for better coverage, continuity, intensity and quality (C2IQ) of services at the Village Health Sanitation & Nutrition Days (VHSND)

 

MONTHLY

Identification of women and children at risk of undernutrition in VHND by ANM
Initiating services for newly-wed women in VHND which was missed earlier

QUARTERLY

Training of health service providers (ANM)
Convergence review meetings at district level and block level

ANNUALY

Orientation of service providers PDS, ICDS, PHED to ensure communities receive their entitled services

 

Creating demand for services

Facilitating coordinated community based activities at various levels

Tier level: Village organisation led activities
SOCIAL ACTION COMMITTEE

Selection of Poshan Sakhi (1 per VO)*
* Else Community Resource Person provided a top-upfund

Optional: Formation of adolescent girls’ clubs by PoshanSakhi and their fortnightly meetings

POSHAN SAKHI/CRP
  • Dashasutra Poshan microplanning (12 days over 2 months) by Poshan Sakhi

  • Monthly maitribaithak of women (open to non-members) by Poshan Sakhi using Participatory Learning and Action

  • One additional monthly home visit/group meeting of at-nutrition risk women

VRP
  • Village Resource Person (VRP) monthly maitri kishan bethak on nutrition-sensitive agriculture Participatory Learning And Action

  • VRP to support home-based Poshanbeds/backyard poultry

SHG
  • All SHG members to mobilize family members for VHND services

  • SHG members to wash their hands beforetheir weekly meeting starts

Tier level: CLF led activities
MONTHLY
  • Families with women and children at risk of undernutrition linked to Agri-poultry linkage and social protection schemes

  • CLF to give loans for secondary education

  • Making Farmer field school sites (Community Krishi Vidhyan Kendra)

QUARTERLY
  • Trainings of Poshan Sakhi and VRP

BIANNUAL
  • Newly-wed couple meets

  • Entitlement camps and check-ups for women

ANNUAL
  • Preparation of FNHW microplans

  • Stock taking of the microplans

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Collaborations

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The State Livelihood Missions (SRLMS) are anchoring and implementing the Swabhimaan programme, in coordination with the Departments of Health, Civil Supplies, Social Welfare, Agriculture and Public Health Engineering, with UNICEF technical and financial support.

UNICEF in turn is partnering with relevant non-government partners (and resource persons) for development of capacity building tools and methodologies and with academia for impact and process evaluation.

The impact evaluation is led by the All India Institute of Medical Sciences (AIIMS) in Bihar, Chhattisgarh and Odisha, with technical support from International Institute of Population Sciences and University College London. The process evaluation and concurrent monitoring of quality of implementation strategy is led by Clinical Development Services Agency, a unit of Department of Biotechnology, Government of India. The programme is reviewed at national level biyearly and is guided by a national technical advisory group.


Expected outcomes by 2020

  • Equitable reach of food security safety-nets and services for adolescent girls and women with a focus on those who are at nutritional risk

  • High impact nutrition and health (including reproductive health and family planning) services for adolescent girls and women to be available consistently

  • Increased access to household access to drinking water and sanitation products/services and practice of personal hygiene behaviours by adolescent girls and women

  • Increased know-how on nutrition sensitive agricultural practices at district and sub-district levels and their application and village level

  • VOs equipped to design, implement and manage integrated, context-responsive, multi-sector nutrition programmes

Expected impact between 2016- 2020

Swabhimaan’s hypothesis is that such village organization-led activities will lead to

  • A 15% reduction in the proportion of adolescent girls with a BMI < 18.5 kg/m2

  • A 15% reduction in the proportion of mothers with children under two with BMI < 18.5 kg/m2, and a 0.4 cm improvement in mean MUAC among pregnant women

  • Improvements of between 5% and 20% in the coverage of 18 key nutrition specific and sensitive interventions over three years