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Strengthening Aspirational Block Program for Improved Nutritional
Outcomes- Shrawasti

Key Initiatives or Changes:

The Hon’ble Prime Minister launched the Aspirational Blocks Programme (ABP) on January 7, 2023.The programme focuses on improving governance to enhance the quality of life of citizens and service delivery in the remotest and less developed blocks of India. In the aspirational district of Shravasti, located in Uttar Pradesh, the block of Jamunaha had been grappling with persistent challenges related to malnutrition among children under the age of five. Despite the efforts of the government and various stakeholders, the nutritional indicators in the region remained a cause for concern.

The project focused on building the capacity of frontline workers. The need for building the capacity of the front-line workers was crucial for achieving the project’s goal and was seconded and supported by the district health officials. During the rapid need assessment carried out to understand the operational gaps, the following gaps were revealed w.r.t to the capacity of the front-line workers:

Understanding the technical and operational details in operating the digital application, Poshan Tracker & E-Kawach Application, including correct data entry in the application.

Correct technique to be followed for weighing a child

Plotting weight on growth charts and interpreting growth curve

Thus, all the ASHA Sanginis, Anganwadi Workers (AWWs), and Auxiliary Nurse Midwives (ANMs) participated in intensive training sessions to address the gaps mentioned.

This project stood as a fine example of how partnership with government departments and joining hands for a common cause can amplify the reach and availability of benefits in the community. The power of convergence and interdepartmental coordination became evident. It resulted in the increased collaboration between the ASHA, ANMs and Anganwadi Worker (AWW) to facilitates the ASHA’s task of mapping households in her coverage area. Thus, the AAAs multiplied their forces in the task of liaising between the community and the public health system. This can be particularly seen with the increased effectiveness of VHSND as the project progressed. Thus, by fostering dialogue between various departments and securing support from key decision-makers, the project achieved synergy among stakeholders. Sustaining this collaborative spirit would be instrumental in realizing holistic nutrition services.

Innovative Approaches or Strategies:

The Project is based on the Technical Assistance Model which comprised of Preparation, Plan, Implementation, Evaluation, and Sustainability components. The Project model consist of 4 pillars (as depicted in the diagram below):

Pillar 1: Awareness Generation

Pillar 2: Capacity Building of Front-Line Workers (FLWs)

Pillar 3: Identification and Reporting

Pillar 4: Case Management

Through the implementation of the strategies, it led to more parents and guardian’s footfall during the Vajan Divas and VHSND for getting the growth monitoring of the child done, thereby resulting in increased enrolment in the Poshan Tracker and E-Kawach application. This joint effort resulted in all the SAM /MAM children identified receiving proper medication, increase in admission in NRC with less resistance from the parents and proper follow up mechanism for the SAM and MAM children. Thus, by working together with government agencies, we have been able to continue our endeavours for the welfare of children

Measures of Success:

The project was able to achieve the following major milestones during the entire reporting period:

Improved capacity of 167 frontline workers, including Anganwadi Workers, Asha Sanginis, and Auxiliary Nurse Midwives (ANMs). These dedicated individuals received training on using the Poshan Tracker and E-Kawach Application, enabling them to monitor and track children’s nutritional status more effectively.

The 167 frontline workers received comprehensive training on documenting and reporting cases of the triple burden – undernutrition, micronutrient deficiencies, and overweight/obesity.

The measuring efficiency for Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) cases also improved remarkably, soaring from 92.77% in June 2023 to an impressive 98.99% by May 2024

Most significantly, the percentage of SAM and MAM cases decreased substantially. In June 2023, SAM cases were 3.09%, but dropped to 1.20% by May 2024 through proper reporting, follow-up, and medication provision. MAM cases also fell from 7.27% to 2.71% over the same period, showing remarkable nutritional status improvement.

The meticulously designed project led to an increasing number of children actively tracked from 26,179 in June 2023 to 29148 in May 2024 ensuring more children received vigilant healthcare. Most significantly, the percentage of SAM and MAM cases decreased substantially. In June 2023, SAM cases were 3.09%, but dropped to 1.20% by May 2024 through proper reporting, follow-up, and medication provision. MAM cases also fell from 7.27% to 2.71% over the same period, a remarkable nutritional status improvement.

Further, through regular meetings and collaboration with stakeholders, the project fostered a culture of teamwork, enhancing program implementation and coordination. The innovative convergence model exemplified effective cooperation among various entities, ultimately strengthening Integrated Child Development Services (ICDS) for the benefit of children

Their comprehensive reports laid the groundwork for replicating their success across other districts, ensuring a lasting impact beyond Jamunaha (the project implementation block). Thus, Jamunaha Block stood as a shining example of what collective action, dedication, and commitment could achieve for a community’s most vulnerable members

The impact of the project’s intervention was profound, not only on Muskaan and her brother’s life but on the entire community. The once lacklustre Anganwadi had become a beacon of hope and opportunity, thanks to the collaborative efforts of Bal Raksha Bharat and Vishal Mega Mart. Gratitude filled the hearts of the community as they witnessed the transformative power of BLES Work, paving the way for a brighter future for generations to come.