Strengthening communities for improving health and nutrition

Strengthening communities for improving health and nutrition

During a community monitoring exercise conducted by the Centre for Youth and Social Development (CYSD) in Nuagaon village in Koraput district of Odisha it came to light that children, and pregnant and lactating mothers were not receiving food entitlements at the Anganwadi Centres (AWC). The Centre could not provide food to the women and their children because their helper was too old to cook food regularly and they couldn’t get another cook. 

A further investigation showed that the Anganwadi Worker (AWW) and the Accredited Social Health Activist (ASHA) lacked resources, and the Mothers Committee* and Jaanch Committee* (Monitoring Committee), that are meant to monitor and regularise food and sanitation aspect of the Anganwadis, were non-functional.
   
Oxfam India works with grassroots NGO partners to facilitate and develop community-based monitoring systems to manage public health and nutrition facilities and create a common platform of networks at village, districts, and state levels to promote and improve access to health services. Regular workshops and trainings are conducted to ensure each individual is aware of their rights and receives their entitlements. 

Oxfam India organises capacity building workshops of front line functionaries, community stakeholders including the Jaanch Committee and Mothers Committee and ensures service delivery through implementation of community monitoring and tracking systems in focus areas.

It also trains mothers and care givers to look after the health and nutritional needs of children. Mothers’ Committee at each Anganwadi Centre and Jaanch Committee at village level have been formed to enhance and monitor community level participation. Functional Mothers’ Committee and Jaanch Committee have played an important role in ensuring the entitlement of beneficiaries at the AWCs.

READ: COMMUNITY BASED ORGANISATIONS RAISE AWARENESS OF HEALTHCARE

And this is what Oxfam India did at Nuagoan. As part of setting up a community-based monitoring system, a village level interface was organised between workers and beneficiaries along with Ward members of Nuagaon. Awareness meetings and trainings were held for women to apprise them of their roles and responsibilities as members of Jaanch Committee and Mothers’ Committee. These trainings included informing the committees and front line workers of their responsibilities. 

The two committees were trained to regularly visit Anganwadi Centres to conduct hygiene checks, monitor food quality and quantity provided to preschool children (age group 0-6 years) and pregnant and lactating mothers. Now both the committee members and the ward member visit the Centre on a very regular basis and play an active role in monitoring community level participation and ensuring beneficiaries receive their entitlements including properly cooked meals.
 
Community members also recruited a new helper at the AWC by nominating a local woman from the village. The nomination was sent to the Block Child Development Programme Officer (CDPO). Once accepted the new helper was posted at the Centre and the old worker took voluntary retirement. 

With the efforts of Oxfam India and its grassroots partner, the Nuagaon Anganwadi Centre is functioning well and 60 beneficiaries — 23 children aged 6 months to 3 years, 25 children aged 3 to 6 years, two pregnant women and 10 lactating mothers — are getting their food entitlements regularly. 

In Odisha, Oxfam India works closely with health watch groups, Gaon Kalyan Samiti (GKS) and the public to raise awareness about the public health system. During interface meetings held at the district level, stakeholders shared case studies from the ground with the Chief District Medical Officer and prepared a health plan. As a result, maternal health and nutrition services are now functioning efficiently in 20 villages of Odisha. 

Oxfam India also closely monitors and advocates for the Free Medicine Scheme in Odisha, along with other civil society organizations and health networks, GKSs, and youth. Constant advocacy resulted in the increase in the scheme’s budget from Rs 263 crore in 2017-18 to Rs 304 crore in 2018-19. We are still continuing the advocacy as 40% of this budget is still being spent on the management and administration of the Odisha State Medical Corporation Limited (OSMCL).

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*The Mothers Committees are formed at each Anganwadi level, comprising of beneficiaries – pregnant women, lactating mothers and ASHA workers. They are support Anganwadi Workers (AWW) in delivering cooked food and ration. 

**Jaanch Committess are formed at all Revenue Villages. The committee is represented by Women Ward Member, Women Self-Help Group (SHG) members, Auxiliary Nurse Midwife (ANM) and CSO members and beneficiaries. They are entrusted to oversee the quality, supply and distribution of food at each Anganwadi Centre.