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Coordinated nutrition intervention programmes in Tuensang have helped to enhance health services in the region. The programme under Poshan Abhiyan, Department of Social Welfare has been integrated into the health effort implemented jointly between Eleutheros Christian Society (ECS) supported by HCL Foundation, the Health Department and the community.
The intervention which was built around complementary feeding is conducted once a month and the feeding serves as a hub for the provision of health services, nutrition education, a platform for inter-sectoral convergence and an interface between the community and the health system. The Church also contributes 2 percent of the feeding cost, provides the space for cooking and feeding and takes care of any other shortfalls.
The project targets pregnant women, lactating mothers and children up to 1 year and is implemented through the Church. The activities built around the feeding include ANC and health check-ups, immunization, complementary feeding and targeted feeding, anthropometry, health talks, nutrition education and counselling, anaemia screening, home visits, capacity building of AWWs, ASHAs and feeding committees, and monthly community review.
In preparation, village level plans were drawn and responsibilities divided for cooking, serving, growth measurements, documentation, ANC and immunization services, education sessions etc. Anaemia screening was conducted periodically to identify anaemia among mothers. Under targeted feeding, those tested with severe and moderate anaemia are closely monitored and provided nutritional supplements and counselling at the Anganwadi centres. The mothers visit the centre every day and receive eggs and supplements like iron, calcium and vitamins.
Complementary feeding has not only improved the nutrition status but has also contributed to the outcomes of the broader health effort. It has provided the opportunity for the community and various players to converge and synergize their efforts thereby improving service availability and access. The strong support from the community and their participation encouraged nurses and staff of health centre to be at their work stations, therefore, improving service utilization.
The involvement of the Church broke cultural barriers around pregnancy and childbirth encouraging pregnant women to show up at the feeding centres without inhibitions. Stigma around pregnancy and childbirth was a challenge in the area preventing pregnant women from freely accessing ANC and hospital delivery services. The program also helped converge the activities of para workers (ASHA, Anganwadi and health workers) who earlier were unaware of each other’s activities.
One important change made was the improvement in anaemia status among mothers. Identification of anaemia through the screening camps and the close monitoring and support provided to anaemic mothers has helped many to escape their condition.
DEVELOPMENT OF DELIVERY POINTS
As part of the larger effort to make health services available, three defunct health centres – Pessao PHC, Wangshu Sub Centre and Monyakshu PHC were activated in villages and treatment services including deliveries have been initiated in all the centres. Altogether, Tobu now has 6 delivery points including Tobu CHC, Changlangshu PHC and Pessao PHC.
Nurses were deployed in Pessao PHC and Wangshu Sub centre through ECS and the community agreed to bear part of their salaries. The community also raised funds and made improvements to the facilities, procured essential medicines and organized the living quarters for the nurses and other staff. ECS provided basic sets of delivery equipment, consumables for delivery, water filters, solar lamps and torches in all the centres. During the year, a total of 274 deliveries were conducted and close to 12000 patients seen through OPDs at the health centres.
Efforts are ongoing to mobilize and build the capacity of mothers through the formation of mothers’ clubs and a total of 53 groups were formed during the year. At present, there are 95 clubs across 17 villages with a total membership of 1166 mothers.
– 1076 mothers provided with food rations during the lockdown period
– 2670 beneficiaries (mothers and children) reached through complementary feeding in 19 villages during the year
– 3 sessions of training for para workers and community/church leaders conducted on nutrition and health care
– Onsite support provided to para workers in all 16 villages
– Daily nutrition support provided to 337 anaemic mothers through the Anganwadi centres across the area
– 3 delivery points activated Pessao PHC, Wangshu SC and Monyakshu SC. A total of 274 deliveries were conducted and close to 12000 patients seen through 6 health centres
– 3 rounds of anaemia camps conducted in 20 villages with over 1800 tests performed