Transcript No Slide Title

Murshidabad district of West
Bengal
Estimated Popn
% Rural
Sex Ratio
% Literacy
No. of Blocks
District Hospitals
No. of SDHs
No. of Rural Hospitals
No. of BPHCs
No. of PHCs
No. of SCs
No. of AWCs
S1
: 58,63,717
: 87.5
: 952
: 55.05
: 26
:2
:3
:9
: 18
: 69
: 632
: 4268
Berhampore ICDS Project
Farrakka
(1)
Samsherganj (1)
Suti-II (5)
Suti-I (2)
Population: 3,78,723
Sex ratio : 947
Raghunathganj-II (2)
Raghunathganj-I
(7)
*
Bhagawangola-I
# of BPHC: 1
Bhagawangola-II
Sagardighi
Nabagram
literacy rate: 54.41
Lalgola
(20)
Raninagar-I
Murshidabad - Jiaganj
Khargram
m
rha
Kandi
Be
por
Bharatpur-I
Hariharpara
Nawda
Beldanga-II
# of PHC : 2
Jalangi
# of Sub Center : 47
# of AWCenter : 235
e
Beldanga-I
Burwan
Raninagar-II
Domkal
Economy :Totally
agricultural
Demography : 63 %
mohamrddan population.
Bharatpur-II
S2
Blocks and Subdivisions of Murshidabad District
Positive Deviance Program
This is a field level learning exercise with the
Objective of eradicating malnourishment among local
children
Strategy of involving of mothers,
Participation and contribution of community,
Capacity building of the community regarding child care,
Behavioral change of the mothers through good practices,
Convergence of other stake holders like PRI, Health Dept.
Center of activities : Village Level Anganwadi Centers
(AWC’s)
S3
Activities Undertaken
Program launched in the month of January 2002
with the following steps:
-Selection of Anganwadi Centers (AWC’s) based upon surveys
of the number of children with Grade 2, 3, and 4 malnutrition
(G234) at the centers.
-Initially 8 AWCs were selected. PD program later expanded
to 22 centers in Berhampore.
-Training for Anganwadi Workers (AWWs) and the ICDS
Supervisors.
S4
Activities Undertaken, con’t
-Village Health Committee (VHC) formed in all the centers.
-Sensitization of the local community and orientation of VHC
members.
-Malnourished children selected for NCCS .
-Mothers meeting and (PDI) home visit carried out.
-Community meeting by VHC members before starting NCCS
Monitoring format at the AWC level and project level have
been developed and introduced .
S5
Status of Families Whose Children
Participate in Local ICDS Program
62 mothers from 7 centers from three GP areas were
interviewed about their socio-economic status. These
interviews suggest:
Average # of children per couple: 2.8
Maximum # of children: 6
All mothers with only one child have daughters, and they are all
pregnant at the present time.
S6
Status of Families Whose Children
Participate in Local ICDS Program , con’t
Almost half of the mothers are illiterate. The rest are
barely literate. (37 out of 62 are illiterate.)
One mother has passed the fourth grade. (highest level of
literacy amongst mothers.)
Most families do not have sanitary latrines. (39 out of 62
do not have a sanitary latrine.)
S8
Status of Families Whose Children
Participate in Local ICDS Program, con’t
A Majority of families are Below the Poverty Line (BPL) (35
out of 62 families.)
In general there is a low awareness of hygiene, general health
topics, and child care practices.
Twelve of the mothers work as maids and report they do not
have time to care for their children.
S7
Impact-2
Change of w eight in 4th round NCCS
out of 242 children
4.50%
11.50%
W.gain mo re than
200 gm
W. gain lessthan 200
gm
16%
W.remain same
68%
S10
W.decreased
Impact -1
Trend in change of Nutritional
Status
166
180
160
140
120
98
102
100
July '03
80
Sep '03
60
20
26
15
25
40
0 3
1 0
0
Normal
S9
Gr-I
Gr-II
Gr-III
Gr-IV
Impact -3
-During the months of August, September and October
2003 the program was unable to provide rice and dal to the
mothers. The mothers demonstrated commitment to the
program by donating these foods during this period.
-Two centers became ‘Living Universities’
-The newly elected PRI bodies and the Health functionaries
have been oriented
S11
Impact –3, con’t
-Surrounding communities have been requesting that
Positive Deviance (PD) activities be implemented in other
AWC’s.
-There has been an increase in awareness of child care
practices.
-The ICDS functionaries and the CINI functionaries
have became a PD team for its success.
S12
Impact-4
Impact on overall ICDS program
Weighing Efficiency
100
92.29
87.83
90
July. 2002
80
July. 2003
70
60
50
40
S13
30
51.74
53.79
Aug. 2002
Aug. 2003
Impact-5
Impact on overall ICDS program
Degree of Malnourishment
50
40
30
20
10
S14
0
38.15
July. 2002
34.36
July. 2003
22.39
19.73
Aug. 2002
Aug. 2003
Difficulties
-Twelve to Thirteen Percent of children did not gain any weight;
Four to Five Percent of children lost weight.
-After completion of the PD program, there were still 15
Grade-III children.
-Some of the mothers were not properly spot feeding their children
-There are some mothers are not participating in the NCCS
sessions everyday.
-Some mothers are not maintaining the caring practices learned in
the NCCS when the NCCS program is not is session.
S15
Difficulties
-All the VHC members are not participating and cooperating
actively
-Panchayat functionaries are not as actively involved in the
program as
-In some of the AWC’s ailing children were unable to make
obtain appointments for medical evaluation.
-Fuel for the NCCS to the AWWs still remained a problem.
S16
Future Plans
-The VHCs (Village Health Committees) and Panchayat
functionaries are to be re-exposed to the PD approach
-The Berhampore Ministry of Health was contacted to assure
that assuring health check-up of those children who are
remaining in grade-II and Grade-III for long period.
-The District Magistrate,Murshidabad has taken steps
for the solution of Fuel issues which is to be materialized.
-Quiz competition among the mothers,VHC members,
AWWs to be organized for their motivation and evaluation
of the program
S17 -More centers to be taken to the status of living university.