NUR URTUR URING WO WOMEN │ NOUR URISHI HING WO WOMBS #Stop S Stunting AROGYA LAKSHMI A Journey towards Maternal Malnutrition-Free Telangana Department for Women Development and Child Welfare Government of Telangana
Key Nutrition Indicators: Telangana IFA CONSUMPTION AND ANEMIA PREVALENCE AMONG PREGNANT WOMEN 58.2 52.8 49.8 39.3 CONSUMPTION OF 100+ IFA PREVALANCE OF ANEMIA NFHS-3 (2005-06) NFHS-4 (2015-16) Low Birth Weight – (RSoC 2013-14) 18.4
Arogya Lakshmi: The beginning and scale up Started One full meal scheme in 2013 Universalized in 2015 with additional to tackle Under-nutrition and Anaemia key features as Arogya Lakshmi Districts ICDS Projects AWCs (100%) (100%) 31 (57%) (54%) 9 2013 2015 2013 2015 2013 2015 Total 3.7 lakhs Pregnant and Breastfeeding mothers are being served every month
Arogya Lakshmi: the Objectives • Reduce the prevalence of anemia & under-nutrition • Bridge the gap between the Recommended Dietary Allowance (RDA) and Average Daily Intake (ADI) • Ensure micronutrients consumption, health check up and immunization • Reduce low birth weight among new born, also reduction in wasting and stunting among children in the long run
Key features Spot Feeding along with IFA supplementation and Nutrition and Health counseling Community participation and monitoring through Anganwadi Level Monitoring and Support Committees and Social Audit Mechanism ICT-based monitoring of commodity supply chain and beneficiary-wise tracking of nutrition outcomes
Arogya Lakshmi Platter One full meal consists of Rice, Dal, Oil, vegetables for 25 days a month One Boiled Egg Pregnant and for 30 days a Breastfeeding month Mothers 200ml. Milk for 30 days a month
Key Elements of the Scheme Counselling Critical for availing Immunization & ANC services and for following Growth feeding practices-24 session monitoring calendar (2 nd month of Administration pregnancy to 6 th month post One full meal of ( Gestational Weight gain and partum, fortnightly) Hb count monitoring; one Micronutrients (Consists of egg, milk, rice, dal, additional home visit from green leafy veg. (Calories - 20-40 th week of gestation for (Iron, folic acid, calcium 1192, Protein- 37gm and women with gestational supplementation with Calcium-579mg) weight gain<3kgs) deworming for PW & BFM)
Increasing Investment on Maternal Nutrition In Rupees 21 (83%) 17 15 (79%) (77%) 7 7 7 7 7 (23%) (21%) (17%) (50%) (50%) 2012 2013 2014 2015 GoI Cost Norm Actual Cost GOI share State Share
Seamless supply chain and building micronutrient interventions • Joint orders for seamless supply chain and Strengthening building micronutrient interventions Convergence with HFW • Joint meetings with AWTs, ASHAs and ANMs • Supply of IFA, Calcium and Albendazole for pregnant women to AWCs Supply chain management • Reporting on consumption shared with HFW by WDCW • Data integration with Health and Family Welfare Improving data quality • Monitoring of NHD data at village level
Community participation and monitoring through ALMSCs and Social Audit Mechanism
Involvement of Stakeholders • Community monitoring and support through Anganwadi level monitoring and support committees (ALMSCs) Community • Greater Involvement of PRI members – Conducted Constituency Level Workshops Interface • Ensuring supplementation micronutrients through community support • AL creates a platform to get together and have peer group discussion • Flexible timings for noon-meal at AWCs Coverage • Mobilization of beneficiaries for NHDs and pregnant for early registration with Quality • Conducting community events: S eemantham (baby shower) for pregnant women and Annaprasana (initiation of CF for 6mths age children)
Social Audit for Awareness on Rights and Entitlements • TSSAAT, Telangana is facilitating Social Audit Process • Involving of community for awareness on rights and and entitlements Status • Completed in 1,132 AWCs in 21 districts • 98.9% aware of their entitlements • 77.3% coming to eat at AWC Findings • Grading of AWCs based on infrastructure, food quality, cleanliness, pre-school, punctuality, register maintenance
ICT-based monitoring of commodity supply chain and beneficiary-wise tracking of nutrition outcomes
Improved MIS for Transparency and Accountability • Online FCR (Commodity Supply Chain Management) • Tracks the actual Distributions, Receipts, Utilisations and Balances of commodities at AWC level. • Helps in Timely placing of indents, Releasing orders, Need based allocations and Timely supply • Mobile App for Egg Supply • Developed to mainstream the supply of eggs to AWCs • Online indents, OTPs to AWTs about no. of eggs
Improved MIS for Transparency and Accountability • Nutrition and Health Tracking System (NHTS) • Name-wise tracking of pregnant and breastfeeding mothers and children below 6 years • Aadhaar authentication and contact details for each beneficiary registration • Provides dynamic information related to service delivery and reminders for service delivery • Hosting of data in public domain; SMSs to beneficiaries
Improved MIS for Transparency and Accountability Total Pregnant and Breastfeeding Registered 4,38,121 Total Services availed 3,66,965
Improved MIS for Transparency and Accountability
Improved MIS
Way forward • Inclusion of women in preconception age Life Cycle Approach • Customized counseling using to Nutrition standard tools to Adolescent Girls, Pregnant Women, Mothers • Fortification of Salt, Oil and Wheat/ Fortification and Rice Diversification • Introduction of millet based menu • Active screening of children and Active Screening pregnant women for nutritional status (Use of MUAC)
Way forward Increasing Stakeholder Involvement Strengthening Arogya Lakshmi Committees at • all levels Involvement of well-trained social capital from • SHGs Improving infrastructure and facilities & • Integration of WASH components Arogya Lakshmi Helpline • Inbound – Grievances and redressal for • Stakeholders and AWTs Outbound – to Stakeholders to provide • information and get feedback on OFM Immediate counselling support for women • on MIYCN
Tha hank you nk you
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