1. “SuPoSHaN” ICDS MISSION
Community Based Intervention - Curative Strategy : Sneha Shivir (VHNCCS) - Preventive Strategy : 20 Counseling sessions, IEC Sessions VHNDs
VIDEO CONFERENCE

2. CRITICAL INDICATORS PARTICULARS INDIA NFHS - 3 (Rural 2005-06) M.P.
NIN (2010)
Prevalence of low birth weight
23.4
19.1
Initiation of Breast feeding with in 1 hour
13.3
26.4
Pre-lacteals given
58.7
16.1
Exclusive Breastfeeding (0-5 months)
46.3
21.6
71.0
Initiation of compl. feeding At 6 months
55.8 -
23.5
% Full Immunization ( months children)
43.5
31.5
84.2
Coverage of 9-59 months children for Massive Dose Vitamin A Supplementation (%)
81.7
Coverage of Pregnant women for IFA Tablet Distribution (%)
78.0
Coverage of months children for IFA Tablet/Liquid Distribution (%)
25.0
Nutrition status (Based on WHO Child Growth Standards )
Underweight
45.9
60.0
51.9
Stunting
38.4
50.0
48.9
Wasting
35.0
25.8

4. Age Group wise Percentage of Underweight Children (0-5 years) M. P
Age Group wise Percentage of Underweight Children (0-5 years) M.P. v/s India (NFHS-III )
Undernutrition in the first 5 years (esp. first 2 years) of life needs special emphasis.
Lifelong adverse impact on growth and development
Higher risk of dying in infancy
Consequences are severe & often irreversible
Lifelong cognitive and physical deficits and chronic health problems
Data Source: NFHS-3 ( )

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6. “SuPoSHaN” Abhiyan “SuPoSHaN” OBJECTIVES Supportive Programme on
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Supportive
Programme on
Sustaining
Health
and
Nutrition
“SuPoSHaN”

8. NUTRITIONAL STATUS OF CHILDREN (0-5 YEARS)
Only 15% needs facility care
WHO Growth Standards (2006): MODERATE = Median <-2 SD to ≥ -3 SD & SEVERE = Median <-3 SD

9. “SuPoSHaN” ABHIYAN
‘Abhiyan' for reduction and prevention of undernutrition
Conceptualized as a community based programme
Targeted convergent approach
Targeted to (70% undernutrition) AWCs - 4 or more SUWs
Rastriya Bal Swasthya Kariyakram (RBSK) and C-NRC of NRHM
“Sneha Shivir” , Mangal Diwas, IEC, ABM
Adapted from globally acknowledged Positive Deviance Approach

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11. “SuPoSHaN” ABHIYAN
‘Abhiyan' for reduction and prevention of undernutrition
Conceptualized as a community based programme
Targeted convergent approach
Targeted to (70% undernutrition) AWCs - 4 or more SUWs
Rastriya Bal Swasthya Kariyakram (RBSK) and C-NRC of NRHM
“Sneha Shivir” , Mangal Diwas, IEC, ABM
Adapted from globally acknowledged Positive Deviance Approach

12. What is Positive Deviance?
Every community has certain individuals or groups whose uncommon behaviors and strategies enable them to find better solutions to problems than their peers, while having access to the same resources and facing similar or worse challenges.
Based on problem-solving and community-driven approach that enables the community to discover these successful behaviors and strategies and develop a plan of action to promote their adoption by all concerned.

13. Participatory Micro Planning at Village level
STRATEGIES
Participatory Micro Planning at Village level
Community Mobilization
Facilities improvement
Weighing drive
Village Mapping
Screening of children
Presence of health worker at 1st screening
Provision of 1st round of medication during special VHNDs (17th – 24th)
Steered by AWW, Gram Swasthya Samiti and Poshan Mitra Team

14. Participatory Micro Planning at Village level
STRATEGIES
Participatory Micro Planning at Village level
Curative
Community Mobilization
Facilities improvement
Weighing drive
Village Mapping
Screening of children
Presence of health worker at 1st screening
Provision of 1st round of medication during special VHNDs (17th – 24th)
Steered by AWW, Gram Swasthya Samiti and Poshan Mitra Team
Entry point to the village for accelerated reduction in moderate and severe under nutrition in children
Steered by Supervisor and Poshan Sahyogini

15. Curative Strategy Sneha Shivir + C-NRC
1st & 30th day Doctor completes screening, tracks status
12 days camp for children
Supervisors and Poshan Sahyogini conduct the camp
3 Supervised feeding of children
Focused counseling session of mothers with PD exemplars
Demonstrating local nutritious recipes - Mothers Learn by doing
Day to day child profiling
Poshan Mitra, ASHA, AWW follow up by 18 home visits
Monthly follow up and weighing of children for 6 months
If required re-organize camp

16. Participatory Micro Planning at Village level
STRATEGIES
Participatory Micro Planning at Village level
Curative
Preventive
Community Mobilization
Facilities improvement
Weighing drive
Village Mapping
Screening of children
Presence of health worker at 1st screening
Provision of 1st round of medication during special VHNDs (17th – 24th)
Steered by AWW, Gram Swasthya Samiti and Poshan Mitra Team
Entry point to the village for accelerated reduction in moderate and severe under nutrition in children
Steered by Supervisor and Poshan Sahyogini
Empowering community to catalyze behavior change for taking out the village from the undernutrition trap
Steered by AWW, Gram Swasthya Samiti and Poshan Mitra Team

17. Preventive Strategy Life cycle approach for improving nutrition
Continuum of care beginning with adolescent girls to first 1000 days and till 5 years of age

18. FIRST 1000 DAYS Pregnancy (9 months 30 x 9 = 270)
Birth – 24 months ( 24 x30 = 720 days)
Total = 1000 days
To increase children’s chances of survival, improve development and prevent stunting, nutrition interventions need to be delivered during the mother’s pregnancy and the first two years of the child’s life.

19. Preventive Strategy Life cycle approach for improving nutrition
Continuum of care beginning with adolescent girls to first 1000 days and till 5 years of age
Strengthen and streamline delivery of ICDS
Universal survey and enrolment of beneficiaries at AWC
Vajan Mela every every month 1st to 4th
Screening of children by health care providers and referrals
Swachhata Abhiyan every month 5th to 7th
Targeted activities Monday to Friday

20. Targeted activities Monday to Saturday
Days
Targeted Activities
Monday
Regular dialogue with community - Special VHNDs + Poshan Meetings with gram swasthya samitis and poshan mitra
Tuesdays
Lakshit Mangal Diwas themes along with sanitation campaign
Wednesday
Intensive home visits targeted to Pregnant women
Thursdays
Intensive home visits targeted to lactating mothers of children 0 to 6 months
Fridays
Advocacy and dialogue with community for behavioral change - 25 IECs
Saturday
Intensive home visits targeted to lactating mothers of children 6 months to 2 years

21. Support - "SuPoSHaN“ Abhiyan
Village level
Sector Level
Block Level
District Level
AWW
AWH
ASHA
Gram Sabha Swasth Gram Tadarth Samiti
Poshan Mitra Team
PRI
Supervisor
ANM
NGO nominated by District officials
BMO
CEO JP
Project Officer
Mobile health team
CEO ZP
EE PHE
CMHO
DD Agri/Horti
Food Officer
DPO
AWTC
DTO (Health)
Home science faculty

22. OUTCOME Sr. no. Out come indicators Target 1
Weight gain of children after 12 days
75% children will show minimum 200 gm weight gain 2
Weight gain of children after 30 days
75% children will show minimum 400 gm weight gain 3
Weight gain of children after 2 months
Growth curve of 75% of children will on positive trajectory 4
Weight gain of children after 3 months
50% children will show positive change in nutritional status 5
Nutritional status of children after 6 months
80% children will show positive change in nutritional status

23. Phase Out Strategy Success in a village will be assessed
by complete elimination of SUW
decrease in MUW
Exit strategy after 1 year of implementation of Sneha Shivir in any village
Weighing all eligible children (0-5 yrs)
Third party would conduct the “audit”
If no cases of severe under nutrition and borderline moderate cases for a period of one year it may be decided to phase out Sneha Shivir
Remaining MUW children would be rigorously monitored and care givers counselled on best practices at regular health education sessions and during home visits

24. IMPERATIVES Active involvement of Health, Panchayats, PHE,
Agriculture, Food
Community participation through poshan mitra team, gram sabha swasth gram tadarth samiti
Sensitive Poshan Sahyogini
Quality training
Good Micro-planning and implementation
Intensive monitoring
Adequate and timely resources

25. TIME LINES March - 3035 camps in 1st phase in 2 cycles
Cycle 1 : March 1 to March 12
Cycle 2 : March 24 to April 4
January and February
Selection of villages, Poshan Sahyogini and Poshan Mitra
Trainings at all level
Microplanning
Preliminary screening of children and medication
April - Preparation for 2500 camps in May (1-12th)
May - Phase 2 camps and Preparation for 2500 camps in June (1-12th)

26. Expectations From Collectors
Build and mobilize for enabling environment and community participation
Strengthening convergence with
Health for screening and monitoring
Panchayat for infrastructure, facilities and participation - employment
PHED for Safe drinking water and sanitation campaign
MDM for improved Hot supplementary nutrition given at AWC
Agriculture for minikits / Food for PDS
Monitor ICDS to ensure :
Universal survey, identification and weighing
Quality of training and inputs of Abhiyan
Delivery of services including THR
Provide administrative, technical and financial sanctions for the optimum usage of resources

27. THANK YOU