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BEST PRACTICES – HEALTH & NUTRITION

Arogya Kunji

District: Chatra in Jharkhand

  • Certain regions of the State are still underdeveloped. Tribals in these areas do not have access to modern healthcare facilities.
  • To offer respite to the people living in these affected areas, the State Government has designed and developed a new Sahiya Arogya Kunji Yojana. This is aimed at poor and deprived citizens of the district, for providing Medical Kits and efficient Ambulance services across the district.
  • Arogya Kunji has greatly improved the outreach and efficacy of timely medical aid and healthcare services in rural areas of this district.

CENTRALISED KITCHENS FOR BETTER NUTRITION

District: Nandurbar in Maharashtra

  • In order to tackle deep-rooted problems of Malnourishment and Anaemia in the tribal dominated Aspirational District of Nandurbar, the Tribal Department, under the aegis of District Administration has attempted to address the issue by establishing a Centralised Kitchen to provide hot and nutritious meals to children in residential schools, also known as Ashram Shalas.
  • Operational since April 2019, the programme has enabled Nandurbar to perform well on Health indicators pertaining to the reduction of Severe Acute Malnourishment and Moderate Acute Malnourishment in the district.

DELIVERY VAN TO PROMOTE INSTITUTIONAL DELIVERIES

District: Kandhamal in Odisha

  • Being a tribal area, traditional healing systems are given more importance over institutional systems, leading to several deaths. Childbirths were usually conducted by untrained ‘dais’ in the villages and pregnant women hardly went to the hospitals for delivery.
  • To solve this issue, on the supply side, all delivery points were made functional. 5 Bike Ambulances and 11 Janani Auto vehicles were deployed in outreach pockets. 7 Maternity Waiting Homes (MWHs) were also established that have significantly contributed to the Institutional Deliveries. On the demand side, awareness generation activities were undertaken to improve intake of the services provided
  • The Bike & Auto Ambulances along with the Delivery Vans in Kandhamal have improved the last mile connectivity for pregnant mothers. As a result, the rate of Institutional Deliveries in Kandhamal is now the highest in the State at 97% & maternal deaths have reduced by 65%.

MODEL ANGANWADI CENTRES

District: Ramgarh in Jharkhand

  • These Anganwadis host regular outreach and awareness campaigns in the community to promote better health and hygiene, such as VHSNDs (Village, Health, Sanitation & Nutrition Days) that have been benefiting families across blocks.
  • The Model Anganwadis include an upgraded in-house kitchen where nutritious meals are prepared for children to ensure a balanced diet. In addition, spaces around the premises such as front yard of the Anganwadis have been developed into a vegetable garden for optimal utilisation of the space and to ensure incorporation of freshly grown produce in the diets being provided to the children.

‘HAMAR SWASTHYA’ APP

District: Rajnandgaon in Chhattisgarh

  • To identify numerous undetected Non-Communicable diseases (NCDs), the Aspirational District of Rajnandgaon has launched the ‘Hamar Swasthya’ App to make people’s health cards available to the doctors and health workers.
  • In the year 2017-18, 8,966 cases of diabetes and 6,871 cases of hypertension were identified in a single day during health camps conducted across all the Panchayats.

HOSTELS FOR PREGNANT TRIBAL WOMEN

District: Vizianagaram in Andhra Pradesh

  • Earlier, pregnant women of remote villages of this district were carried by dollies resulting in many casualties with very high maternal mortality rate. Thereafter, the District Administration along with the Integrated Tribal Development Agency came up with the idea of constructing Hostels for pregnant women of these villages.
  • Pregnant women are brought to the Hostel one month prior to the Expected Delivery Date (EDD). There, they are provided with home-like care and support along with nutritional food and intensive medical care, under the close observation of gynaecologists. Post-delivery, the mother and child are shifted to their homes by Talli Bidda Express.
  • The Hostels are evoking good response from the tribes. Pregnant women admitted have expressed great satisfaction over the facilities being provided in these Hostels.

KALPANA PROGRAMME

District: Dhenkanal in Odisha

  • Established in January 2019 in the District Headquarters Hospital of Dhenkanal, ‘Kalpana Poshan Kendra’ derives its name from Kalpana Dash (renowned mountaineer).
  • It is based on the concept of establishing Nutritional Rehabilitation Centres under the umbrella programme of National Health Mission. Kalpana Poshan Kendra helps in recovering the lost weight of children through intensive feeding of therapeutic food (rich in micronutrients) supplements.
  • Capacity building of primary care givers in preparing home-made nutritious food from locally available ingredients and counselling of mothers on family planning are also conducted here.
  • The Kalpana Programme has been instrumental in improving the sex ratio from 852 in March 2018 to 972 in August 2019.

KANYA TARU YOJANA

District: Hailakandi in Assam

  • For encouraging Hospital Delivery and discouraging Home Delivery, parents of girl children born in any of the Government Hospitals were gifted with 5 saplings (Coconut, Litchi, Assam Lemon, Guava & Amla). Parents were asked to take care of the saplings like their daughters.
  • The fruits of the trees can be used to feed the child to develop her immunity through Vitamin C in Amla, fight malnutrition by Coconut and the profits earned from the sales could be redirected to investing in the girl’s education and improving green cover of the district.

SANITARY NAPKIN PRODUCTION BY SHGs

District: Hailakandi in Assam

  • Women in SHGs in the Aspirational District of Hailakandi have undertaken the manufacturing of
    hygienic low-cost Sanitary Napkins. Apart from empowering them and other women, this has
    significantly improved the awareness regarding menstruation and personal hygiene.
  • This initiative has ensured hygienic menstrual days for majority of women in the district.

CHILD PROTECTION UNIT

District: Muzaffarpur in Bihar

  • The Child Protection Unit in the district is a fundamental unit implementing integrated role on child rights, health and education. This unit apart from mobilising the community, emphasizes the importance of gender equality, mortality and also on other critical Health indicators including pre & post-natal, mother and child healthcare.
  • The community members are sensitised using informative videos during daily Panchayats & Ratri Chaupals.
  • The number of participants in these activities has significantly increased, with girls and women pro-actively spreading awareness and practicing them too.

SWASTH BEGUSARAI

District: Begusarai in Bihar

  • Diarrhoea, was a major cause of death in India, contributing to an average of 15.5% of total deaths from 1990 to 2016.
  • Begusarai District pledged to eradicate this disease from its root, and has therefore, marked a fortnight for creating awareness for its prevention.
  • Everyone in the District, from school students to frontline workers, to local people,  has participated to make it a Jan Andolan. Women from Frontline Health Workers and Self-Help Groups are creating awareness by encouraging mothers to use ORS and Zinc solutions for better health of their children.
  • During the Intensified Diarrhoea Control Fortnight, students encourage everyone in their family and neighbours to practice safe sanitation.
  • The Aspirational District of Sheikhpura has also taken inspiration from Begusarai and replicated the idea of making a few days focused on Diarrhoea in order, to fight and eradicate it.

DAKSHATA

District: Gadchiroli in Maharashtra

  • Gadchiroli faces a distinct issue of High Maternal Mortality, significantly higher than even the State average (136 in Gadchiroli vs. 68 at the State level).
  • In areas with challenging road connectivity due to dense forests, scattered populations in small pockets, and heavy rainfall, the District Administration enabled the Dakshata Initiative in 2016-17 to find solutions to this multi-pronged problem.
  • The initiative focuses on Capacity Building for supply side frontline workers, routine tracking of pregnant women to enable safe deliveries, analytical exercises to examine the causal factors and bottlenecks to efficient health service delivery, and effective decentralisation in decision-making, allowing village level contextual needs to be translated to planning interventions at the Block and District level.
  • The effective and strategic implementation of Dakshata training led to skill enhancement of frontline workers (ASHA and ANM) and MOs of the Health Department.

AMA SANKALPA

District: Rayagada in Odisha

  • Rayagada, a mineral-rich district in the southern part of Odisha has a predominant tribal population of 57.52%. Citizens were not availing health services due to poor connectivity, non-availability of referral systems in hard to reach areas, and low literacy. Hence, the District Administration developed a specific Action Plan to identify the real beneficiaries to uplift their standards by reducing IMR and MMR. The programme relies on a bottom-up demand-driven approach to improve uptake, with IEC & BCC relevant methods.
  • Three ‘Ama Sankalpa Ratha’ Yatras were organised to spread a message about the precautionary measures for maternal and child health. This was accompanied by folk shows on District-specific issues played at the village level through which Health messages were disseminated. In addition to this, supply side interventions were also strengthened.
  • For the early identification and referral of Severely Acute Malnourished (SAM) children between 6 months to 6 years; a special plan ‘Project Surjyamukhi’ under Ama Sankalpa was prepared.

MISSION API – 10

District: Koraput in Odisha

  • In the Aspirational District of Koraput, the incidents of Malaria-related deaths were very high due to hilly terrain, forest cover, inadequate health facility coverage and low education levels of the population. To combat this, Mission API–10 was launched on July 15, 2017.
  • The two main interventions under API–10 include use of Long Lasting Insecticidal Nets (LLINs) coupled with supply side interventions, complemented by bottom-up incentives and nudges such as ‘bell ringing’ as reminders to use nets and night patrolling by ASHA/AWW/Volunteers.
  • This innovative initiative to create awareness about Malaria has brought down the Annual Parasite Incidence (API) to 2 in the affected area. Extensive sensitisation was ensured through demonstrations in local markets, posters, Nidhi Ratha and rallies.

SOURCE- NITI Aayog website

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