It’s heartening to see Kamlabai walking along the dusty tracks of her home to the Anganwadi Centre (AWC) where Suresh is to be given his 4th dose of Vitamin A. She narrates excitedly, “Peechhle saal hamar baccha ke liye doctor davai mein kafi paise kharch ho gayi, par ab hum ANM (Auxiliary Nurse Midwife) didi ke salaah mutabik saare tike aur syrup samay samay par Anganwadi aake laga jate hain….” (Last year we had to spend a lot on doctors and medicines for our child but now as per advice from ANM, we bring our child to the Anganwadi Centre frequently to get his timely bout of Immunization and Vitamin A doses…..)
Suresh, aged 4½ years from Machandur village, was diagnosed to be in the 3rd grade of malnutrition when he arrived at the Dargahan AWC. After appropriate diet changes, availing all services and regular follow ups by the Anganwadi Worker (AWW) and ANM, within two months, he was in the 2nd grade. From the last few years, malnutrition has been significantly reduced, thanks to concerted efforts by the team of service providers.
No wonder, one cannot miss noticing the enthusiasm of Ms. Ramshila Thakur as she travels long distances to coordinate the vaccination program during the ‘Shishu Sanrakshan Maah’ at the Anganwadi centre in Dargahan, a small village in the Charama block of Kanker district in Chhattisgarh. As ANM, she provides her services to 5 more villages along with Dokla and takes pride in the heightened awareness and participation among villagers for health programs.
‘Shishu Sanrakshan Maah’ is a Child Survival Initiative by the state government supported by UNICEF and other players like The Micronutrient Initiative (MI) and CINI to protect the children against various infections and diseases. The program is conducted in the months of April and October and focuses on coverage and follow up of routine immunization, administration of Vitamin A for children from 9 months to 5 years of age in regular intervals of six months, Iron Folic Acid supplementation for pregnant women, appropriate complementary feeding (ACF) and impregnating bed nets for protection from malaria.
Nilima a 9 month old child being immunized at Dargahan AWC
Radhabai too has heard about ‘Shishu Sanrakshan Maah’ and has come with her nine month old granddaughter Nilima to the AWC at Dargahan, to get her vaccinated. Nilima will be given her first dose of Vitamin A. Radhabai knows why Nilima needs it. “Vitamin A se uske (Nilima’s) beemar padne ka khatra kam hoga” she tells (Vitamin A dose would make my granddaughter less prone to diseases). The ANM, Ramsheela Thakur reminds her to come again with Nilima after a span of six months for her next dose.
The AWW Saraswati Sinha and Ramsheela Thakur jointly counsel women to come to the AWC every Tuesday to avail all health & nutrition services. Vitamin A is administered every Tuesday at the Anganwadi Centres and regular monitoring is done to keep track of Left outs / Drop outs so that they are covered in the schedule planned for every AWC. Vitamin A deficiency is responsible for a weak immune system and is also the most visible cause of night blindness. However, the program has helped improve child health in the region. Awareness in the region is high. As Arunabai, a villager rightly observes, “Vitamin A ki khuraak humare bachhon ke swasth rahne ke liye zaroori hai” (Vitamin A dose is necessary for our children to remain healthy).
Umabai from Dokla, another village in the vicinity, vividly remembers how she was trained by the Department of Health to work as a Mitanin and the recognition that she has received from the community speaks in volumes for her. As a Change Agent she was trained on community processes and has been instrumental in counseling women on technical interventions like pre natal care, care of new born, early & exclusive breastfeeding, AC F, administration of Vitamin A and immunization. She makes regular home visits to targeted families especially the ones excluded from the routine services and counsels the mothers and family members to take full advantage of the ‘Shishu Sanrakshan Maah’ to protect their children from various infections and diseases.
Dr. J L Uike, Block Medical Officer of Charama recounts that the dietary patterns of people in the tribal communities of Kanker and Bastar also affect the nutritional status of the community. Infact the dietary patterns being followed doesn’t meet the nutritional needs of these individuals for they consume rice-gruel as the only food.
Here, concepts like ‘Tiranga bhojan’ have helped villagers to inculcate right food habits wherein they are told to follow the colours of the national flag, the white for milk and eggs; the green for fresh green vegetables and the saffron for ripe fruits, a combination of all three being necessary for healthy development of children. Deworming is also followed up with regular supply of Albendazole tablets for all children above one year of age. Apart from this, focused counseling on Appropriate Complementary Feeding (ACF) is given to promote adequate intake and effective infant feeding practices from 6 months age. Efforts are on to complement the ongoing endeavor in increasing their knowledge and awareness and towards making a positive behavior change.
The gleam in the eyes of Suresh’s mother is obvious when she sees him playing happily in the dust for she is hopeful now of Suresh’s progress towards a healthy future.