By Azera Parveen Rahman
MORIGAON, India, 5 February, India - The students listen with rapt attention to an instructor teaching her students the correct way to monitor a child’s growth using the recently-introduced WHO Child Growth Standards chart.
A rather unusual lot, the students are all angwadi workers who are being trained to improve the quality of services that they deliver to the community under the Integrated Child Development Services (ICDS) programme.
The course is part of the Field Learning Site (FLS) approach which focuses on peer learning.
The angwadi Centres (AWCs) are identified and supported as “model” learning sites; these, in turn, provide on-the-job capacity building through peer learning and demonstration to ten other AWCs in the vicinity.
With this cascading approach, a large number of AWCs are reached in optimal time. The information and knowledge shared by the FLS to 10 selected AWCs gets further disseminated as these AWCs, in turn, function as ‘satellite FLS’ bringing on board angwadi workers of neighbourhood AWCs.
Since 2008, the North East Diocesan Social Forum (NEDSF), in partnership with UNICEF Assam, has been collaborating with the Department of Social Welfare, Government of Assam, to promote community-based innovations for child nutrition, growth and development. In 2012, 100 angwadi centres (AWCs) spread across districts of Darrang, Morigaon, Goalpara, Barpeta and Kamrup (rural) were identified to develop them into FLSs.
Rashmi Sharma, the angwadi Worker (AWW) at the FLS in Morigaon district of Assam, is a quiet young woman with nearly six years’ experience of the field. In the community, as an AWW, she is known to be a vivacious leader, sharing with her peers whatever information she has gained from her trainings.
Her enthusiasm is contagious. “It is a matter of great pride that they find me capable of training other angwadi workers. Not only it is a big boost to my confidence, it is also a brilliant learning experience for me as well, says Rashmi, dressed in a plain mekhla chador, the traditional Assamese attire. She has been training since January 2012 to run the AWC-cum-FLS.”
Rashmi’s “students”, three of whom have been working as AWWs for more than two decades, found the training to be a “refreshing” learning experience.
“I have been working as an AWW for the last 24 years, that is almost how old Rashmi is!,” Usha Rani Sharma of the Kanhi Bari AWC, and a student of the FLS chuckles . “The reason why I mention my years of experience and Rashmi’s age is to point towards the fact that knowledge knows no barriers. I have learnt a lot from Rashmi after attending these sessions at the FLS. It has been so long since we have received training. And although there have been refresher courses, these sessions are so much more enriching as we get to interact with our peers and can share our learning and queries with each other,” Usha Rani says.
Bina Devi, another AWW who is Usha Rani’s class mate and Rashmi’s student nods in agreement. “Small things, for example the usefulness of posters, was unknown to many of us. But now we have understood that this makes it easier to communicate messages to the community in which we work, even among tribal populations who have low literacy levels”.
Group learning also has other advantages, the AWWs say. “When we learn in groups, we get to share our experiences, and learn from each other. Since it is a small group, we do not hesitate to ask questions and address our doubts – this helps us deliver services to the community more efficiently,” says Deepika Kalita Devi, AWW of the Paschim Kumura Bari AWC, who has been working here since the past two years.
This learning has helped to create a better understanding of concepts that in turn has led to achieving better results. The renewed effort that AWWs put into their work has contributed to get better responses and more participation from the community.
“Earlier we simply weighed the child and plotted the data in the growth chart. Now following our training, we explain every detail to the mother on why it is important for a child of a particular age to have a certain weight; what the dangers of malnutrition are; how the growth chart can indicate other related problems. So now mothers understand how and what kind of care needs to be provided, they know how to reason better and therefore respond better too,” Deepika explains.
Barnali Ghosh of the NEDSF adds that there is a certain ‘fear about maths’ that AWWs have -- most of them are not educated enough to be able to maintain growth charts and therefore often face challenges. However, with adequate training on the correct plotting of weight on the colour coded graphs, the problem is gradually getting addressed.
“Now mothers themselves come to the AWCs to enquire about what kind of food they need to feed to their children or even how they can weigh them. It is indeed remarkable that although interpersonal communication takes place during home visits, mothers also come to the AWCs to read the posters. The motivation of mothers in the community is evident and they are able to relate to behaviour change messages more promptly than before.
“So with increased awareness, our work has also become easier,” Rashmi says, adding that identifying malnourished children is far easier today as growth monitoring is conducted once a month, unlike earlier when it was irregular (once in three months or so).
Deepika is a proud and happy AWW and she is popular too in her village. Children come to her when they feel unwell and women seek advice even about their family problems.
“Earlier I did not understand why there were high incidence of maternal and child mortality. But after becoming an AWW and with this training, I now fully understand the causes. Now I can educate my community better and create awareness about exclusive breast feeding the child up to the age of six months and not to feed honey to a new born, as is a common practice,” Deepika says.
Happy with the manner in which peer education has been used as an innovation for the Integrated Child Development Services (ICDS) programme, Sanathan Das, the Child Development Project Officer (CDPO) of Morigaon district, is all praise for the effort.
“It is heartening to see the women from the community coming to the AWCs and enquiring why their children are not as healthy as their neighbour’s. It shows an increased level of awareness. The AWWs are also motivated to work harder to improve their centres’ performance. The FLS has definitely turned things around, and considering the demand that has been generated, we will need more of them soon,” he adds.