India: Childhood Malnutrition Eradication Program

Case Study: From Poor Housewife to Accomplished Government Health Supervisor

June 30, 2016

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Rekah Mawi

Liberating Human Potential

Rekah Mawi is a resident of the Barwani Tribal district of Madhya Pradesh, India. At an early age, she married a daily wage earner named Anil. Rekha soon realized that her husband was an alcoholic, and his meager daily income coupled with his frequent, compulsive spending on alcohol was not enough to support the family. Rekha was specially concerned for the welfare of their two children.

On April 1, 2010, Rekha met with Radha Chouhan, the District Coordinator of RMF India’s Barwani office. Rekha shared her plight with Radha, who recommended her case to RMF’s district management team. With management’s approval, Rekha was hired as a cook for RMF’s Barwani office. During her days as a cook, RMF project management learned that Rekha had studied up to the 12^th standard, and noticed that she possessed strong interpersonal and communication skills.

With these qualifications, Rekha was capable of serving as a Community Nutrition Educator (CNE). Subsequently, Rekha was given the new role of CNE, to promote health and nutrition in 10 villages in the district of Barwani. She received the required counselling training from RMF, and started conducting home visits to screen children for malnutrition status and connecting households with service provision centers such as Anganwadi centers and/or Nutrition Rehabilitation Centers. Rekha soon started to recognize her own abilities, and so did RMF’s district team management. In addition to individual and community counseling, Rekha also referred several children to seek lifesaving treatment at NRCs.

Fostering Change

The local community, including government workers on the frontline, also began to recognize Rekha’s contributions in fostering behavior change and improving the health of mothers and children. By that time, Rekha had become more confident in her abilities, and was very competent in community-centered communication and helping local people value and access available government services.

In Feburary 2013, local government

appointed Rekha to serve as an ASHA (Auxiliary Social Health Activist) in Rajghat (one of the villages where she worked as an RMF CNE). She showed great commitment and passion in her new role.

As they say, fortune follows those who chase their dreams. In May 2015, based on her progressively more remarkable performance, the Department of Health promoted Rekha as an ASHA supervisor in the same catchment where she served as an ASHA worker. Today Rekha stands as a courageous, committed ASHA supervisor helping women and children live healthy lives. For the year 2015-2016, the state government of Madhya Pradesh awarded Rekha the “Best Cadre Award” for exemplary performance.

Empowering Dreams

Today, Rekha acknowledges the difference RMF India made in her life by helping empower her to accomplish her dreams. Rekha states candidly and confidently, “RMF has helped change my life for a better.” RMF India takes this opportunity to wish her the very best for all her future endeavors.

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Background

This project empowers communities through health literacy and connects rural communities with the government health and nutrition services available. This project aims to prove that a holistic, decentralized, community-based approach to malnutrition eradication will have better health outcomes, be more inclusive for children under 5, and will be more cost-effective in the long-run than centralized approaches, especially for rural, marginalized tribal communities. Our team of up to 75 Community Nutrition Educators (CNEs) and 6 District Coordinators has covered enormous ground across 5 districts and 600 villages in Madhya Pradesh.

Objectives

To reduce the prevalence of underweight children under 5 years old and to reduce child mortality from malnutrition by strengthening communities and village level government facilities’ capacity to identify, treat, and prevent malnutrition.
Continue to identify new SAM and MAM cases, refer complicated cases to the NRC and provide home-based counseling for all malnourished children
Refer 1,000 SAM children to government centers for treatment with a 50% success rate Quarterly
Conduct 2,500 Community Nutrition Meetings Quarterly
Conduct 9,000 Individual Family Counseling Sessions Quarterly
Send CNEs to Nutrition Rehabilitation Centers (NRCs) to help counsel families present
Continue to develop linkages with government health and nutrition services
Strengthen institutional capacity with support from World Bank’s India Development Marketplace Award.