Tackling the issue of migration and undernutrition: persistence of the Village Nutrition VolunteerPhoto credit:
Ever since the Karnataka Multi-Sectoral Nutrition Pilot project has begun, migration of beneficiaries and households has been a challenge in achieving the project objectives. Once the Fortified Blended Food distribution started, the VNVs would always face the challenge to distribute the food packets to the migrating beneficiaries. One such VNV who was able to face the challenge and take a bold step to bring about a change is Lalitha. When Lalitha (VNV) met the underweight, malnourished twin Lakshmi Jr and Ramu for the first time, she almost thought, the children will not have a chance of getting any services from the nutrition program. Their parents Noorappa and Lakshmi were constantly in search of livelihood which would take them to different cities in search of jobs. Each time they came back to the Tanda (Lambani Tanda is a small Village/hamlet where Lambani community people reside), it will be only for two or three days. Lalitha would never get a chance to meet them. This time when Noorappa and Lakshmi came to the tanda for the festival, Lalitha was determined to meet the parents, counsel them on registering the twin under nutritional program.
Why was Lalitha adamant of meeting the parents of the twin? Twin Ramu and Lakshmi Jr were both born to Lakshmi who was married at the age of 17 years and the twin were born underweight (2.4 kgs each) in a government hospital. Throughout her pregnancy, Lakshmi was working in cities without any ANC care.
Studies shows the level of malnutrition is high among children whose parents migrate in search of livelihood. Inherent malnutrition in mothers, lack of food and nutrition security, feeding and dietary practices and illness are some of the reasons identified for high levels of malnutrition. The studies further show that children of migrating families were less likely to be enrolled at the anganwadi centres where the government provides supplementary food to preschool children. The anganwadi centres were less likely functional in areas with high migrating population.
Similarly, Noorappa and Lakshmi who are regular migrating couple, belongs to H N Tanda, Devadurga taluk, Raichur district. When Lalitha met them in August 2016, the twin were 13 months old with MAUC of Ramu being 11 cm and Lakshmi Jr’s being 10.5cm. Lalitha registered them under the nutrition program and counselled the parents on every day hygiene including handwashing each time they cook and feed the twin, complimentary feeding with food that is rich in iron, protein, carbohydrates using the IEC materials, importance of foot wear, six monthly de worming tablet. She also told about the fortified blended food(FBF), Shaktivita, which will be distributed in December 2016.
The VNVs in every monthly meeting were trained to focus, meet and counsel the migrated registered families on all the 11 points. This will help them to practice basic hygiene on regular basis, access need based health facilities, making of ORS at home.
When the family of Noorappa and Lakshmi came back to the tanda in December 2016, Lalitha revisited them, with a packs of Shaktivita in hand. She did a demonstration to the family on ways of cooking Shaktivita, daily measure to be fed to the children and counselled them on feeding. Lalitha followed up with the family for the next few days on Shaktivita consumption. The children were consuming it well. On seeing this, when they were ready to go to city for work the family requested for few advance Shaktivita packets. Lalitha handed them the extra Shaktivita packets on the promise to be fed to the children daily.
The parents of Ramu and Lakshmi Jr saw progressive difference in their children’s health and weight gain by following the instructions given by Lalitha. They continued to visit the Tanda at regular intervals and would get the children’s Shaktivita packet and Lalitha would meet them as many times as possible when they were in the Tanda.
Now after 14 months i.e. in October 2017, after meeting the parents of Ramu and Lakshmi Jr, Lalitha and the supervisor Girish are much satisfied, reason being the twin’s MUAC is 12 cm and they look healthy. The joy of the parents too can be felt each time they meet Lalitha and ask for Shaktivita packets.
In the parents own words
“Lalitha’s persistence initially would irritate us, now that we are seeing our children growing well and putting on weight, we cannot thank Lalitha enough for guiding us about our children”
Village Nutrition Supervisor (VNS): Girish Rathod
Village Nutrition Volunteer (VNV): Lalitha Rathod