The Rajasthan government’s sincere efforts to provide succour to vulnerable communities like Sahariya are bearing fruit

At 8 am, the sun is already beating down on the local Anganwadi centre in Goverdhanpura village in Kishanganj block of Baran district, Rajasthan. Tarush, who is just over two years old, is restless in the sweltering summer heat. As his mother Vimla Bai Sahariya, calms him down and helps seat him on the weighing machine, she is hoping his weight will be normal.

Anganwadi worker (AWW) Sushila Bai Sahariya, who is in charge of recording his monthly growth parameters, allays her fears. She informs her that at 10.5 kg body weight, and measuring 13.9 cm on the mid-upper arm circumference (MUAC) score chart, Tarush had just made it to the normal category in the anthropometric physical measurement scale used to assess nutritional status in children. Had his MUAC score, a diagnostic criterion to determine severe acute malnutrition in children between six months and five years, dropped to 13.5 cm or less, he would have been considered malnourished.

On hearing this, Vimla, her 75-year-old mother-in-law Surja Bai and Rajendra Kushwaha, the Foshan (nutrition) champion who accompanied them to the Anganwadi centre (AWC), breathe a sigh of relief. Tarush had just recovered from a bout of diarrhoea and all three were concerned that this may have caused a setback in his development. Underweight Undernourished

It was not without reason that Vimla was anxious. Two years ago when Tarush was born pre-term at seven months, he weighed just 2kg. Although this was nothing new for a state where one in three newborns are underweight, there was a high probability that poor maternal nutrition and improper child-feeding practices prevalent in the district, particularly among the Sahariya tribe (to which Vimla also belonged), would further exacerbate the situation.

If undernutrition is not tackled in time, it can cause irreversible damage to a child’s physical growth and brain development. Further, underweight children are prone to wasting, that is, low weight relative to their height. According to the latest National Family Health Survey (NFHS-5), 16.8 % of children in Rajasthan suffer from wasting. In the Baran district, where Tarush lives, 21.3 % of children are wasted.

Tarush, too, was a prime candidate. He could have quite easily become a part of these grim statistics as every baby weighing less than 2.5 kg at birth is considered at risk. Luckily for him, his mother had been enrolled on the RajPusht programme just a month before his birth in 2020. This was key to enabling Vimla and Tarush to reap the benefits of RajPusht’s targeted interventions to improve maternal nutrition and child-feeding practices aimed to bring down the birth of underweight babies.

Hopes of reducing the high prevalence of low birth weight and wasting in Rajasthan have soared primarily due to direct cash transfers to the women’s account under RajPusht to enable pregnant and lactating women to buy nutritious food for themselves.

Innovative Strategies

A collaborative initiative between the Rajasthan government, Children’s Investment Fund Foundation and IPE Global, RajPusht leverages maternity cash benefit schemes like the central government’s Pradhan Mantri Matru Vandana Yojana (PMMVY) and the state-funded Indira Gandhi Matritva Poshan Yojana (IGMPY). This is backed up by focussed individual attention to improving nutrition, knowledge and practice through a cadre of Roshan champions (PCs) or nutrition field workers selected from the community and trained by Sanskar Seva Sansthan, the Baran-based civil society organisation. According to Laxmi Kahar, programme manager, SSS, there are 38 PCs, (27 men and 11 women) in Kishanganj block to coordinate with the 1618 Anganwadi centres. Each PC looks after about 40 AWCs. By working in tandem with AWWs, ASHAs and ANMs, the government’s frontline health workers, and the specially trained PCs are making a difference in the lives of women and children.

Knowledge is Power

Together, these strategies have led to an improvement in women's nutrition knowledge by 38%. Even the husband’s nutrition knowledge is now 19%. Additionally, until March 2023, over 1,50,000 women received cash benefits under IGMPY in the 33 districts, says Krishna Singh Gohil, Operations manager, IPE Global.

Both PMMVY and IGMPY provided conditional cash benefits of Rs 6000 each for the first and second child. But under IGMVP, currently implemented only in Rajasthan, an additional amount of Rs 2000 is given if the second child is a girl.

In Baran, a district dominated by the Sahariya tribe, classified by the government as a particularly vulnerable tribal group (PVTG), a total sum of Rs 18,181,000 has been given to 9274 women under the IGMPY during the period November 2020 to June 2023

To be continued…

(The writer is a senior journalist)