Monomita Nag, 35, a community resource person, instructing pregnant women on dietary diversity using a ‘tiranga’ booklet. Dhana Anjaria (second from right) went from weighing 41 kg to 54 kg after following Nag’s advice
Koraput and Angul, Odisha: Mild winter sunlight streamed through the banyan trees under which Dhana Anjaria sat cross-legged with two other pregnant women of Dumuriput village in Koraput district, 500 km west of state capital Bhubaneswar. They were listening with rapt attention to tips on nutrition for pregnant women.
Monomita Nag, 35, a community resource person (CRP), was instructing the group on the importance of dietary diversity using a booklet coloured orange, green and white. These are the colours of the tiranga (the Indian flag), but Anjaria, who knew the booklet by heart, had decoded other meanings from it. “Orange is for milk, egg, meat and pulses, white for roots, tubers and cereals, and green is for vegetables,” said Anjaria, 21, seven months pregnant with twins.
Anjaria had conceived within the first year of marriage. She could have been among half of all Indian women who are anaemic, and one-fifth who are thin. But she is neither, and also confident that her children will be born healthy.
The nutrition advice she was getting from Nag started long before her pregnancy. It began during a meeting she had with Nag as a newly-wed along with her husband. Anjaria’s mid-upper arm circumference (MUAC) -- used as a rapid assessment of her nutritional status -- measured 22cm. (An MUAC under 23 cm indicates risk of malnutrition in women.)
Anjaria followed Nag’s advice, went from eating twice a day to four times, including non-vegetarian foods, and also started resting more. She was particular about not skipping her calcium or iron folic acid tablets. Over months, her weight increased from 41 kg to 54 kg.
Nag conducts monthly meetings in the village of self-help groups on microfinance activities as a part of the Odisha Livelihood Mission, started in 2006, its an autonomous body under the panchayati raj department that implements diversified livelihoods to reduce rural poverty.
Women’s collectives have proved effective in driving nutritional outcomes earlier too -- the idea has been implemented along with economic empowerment through community conditional cash transfer programmes in Indonesia, Bangladesh and Nepal.
In India, this strategy was adopted in Kerala’s Kudumbashree programme, Andhra Pradesh’s Society for Elimination of Rural Poverty Project , in parts of Telangana and Jamkhed (Maharashtra) too. “Without health, livelihood [programmes] cannot work,” said Saroj Kumar, block project manager, OLM, Angul. “Most poor lose a lot of money in [buying] medicines. When they save this money, they can save it or use it for income generation.”
IndiaSpend visited Koraput and Angul districts to understand how it Swabhimaan is being implemented as a part of OLM and to study its impact. We found behavioural change and increased knowledge about health and nutrition among adolescents and women in villages covered by the project.
Why self-help works