Impact4nutrition

Supplementary Nutrition Centre: An Initiative of GMR Varalakshmi Foundation

August 20, 2021   | author: GMR Varalakshmi Foundation

Improving health outcomes by addressing nutritional issues among pregnant and lactating women

GMR Varalakshmi Foundation (GMRVF), the CSR arm of the GMR Group, is a not-for-profit organization registered under Section-8 of the Companies Act. The foundation implements all CSR activities of the GMR group around its business units across 15 locations in India. The foundation works with a vision to make a sustainable impact on the human development of under-served communities through initiatives in Education, Health and Livelihoods.

Health is a significant thrust area of GMRVF’s work, with a keen focus on maternal nutrition. In the rural communities of India, child mortality and congenital deficiencies related to poor maternal health are a few of the top challenges faced today. Malnutrition is a major cause of death among children below five years of age, with the reasons being – poor nutrition in pregnancy and lactation phases, certain unhealthy behaviours and practices, and lack of awareness on the supplementary diet. The mother must enjoy good health during pregnancy as well as the lactation period which would result in healthy foetal development, delivery as well as a well-nourished baby.

To fulfil the needs in its communities, GMRVF initiated ‘Supplementary Nutrition Centre for Pregnant and Lactating Women’ at different locations in India.  The nutrition centre is a holistic care centre for pregnant and lactating mothers (institution-based service delivery). The program was launched as a pilot initiative at Airport Rehabilitation Colony in 2007 and Rangnayakula Thanda village in 2008 near GMR Hyderabad International Airport Ltd. in Telangana. Currently, the foundation covers 15 villages in 4 states and has reached out to more than 4000 women since the inception of the program. The centre is used as a platform to provide supplementary nutrition daily and improve overall awareness of health and nutrition aspects.

Image: Beneficiaries consuming supplementary nutrition together

The program targets pregnant and lactating women who do not have more than 2 children (from 3 months pregnancy to 6 months lactation period) and aims

  • To provide healthy supplementary nutrition
  • To increase institutional and safe deliveries in the target area
  • To increase awareness on a healthy diet, immunization, gender sensitization, childcare, family planning etc.

The intervention follows the ‘Theory of Change’ model wherein it focuses on ‘mapping out’ or ‘filling in’ what has been described as the ‘missing middle’ between what a program or change initiative does (its activities or interventions) and how these lead to desired goals being achieved. The long-term goal of the Nutrition Centre initiative is to reduce maternal and child mortality rates and improve maternal and child health. Maternal deaths are preventable when women have access to proper care during pregnancy, skilled care during childbirth and support in the weeks after childbirth. Nutrition Centres offer exactly these supports in a centre-based approach, which has been successful by following:

  • Creation of centre-based services for pregnant and lactating women
  • Provision of supplementary nutrition and monitoring the women’s consumption at the Centre itself.
  • Regular medical check-ups during pregnancy
  • Awareness of the importance of health and nutrition
  • Awareness of institutional deliveries and immunization
  • Awareness on colostrum feeding, breastfeeding and family planning
  • Celebrating special events such as Godh Barai, Annaprashan, Healthy Baby Show, etc.

The special feature of this initiative is the provision of supplementary nutrition being provided at the centre every day and training beneficiaries on the ‘Gudiya Model-A Self-Monitoring Tool’.

What makes the Nutrition Centres unique and effective is that the women consume their daily intake of nutrition at the Centre itself in a joyful environment with their peers. Trained volunteers also conduct formal and informal sessions on various precautions to be taken, and in case of any problem faced by the beneficiaries, they guide, monitor, and provide credible and easy-to-understand resources to read at the time of visit to the Centre. Nutrition Centres provide diverse nutritious foods in different combinations 6 days a week such as boiled eggs, seasonal fruits, peanut chikki, dates, and coconut.

The Gudiya Model provides information on all essential health practices during pregnancy. The tool was introduced by UNICEF in the Chandrapur district in 2010 and brought about a silent revolution in the way communities access health services. The ‘Gudiya’ model is user friendly and tracks families progress on 13 critical health and nutrition indicators.

Owing to the effectiveness of the program it saw several encouraging outputs:

  • 100% enrolment of all pregnant and lactating women of the project villages in the Nutrition Centres through door-to-door surveys by the Nutrition Centre volunteers, counselling of pregnant and lactating women, and their family members.
  • All pregnant women complete a minimum of 4 ante-natal check-ups by a certified practitioner to avoid complications during childbirth.
  • Improvement in the number of institutional and safe deliveries through several awareness programs for pregnant women and their family members on the importance of institutional deliveries and ensure that the women admitted to the hospitals for delivery.
  • Improvements in the rate of immunization.
  • Ensuring the weight of children at birth is not less than 2.5 kgs by providing supplementary nutrition.
  • Ensuring all women practice colostrum feeding and exclusive breastfeeding for up to 6 months through regular awareness programs by volunteers in the Nutrition Centre.

The inputs have resulted in tremendous positive outcomes as highlighted below:

Pre-natal Outcomes:

  • The average percentage of women undergoing 4 Antenatal check-ups (ANC) during pregnancy has increased from 73% to 90% from 2008 till now and in some centres, it has gone up to 100%.
  • Institutional deliveries have gone up to 100 % from 80% in all centres.
  • Supplementary nutrition to pregnant women helping to gain weight by 7-10 per cent during the pregnancy period.
  • Only 3-5% women members of Nutrition Centres had to undergo Caesarean delivery in past four years.
  • Women are more confident as they have completed all check-up regularly where a doctor is confirming the good health of babies, undergone series of counselling sessions and a birth preparation plan is prepared by pregnant women before the date of delivery.

Neo-natal Outcomes: 

  • Weight of the child at birth over 2.5 kg in more than 98% cases.
  • 100% complete immunization, compared to 65 % in 2008 in GMRF NCs.
  • 100 percentage initiation of colostrum feeding and exclusive breastfeeding up to 6 months.

The set of activities adopted in the Nutrition centre is unique and effective in improving the health status of pregnant and lactating women. All beneficiaries have shown satisfaction mainly because of the quality of food support, services and constant health check-ups. The foundation played a major role in bringing behavioural change in pregnant and lactating mothers through the Nutrition Centres. The constant awareness drives and supplementary nutrition in the centres, creating a healthy environment and providing space for mental relaxation helped to improve the health and nutrition status of women in project villages.  Efforts are continuing in the nutrition centre to make it sustainable by adopting Positive Deviance Hearth approaches and involving all stakeholders with the sole objective of improving the health status of women and reducing infant and maternal mortality rates.

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