Bommai Samrath, a 29-year-old mother from Nayapara village in Bastar district of Chhattisgarh had always thought a bowl of rice and dal was adequate for each of her children. She herself had never bothered to have much more for her meals. As a result, her elder child had ended up as a low birth weight baby, and limped through childhood with regular coughs, colds and diarrhoea. She herself struggled with anaemia, until she joined the ChildFund India’s Mother and Child Health and Nutrition (MACHAN) programme around her second pregnancy in 2017.

For 26-year-old Malati Kashyap of Katora village in the same district, rice and dal seemed adequate for her two sons – six-year-old Laxman and two-and-a-half-year-old Hitesh. While her sons often fell ill with coughs and colds, she always felt tired at the end of the day.

It was a ditto scenario for 51-year-old Champa Devi of Billori village in the same district. But exposure to the MACHAN programme has now enlightened her. As she is bringing up her four-year-old grandson, Ayush, she has learnt to supplement his diet with green leafy vegetables grown in her kitchen garden, along with local millets and sesame snacks. She has also learnt to ignore the myths that guided her community in the past such as keeping pregnant mothers and infants away from consuming coconut water, bananas, yam, papaya, brinjal.

Knowledge sharing

Besides, Champa Devi has realised how dangerous misconceptions such as preventing the consumption of solid food can risk the health of a mother who has just delivered her baby. More than anything else, she now revels in sharing her knowledge with tribal women in her community in her new role as ‘mentor mother’ after having been trained by ChildFund. Vandana Baghel of Nayapara village in Bastar district has also taken the training, and armed with sufficient knowledge on nutrition, packs healthy meals made from local foods for her children and driver-husband when they leave home. What’s more, since Champa Devi and Baghel have high school certificates, they are ‘mentor mothers’ to their community and help women overcome their doubts on how and what food to serve their families.

Although traditional millets like ragi/ manduwa , jaggery, sesame, and green vegetables had once been an indispensable part of the diet of tribal hamlets in Chhattisgarh, a lopsided modernised lifestyle has weaned people from the positive aspects of their lifestyle in the last several decades and brought in rampant malnutrition, and stunting among children. Mothers like Samrath and Kashyap have now come to realise that feeding two meals a day is insufficient for children. “We have now learnt that children need to be fed in small amounts 4-5 times in a day. Healthy snacks made of millets, jaggery and milk contribute to their growth and well-being,” the mothers chime in unison.

Each of them is now registered at the anganwadi from where they receive a nutrimix of dry grains comprising millets like bajra and ragi, wheat, channa (gram), and jaggery. They have learnt to follow recipes to make pakodas (fritters), halwa and rotis out of the mixture, especially for infants and lactating mothers. The mothers have also learnt that adding a spoonful of hot ghee or edible oil not just helps in enhancing the taste of the food but serves to supplement the child’s nutritional needs. Mothers now strive to feed their children a tiranga (three-coloured) meal of cereals, yellow lentils, yellow and green vegetables. The grains and lentils are supplemented by vegetables from their own kitchen gardens. They no longer aim to feed store-bought cereals to their children. “I feed dalia and halwa to my children now,” says Kashyap. Comprising some of the poorest people in India, the tribals of Chhattisgarh, Madhya Pradesh and Odisha are generally landless, and earn their living as farm labour, loaders, or helpers at wholesale markets and retail shops. A few may be employed as drivers. Since literacy levels are low, superstitions and myths prevail in the community, especially where nutrition is concerned. Malnutrition among adolescent girls results in anaemic pregnant women in the community. This, in turn, results in low birth weight babies, who cannot breastfeed. Consequently, such infants are vulnerable to infections, accounting for both high maternal and infant mortality in these regions.

Nutrition programme

“To tackle superstitions and misconceptions, ChildFund embarked on a programme to bring positive deviance in the community, where nutrition is concerned, wherein local foods — “the low-hanging fruit” — were promoted to make a difference,” explains ChildFund health specialist, Pratibha Pandey.

MACHAN is meant to complement and align with the Central government’s Poshan Abhiyaan (National Nutrition Mission). It identifies ‘mentor mothers’ in a community and trains them on child health, hygiene, and nutrition to act as change agents. The mentor mothers conduct door-to-door awareness drives as well as group sessions with mothers, reaching out to pregnant and lactating women and children.

MACHAN is being implemented in 57 districts across 14 States. However, in view of the high numbers of malnourished and under-nourished infants in the tribal regions of India, (reported to be 45 per cent according to the National Family Health Survey- 4), the emphasis has been on working with tribal mothers in Chhattisgarh, Odisha and Madhya Pradesh.

In Chhattisgarh, the positive results were stark and notable, with infants in the 0-6 months showing a pronounced weight gain within three months of joining the programme. A baseline study conducted by ChildFund in 2018, showed that nearly 2000 children shifted from being severely malnourished and 1,000 children from moderately malnourished to normal nutrition levels. There was also a five per cent drop in anaemia among six months to 59-month-old infants.

Ills of child marriage

Since malnutrition cannot be treated in isolation to other social factors prevalent in a community, MACHAN is also creating awareness about the ills of child marriage and attending to the nutritional needs of adolescent girls. According to Pandey, targeting child marriages has been a major factor in bringing down the incidence of anaemia among pregnant women, preventing low birth weight babies, and bringing down infant mortality.

Although there is still a long way to go as far as pulling tribal children out of the red zone of malnutrition is concerned, a beginning has been made by dispelling myths and misconceptions. It remains to be seen how communities build on these gains.

(The writer is a freelancer based in Pune)

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