Udaipur Takes the POSHAN Message to Every Doorstep

Frontline Workers are breaking myths and taboos through an intensive behavior change communication strategy in Udaipur, Rajasthan

Soma Biswas & Krishna Singh Gohil

The article was originally published in Outlook Poshan

Yasodha, mother of a 19-month-old girl and five months pregnant with her second child, is happy that due to the combined efforts of Front-line workers (FLWs) and POSHAN Champions, she is more aware of what food and nutrition supplements she needs to ensure better health for herself and her unborn child.

Living in a tiny village Saleda, around 10 kms away from the block headquarter of Bhinder, in Udaipur district, with her family of 6 members, Yasodha had relied completely on knowledge of her mother in-law and family members during her first pregnancy and delivery. Though she delivered a healthy baby, she faced many complications.

“I appreciate the way they have informed me about my health and are guiding me to gain proper weight – what nutritious food to eat during pregnancy,” says Yasodha. “Not only me, but my husband and mother in-law also know about this. Nowadays, my husband accompanies me for my Antenatal care check-ups.”

Yasodha has counselled at her village’s Anganwadi Centre (AWC), at community level, during monthly PLA (Participatory Learning & Action) meetings and at home by POSHAN Champions. When she is unable to go to the AWC, the Anganwadi Worker (AWW) or ASHA worker, along with POSHAN Champion, visit her at home.

Today, Yasodha is among the many pregnant and lactating women (PLW) in the village who are benefiting from the intensive nutrition counselling provided by FLWs and POSHAN Champions. There is an awareness about how much weight they should gain during pregnancy, what should be eaten during times when they don’t feel like eating, what will happen if they don’t take iron and calcium supplements regularly, etc.

Intensive interpersonal communication (IPC) by the FLWs has increased awareness amongst PLWs and has also motivated family members to openly support them.

Since the launch of the POSHAN Abhiyaan, efforts have been made by stakeholders to spread the messages of nutrition. In its efforts to intensify its initiatives to improve the status of nutrition in the state, Government of Rajasthan has started implementing a state-wide ‘Social and Behaviour Change Communication Strategy’.

The first state to do so, Rajasthan has stepped up the efforts to improve the nutritional status in the state. In some pockets, these efforts are bearing encouraging results, though these are too few and too scattered. Udaipur district in Rajasthan has such good examples.

In Udaipur, FLWs have joined hands with POSHAN champions trained under RajPusht program to impart specific counselling to every PLW. A layered approach has been adopted where messages are being imparted to the PLW through multiple channels at multiple levels – an Anganwadi worker counselling at Anganwadi centres, ASHA during community-level meetings, ANM on the MCHN days and the POSHAN champions supplementing the counselling effort by the AWWs and ASHA during the home visits.

Home-based counselling is not restricted to PLWs but is extended to other family members also. Doctors have also been oriented to ensure that these messages are reiterated during the hospital visits and post-delivery by the hospital staff. The entire attempt is to maximise the touchpoints for a PLW, thus increasing the opportunity for her to get her queries addressed and  empower her with knowledge. In the recently organised POSHAN Pakhwara, a combined force of 6,866 ANM, ASHA, AWW and POSHAN champions visited the homes of all PLWs in Udaipur district to spread the nutrition and child care messages.

Repeated training of the FLWs along with specific counselling tools like Job Aids have been delivered to support this entire process. In these training sessions, specific information on nutrition is imparted, besides skills of counselling using various information tools. The process ,though long, is starting to show impact on the ground.


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