Supportive Supervision Solution changing the nutrition landscape in Gujarat, India

Alive & Thrive India is supporting Commissionerate of Women and Child Development and Nation Health Mission (NHM) Gujarat for conducting implementation research on rolling out system strengthening interventions and engaging with local governance for improving quality ad co-coverage of nutrition services in three selected districts of Gujarat (Bharuch, Mehsana and Surat). In line with the Government of Gujarat’s priority Alive & Thrive is supporting respective state department to develop and roll out Supportive Supervision capacity building package and Mobile based Applications for supervisory cadres. The NHM-Gujarat and Integrated Child Development Scheme (ICDS) Mobile Apps focuses primarily on improving the quality and secondarily the coverage of Health and Nutrition services. The apps further have features which promotes using data at every level for enabling decentralized decision making and hence resolving local issues effectively. The local governance sub-component anchored with the local elected representatives focuses primarily on improving intervention coverage and co-coverage by making them accountable for service delivery of nutrition specific and sensitive services to families with pregnant women and under two children. Happy to share the success stories after the roll out of supportive supervision solution in Gujarat, India:

Improving Quality of Review of Field Visits in Surat

It was a packed room at the Ghatak (Block) 5 of Surat Municipal Corporation. Krishna Tank, the municipality’s Child Development Program Officer (CDPO), was conducting the monthly review meeting for July as the month began. The review meeting included all the Mukhya Sevikas (Lady Supervisors) of Anganwadi workers (AWWs) in Gujarat, as well as the Block Coordinator of National Nutrition Mission in attendance. Krishna Tank is one of the active CDPOs of Surat Corporation who participated in the training conducted on supportive supervision and data usage as a part of Alive & Thrive’s ongoing implementation research in Gujarat. During the training, we learnt about several aspects of supportive supervision and now we are trying to incorporate it during the field visits as well as review meetings,” she said.

“During the training, we learnt about several aspects of supportive supervision and now we are trying to incorporate it during the field visits as well as review meetings,” she said. Following the training, she has been conducting joint home visits and community-based events with Mukhya Sevikas and AWWs. During these visits, she observed that counselling on Early Initiation of Breastfeeding (EIBF) and Exclusive Breastfeeding (EBF) was not complete and correct. AWWs were struggling with technical points and Mukhya Sevikas also lacked knowledge to support them. To remedy the situation, she conducted a half-hour session on EIBF and EBF during the review meeting to build the capacity of Mukhya Sevikas to provide better support to AWWs during counselling sessions to pregnant and lactating women. Aside from conducting the training, CDPO Bharuch instructed Mukhya Sevikas to conduct at least 10-12 home visits every month and focus on the quality of visits. She also used the Supportive Supervision App, a mobile-based tool being used to facilitate supportive supervision visits, to identify recurring gaps in service delivery, and held a discussion on the identified issues during the meeting.

Improved Monthly Review Meetings by Mukhya Sevika in Surat

Meet Leelaben Gamit, Mukya Sevika (Lady Supervisors) from Ghatak-2, Surat corporation, Gujarat. After the training on supportive supervision (SS), she started sharing the meeting agenda in advance and pre-planning the meeting in the Supportive Supervision mobile app. She uses the app to conduct review meetings and schedule meetings, ensuring 100% attendance of Anganwadi workers. She also uses the app to review the Monthly Progress Report, share her observations of home visits and community-based events, and report gaps identified during the visit. Additionally, she had used the app to plan major events for the following month and prepare the meeting minutes, including the actionable points. This is how Gujarat is enhancing the quality of monthly sector review meeting through Supportive Supervision.

Engaging Members of Panchayati Raj Institution (PRI) to tackle undernutrition in Bharuch

The locally elected representative (Sarpanch) Smt. Niruben Ratlilal Patel from Sarangpur Village, Bharuch, Gujarat, has become a force in regularizing and facilitating infrastructure facilities for conducting Village Health Sanitation and Nutrition Days (VHSND) i.e. Mamta Days. The VHSNDs had weaker participation due to lack of proper infrastructure, since it was organized in an open space and without toilet facilities.. With Niruben’s initiative, it has been shifted to a private space with toilet facilities. With the change of infrastructure, the beneficiaries have started to avail the benefits of the VHSND more frequently. Hence, Niruben’s initiative to shift the VHSNDs to a better facility proved to be instrumental in increasing the beneficiary participation in the event. Niruben’s efforts are a model for elected representatives, whose influence can be instrumental in increasing awareness and utilization of health services.

Participation of Ward Member in Community Based Event ‘SUPOSHAN SAMVAD’ in Mehsana

After the roll out of the Supportive Supervision (SS) Solution in Gujarat, Mehsana, an Anganwadi Worker (AWW) from Visnagar Block, invited the elected ward member to participate in a community event, “SUPOSHAN SAMVAD.” As proposed in the Supportive Supervision Solution, AWWs are ensuring active participation of Panchayati Raj Members in the ongoing community-based events. The ward member sensitized the beneficiaries about the Take-Home-Ration (THR) and distributed a Nutrition Kit among them.

World Breastfeeding Week Celebration (1-7 August 2022)

Stepping Up for Breastfeeding: Way forward to Healthy Future Generations of Gujarat, India

To raise awareness of the importance of breastfeeding and to advocate for additional investment to protect, promote and support breastfeeding, a panel comprised of nutrition leaders discussed key issues related to breastfeeding during World Breastfeeding Week 2022. The Commissionerate of Women and Child Development (CWCD), and Department of Integrated Child Development Services, Gujarat, in association with Alive & Thrive organized the panel discussion, “Stepping Up for Breastfeeding: Way forward to Healthy Future Generations of Gujarat” on 2 August 2022. The occasion was graced by Dr. Sumita Ghosh, Additional commissioner-Child Health, Ministry of Health and Family Welfare, Government of India. Dr Ghosh chaired the session on the importance of breastfeeding for early growth and development of child.

Joining the discussion was Dr. Hema Divakar, Chair, Well Women Health Care Committee International Federation of Gynaecology and Obstetrics (FIGO), India’s Ambassador of FIGO and Former FOGSI President. Dr Divakar emphasized the need to create an enabling environment for women to breastfeed, focusing on how to prepare and support women during pregnancy, at delivery and during the postpartum period.

Another eminent dignitary, Dr. Satish Tiwari, Professor of Paediatrics, PDM Medical college Amravati, Maharashtra and President/Chairperson, Infant, Young Child Feeding (IYCF) chapter of IAP (2022-23), Founder Convenor of Human Milk Banking Association of India, further added how adherence to the Infant, Milk Substitute Act is a collective responsibility of the society and its monitors.

To enhance and promote breastfeeding, Dr. Sebanti Ghosh from Alive & Thrive threw light on closing the knowledge gaps in protecting and supporting breastfeeding. The discussion was joined by Saachi Bhalla from the Bill & Melinda Gates Foundation, who emphasized the need to continue investment in breastfeeding to reduce the risk of childhood infections, particularly diarrhoea and respiratory diseases, in addition to wasting and stunting due to inadequate breastfeeding.

Shri K.K Nirala, Commissioner and Secretary Commissionerate of Women and Child Development, represented the Government of Gujarat on the panel. He shared different initiatives taken to strengthen breastfeeding and complementary feeding in the state, including community-based events like the Mangal Diwas celebration to foster the participation of society at the starting of antenatal period and for creating awareness about nutrition, complementary feeding, and child growth monitoring

A&T in partnership with GSVM Medical College, Uttar Pradesh, India presented MBFHS in the Global Breastfeeding Collective

Alive & Thrive in partnership with GSVM Medical College, Kanpur, Uttar Pradesh, participated in the Global Breastfeeding Collective Webinar, “Take Ten Steps Up for Breastfeeding,” during World Breastfeeding Week.

The detailed visual presentation focused on Mother and Baby Friendly Health Systems (MBFHS) in GSVM Medical College, Kanpur, UP, by Dr Y.K. Rao, Head of Department, Department of Paediatrics, GSVM Medical College. Dr. Rao discussed the importance of implementing the Infant Milk Substitutes (IMS), Feeding Bottles and Infant Foods (Regulation of production, supply and distribution) Act of 1992, amended in 2003; the efforts of the interdepartmental committee from Paediatrics, Gynaecology & Obstetrics and Community Medicine to ensure MIYCN interventions are provided at appropriate service delivery points as standard practice; and building staff competency and training doctors and nurses using a Point of Care Quality Improvement (POCQI) approach on supporting and counselling mothers & families on maternal nutrition & breastfeeding during antenatal visit, skin to skin contact and early initiation of breastfeeding in both normal & post caesarean delivery. He also shared key MIYCN practices during ante-natal care and support with breastfeeding.

For a recording of the webinar, click here: Globalbreastfeedingcollectivewebinar

For the presentations, click here: PowerPoint Presentation Slides

Alive & Thrive's Collaboration with IAP and IYCF Chapter for WBW 2022, India

A week-long national webinar series on protecting, promoting, and supporting breastfeeding reached hundreds of pediatricians during World Breastfeeding Week. The Indian Association of Paediatrics (IAP) and its Infant, Young, Child Feeding (IYCF) Chapter, the National Neonatology Forum (NNF), the state IAP and IYCF chapters of Karnataka, Kerela and Maharashtra, and the Breastfeeding Promotion Network of India (BPNI) organized the seven-day series, conducted during World Breastfeeding Week, with support from Alive & Thrive. Dr Sebanti Ghosh and Praveen Kumar from Alive & Thrive were among the key speakers during the webinar series. The webinar series aimed to sensitize diverse stakeholders, including health functionaries, on various aspects of Breastfeeding. The series emphasized seven different themes, including Scientific evidence supporting Breastfeeding; Breastfeeding – techniques, barriers, taboos, myths; Breast pathology associated with breastfeeding; Breastfeeding in special situations; Human Milk Banking/Comprehensive Lactation Management Centres (CLMCs); IMS Act International Scenario; and Association of media, including use of print and electronic media, social network platforms (Facebook, twitter, YouTube, Instagram), and celebrities.

Alive & Thrive Contribution to Key Stakeholder Events, India

FEMPEDICON 2022: Alive & Thrive collaborated with the Indian Association of Paediatrics Women’s Wing for its first annual conference, “FEMPEDICON,” on 30-31 July 2022 in Nashik, Maharashtra. It was the first national conference for women medical professionals organized by IAP and the Federation of Obstetric and Gynaecological Societies of India (FOGSI) and focused on health and nutrition of girls and women with the theme, “Towards Empowering the Community.” The event was inaugurated by Dr Bharti Pawar, Honorable Union Minister of State (Independent Charge) for Health and Family Welfare. It was attended by over 200 delegates.

Dr Sebanti Ghosh from Alive & Thrive was invited as a guest speaker for the plenary session along with the Ministry of Health and Family Welfare and UNICEF. Dr Ghosh presented on the importance of integration of nutrition across all life stages for women, beyond maternal nutrition.

National ECD Conclave: An Early Childhood Development (ECD) Campaign, PAALAN 1000 Days, was launched by Dr Bharti Pawar, Honorable Union Minister of State (Independent Charge) for Health & Family Welfare, Government of India, on 16-17 August 2022 in Mumbai, Maharashtra. The campaign was launched along with print and audio-visual materials (for radio & TV spots) and a parenting mobile application. The conclave emphasized the implementation of a nurturing care framework by integrating and strengthening ECD with a focus on Home-Based Newborn Care (HBNC) and Home-Based Care for Young Children (HBYC) programming; multisectoral approaches and partnerships with development partners and international/national NGOs to support roll-out at state level; integration of ECD in HBYC programming and focussed skill building of ASHAs on ECD; and empowering mothers and families for ECD.

Dr Sebanti Ghosh represented Alive & Thrive as one of the key panellists in the plenary on adoption and implementation of Nurturing Care of integrated pathways of responsive health, nutrition, age-appropriate play and stimulation-based care during 1,000 days across both facility and community-based continuum of care.

Third National AMB Workshop for Master Trainers:

The third national level training of trainers for Anemia Mukt Bharat (AMB) was organized by the National Centre of Excellence and Advanced Research on Anemia Control (NCEAR-A) and the Institute of Economic Growth (IEG), supported by UNICEF on 18-19 August 2022. Faculties from All India Institute of Medical Sciences (AIIMS) from various states participated in the event.

The workshop focused on expanding the role of state AIIMs faculty beyond Master Trainers to support program planning and concurrent monitoring with a focus on quality of implementation; strengthening role of state AIIMS as State Centres of Excellence and Advanced Research on Anemia Control (SCEAR-A) with support from development partners; the criticality of sustained funding through government and institutional continuity for effective functioning; appropriate management of anaemia (therapeutic treatment) along with prophylactic Iron Folic Acid (IFA) supplementation across the key age -groups; 360-degree SBCC approaches for IFA adherence/compliance; diet diversification and improved food systems linkages; and strengthening system-led data driven reviews, especially convergent reviews with other relevant departments.

On behalf of Alive & Thrive, Dr Sebanti Ghosh presented on strengthening efforts for addressing and management of anemia due to other causes, focus on coverage with quality, supportive supervision of frontline workers and providers, data use, and strengthening the Health Management Information System (HMIS) to include indicators on consumption and therapeutic treatment and enhancement of engagement of medical colleges to support.

Share This Email