EXPERT SPEAK

Power of Early Initiation of Breastfeeding- Bihar Point of View

Breastfeeding is recognized as the optimal form of infant nutrition for the first six months. Although it is widely known to enhance survival and support ideal growth and development including cognitive development; only two out of five new-borns globally are breastfed within the first hour of birth and only 2 out of 5 infants (< 6 months) are breastfed exclusively for six months. Failing to breastfeed optimally translates into real costs in human life, quality of life, and national economic outcomes.

In India, only 42% of the children are breastfed in the first hour of life and the prevalence of exclusive breastfeeding in children below the age of six months is 55%, which means that at least 1,09,62,022 children each year are not receiving the recommendation nutrition in the critical first six months of life. According to the recent findings of the National Family Health Survey-5(NFHS-5), the state of Bihar has witnessed a considerable drop in the early initiation of breastfeeding (EIBF) despite major improvement in institutional delivery from 63.8% in NFHS 4 to76% in NFHS 5. This trend has been a major concern as EIBF ensures that the infant receives the colostrum which is the first milk rich in protective factors and acts as the first vaccination for the child. However, the survey results in Bihar showed improvement in exclusive breastfeeding from 53.4% in NFHS-4 to 58.9% in NFHS 5.

An innovative social and behavior change communication model has been implemented by World Vision India (WVI) with the 1000 days approach in Bihar, called as Timed and Targeted Counselling (TTC) model. In this model, Community Health Facilitators (CHF) visit the homes of pregnant women and mothers with children under two years of age. They use problem and solution stories that help the family understand the barriers in adopting positive behaviors and recognize the potential solutions. There are twelve house visits by the CHF during this 1000-day window period. During the counseling, the CHF involves decision makers or influencers at home like the husband or the father of the child, mother-in-law or grandmother of the child. The innovative SBCC model Timed and Targeted Counselling engaging the Community Health Facilitators implemented by World Vision India promotes child well-being and addresses child vulnerabilities in 583 communities in 9 districts (Madhepura, Saharsa, Khagaria, Nalanda, Nawada, Muzaffarpur, Gaya, Purnia and Jamui) of Bihar, impacting 1,32,175 households with a population of 7,58,335!

Dr. Ratnesh, State Master Trainer, MIYCN facilitated the session on counseling using an algorithm, flip book, and counseling cards. 

Recently the State has taken the initiative to integrate maternal nutrition package into Ante Natal Care (ANC) platform at ANC clinics and Village Health Sanitation and Nutrition Days (VHSNDs) across the state. The directives, guidelines, and IEC materials (flipbooks, counseling cards, Algorithms, etc.) for maternal nutrition assessment and counseling have been approved by NHM Jharkhand and rolled out across 24 districts

The proactive approach adopted by Kiranbhai Lavghanbhai Vasava, Sarpanch of Samor village proved pivotal in identifying issues with service delivery and taking corrective action. The 33-year-old Sarpanch visited the Samor Primary School as a part of the intervention to improve nutrition service quality and ensure coverage of services under the Gujarat IR being conducted by Alive & Thrive to support the state government. 

Stanpan hain vardaan: Rani Devi, Muzaffarpur, Bihar

Meet Rani Devi, a resident of Ramdas Majholi villages in Muzaffarpur, Bihar. Besides being a farmer herself, she also sometimes helps her husband in the field and looks after her family. Having grown up in a small village where people are unaware of health-related issues, and ignorant of women's health, especially during pregnancy, Rani Devi suffers the same ignorance because there is no one to guide her. The Muskaan Self-Help Group, affiliated with the Sangam Mahila Gram Sangathan, has been Rani Devi's primary source of support. 

Counseling and support for Sandhya Devi from Buxar, Bihar

Sandhya Devi, from Simri in the Buxar district, is a mother of two children. At 19 years of age, Sandhya married Arjun Thakur, who works in the private sector and is the sole earner in the joint family. Sandhya became pregnant shortly after her marriage. Due to a lack of information, she was unable to get the proper care and food during pregnancy, and as a result, she gave birth to a weak baby who weighed around 2kgs. The baby girl was born in a government hospital. For five days, the girl was under the special care of a doctor in a private hospital due to her low birth weight, and it seemed that she wouldn’t survive. By god's grace and the strong efforts of doctors, the child was saved. As time passed, the girl started growing, but because of financial constraints and lack of knowledge, her upbringing/eating habits were not properly nurtured

For more information, please visit: www.wecollaborate4nutrition.org