Under Integrated Child Development Services (ICDS), the government provides this Supplementary Nutrition, popular as ‘Panjeeri’, ‘Poshaahar’ or ‘Pushtaahar’, to severely and moderately malnourished children from six months to six years of age, as well as to pregnant women and nursing mothers.

The purpose of this Poshahar is to bridge the gap between Recommended Dietary Allowance (the standard nutrients in a daily diet for proper growth of children), and the Average Daily Intake. The government spends Rs 6, 9 and Rs 7 per day, per beneficiary (malnourished children, severely malnourished children, and pregnant/lactating mothers, respectively). The Poshahar is distributed through Anganwadi workers but many villages in UP use it as cattle feed.

“I asked women in my village, why they fed the nutritious supplement to their cattle, they said it was not tasty and children refused to eat it,” says Nazish, a 27-year-old woman and a mother of three sons, residing in Manpur.

Coming from an orthodox family, Nazish is now working as a Community Process Facilitator (CPF) in her village and educating women the importance of Supplementary Nutrition. She is also raising awareness about the impact of hygiene and nutrition on the health of mothers and children.

Nazish is part of a multi stakeholder intervention Nutrition and WASH (Water Sanitation Hygiene). The programme, conceptualised and designed by UNICEF, under the guidance of ICDS and Panchayati Raj Department, is being implemented on the ground by a not-for-profit organisation, Shramik Bharti through community leaders.

UP’s 40 Gram Panchayats (GPs) in Muzaffarnagar and Mirzapur districts are selected for the pilot project. These Panchayats have already achieved the status of ‘Open Defecation Free’ (ODF), however, the status of nutrition is not up to the mark.

The six-month pilot programme focuses on convergence of sanitation and hygiene with nutrition for achieving sustainable results of healthy mothers and healthy babies.

UP tops the list of states having highest child deaths. The state has an estimated number of 500,000 annual child deaths, of which at least 45 per cent can be attributed to malnourished mothers and children, according to a Lancet study. The National Family Health Survey (NFHS) data also confirms that at least 46 per cent children in UP have stunted growth.

The figures available with the Ministry of Women and Child Development highlight the status of UP in comparison to nation as far as malnourishment in children is concerned. 

Malnourishment in children	% in India	% in UP
Severely malnourished children	09%	13%
Moderately malnourished children	29%	34%
Stunted children	39%	50%
Severely stunted in UP:	17%	28%

Poor quality, inadequacy, and inappropriateness of complementary feeds, coupled with poor focus on adolescent and maternal nutrition, compromised environmental sanitation, and poor hygiene practices emerge as key impediments to tackling the malnutrition burden in UP, according to UNICEF study.

The pilot project is an effort to address the issue.

The objective is to improve the nutritional status of children by promoting sanitation and hygiene behaviour of pregnant women, nursing mothers, and their children. To achieve the results, 40 community women with leadership qualities, such as Nazish, one from each Gram Panchayat, have been selected.

The selected women underwent rigorous training to learn about issues relating to nutrition, hygiene, and sanitation. Now these women, one in each village, are working as Community Process Facilitators (CPFs) and are raising awareness among families about the role of nutrition and hygiene.

“First time I had stepped out of my village and first time I sat on a train when I went to Kanpur for training,” says Nazish, who is now educating other women in her village about the importance of Supplementary Nutrition. “Now no woman in my village gives that Poshahar to animals,” vouches Nazish.

The CPFs also maintain registers of their villages, in which they keep the record of all children in the age group of six months to six years. All these children are weighed monthly and their weight is recorded in the register. The CPFs share this information with mothers to show them the impact of following the correct diet on their children.

“In just three months, of the 42 malnourished children in my village, six have improved from severely malnourished to moderately malnourished,” says Nazish. “Now even mothers are curious to know the growth progress of their children and they keep pestering me to know the weight of their child.”

During the Nutrition week, from 1 to 7 September, collaborative events were organised in Mirzapur and Muzaffarnagar, involving CPFs, Self Help Groups, ICDS, Panchayati Raj Department, Health Department, as well as UNICEF and Shramik Bharti.

The CPFs organised food mela at block level in Mirzapur and Muzaffarnagar. Accompanied by Anganwadi workers, the CPFs cooked a variety of dishes using the Poshahar. They cooked in nutritious recipes, including dalia, halwa, khichdi, kheer, porridge, chila, pua, barfi, laddoo, etc, by adding easily available cereals, vegetables and nuts in Poshahar.

The audience to these mela was pregnant women and nursing mothers from all 40 Gram Panchayats where the project is going on. The CPFs not only made the audience taste the dishes but also shared the recipes. Anganwadi workers and CPFs grabbed the opportunity to counsel the mela visitors about the daily requirement of calories during pregnancy and while nursing the baby. They also explained the frequency of diet and its nutritional values to all pregnant women and nursing mothers.

The government officials from ICDS, Panchayati Raj and from district administration played the role of judges. The recipes were judged on the basis of their nutritional value and cost involved. They gave away prizes to each cook as an encouragement. More than 200 mother and their children participated in the event.

On the occasion, a healthy baby contest was also held to motivate mothers for smart feeding and hygiene practices. The criteria judges adopted for healthy baby contest was their full immunisation, growth, hygiene etc.

The programme may soon be replicated to other parts of the state where the nutrition level of children and women is low.