Abstract

BackgroundWe examined the feasibility of engaging women collectives in delivering a package of women’s nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach.MethodsConducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women’s nutrition services. A capacity assessment tool was developed to map all types of community collectives and assess their awareness, institutional and programme capacity as a funded stakeholder for delivering women’s nutrition services/behaviour promotion.ResultsLimited targeting of pre-pregnancy period, delays in first trimester registration of pregnant women, and low micronutrient supplementation supply and awareness issues emerged as key bottlenecks in improving women’s nutrition in these districts. Amongst the 18 different types of community collectives mapped, Self Help Groups (SHGs) and their federations (tier 2 and tier 3), with total membership of over 650,000, emerged as the most promising community collective due to their vast network, governance structure, bank linkage, and regular interface. Nearly 400,000 (or 20% of women) in these districts can be reached through the mapped 31,919 SHGs. SHGs with organisational readiness for receiving and managing grants for income generation and community development activities varied from 41 to 94% across study districts. Stakeholders perceived that SHGs federations managing grants from government and be engaged for nutrition promotion and service delivery and SHG weekly meetings can serve as community interface for discussing/resolving local issues impeding access to services.ConclusionsWomen SHGs (with tier 2 and tier 3) can become direct grantees for strengthening coverage of women’s nutrition interventions in these tribal districts/pockets, provided they are capacitated, supervised and given safe guards against exploitation and violence.

Highlights

  • We examined the feasibility of engaging women collectives in delivering a package of women’s nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India

  • Estimates have been reported from Census 2011, Annual Health Survey (AHS) 2012–13, District Level Household Survey (DLHS) 2 and 3 and HUNGaMA survey

  • Data on anaemia in pregnancy dated DLHS 2002 according to which all pregnant women were mild to moderately anaemic in the study districts

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Summary

Introduction

We examined the feasibility of engaging women collectives in delivering a package of women’s nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach. Indian experiences include Kudumbashree (Kerala), Society for Elimination of Rural Poverty Project (Andhra Pradesh and Telangana), Self Employed Women’s Association-rural (various states), Community Health Care Management Initiative (West Bengal), Jamkhed model (Maharashtra) and urban health models by Urban Health Resource Centre and Mahila Abhivrudhi Society, Andhra Pradesh All these experiences build on bank linkages of women collectives and government or non-government organisation (NGO) as their promoting agency. This study assesses feasibility of community collectives as a funded stakeholder that is; their readiness to receive and manage grants for delivery of essential women’s nutrition interventions in eastern India tribal regions with the highest prevalence of stunting

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