S1

Murshidabad district of West Bengal

Estimated Popn : 58,63,717% Rural: 87.5Sex Ratio: 952% Literacy: 55.05No. of Blocks: 26District Hospitals: 2No. of SDHs: 3No. of Rural Hospitals: 9No. of BPHCs: 18No. of PHCs : 69No. of SCs: 632No. of AWCs: 4268

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Burwan

Farrakka (1)

Bharatpur-II

Bharatpur-I

Beldanga-II

Nawda

Raninagar-II

Suti-I (2)

Khargram

Nabagram

Kandi

Raghunathganj-I (7)

Sagardighi

Raghunathganj-II (2)

Suti-II (5)

Samsherganj (1)

Bhagawangola-II

Murshidabad - Jiaganj

Beldanga-I

Berhampore

Hariharpara

Domkal

Raninagar-I

Bhagawangola-I

Lalgola (20)

Jalangi

*

Population: 3,78,723Sex ratio : 947literacy rate: 54.41# of BPHC: 1# of PHC : 2# of Sub Center : 47# of AWCenter : 235Economy :Totally agriculturalDemography : 63 % mohamrddan population.

Berhampore ICDS Project

Blocks and Subdivisions of Murshidabad District

Positive Deviance Program

This is a field level learning exercise with theObjective of eradicating malnourishment among local children Strategy of involving of mothers,Participation and contribution of community,Capacity building of the community regarding child care,Behavioral change of the mothers through good practices,Convergence of other stake holders like PRI, Health Dept.

Center of activities : Village Level Anganwadi Centers (AWCs)S3

Activities Undertaken

Program launched in the month of January 2002 with the following steps:

-Selection of Anganwadi Centers (AWCs) based upon surveys of the number of children with Grade 2, 3, and 4 malnutrition (G234) at the centers.

-Initially 8 AWCs were selected. PD program later expanded to 22 centers in Berhampore.

-Training for Anganwadi Workers (AWWs) and the ICDS Supervisors.S4

Activities Undertaken, cont

-Village Health Committee (VHC) formed in all the centers.

-Sensitization of the local community and orientation of VHCmembers.

-Malnourished children selected for NCCS .

-Mothers meeting and (PDI) home visit carried out.

-Community meeting by VHC members before starting NCCSMonitoring format at the AWC level and project level have been developed and introduced .S5

Status of Families Whose Children Participate in Local ICDS ProgramS6

62 mothers from 7 centers from three GP areas were interviewed about their socio-economic status. These interviews suggest:

Average # of children per couple: 2.8

Maximum # of children: 6

All mothers with only one child have daughters, and they are all pregnant at the present time.

S8Status of Families Whose Children Participate in Local ICDS Program , cont

Almost half of the mothers are illiterate. The rest are barely literate. (37 out of 62 are illiterate.)

One mother has passed the fourth grade. (highest level of literacy amongst mothers.)

Most families do not have sanitary latrines. (39 out of 62 do not have a sanitary latrine.)

Status of Families Whose Children Participate in Local ICDS Program, cont

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A Majority of families are Below the Poverty Line (BPL) (35 out of 62 families.)

In general there is a low awareness of hygiene, general health topics, and child care practices.

Twelve of the mothers work as maids and report they do not have time to care for their children.

Impact-2S10

Chart2

0.68

0.16

0.115

0.045

Change of weight in 4th round NCCS out of 242 children

Sheet1

NormalGr-IGr-IIGr-IIIGr-IV

July '03025166261

Sep '03398102150

Sheet1

00

00

00

00

00

July '03

Sep '03

Trend in change of Nutritional Status

Sheet2

W.gain more than 200 gm68%

W. gain lessthan 200 gm16%

W.remain same11.50%

W.decreased4.50%

Sheet2

0

0

0

0

Change of weight in 4th round NCCS out of 242 children

Sheet3

Impact -1S9

Chart1

03

2598

166102

2615

10

July '03

Sep '03

Trend in change of Nutritional Status

Sheet1

NormalGr-IGr-IIGr-IIIGr-IV

July '03025166261

Sep '03398102150

Sheet1

00

00

00

00

00

July '03

Sep '03

Trend in change of Nutritional Status

Sheet2

Sheet3

Impact -3-During the months of August, September and October2003 the program was unable to provide rice and dal to the mothers. The mothers demonstrated commitment to the program by donating these foods during this period.

-Two centers became Living Universities

-The newly elected PRI bodies and the Health functionaries have been oriented

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-Surrounding communities have been requesting that Positive Deviance (PD) activities be implemented in other AWCs.

-There has been an increase in awareness of child care practices.

-The ICDS functionaries and the CINI functionaries have became a PD team for its success.

S12Impact 3, cont

Impact-4Impact on overall ICDS programS13

Chart1

51.7487.8353.7992.29

July. 2002

July. 2003

Aug. 2002

Aug. 2003

Weighing Efficiency

Sheet1

July. 2002July. 2003Aug. 2002Aug. 2003

51.7487.8353.7992.29

Sheet1

00000

July. 2002

July. 2003

Aug. 2002

Aug. 2003

Weighing Effience

Sheet2

Sheet3

Impact-5Impact on overall ICDS programS14

Chart3

38.1522.3934.3619.73

July. 2002

July. 2003

Aug. 2002

Aug. 2003

Degree of Malnourishment

Sheet1

July. 2002July. 2003Aug. 2002Aug. 2003

51.7487.8353.7992.29

July. 2002July. 2003Aug. 2002Aug. 2003

38.1522.3934.3619.73

Sheet1

00000

July. 2002

July. 2003

Aug. 2002

Aug. 2003

Weighing Efficiency

Sheet2

00000

July. 2002

July. 2003

Aug. 2002

Aug. 2003

Degree of Malnourishment

Sheet3

DifficultiesS15

-Twelve to Thirteen Percent of children did not gain any weight; Four to Five Percent of children lost weight.

-After completion of the PD program, there were still 15

Grade-III children.

-Some of the mothers were not properly spot feeding their children.

-There are some mothers are not participating in the NCCS sessions everyday.

-Some mothers are not maintaining the caring practices learned in the NCCS when the NCCS program is not is session.

S16Difficulties

-All the VHC members are not participating and cooperating

actively

-Panchayat functionaries are not as actively involved in the program as

-In some of the AWCs ailing children were unable to make obtain appointments for medical evaluation.

-Fuel for the NCCS to the AWWs still remained a problem.

-The VHCs (Village Health Committees) and Panchayat functionaries are to be re-exposed to the PD approach

-The Berhampore Ministry of Health was contacted to assure that assuring health check-up of those children who are remaining in grade-II and Grade-III for long period.

-The District Magistrate,Murshidabad has taken steps for the solution of Fuel issues which is to be materialized.

-Quiz competition among the mothers,VHC members, AWWs to be organized for their motivation and evaluation of the program

-More centers to be taken to the status of living university.

Future PlansS17