Inappropriate feeding practices is a major challenge across many parts of the world, and Bihar is no exception -- resulting the highest stunting levels in the country. The complexity in ensuring timely initiation, consistency, frequency, diversity, and quantity in complementary feeding is a herculean task.
Farhana Khatun, from Samastipur, Bihar, used to follow the traditional feeding practices prevalent in the community regarding feeding her daughter, Dilkash, and banked on the advice of the elders in feeding her. As a result, Dilkash was given water with milk when she was four months old, and initiated into complementary feeding at the age of 8 months, and Farhana stopped breastfeeding her when she completed 18 months of age.
Farhana, who hails from Kasaur village in Lakhanpatti panchayat in Waris Nagar block of Samastipur district, was living with two children, a three years old daughter, and a 13 months old son along with her sister-in-law who has a 9 months old daughter. He husband works in Surat, Gujarat, and visits his family only twice a year.
Thanks to JEEViKA (a state government initiative for promoting and nurturing Self Help Groups), it was a matter of happy coincidence that when Farhana’s son completed five months of age, the Community Mobilizer (called “CM Didi”) discussed various aspects of complementary feeding in one of the weekly meetings of the Self Help Group members through an interactive session with pictures. This led to timely initiation of complementary feeding of Farhana’s son after six months.
Ever since she joined Barkat, a Self-help group (SHG) under Adarsh village organization (VO) as treasurer, she became a very active member. She admits that until a couple of months ago before she joined the SHG group, she knew nothing about the initiation of complementary feeding, food groups for children, frequency, and quantity of complementary feeding.
During the home visit of the complementary feeding (CF) campaign, it was observed that, though Farhana had initiated CF at the right age, she still did not have all the required information related to quantity, frequency, diversity, and consistency. The team members who did the home visit adopted a problem-solving approach and explained to her the details about the different aspects of complementary feeding.
The team also pasted a sticker which pictorially conveys the details about child diet diversity, frequency, consistency, and quality near her kitchen and invited her to participate in the video show and food demonstration activity of the campaign, along with recipes prepared by her using at least 4 food groups. Farhana participated in the demonstration of recipes and got convinced about the right feeding practice for her child.
After one month, during a follow-up visit, it was observed that Farhana was following the right practices for her child by feeding him in a separate bowl -- half bowl of CF comprising diverse food groups, at least thrice a day along with continued breastfeeding. Now Farhana has not only herself become an active follower of proper child feeding practices but ensured that her sister-in-law, who lives in the same house, also adopted the right feeding practices and ensured dietary diversity in complementary feeding.
Inappropriate feeding practices is a major challenge across many parts of the world, and Bihar is no exception -- resulting the highest stunting levels in the country. The complexity in ensuring timely initiation, consistency, frequency, diversity, and quantity in complementary feeding is a herculean task. The family members struggle with it, as it not only involves right knowledge, access to food, time to feed, capacity to procure adequate and nutritious food, etc. Right knowledge at the right time plays a significant role in initiating complementary feeding and JEEViKA is playing a catalytic role in this.
Farhana’s is a befitting case because her access to information as a member of the SHG created a life-changing impact on her child. Her story reconfirms the globally proven science that repeated, and timely contact will change the behaviour at the community level, which JEEViKA is following to change the practices at the community level related to complementary feeding by training the SHG women on Behaviour Change Communication (BCC) and campaign as two different strategies.
“I started giving complementary food to my elder child when she turned eight months and fed her the same type of food almost daily for months because of lack of right knowledge about complementary feeding. But now I have right information and use it to feed my younger child,” said a smiling Farhana, her eyes reflecting her conviction.
JEEViKA is implementing a rural livelihood project in Bihar (Bihar Transformative Development Project) with funding from the World Bank. The project has five major components of which Health, Nutrition, and Sanitation (HNS) is one of the components. The project is implemented across Bihar covering 534 blocks in 32 districts, and the project recipients are women who are the members of SHGs (96,95,597 number of women organized into 8,35,987 groups).
The complementary feeding campaign is aimed at changing the behaviours of caregivers, primarily lactating women and their husbands, and mothers–in–law. Improved knowledge of food groups and their importance in regular diet, and knowledge on initiation, consistency, adequacy and diversity of complementary food are the central issues of the campaign.
It is a one day activity at Village Organisation level, and the activities include:
• Identification of households with children of 6-11 months age in the VO areas/Villages
• Conducting home visits to identified families along with Health Sub-committee members (They are from VO) and invite the mothers, fathers and in-laws for a video show. Ask them to bring any one food item prepared using foods from at least 4 food groups.
• Conduct a rally with school children using relevant slogans
• Screen the video and orientation on diet diversity and age appropriate complementary feeding using a poster/flip chart
• Practical demonstration of the recipes, and felicitating a mother who is practising good behaviours pertaining to complementary feeding.
Health, Nutrition and Sanitation activities in the project are specifically aimed at changing behaviors of the project’s recipients ( Pregnant women, Lactating mothers and Children below 2 years from SHG households) with an objective of improving dietary diversification among SHG households.