MALNUTRITION
48 OUTLOOK 22 July 2019
by Rama DiwediL
AXMI had seen childbirths in her village,
assisted midwives, and helped expect
ing mothers. But she was unable to und
erstand the possible reasons for her
own ordeal—excessively swollen feet
and hands, protruding eyeballs and loss
of appetite. She suffered it all. Eight months
pregnant, this woman in her midtwenties
used to live alone during the day as her hus
band worked in the field. “I thought we were
being punished for our bad deeds; nobody
faces such troubles during pregnancy,” she
says. She had developed an unusual habit: “I
started liking the taste of red bricks and sand;
didn’t know what was happening to me.”
It was only in her third trimester, after attend-
ing community dialogue sessions by Prerak
Vandana Pandey of Poshan (the PM’s Overarching
Scheme for Holistic Nourishment), she under-
stood what was ailing her. “She was ignorant of
her diet through a major part of the gestation and
became deficient in important nutrients,”
Pandey recalls. She suffered from severe oedema
that caused a bloated body. Her unawareness led
to a complicated delivery and poor health of both
mother and child. Her child was delivered safely,
though, and is in good health.
Another woman, Pushpa, from the same vil-
lage gave birth to a stillborn last year. This hap-
pened despite a “normal” pregnancy and
dili gent adherence to mother-in-law’s home
remedies. She is scared to conceive again.
Such cases are not rare in Sarai Mubarak, a
village in Uttar Pradesh’s Ghazipur district,
where children are born with under-developed
brains and other birth defects; mothers are igno-
rant of proper maternal healthcare. These
women are malnourished, as are their children—
even those in the womb. For a healthier society,
the pregnant and lactating women not only need
dietary nutrients, but counselling to undergobehavioural changes. This is where DigiPoshan,
a Digital Empowerment Foundation and
UNICEF initiative, aims to make a difference. It
strives to improve nutritional outcomes for
children, adolescents, pregnant women and
lactating mothers by leveraging technology.
With the help of a trained cadre called Preraks,
community dialogue sessions were conducted at
187 locations across 10 Indian states.
They use tools such short films, collaterals,
digital storytelling and interactive devices to pass
on information on nutrition. They act like agents
of change during the six-month tenure of the
programme, mobilising and addressing issues
such as antenatal check-ups, diet care during
pregnancy, iron and calcium supplementation,
benefits of institutional delivery, importance of
breast milk and early initiation of breastfeeding.
In Laxmi’s case, the village ASHA worker is
monitoring the pregnant woman’s cravings for
red bricks—an offshoot of calcium and iron de-
ficiency in her blood. Lack of these two minerals
is a common maternal health issue in the coun-
tryside. Laxmi has been given supplements.
“Humare liye to Prerak didi vardan roop thi (For
us Prerak was like a boon),” she says. And on her
balanced diet: “I now know that iron and cal-
cium supplements help increase the haemoglo-
bin level. It makes their bones stronger.”
Not just pre-birth care, initial days are crucial
too for the baby’s health and for a better immune
system. But a lack of day-to-day knowledge,
ign orance of first-time mothers, and homeIt is common
in villages to
have stunted
children as
most women
aren’t aware
of a good diet
in pregnancy
for a healthy,
strong babyIn Poshan, hope rises for babies and mothers—
malnourished, low on basic minerals like iron