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by Caitlin McQuilling
“Don’t automate a broken system”
Monitoring and evaluation is often the most difficult part of any development program. It’s often an afterthought for implementers, too busy worrying about rolling out the immediate and the tangible to worry about how they’ll evaluate their work at some later stage.
It’s important that data is not something that’s just written down in a grid each month and never seen again. The strongest programs are the ones in which ground level staff find their reporting useful in their daily work. By making data helpful to ground level staff it makes their reporting in turn more accurate.
Even though RMF put a focus on our M&E from the beginning of our program, it has continued to be one of the biggest struggles in implementing our program on the ground. As our program grows we are not only constantly assessing, analyzing and evaluating our data but also try to give the same level of analysis to the processes by which we collect data.
In this age where there seems to be a tech solution for everything, many development programs make the mistake of thinking that technology will be a “silver bullet” which will fix all of their challenges in the field. The best advice we received from one of the technology experts we were consulting with when deciding which direction we should take our program was “don’t automate a broken system,” meaning that before introducing any new technology, an organization should make sure their fundamentals are solid. As we moved forward with the planning of two innovative technology pilot programs for data collection integrating technology such as mobile phones or digital slates, we also needed to ensure that the fundamentals of our program are strong and that we understand and were honest about our strengths and weaknesses in data collection.
The following is a description of our current M&E system and the steps we went through to refine our processes and fix the problems we encountered.
Quantitative
- Daily Diaries: A simple book in which the CNEs freely record their daily activities and notes in the field
- MUAC Diary: CNEs each record in this daily register the names of SAM/MAM children they see and their Mid-Upper Arm Circumference.
- Triplicate form: a triplicate carbon paper form which the CNEs use to refer children to the NRC and track the referral through the system. One copy goes to the CNE, one to the family, and one is deposited at the NRC which we collect at the end of the month.
- Weekly Reporting format: Using the daily diaries, triplicate forms, MUAC registers the CNEs fill in the weekly reporting format and give that to their supervisors.
- Monthly Reporting format: The Supervisors collect all the CNEs’ weekly reporting formats and consolidate these into the monthly format.
Qualitative
- CNE feedback form: Filled out once a month by the CNEs to provide RMF management information about case studies, challenges, and success stories in the field.
- CNE Needs form: Filled out monthly by putting a simple tally in the boxes where they’ve had to give counseling. Supposed to be a very easy way to assess the counseling needs in the field.
Process of verifying our data
We held our own internal audit of the first year of our reporting (May 2010 – March 2011). Since our program is reporting big numbers and getting a lot of attention from government and NGOs, we wanted to be sure internally that our data was airtight and accurate.
Thanks to having a multi-layered MIS, we were able to go to the source of our reporting to get the accurate data. By back-tracking of the data we were not only able to verify our data down to the individual child but also identify at which steps our MIS wasn’t working well.
Each CNE maintains a daily diary where she notes down information on the village she visited each day. Then she copies all the information on children under 5 into a MUAC register, where she records the MUACs of children on each visit to the village over the months. In this we have a full year record (or whenever the child was first identified) for each individual child. This register is used by the CNE on a daily basis so that she can remember the history of each child she visits and so that she can see whether the child is improving or worsening on each visit to the village and can direct her counseling accordingly. We believe that we have accurate MUAC registers for all CNEs, except for a few CNEs who we let go for poor performance. For those villages we had the new CNEs we hired do fresh surveys and collect fresh data and compared that with the questionable data.
The CNEs use this register to fill out their weekly reporting format, which is submitted to their supervisor each week. This format is where the problems with calculating and addition started.
The Coordinators then collect all the CNEs weekly formats and use those to create the district monthly aggregate report. This is also where some errors occurred.
The weekly reporting formats and monthly reporting formats were filled out in hard copy by CNEs and District Coordinators, who did math by hand or using their cell phone calculators. This many times led to human error which was not picked up until later when the data was entered into excel sheets by our data entry operator. It was also a cumbersome process for the coordinators to consolidate all this data on a monthly basis and often took longer than RMF management would have liked.
Dr. Athar Qureshi, RMF’s Director of Programs, worked with the coordinators to create a new format, by village, where we reworked the totals for each village by month. This gave us a more accurate number. The Coordinators spent a weekend filling in all the data and checking the math.
Once the data was in an excel spreadsheet the team analyzed it and compared it to the original data submitted, the baseline data, and the NRC survey. The NRC survey and baseline data are results we’re sure about because we can link those to the individual children, so those are good points to verify the data from. We found that most of our data was reported accurately, with minor errors here and there, but that the process in which we collected our data was extremely time consuming and even more time consuming to go back and check. This also made it difficult for the District Coordinators to apply the program data in the field and to do cross checking of reports which CNEs submitted.
During this review we also realized that there were many activities CNEs were conducting on a daily basis which were not reflected in our reporting formats. CNEs recorded activities that were not reflected in the reporting formats as notes in their daily diaries, but each CNE recorded these activities in their own method. During the data cross-checking these daily diaries proved to be very useful for checking numbers, names, and dates whenever there was a question in the reporting formats. RMF realized the utility of having uniform reporting and a structure to these daily diaries while still allowing the CNEs some free area to write their personal notes.
We also faced some difficulties in the formatting of data from month to month as the overall compilation of the data was done by different people at different time intervals. Before January of 2011, RMF did not have a data entry operator and instead all program data was entered by DCs or program managers. Depending on how busy various individuals’ schedules were, one individual would enter the data for a few months and then another person would take over.
Lessons Learned
While this review of program data was tedious and painful at times, it was a tremendous learning experience for all staff members involved. For the CNEs it was a process of reflection on the quantum of work they had done and also a time to formally point out questions they had and challenges they faced. By spending so much time sorting through the program numbers, DCs gained an increased familiarity with what the numbers were actually capturing and became much more comfortable with data. RMF’s program management also got to see where the gaps in reporting were and where we could support program staff better.
The following were some of the key lessons we learned and changes we’ve made to our reporting system:
- The Daily Diaries and MUAC diaries are key, but structure is important
- Someone needs to “own” the data
- In November 2010 RMF realized this problem and requested our donors to provide us additional funding for a data entry operator and monitoring and evaluation officer who would “own” the data and make sure entry was uniform across all 5 districts.
- Each piece of data should be clearly defined
Next steps
Following this review, the team created new, more intuitive daily reporting formats and a revamped MUAC diary to help address many of the problems we identified. When introducing these new formats Dr. Athar and our Monitoring and Evaluation Manager, Julia Tewaag, held a two-day training for each district (10 CNEs and one DC) to introduce the formats, ensure everyone was clear on definitions and to walk CNEs and DCs through exercises which would help them better apply their data in the field.
With our M&E house in order, RMF is now ready to automate! We have just launched an exciting pilot together with Dimagi and Microsoft Research India (MRI) to help us decide what is the best technology for our program to use. With the help of Google and the Open Data Kit project, we’re also testing how Androids can be of use in our program. More on those pilots in the next series of blog entries.
For more information about RMF’s Malnutrition Eradication Program in India, click here
We can use any financial help you are able to provide on this project to continue our Education,Treatment and Outreach and help toward our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org
Tags: donate to india, India, madhya pradesh
Community Mapping
The month of April was RMF’s Community Mapping Month in Barwani district as part of our Community Mobilization Pilot with the Department of Women and Child Development. The team started this community mobilization activity by having a two day training on the method for Community Nutrition Educators (CNEs). This was to ensure that all CNEs used similar, participatory methods in doing the mappings.
The first day was at the office in conjunction with the weekly team meeting where mapping techniques, use of symbols, and methods to involve community stakeholders were discussed. The second day of training, Anjana split the CNEs into two groups and took them out to a village near Barwani to do a practical mapping exercise as a group. This hands-on mapping training turned out to be the most effective, with the feedback from many CNEs saying that this gave them the most clarity and confidence.
CNEs started the mapping exercise by meeting with the village Patwari wherever possible to discuss the village layout, ensure his/her participation in the mapping exercise and to obtain a village map. They made an appointment with key community stakeholders, including anganwadis, Sarpanches, patwaris, and active mothers, to do the community mapping exercise on their next visit.
In each village, we ask the community to lead this exercise, with the CNEs prompting the community members to dive deeper and deeper into the mapping exercise. CNEs were instructed to ask community members to map out both the things there were proud of in their communities and the things they thought were bad for health. Good things included schools, new latrines, and village meeting places. Bad places included liquor shops and open defecation sites. In each instance, CNEs were instructed not to pass any judgment or not to make any suggestions, but to let communities do this analysis on their own.
Community mapping covers:
- Households in the community (some villages got down to the level of detail of the names of the family members in each house, other just mapped out the homes)
- Location of SAM kids
- Water sources, streams, rivers, damns, ponds
- Hand-pumps
- Public buildings: AWCs, schools, panchayats, PDS shops, AWW homes, temples
- Shops (general stores, PDS shops, liquor stores)
- Local doctors, health centers, medicine men
One of the best examples of this method leading to community realization and behavior change was in Badgaon with CNE Saroj. At the beginning of her mapping session, a handful of women sat around the poster paper, with their heads and faces covered and didn’t say much. As the anganwadi and ASHA led the mapping and did most of the work the women started to contribute more and more, peeking out from behind their veils and laughing and arguing as they discussed various aspects of the community. In the beginning, a few men stood around the outside of the circle, attempting to look as disinterested as possible. As the mapping progressed, they too couldn’t help themselves with participating more and more.
During her mapping exercise she asked community members to map out the positive and negative things in their village. The women listed newly constructed latrines (under TSC) as positive things in their village. Then Saroj asked them if they were being used. The community members laughed nervously and admitted that no one used these newly constructed latrines and still continued to defecate out in the open. Saroj asked where the open defecation sites were. The anganwadi worker plotted these right next to a stream. Without passing any judgment Saroj asked the community what they used the water for. They all said bathing. Then as Saroj remained silent, women in the group all started to giggle at the same time. They were making the connection between the open defecation and the proximity to the stream they used as a water source. And in this moment, this simple mapping activity may have had the largest Behavior Change result of any of the activities RMF has undertaken in this village thus far. Community members started to chatter amongst themselves and comment that they should start using the new latrines right away and started speculating that this contaminated water may be why children are getting sick. It’s too early to see if this has made a true change in the community, but this kind of self-realization is bound to be much stronger than any lecture or training session.
This was the most dramatic example of the effects of community mapping observed so far by RMF Managers (Caitlin was present during this session), but the community mapping seems to be a very effective and well-received activity. It’s a chance for local communities to show off their knowledge for a change and makes them feel proud of their knowledge. RMF CNEs have reported enthusiastic participation of community members in each session. Anganwadi workers have told us that this is “a very simple activity” and fun.
The key to making these mapping exercises work is to make sure the CNE understands that this is not just about drawing a map, but that it’s a community mobilization activity. CNEs can facilitate the map making process, being the illustrator or scribe, but the actual process must be conducted by community members.
We found that the mapping exercise is better with a small group of 5-10 individuals, otherwise it gets too crowded and confusing and leads to less participation. To be able to include more individuals in the process, CNEs did the mapping in 2-4 sections per village, depending on the village size and number of anganwadis. One map was made for each village, but the CNE drew the map in various stages depending on how many anganwadi centers there were in the village, so that each section of the community could participate meaningfully. The final complete village map was then copied and given to each anganwadi center to hang on the wall so that each anganwadi center has a full map. Another important pointer the CNEs found was to begin the mapping process by drawing the village boundaries instead of just diving into mapping locations. This was scale could be developed.
To date mapping has been completed in 114 villages in Barwani district. Given the success of this activity it will be scaled up to all RMF villages in the 4 other districts this quarter.
For more information about RMF’s Malnutrition Eradication Program in India, click here
We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.
RMF Community Nutrition Educator, Samoti, and a child recovering from SAM. Photo Credit: Ximena Prugue
In March 2009, when I was conducting the initial field visits to develop RMF’s Malnutrition Eradication Program I visited a village called Shali Dana, in Kalwa block of Khandwa district in Madhya Pradesh. I remember being shocked and overwhelmed by the amount of children with severe acute malnutrition I saw in this village and the complete apathy and absence of government services in this village. We saw dozens of glassy eyed children with thinning hair, bulging stomachs, and protruding ribs, empty anganwadi centers, and children who had been tortured by traditional healers in the name of recovery because of the absence of government health services. Seeing this village convinced me that RMF had no choice but to do something drastic about this problem.
Samoti visiting Shali Dana
Fast forward to March 2, 2011. Today I spent the day with our Community Nutrition Educator Samoti in Shali Dana. She’s been working in this village for exactly one year and has made over 25 visits to this village, every 2 weeks. Samoti has spent this last year developing a strong relationship with the community, visiting each house with malnourished kids on a bi-monthly visit, and has supported and encouraged government anganwadi workers. Also over the last year, our friends at Spandan, a wonderful local NGO, have worked closely with the government anganwadi center to upgrade the center using community resources and have been working with the anganwadi worker to improve the quality of preschool education and other services offered to the community. They have also done a lot of work to promote education in this village in both Hindi and Korku, the local tribal language which is in danger of dying out.
I almost started crying today as I sat in a beautifully painted anganwadi center listening to excited, energetic kids singing nursery rhymes in their native Korku when I remembered that this was the same village which shocked me so 2 years ago. While being serenaded by the children Samoti showed me her register and went over the details of all the children with severe acute malnutrition in the village. When she did her baseline survey in March 2010, this village had 14 children with severe acute malnutrition, roughly 15% of all children under 5 in the village, an alarming rate of SAM.
Photo credit: Ximena Prugue
Now the village has 0 SAM children. We visited the households of 10 kids today who were formerly SAM. Some of these kids were positively fat, while others were now moderately malnourished. Watching Samoti made me proud. As she walked through the village, she was greeted by each family walking by. She scooped up children as she walked, joked with elderly women, and walked straight into people’s homes announced to pinch babies on the cheek. If I didn’t know Samoti to be one of the warmest and most compelling women I’ve met, I would think this was all staged. But having terrified 100s of kids by measuring their mid-upper arm circumference to assess their level of malnutrition I know that you cannot just come to a village once or twice and have kids walk up to you with their arms out, waiting for their MUAC reading. And that’s exactly what a few of the toddlers in this village did!
If you’ve read the annual report from the Eradicate Malnutrition Program its easy to be overwhelmed by the numbers:
- 65 staff across 600 villages
- 37,141 families and 56,194 children reached during the baseline survey
- 6,857 village nutritional training sessions conducted, training over 68,410 people
- Counseled 91,034 individuals on malnutrition prevention and treatment
- Successfully referred 895 children to NRCs
- Achieved a 25% reduction in childhood malnutrition across intervention villages, 17,994 children who directly improved because of this intervention
They’re unbelievable numbers when you add them up, even for those of us who saw the progress in the field and did the adding. I’m one of the members of the RMF team who spent hours and hours analyzing our program data. Eyes bleary from staring at excel sheets and going absolutely crazy over the errors while cleaning data, we sacrificed our sanity and eyesight to make sure our data is as accurate as possible. Even though I personally verified forms and conducted spot checks in the field to ensure the accuracy of reporting, I have a hard time believing that we reached over 80,000 children!
Young mothers and their children in Shali Dana
But today watching a new mother glow as she was breastfeeding her chubby infant and watching Samoti joke with mothers in the formerly tragic Shali Dana, I saw beyond the numbers and graphs to what RMF’s best at. Here’s an invitation to every RMF supporter: come out and see for yourself the reality behind our numbers. There’s nothing like it.
For more information about RMF’s Malnutrition Eradication Program in India, click here
We can use any help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, click on the Donate button below or visit our website at www.realmedicinefoundation.org
Tags: children in india, donate to india, India, india children, india food crisis, india madhya pradesh, india malnutrition, india poverty, nutrition india
An angel, from JustDial.com by Caitlin Mcquilling
I’m often asked what keeps me going in the face of the hardships and emotionally taxing situations we face working on issues such as childhood malnutrition and HIV/AIDS day in and day out. My answer is simple: it’s all about finding inspiration in the most unexpected of places and circumstances.
Caitlin, and the mothers and children at the Malnutrition clinic
On Tuesday while out on a village visit we came across a little girl, Gila, who was extremely sick and dangerously malnourished. She and her family had just returned from a month long stay at a private hospital in Dahod, Gujarat where Gila was properly diagnosed with tubercular meningitis, but unfortunately was not given the proper treatment. Over the month she was there the family spent their entire savings and then some only to see Gila rapidly deteriorating. After a month when the family could no longer afford “treatment” they were sent home. This is when we found the family in the village, desperate for us to help in any way we could. As soon as I saw Gila I knew she needed expert medical care not available in the state of MP. We told the family that we would have to bring the little girl to the hospital immediately and they eagerly agreed without a second thought.
Along with Gila’s father, Suroj, we consulted a doctor in Jhabua to get his opinion on whether or not the girl could travel. With the doctor’s immediate advice to go straight to Ahmedabad Civil Hospital and BJ Medical College, I set out along with Sumitra, our CNE who first met the family, our wonderful and uncomplaining driver Mesul, and the little girl’s father and cousin on the 8 hour car ride.
As soon as we reached BJ Medical College, one of the best government health facilities in the country, we were rushed straight to the pediatric ICU. The wonderful team of doctors there immediately put the little girl on oxygen and started treatment immediately. They told us that the little girl’s condition was extremely serious and her chances of survival weren’t good, but promised to do everything they could to save her. I spent the day in the hospital with the family on Wednesday, understanding the next steps with the doctors, getting all the lab tests they needed expedited, and making sure that they were comfortable. We set the family up with a network of kind local volunteers who promised to look after the family on a daily basis since RMF couldn’t station one of our team members at the hospital for the 3-4 weeks the family would need to be there.
At 5am on Thursday while I was rushing to get my things together for the airport, I got a phone call from Suroj. Between sobs, Gila’s father told me that she had passed away a half hour before and he didn’t know what to do. He wanted to go home as soon as possible to cremate Gila, but didn’t know how he would get her body the 10 hours home. He begged me to help the family find a way home as soon as possible. When I got into the taxi a few minutes later I knew my options were severely limited. I had to be on a flight in an hour to go to an important meeting in Bhopal, but I also couldn’t leave this family stranded. I’m not very familiar with Ahmedabad, especially to find an emergency hearse at 5am capable of making an 8 hour trip across state boundaries. But as I greeted the taxi driver, that my friend found from JustDial.com, I immediately had a good feeling about him. I had 20 minutes to convince Nitin, the driver, to drive 10 hours with a sobbing father and a dead body.
I laid it on thick. In my remedial Hindi I told him about the work RMF does in Jhabua, about the malnourished kids, about this caring family who tried to do everything for their daughter but who were failed by the medical system. I wasn’t ashamed to beg this man to do us this favor. By the end of the taxi ride this driver had no choice but to agree to my outrageous request to go directly from the airport to the district hospital to find a family who didn’t speak his language (Bhili v. Gujarati) and to take them and child’s body 8 hours to a tribal area which many individuals in Ahmedabad have prejudice about. The driver was hesitant to take on this responsibility but conceded to take the family as far as Jhabua (not their village) as long as there was a death certificate. While the taxi driver seemed honest, I could only wish for the best as I handed him money and ran into the airport to catch my flight.
While going through airport security I arrange an expedited death certificate from the hospital and connected Nitin with Suroj and Suminta. As I boarded the flight Nitin was lost on the hospital campus. On my layover in Indore I confirmed that Nitin had in fact picked up the family and that they were safely on the way to Jhabua. Phew. Job done. I could now concentrate on PowerPoints and process indicators.
Thursday evening I got a call from Sumitra, our CNE who met the family in Jhabua when they arrived. After she filled me in on how the family was doing, how the cremation went, and so on, she also had a message for me.
Not only had Nitin driven the family the 10 hours to Jhabua as agreed, he also insisted on driving them all the way to their remote village himself. Not only did he go out of his way to drive them to the village, he attended Gila’s cremation as a member of the family. The next morning he called Sumitra, not to complain, as many people would, but to thank her. He told Sumitra that he was grateful that RMF asked him to do this. He said it made him feel so good that he was able to be there for this wonderful family during their time of need and was just happy to be part of all of this.
Thank you Nitin. Its individuals like you who keep us going and remind us that even in the most terrible of circumstances, humanity can be found from the most unexpected places.
For more information about RMF’s Malnutrition Eradication Program in India, click here and for more on our HIV/AIDS click here.
We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.
Tags: children, children in india, hiv in india, HIV treatment, India, india malnutrition, malnutrition in india
Introducing a new pilot initiative within RMF’s Eradicate Malnutrition Program: Strengthening Community Management of Childhood Malnutrition through community mobilization, and nutrition and health education of mothers and pregnant women in Barwani, Madhya Pradesh
Madhya Pradesh has the highest rate of childhood malnutrition in India, with upwards of 60% of all children under 5 years old underweight. In many tribal communities in the state, this rate may be even higher, with alarmingly high rates of severe and moderate acute malnutrition. These communities often have limited access to government resources meant to prevent and treat malnutrition and have low levels of awareness about proper young child care.
To respond to these alarming levels of malnutrition in Madhya Pradesh, the Real Medicine Foundation (RMF) launched a childhood malnutrition program across 5 of the worst hit districts in Southwest Madhya Pradesh – Jhabua, Alirajpur, Khandwa, Khargone, and Barwani – employing 55 local women to act as Community Nutrition Educators to help empower communities to combat malnutrition and to identify children with severe acute malnutrition. Given the success of these women in addressing malnutrition at the community level over the last year, RMF is teaming up with the Department of Women and Child Development and the Madhya Pradesh Technical Assistance Support Team MPTAST) to roll out a pilot program in Barwani district to address childhood malnutrition through community mobilization. This program is supported with financial help from DFID and from technical assistance from Action Against Hunger.
Our staff attending training session
Project Objective
To build the capacity of anganwadi workers and supervisors to drive community mobilization and provide high quality health and nutrition education services in order to develop community capacity to recognize malnutrition, respond to malnutrition using local resources and make referrals when necessary, and to prevent malnutrition in the long-run.
Target Area
This pilot program will provide full coverage to two blocks in Barwani District – Pati and Barwani blocks –with a total of 204 villages and 370 anganwadi centers. The target population will be children under 5 years old and pregnant and lactating mothers.
Barwani is a remote and rocky district at the southern most corner of Madhya Pradesh, boarding Maharashtra and Gujarat, with a population of 10,81,039 (2001 census). It is the second most tribal district in Madhya Pradesh, with 67% ST population. The size of each village varies from roughly 800 and 3000 people, with larger towns scattered throughout the blocks. Barwani is considered one of the most remote districts of India. Many of its villages are located in hilly regions, cut off from roads and access to markets.
Staff in the field
Social Mobilization Approach
The project’s social mobilization approach is founded on strengthening the capacity of the government’s ICDS programme to mobilize communities for child nutrition by delivering quality nutrition and health education classes to mothers. This will lead to increased community understanding of child nutrition issues, more women and families adopting better nutrition practices, and increased demand for government services that people are entitled to.
The project will achieve this by capacitating Anganwadi Workers, Supervisors and CDPOs to hold regular monthly community sensitization meetings to generate interest in and sustain momentum for community action. The sensitization meetings will increase awareness of malnutrition, its signs and the care that malnourished children need. Tools are being developed to help raise awareness of the scale of malnutrition in the village, how it can be identified, the location of pockets of malnutrition in the village, and stimulate debate on what individual families and the community can do to address this problem.
Through awareness raising events, influential persons and opinion leaders will provide support to the sensitization program through the Village Health, Sanitation, and Nutrition Committee which will serve as the local nutrition monitoring group. These newly formed Village Health, Sanitation, and Nutrition Committees will monitor the regularity, reach and quality of services provided at the Anganwadi Centre. They will provide feedback and suggestions to key members of the local community and will report any gaps in services to the panchayats for community action. Community leaders and influential persons and the local monitoring group will meet regularly to share monitoring information, help resolve local problems and enable the smooth functioning of Anganwadi Centres. Additionally, by focusing on strengthening anganwadi supervisors’ capacity for supportive supervision, the project will not only institute a system of stronger monitoring and evaluation into the program, but will begin a process of on-going trainings.
Output
As a result of the on-going capacity building and trainings, this project will capacitate Anganwadi Workers to hold regular, participatory and practical health and nutrition education sessions for the mothers of malnourished and underweight children. It will also strengthen their interpersonal communication skills which will benefit other elements of their duties.
Anganwadi Workers with support from Supervisors and CNEs will hold nutrition and health education classes twice a month. CNEs will also assist supervisors and anganwadi workers on active case finding in children from hamlets and areas within villages who are not currently accessing anganwadi resources and will help connect these families with the system. Referrals for complicated cases of SAM and MAM will be made to the Barwani NRC.
Progress thus far
RMF began the groundwork for this project in November 2010 and officially started working on the project at the project’s approval in December 2010. The first step was to introduce the program to local leadership, and then work to recruit new positions for the program, begin developing manuals and IEC/BCC tools, hold the training for new CNEsm and to make the plan for the project moving forwards.
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For more information about RMF’s Malnutrition Eradication Program in India, click here.
We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.
Tags: barwani, charity india, children in barwani, India, india barwani, india children, madhya pradesh india, malnutrition crisis in india, malnutrition in barwani, malnutrition in india, no-profits india
Continuing with our Malnutrition Eradication Program series and fundraiser
Sonu, one of our NRC’s most dramatic success stories, continues to improve and put on a healthy amount of weight!
All children who are treated at RMF’s NRC come back every 15 days for 2 months for follow-up clinics to ensure that the children are still healthy and gaining weight. They are seen by our pediatrician, given a nutritious meal, and given a transportation allowance to allow them to get to the NRC and back home. These are always our staff’s favorite days of the month when we get to see the children again who we had bonded so much with over the 2-3 weeks they were in our care.
See how healthy he looks today in these latest pics taken at the NRC
Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com
For more information about RMF’s Malnutrition Eradication Program in India, click here.
We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.
Tags: India, india charity, india food crisis, india hungry children, india jhabua, india malnutrition, india real medicine, india rmf, india treating children
Tags: 501 (c)(3), annual report, annual report 2010 charity, non-profit annual report, real medicine foundation annual report, Related Links
Its all in the follow-up.
Sonu, when he first arrived at the NRC
Sonu, one of our NRC’s most dramatic success stories, was back at the NRC for his second follow up looking positively chubby. All children who are treated at RMF’s NRC come back every 15 days for 2 months for follow-up clinics to ensure that the children are still healthy and gaining weight. They are seen by our pediatrician, given a nutritious meal, and given a transportation allowance to allow them to get to the NRC and back home. These are always our staff’s favorite days of the month when we get to see the children again who we had bonded so much with over the 2-3 weeks they were in our care.
Sonu today!
To the RMF India team these follow up visits are just as important as the in-patient care because they help ensure that the weight gains our children achieved during their time as an inpatient can be sustained over the long term. RMF doesn’t stop after the government’s 4 required follow-ups are completed. RMF assigns one Community Nutrition Educator to each child discharged from the NRC who visit the family every 2 weeks. At the home they provide targeted counseling to the caregivers, ensuring that they understand the lessons they learned at the NRC and can apply them to a real life context.
For RMF, the NRC follow-up is never over.
With Sonu, so far so good!
For more information about RMF’s Malnutrition Eradication Program in India, click here.
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We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards our goal of Malnutrition Eradication in this region of India.
To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.
Tags: donate to children india, India, india hungry children, india malnutrition, malnutrition education, malnutrition eradication, malnutrition treatment, real medicine india
By Caitlin McQuilling
Over a year ago Ganesh Kamath was shocked to read about the staggering malnutrition rates in India. A native of Kerala who has lived in California for over 50 years, Ganesh knows India well, but was shocked to find out that almost half of all Indian children are malnourished. He started to research the problem some more and was moved by the grim tales of malnutrition coming out of the media in India. He and friends, who all felt that malnutrition should not exist in India, formed a group to look into this issue and explore ways in which they could do something. After a year of research and bouncing ideas back and forth Ganesh volunteered to go to India on behalf of the group to see firsthand what the problem was and what could be done. After contacting various NGOs working in India, they decided that Real Medicine Foundation was a good place to start and sent Ganesh out on a fact finding trip to see the reality on the ground.
Ganesh arrived in Jhabua after a grueling few days of travel but, notebook and camera in hand, was ready to start right away. Over the 5 days he was here Ganesh joined RMF India on our daily routine in the field, in the office handling 10 things at once, in the NRC, and at the Bhil Academy. Ganesh handled it all with enthusiasm, interest, and respect for the work going on. We spent three days out in the villages on spot checks to see our CNEs in the field and to check on NRC follow up cases. One day after over an hour in a jolting car ride we had to walk about 2 miles in the heat of the day to reach an anganwadi center buried in a remote village. This up and down hill walk through fields and across streams wore out me, and I’m a runner, but Ganesh was right there with us. He was able to see first -hand the scope of RMF’s work, the challenges we’re up against, and to meet the women who make this all happen. Now that’s due diligence!
Ganesh will now head back home and report to his group about what he’s seen here in India. He has many great ideas on how he can help out RMF and some of the individual children he met here. Ganesh plans on giving talks to local groups about the program and approaching his friends and neighbors about how they can contribute to ending malnutrition in India one child at a time.
RMF thanks Ganesh for coming halfway across the world to see malnutrition in India and what RMF is doing to stop for himself. It was a pleasure to host such a compassionate and caring individual for the past five days. We look forward to working with you and your friends to eradicate childhood malnutrition in India.
For more information about RMF’s Malnutrition Eradication Program in India, click here.
Folllow us on Twitter or Facebook
To contribute to this initiatives, please click Donate button or visit our
website at realmedicinefoundation.org.
Tags: India, india jhabua, Jhabua, malnutrition in india, malnutrition treatment, nutrition in india, volunteer in india, volunteering, Volunteering in india
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