Technically supported by PCI, the HN Integration model of JEEVika can bring significant improvement in some of the complex and stagnant indicators like dietary diversity in complimentary feeding at scale
For the last two decades Project Concern International/India (PCI) has been working in India in the areas of health, nutrition, and community development with programmes focussing on low-income, vulnerable and hard-to-reach populations in close partnership with the national and state governments and civil society organisations.
Flagship programme: HN integration model
Integration of Health and Nutrition (HN) interventions with the women’s Self-Help Group (SHG) platform is one of the hallmark approaches conceptualised by PCI. This approach initiated in 2012, had proven to deliver outstanding results when tested on 18,000 SHGs in Bihar. Later in the year 2015, PCI got opportunity to provide technical support on this to JEEViKA, the State Rural Livelihoods Mission (SRLM) of Bihar. JEEViKA has promoted a huge network of 1 million SHGs in Bihar. JEEViKA, with the technical support of PCI, designed HN integration model to improve key health and nutrition outcomes of JEEViKA families through sustained social and behaviour change (SBC) efforts, and convergence with other departments. This model of JEEViKA could bring significant improvement in some of the complex and stagnant indicators like dietary diversity in complementary feeding at scale. Thus, the HN integration model of JEEViKA has proven to be effective in bringing change in outcomes and is also replicable at scale in other states. JEEViKA has nearly 1 million groups covering around 1.2 crore families.
Strategic preparedness
The on-ground HN activities of JEEViKA with the SHGs came to a halt with the advent of the COVID-19 pandemic. The vacuum created by the absence of a platform for regular message dissemination was almost immediately addressed by the JEEViKA with the decision to continue the activities via both virtual and physical (wherever possible) modes for maximum engagement and penetration. PCI as the technical support agency also partnered in the efforts of JEEViKA to ensure that there is no reversal of the achievements made over a period of time in H&N indicators.
Two major shifts in the approach of JEEViKA; (a) the entire cascade approach of capacity building in JEEViKA has shifted from classroom training to digital training. PCI has facilitated development of digital training and material on breastfeeding, complementary feeding, maternal nutrition, kitchen gardening in the COVID-19 context for the JEEViKA staff and JEEViKAcadres (b) JEEViKA’semphasis is now also on behavior and practices related to precautions and prevention against COVID-19. Here, PCI provided support in developing audio jingles and video messages on the right eating practices to build immunity against COVID-19. These are being shared by JEEViKA with the SHG members via WhatsApp.
Output
Pre COVID-19: JEEViKA’s integrated HN model has helped in impacting the dietary diversity and minimum acceptable diet has increased two-fold in 101 JEEViKA blocks of Bihar in 2018-19.
During COVID-19: 48.8 lakh SHG members were trained by JEEViKA on COVID-19 facts, myths, and precautions using the training tools designed with technical support of PCI.
Impact
JEEViKA’s integrated HN model helped in demonstrating a two-fold increase in the dietary diversity in child feeding in Bihar – a “sticky indicator” which has not seen improvements to this degree at scale in India. Although the sudden outbreak of the pandemic had challenged the continuity of the programme but JEEViKA successfully adapted the programme through the virtual platforms and measures. PCI had the opportunity to support JEEViKA in this endeavor and connected with a huge number of SHGs through virtual training modes, digital content etc.
Sustainability
With the systematic phase-out of lockdown, in-person activities in JEEViKA are resuming in different parts of the state maintaining all safety protocols. However, a hybrid model has already been established, tried and tested by JEEViKA, virtual tools have been developed PCI and everything is being digitalised to ensure that a backup system is ready to support the JEEViKA programme whenever routine activities face any obstacles on the ground.
Post-COVID-19 growth model
JEEViKA’s integrated HN model is one of the most cost-effective and scalable approaches for community-centric and demand-side intervention for HN that has strong and scientific evidence of bringing outcome-level changes at scale. JEEViKA could bring change in some of the complex and stagnant indicators, which could not be changed by us, the public health community, through many of the conventional public health and nutrition programming. This model therefore provides huge opportunity for learning to the development and public health community globally, which are looking for replicable and scalable models.
Indrajit Chaudhuri
Country Director
Project Concern International, India
