Author: thegoodsight

In the fight against hidden hunger, biofortification offers a sustainable, scientifically validated solution to boost diets and enhance global well-being

Approximately 2 billion people worldwide silently grapple with the pervasive effects of micronutrient malnutrition, often referred to as “hidden hunger.” This insidious condition arises from the absence of critical micronutrients like vitamin A, zinc, and iron in daily diets, taking a toll on the mental and physical development of children and adolescents, leading to lower IQ, stunting, and even blindness. Vulnerable groups, particularly women and children, bear the brunt of this issue, while hidden hunger erodes the productivity of both men and women due to increased susceptibility to illness and diminished work capacity.

In India, studies reveal that an estimated 50 to 70 per cent of women of reproductive age suffer from anemia, linked to iron deficiency. Additionally, zinc deficiency emerges as a formidable health concern for millions, especially children, contributing significantly to childhood stunting and even premature mortality. The absence of zinc, a vital nutrient essential for proper growth and overall health, underscores the urgency of innovative solutions.

Micronutrient malnutrition is further exacerbated by the inadequacies of local food systems, challenges related to the affordability and accessibility of nutritious foods, and the escalating impact of climate change on the quality and quantity of food production.

According to the Copenhagen Consensus of 2008, a panel of renowned economists, including five Nobel Laureates, ranked efforts to reduce hidden hunger among the most cost-effective global solutions. Biofortification, a pivotal strategy, secured the fifth position among these solutions.

Biofortification: A Promise of Health

Biofortification is a process that elevates the nutritional content of staple crops already part of the population’s daily diet, achieved through conventional and modern agricultural breeding techniques. This approach aims to measurably alleviate micronutrient deficiencies by enhancing the micronutrient content of edible plant parts.

Biofortified crops, the outcome of this remarkable process, exhibit not only high yields but also resilience to drought and heat. Importantly, they align with farmers’ preferences, making them a sustainable choice. Regular consumption of these crops has been shown to have a tangible impact on health, as substantiated by nutrition studies. This underscores their potential to effectively combat malnutrition.

In the relentless battle against hidden hunger, biofortification emerges as a beacon of hope, offering a sustainable and scientifically validated solution to enhance the nutritional value of diets and improve the overall well-being of communities worldwide.

Biofortification’s Advantages

Targeting Vulnerable Populations: Biofortification primarily targets populations who regularly consume significant quantities of staple foods as part of their daily diets. These individuals often lack access to diverse and nutrient-rich foods.

Rural Focus: It is particularly beneficial for rural areas, where approximately 75 per cent of subsistence farmers reside. These communities heavily rely on diets centered around staple foods such as cereals (wheat, rice, pearl millet, maize, and tuber crops) in various geographic regions. Often, supplementation or fortified food products are not readily available in these remote areas. Consequently, the introduction of locally produced, more nutritious staple food crops can have a profound impact on the daily nutrition of these communities.

Cost-Effectiveness: Biofortification proves to be a cost-effective approach. Following the initial investment in developing biofortified crops, these crops can be adopted at a relatively low additional cost and remain available in the food system year after year.

Sustainability: Biofortification embodies a sustainable approach as it hinges on foods that populations regularly consume. Biofortified crops can be cultivated to deliver essential nutrients without incurring recurring costs, making them an economically viable and sustainable solution to combat malnutrition.

Incorporating biofortified crops into regular diets offers an effective, sustainable, and economically feasible means of enhancing nutrition among vulnerable populations, particularly in rural areas.

HarvestPlus: Catalyzing Global Change HarvestPlus is at the forefront of promoting and disseminating biofortified crops globally, spanning Asia, Africa, and Latin America. With more than 86 million people worldwide benefiting from these naturally nutritious crops, Dr. Howarth Bouis, the Founder and Director of HarvestPlus, received the prestigious World Food Prize in 2016 for his pioneering work. In India, HarvestPlus collaborates with over 135 partners from various sectors, including public, private, farmer-producer organizations (FPOs), National Rural Livelihood Programs, and community organizations. HarvestPlus collaborates to scale biofortified crops in Bihar, Uttar Pradesh, Odisha, Karnataka, Punjab, and Jharkhand.  For scaling biofortified crops, HarvestPlus focuses strategically on seed availability and accessibility, demand creation for seeds, awareness about the benefits of nutritious grains, developing value chains, and favorable policies for linking to safety net programs.

Major Accomplishments

• Establishment of strong partnerships between ICAR, SAUs, Livelihood programs, private and public sector and community organization.
• The Prime Minister’s endorsement of biofortified crops in 2020 marked a transformative moment.
• The Indian Council of Agricultural Research (ICAR) announced that 10 per cent of its Frontline Demonstrations would include zinc-biofortified wheat and rice varieties. Front Line Demonstrations (FLDs) facilitate direct interaction between researchers and farmers, allowing scientists to gain valuable feedback from the field.
• First minimum micronutrient standards for iron and zinc for pearl millet products for being accepted in the national testing trials.
• 1.7 million smallholder farmers growing biofortified crops. An estimated 7 million people benefitted by consuming biofortified crops.
• Two nutrition efficacy studies in biofortified pearl millet and zinc wheat were published which provides the proof of concept that these crops are efficacious.
• 76 biofortified varieties available for cultivation, that have been released by the ICAR and SAUs.

In 2023, HarvestPlus commemorates the remarkable 20-year impactful journey, this milestone stands as a testament to the program’s profound contributions to global nutrition and agricultural development, underscoring its pivotal role in advancing nutrition security and improving livelihoods on a global scale. In scaling biofortified crops in India, we see not just a cost-effective and sustainable solution to combat malnutrition but a beacon of hope for healthier, brighter futures for millions.

“HarvestPlus remains steadfast in its commitment to scale biofortified crops, ensuring that the most vulnerable populations have access to and availability of nutritious diets. Our approach adds value from the farmers who cultivate these crops to the end consumers. At our core, we are driven by the mission to enrich nutrition on every plate.”

Binu Cherian, Senior Country Manager, HarvestPlus

Empowering Healthier Rise Against Hunger India’s pilot phase of the 1000 Days Nutrition Flagship Program is concentrated in eight districts spread across the states of Odisha, Chhattisgarh, Bihar, and Jharkhand, known for their remote and challenging terrain and inhabited by PVTGs

In an unwavering commitment to combat ill health, malnutrition, and food insecurity, Rise Against Hunger India has embarked on a transformative journey. The organization’s recently launched “1000 Days Nutrition Flagship Program” is pioneering a community-based approach to address these issues, particularly among the most marginalized and vulnerable communities, including PVTGs (Particularly Vulnerable Tribal Groups).

Rise Against Hunger India’s 1000 Days Nutrition Flagship Program is in its pilot phase, targeting selected pockets in eight districts across four states: Odisha, Chhattisgarh, Bihar, and Jharkhand. These regions, characterized by their isolation and challenging terrains, are home to PVTGs. At the heart of this initiative is a profound emphasis on community engagement and ownership. Pregnant women in these communities are coming together to strategize their nutritional well-being during the critical 1000 days period – from pregnancy to a child’s second birthday.

The program introduces an innovative concept: the establishment of community kitchens in resource-scarce settings. These kitchens cater to the dietary needs of pregnant and lactating mothers, offering them a safe space to share experiences, express challenges, and collectively discuss coping strategies. The core implementation revolves around the formation of dedicated groups of pregnant and lactating mothers who collaboratively determine optimal cooking and feeding processes to meet nutritional requirements

Collaboration for Seamless Integration

In cases requiring additional support, the program augments local systems and infrastructures. This collaboration ensures seamless integration with Front Line Workers (FLWs) and institutions like Anganwadi Centers (AWCs). 

The close relationship with FLWs aligns efforts toward common goals: ensuring the consistent and regular provision of nutritional food, tracking the progress of mothers and children, and collectively identifying warning signals in critical cases to provide the necessary care. This collaboration also serves as a mechanism for people-centric participation in making local systems active and responsive.

Rise Against Hunger India’s field team plays a pivotal role by providing nutrient-rich food packets, including khichdi mix. They also facilitate local management of the entire process, from finding suitable locations to taking responsibility for cooking and ensuring safe storage of supplies. FLWs are key partners in this program, aiding in the identification of pregnant women at nutritional risk and effectively tracking and monitoring danger signs, as well as early identification of complicated pregnancies for targeted interventions.

Impact

The program envisions benefiting 800 pregnant and lactating women in the intervention areas. The immediate impact is evident, as extra nutrition, in the form of hot cooked meals, is consumed on the spot. A robust tracking system monitors weight gain and improvement in BMI, with a focus on reducing adverse pregnancy outcomes such as low birth weight and pre-term births, particularly among project beneficiaries. The program’s constant engagement with participants equips workers to identify critical cases and high-risk pregnancies, ultimately reducing maternal mortality and morbidity.

Beyond its tangible impact, this initiative holds the potential to break the intergenerational cycle of malnutrition. It fosters a cultural shift wherein maternal nutrition gains importance within families and communities, creating a lasting change that will continue to be observed in the coming generations. The formation of mothers’ groups within the community is instrumental in improving relationships with the community and front-line health workers, leading to better nutrition services and community participation in healthcare governance.

This project represents just one facet of Rise Against Hunger India’s holistic approach. While addressing immediate nutritional needs within the crucial 1000-day window, the organization is also actively working to improve food and livelihood systems in these communities. Additionally, education and counselling sessions for caregivers are being carried out, focusing on behavioural and practice changes. Collectively, these efforts aim to achieve nutrition security in these communities within the next 5 to 7 years

“Ensuring nutrition during the critical 1000-day period, especially during pregnancy, is one of the most effective ways to break the intergenerational cycle of malnutrition in communities. Rise Against Hunger India’s 1000 Days Nutrition Flagship Program exemplifies empowerment, community engagement, and a steadfast commitment to nurturing healthier generations. It embodies the organization’s unwavering dedication to building a world free from hunger and malnutrition.

Dola Mohapatra

Executive Director, Rise Against Hunger India

Bal Raksha Bharat has consistently aligned with Government of India’s endeavors to foster enduring improvements in child health and nutrition, aligning with the nation’s commitment to achieving the Sustainable Development Goals

Malnutrition in low and middle-income countries is not solely about the inaccessibility of resources or income or lack of access to food, it is also about many other significant factors like- cultural influence, contextual elements, gender dimension, and promotion of positive health behavior. 

One of the ways to enhance nutritional outcomes is through transforming the caregiving behaviors of mothers and families. This transformation is achieved through behavior change communication to enhance caregiver’s knowledge, attitude, and practices on various aspects of child nutrition, including early and exclusive breastfeeding, care during pregnancy, proper dietary diversity, timely and age-appropriate complementary feeding, immunization, hygiene, and other services crucial to combat malnutrition.

Declining rates of malnutrition in India can be attributed to the strategy of integrating nutrition with other programs and priorities and bringing the nutrition agenda to the public, which signifies a localized and community-focused approach to address malnutrition. It helped in increasing awareness and generates a sense of ownership among the community. In the recent past multiple initiatives have been taken up by the government of India to address malnutrition and raise awareness among common mass and families, like POSHAN Abhiyan, Jan Aandolan, Mission POSHAN 2.0, Saksham Aaganwadi, Poshan Bhi Padahi Bhi, Paalan 1000 campaign, PMMVY, Anemia Mukt Bharat, Poshan Panchayats, livelihood promotion through MGNREGS, Swachh Bharat Abhiyan etc.

As a significant step towards promoting local and traditional nutritious and healthy food, the United Nations at the behest of the Government of India, declared 2023 the Year of Millets and India has a vision to make this a People’s movement for Millets. India’s 2023 G20 presidency marks a significant milestone, particularly in the area of health and nutrition. It has secured remarkable commitments from all member nations, focusing on promoting local, affordable, and nutritious grains like Millet, supporting food security in developing countries, and ensuring access to safe, nutritious diets. This presidency also highlights nutrition-sensitive issues in agriculture, all in pursuit of the right to adequate food.

Malnutrition is also a multi-dimensional issue that requires a cross-sectoral approach that encourages convergence at all levels, including Panchayat and Households. The goal of achieving multi-sectoral convergence is to ensure that interventions from diverse sectors align effectively to benefit households. Gram Panchayat is the perfect platform for strategic community-level convergence. Poshan Panchayat, one of the initiatives of the Government of India, and other village gatherings provide a better platform for increasing demand side interventions for nutrition and improving public participation. Poshan Panchayat is a breakthrough in improving convergence at the grassroots level. Civil Society organizations have a significant role to play in facilitating convergence activities at the community level and in the success of Poshan Panchayats. These organizations can become the partners of choice for identifying the community’s nutritional needs, sharing ideas, and implementing projects in collaboration with the government. It will also help strategically identify tasks and implement them with agreed plans at the local level.

Given the intricate nature of human behavior, achieving behavioral changes in dietary and nutritional practices is not always easy. Therefore, despite all concerted efforts, the rate of malnutrition reduction reflected in the last two rounds of NFHS (4 & 5) is sub-optimal. However, civil society organizations and NGOs play a critical role in bringing positive behavior change among families and caregivers. Having a community presence and acceptance within communities, such organizations have a significant advantage in shaping and improving nutritional and healthcare practices.

Bal Raksha Bharat (Also known as Save the Children) working closely with communities and families in 15 states and 3 union territories of India, catalyzes immediate and lasting change for children and brings positive behavior change in caregivers.  Over the years, Bal Raksha Bharat has worked to support the Government of India’s credible efforts to bring about lasting change in health and nutrition for children and to achieve Sustainable Development Goals adopted and committed by the Government of India.

Bal Raksha Bharat’s ambition for children is that all children survive, learn, and are protected. For the survival and nutritional well-being of our children and mothers, the organization works with its partners at national, regional, community, and household levels through a life-cycle approach to prevent and treat malnutrition by bringing multi-sectoral nutrition interventions to families. Bal Raksha Bharat is committed to delivering holistic development and care for children and, thus, its nutrition strategy is highly adaptive and contributes significantly to the overall nutritional well-being. 

For malnutrition reduction in under five children, Bal Raksha Bharat tested and piloted innovative nutrition models, the use of technology which are replicable within the existing structure of Anganwadi and ICDS system. Such nutrition interventions are highly effective and cost-efficient.  Technical assistance to district and state departments/POSHAN Abhiyan and system strengthening is another approach to strengthen and support the nutritional service delivery and strengthening the existing mechanism to address malnutrition. As a part of its strategy, Bal Raksha Bharat’s programming is based on establishing linkages between existing nutrition and sanitation programs, and income support efforts at the community level, along with a robust behavior change communication strategy.

Bal Raksha Bharat has made a significant and direct impact on the lives of an impressive 3.2 million children through its essential health and nutrition interventions, while also connecting them with government schemes and programs.

Bal Raksha Bharat works in three modes – providing technical assistance to national and sub-national (state, district, block) governments, supporting quality improvements in service delivery in state and sub-state systems, and acting as a convener at the national and state levels to ensure that information, knowledge, learning, and resources are shared.

 Bal Raksha Bharat’s approach to nutrition programming and implementation is based on:

1. System Strengthening: Engage and support department and ICDS at national, state and district in strategic planning, implementation, capacity enhancement of FLWs, and handholding support to POSHAN Abhiyan and Jan Aandolan initiatives
2. Targeted Interventions & evidence building: Testing and piloting targeted and focused interventions, studies & research for malnutrition reduction with a focus on a local, affordable nutritious diet and counseling
3. Innovative cost-effective replicable models: Presenting technology-enabled, cost-effective innovative models to be incorporated into the existing system for improved and sustained nutritional outcomes in children & mothers
4. Community Participation & Mobilization: For effective behavior change within the community, it is imperative to have community ownership and awareness. We mobilize the community and spread nutrition literacy using local influencers and existing platforms like VHSND and other village-level platforms.Top of Form

empowHER India’s core focus lies in arming girls with the knowledge and skills required to make informed nutrition choices

By Anamara Baig

It is imperative to highlight the close relationship between adolescent empowerment and nutrition. empowHER India, a non-profit organization, has been working to bridge this gap by educating and empowering adolescent girls, recognizing that without proper nutrition, true empowerment is just not possible.

The proverb, “If you give a man a fish, you feed him for a day; if you teach a man to fish, you feed him for a lifetime,” aptly encapsulates empowHER India’s philosophy. While providing food and supplements certainly has a place as part of the solution, empowHER India focuses on equipping girls with the knowledge and skills they need to make informed decisions about their nutrition.

Malnutrition remains a persistent challenge in various parts of India, even as food availability and income levels are on the rise. With the knowledge that malnutrition isn’t solely a result of food scarcity; it also stems from a lack of awareness and education regarding proper nutrition. Adolescent girls, in particular, are vulnerable to this issue, exacerbated by their exposure to unhealthy junk foods and sugary beverages, leading to a decline in the consumption of essential nutrients like leafy greens and vegetables.

As part of our intervention adolescents are taught the following:

1.            Dietary Food Groups: Understanding the basics of nutrition is essential. EmpowHER India teaches girls about the various food groups, helping them make informed choices about what they eat. This knowledge lays the foundation for a healthier diet.

2.            Balanced Diet: Ensuring a balanced diet is a key aspect of good nutrition. Girls are educated about how to incorporate foods from different groups into their daily meals, providing them with the nutrients their bodies need to thrive.

3.            Nutrition for Adolescent Girls: Adolescent girls face unique nutritional challenges, such as iron deficiency. empowHER India equips them with the knowledge to recognize and combat these challenges. Iron-deficiency anemia is a common issue among young girls, and addressing it is crucial for their overall well-being.

By imparting knowledge in these areas, empowHER India empowers adolescent girls to take control of their health and nutrition. In doing so, they break the intergenerational cycle of malnutrition and set the stage for healthier, more empowered lives.

empowHER India under the SETU program has impacted over 5,000 adolescents. Nutrition is a key component of this program. Here is a link to a video where a mother discusses the changes she observes in her daughter’s food choices: https://youtu.be/S0jO0winKYE?si=mGSLtcimcf-Bdsq_

We consistently get this feedback from girls and mothers that after attending the SETU classes, there has been a marked improvement in their eating habits.

Anamara Baig is the CEO of empowHER India. Under Anamara’s leadership, empowHER India has implemented several programs aimed at promoting gender equality.

Solidaridad’s Good Farming – Good Food (GFGF) initiative in Madhya Pradesh is putting food and nutritional security at the heart of farming

Madhya Pradesh is known for its rich agricultural landscape dotted with lush green farms. However, malnutrition is a pressing concern, leading to alarmingly high infant and maternal mortality rates in the state. In addition, estimates suggest that over 50% of the rural population in the state, particularly women and children, is anaemic.

It is, therefore, quite ironic that a solution to these ills stares one right in the face if only one knows where to look for it. The state is the largest producer of soybean, one of the most affordable sources of protein. Yet, communities growing this crop are among the most impoverished, and traditional models of nutritional improvement have had limited impact so far. More institutionalised mechanisms with community ownership need to be encouraged and implemented.

Towards Improving Health and Nutrition Levels of Rural Households

Committed to sustainable development, Solidaridad is working to address nutrition and health issues in rural Madhya Pradesh with its Good Farming – Good Food (GFGF) initiative. Implemented in five districts covering around 420 villages, the programme aims to revolutionise farming practices, ensuring bountiful harvests and food and nutritional security.

The GFGF programme actively contributes to the United Nations’ sustainable development goals (SDGs) — in particular, SDG 2 (Zero Hunger), aimed at eradicating hunger, improving nutrition levels and promoting sustainable agriculture.

A trained nutrition team leads awareness initiatives to disseminate crucial information about balanced diets, the significance of key nutrients, and the impact of nutrition on overall health in project areas. For this purpose, the team has been running a platform that delivers knowledge on beneficial practices to the communities. Acting as a significant service-provider, the team also reaches out to and interacts closely with community members.

Integral Components of the Programme

Bestowing Health: Hema’s Journey to Wellness

Like many others in the village of Karadiya Pari in Dewas district, Hema had limited knowledge of the importance of proper nutrition during pregnancy. Malnutrition was widely prevalent — and Hema, in her role as an anganwadi worker, had witnessed its adverse effects on pregnant women and their infants.

The GFGF campaign in Hema’s village transformed things for the better by providing educational materials, conducting workshops and spreading awareness on the need for balanced diets, especially during pregnancy. Since early 2022, Hema has eagerly participated in these sessions, learning and making use of everything the programme has to offer. Now, she finds herself at the forefront of a health revolution.

In Hema’s village, the programme focused on one key aspect: the inclusion of soy-based food and homegrown vegetables in daily meals. Hema was drawn to this aspect as it seemed practical and accessible. To further help matters, the nutrition team distributed soy seeds and provided instructions on setting up home gardens. Guided by this knowledge, Hema decided to implement these changes in her own life.

She started adding soy products such as soy chunks and soy milk into her diet, to ensure an optimum protein intake. She also cultivated a small vegetable garden around her home, growing a mix of beans, tomatoes and leafy greens, relying on the gardening techniques she has learnt in the GFGF programme. The GFGF has also been providing nutritional counselling during the time of her pregnancy.

Her commitment to a nutritious lifestyle has not gone unnoticed; it has inspired other women in her village to do the same. More and more women have started participating in the GFGF initiative, leading to a positive ripple effect. Hema’s personal success story itself has become a useful tool in subsequent GFGF awareness campaigns. She has shared the story of her journey numerous times in community meetings, highlighting the health benefits of soy and homegrown vegetables. The dietary changes have been wholeheartedly embraced by the villagers, leading to a visible reduction in the number of cases of malnutrition, especially among pregnant women.

The Bigger Picture

The GFGF initiative aligns itself with several goals and missions at the national and state levels. The significant ones include:

• The soybean revolution 

In the quest for sustainable and nutritious food sources, the GFGF programme has embraced a transformative approach by promoting soybean-based foods. Soybeans are a nutritional powerhouse, packed with high-quality protein, essential amino acids, and a range of vitamins and minerals. Recognising the potential to address protein deficiencies, the programme encourages farmers to integrate soybeans into their agricultural practices. The promotion of soy-based food is a nutritional cornerstone, contributing to well-balanced diets, particularly in communities where access to diverse and nutrient-rich foods is limited. This proactive approach goes beyond immediate relief, and aims for sustained improvement in public health.

The success of the GFGF programme is also underscored by the decision to include soy chunks in mid-day meals. This strategic move by the government of Madhya Pradesh represents a synergy between agricultural practices and public health, yielding positive outcomes on multiple fronts.

• National forum for soy-food promotion

Solidaridad is working together with The Soybean Processors Association of India (SOPA) for the formation of a forum to promote soy food in India. The forum will bring together research institutes, businesses and farmers’ organisations, beyond the project consortium and support partners. It will serve as a central hub for the exchange of information on the progress of projects and lessons learnt on best practices. It will also facilitate collaborations and synergy with relevant government schemes. Ultimately, it will also ensure the continuation of projects beyond their prescribed periods.

To this end, an MoU was signed with the Indian Institute of Soybean Research (the premier institute for studies in soybean) to promote collaborative efforts on sustainable soybean production technologies, multiplication of improved food-grade soy varieties, training and capacity-building of farmers, and encouraging the consumption of soy-based food in the interest of farmers and farming communities, youths, entrepreneurs, processors and consumers.  

• Alignment with POSHAN Abhiyaan (formerly National Nutrition Mission)

The project’s interventions are well aligned with POSHAN Abhiyaan, the Government of India’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers. Under the programme, poshan maah (nutrition month) is observed in September every year. This time too, Solidaridad took part in the celebrations by collaborating with the local administration in their efforts. The month saw activities such as slogan writing, visits to the poshan vatika (nutrition garden) and sessions on explaining the importance of nutritious food to pregnant women and adolescent girls. Other vital interventions undertaken during the month include training of stakeholders (for example, mid-day meal cooks, Anganwadi workers and household members), establishing and monitoring the nutrition garden to ensure healthy intake of vegetables, awareness meetings on various health issues, with a special focus on parents of malnourished children (along with discussions on nutrition with rural households and stakeholders), and culinary activities, especially food prepared with ingredients available locally (plus a live demonstration of soy-food preparation).

Closing the Gap

Madhya Pradesh’s journey towards better nutrition is a remarkable story of knowledge gathering, community engagement, collaboration, and transforming the state’s future. In this quest, the knowledge of the potential of soy is unlocking new culinary horizons, while community mobilisation is building bridges of trust and awareness.

“Through sustainable agriculture techniques, we empower our farmers to grow nutritious, pesticide-free produce that not only enriches their livelihoods but also enhances the health of their families. The GFGF programme strives to create a ‘cycle of health’, where healthy farming practices lead to nourishing food, which, in turn, results in the holistic health and happiness of our farmers and their families. We are not only growing crops; we are growing a healthier future,” says Suresh Motwani, Programme Coordinator, GFGF. As the sun sets on a month of learning and sharing, the hope for healthier lives in Madhya Pradesh shines brighter than ever.