Objectives
Effective delivery of interventions for improving women’s nutrition, using cash grant to women collectives, remain to be tested in Indian settings. Swabhimaan multi-sectoral demonstration programme (2015-17) was designed to test the delivery of nutrition services to women (before conception, during pregnancy and lactation) via 641 federations of women groups, using cash grant, in Bihar, Chhattisgarh and Odisha.
Methods
The programme design was informed by nutrition situation analysis, scoping studies, and consultations with multi-sector partners and communities, leading to: (i) Ministry of Health policy decision to include missing maternal nutrition interventions in antenatal package (maternal calcium supplementation and deworming); (ii) National agreement to integrate nutrition-specific interventions into Livelihood and Agriculture programmes, such as cash grants; (iii) revising public system implementation strategies to integrate nutrition for levering government resources; and (iv) community validations.
Results
The State Livelihood Missions are anchoring and implementing the Swabhimaan programme, in coordination with Departments of Health, Civil Supplies, Social Welfare, Agriculture and Public Health Engineering, with UNICEF support. This involves: increased capacity of health, nutrition, water and sanitation public service providers to deliver women nutrition entitlements and services; cash grants for 641 women’s self-help group federations to implement village maternal nutrition plans; capacitating farmer producer groups on agro-ecological techniques; special camps for undernourished women; and a step-dose controlled, non-randomized, impact evaluation.
Conclusions
Evidence-informed, participatory and consultative dialogue involving key sectors and communities led to enhanced commitment to integrate interventions for improving women’s nutrition using a multi-sector approach. The built-in evaluation will inform future scaling up decisions.
