POSHAN Abhiyaan performance of Nagaland during pandemic times

Launched by Prime Minister Modi on International Women’s Day on 8 March 2018, POSHAN Abhiyaan is the Government of India’s flagship program to improve nutritional outcomes for children, pregnant women and lactating mothers, and adolescents.

The latest fourth progress report on POSHAN Abhiyaan released by NITI Aayog objective was to examine the progress to date on rolling out all POSHAN Abhiyaan interventions using relevant data; to discuss the importance of preserving progress on the nutrition agenda in the context of the COVID-19 pandemic; and to recommend key actions to accelerate progress towards India’s nutrition goals.

Governance and Institutional Mechanism, Strategy and Planning, Inputs for Service Delivery & Capacities and Program Activities, and Intervention Coverage were the four themes under which data were obtained either in the form of questionnaires or data provided by the Women and Child Development (WCD).

What progress Nagaland have made so far

The theme ‘Governance and Institutional Mechanism’captures two critical components pertaining to governance and institutional mechanisms as envisaged under POSHAN Abhiyaan: Fund utilization by States/UTs and   constitution of committees and resource groups to develop and follow Convergence Action Plan (CAP).

According to the report titled ‘Preserving Progress On Nutrition In India: POSHAN Abhiyaan In Pandemic Times’, under small states, Nagaland scored a maximum score of 12 points while Mizoram and Sikkim scored 11, and Arunachal Pradesh and Tripura scored 9. Complete data for Goa and Manipur were not available. By the end of FY 2019-20, Nagaland was also reported to be utilizing the maximum funds (87%).

Under Human Resource, it was reported that Nagaland had filled 100% positions of Joint Project Coordinator and Project Associate while less than 25% positions were filled for consultants. Nagaland was among the top performing states in the Human Resource indicator.

In March 2020, Nagaland reportedly distributed 100% of mobile phones, 100% of growth monitoring devices and also recorded a 100% trained Child Development Project Officer (CDPOs) and 100% Lady Supervisor (LS) trained on Dashboard/Mobile.

Nagaland also recorded 100% functional Health and Wellness Centers (HWCs) but only 76% of sub-centers and 64% of Community Health Centre (CHCs) were functional thereby calling for more attention towards infrastructure. Nagaland also had occupied more than 75% Auxiliary Nurse Midwife (ANM) positions; however it recorded less than 25% of pregnant women that attended 4 or more Antenatal Care (ANC) visits.

How Nagaland delivered POSHAN Abhiyaan during the pandemic

To curtail the spread of the pandemic, AnganwadiCentres (AWCs) were closed, and services were disrupted during the pandemic.

Operation of Integrated Child Development Scheme (ICDS) platforms including Anganwadi Centres, Poshan Abhiyaan Monitoring 57 Village Health Sanitation Nutrition Day (VHSNDs), home visits, counseling and food supplementation for children and pregnant and lactating womenwere examined for assessing the impact of COVID-19 on implementation of these key women and child services.

Regarding the ‘Disruption and Restoration of Services’ according to Health Monitoring Information System (HMIS) Data October 2019- December 2020, Ministry of Health & Family Welfare, following were recorded in Nagaland state:

Service Disruption: Percentage of beneficiaries receiving service during lockdown i.e., between April-June 2020 (T1) compared with the pre-pandemic period i.e. between Oct –Dec 2019 (T0)

Early Restoration: Percentage of beneficiaries receiving service between July-September 2020 (T2) compared with the pre-pandemic period i.e., October-December 2019 (T0)

Restoration: Percentage of beneficiaries receiving service between October-December 2020 (T3) compared with the pre-pandemic period i.e., Oct -Dec 2019 (T0)

In the ‘state innovation in delivering health services’, Nagaland recorded ‘Home distribution’ alone for distributing IFA (Syrup, pink, red, blue).

Nagaland was among the bottom performing states in the percentage of children (0-5 years) registered under AWC weighed at AWC with only  44%

In the percentage of children (12-23 mo) fully immunized, Nagaland recorded only 1% making it the bottom performing state.

Nagaland also performed poorly in the percentage of pregnant women who registered for ANC in the first trimester with only 31%

The percentage of pregnant women given TT2/Boosters was 40% while the percentage of 5-9 years children who were given weekly IFA tablets recorded 0%.

There were 275 children that were malnourished in Nagaland.

The report in conclusion recommended the following:

· Accelerating the use of funds released for POSHAN Abhiyaan, ensuring adequate number of health facilities and supplies, ensuring that technology integration continues, and ensuring that capacity building of workers is focused both on coverage and quality.

· Maximizing convergence-related efforts in the coming years, targeting and focusing all efforts to achieve household convergence of key programs, especially those addressing the determinants that have been slow to move or negatively affected in 2020.

· Creating an enabling environment for seamless data sharing between ICDS-CAS/ POSHAN Tracker and Reproductive and Child Health (RCH) services to facilitate convergence between WCD and health services. Additionally, conducting joint convergent training/activities with field-level staff on how to constantly share data and information.

· Utilizing POSHAN Tracker which must be integrated with the Reproductive and Child Health (RCH) portal to identify prevalence of malnutrition.

Mokokchung Times