A Tri-partite MoU between A&T, IIPH-Delhi, PHFI, and All India Institute of Ayurveda to improve MIYCAN Outcomes

To strengthen Maternal, Infant, Young Child, and Adolescent Nutrition (MIYCAN), A&T along with the Indian Institute of Public Health Delhi (IIPH-D), Public Health Foundation of India (PHFI) signs a Memorandum of Understanding with All India Institute of Ayurveda, Ministry of Ayush (MoA) during its 6^th Foundation Day on 20 October 2023, in the presence of the Shri Sarbananda Sonowal, Hon. Union Minister, MoA, Dr. Sanjay Zodpey, President, PHFI and other eminent dignitaries. The collaboration aims to improve the knowledge and practice around MIYCAN for Ayush Practitioners and nursing professionals in India.

The Indian Institute of Public Health Delhi (IIPH Delhi), the Public Health Foundation of India, in collaboration with Alive & Thrive and WeCan with contributions from Food, Drugs, and MedicoSurgical Equipment Committee of FOGSI, Indian Academy of Pediatrics (IAP-IYCF Chapter), Indian Society of Perinatology and Reproductive Biology (ISOPARB), Human Milk Banking Association, Indian association of Preventive and Social Medicine (IAPSM) and Nutrition International developed an eLearning course on Maternal, Infant, Young Child and Adolescent Nutrition (MIYCAN). This course would sensitize participants on the importance of the first 1000 days of life with specific emphasis on the critical importance of maternal nutrition, breastfeeding, complementary feeding, adolescent nutrition, health systems protocols, and evidence-based approaches for quality MIYCAN programming.

The partnership between AIIA, A&T, and PHFI/IIPH-D has evolved through a range of discussions, and A&T and IIPH-D have agreed to provide technical support to AIIA by extending access to technical information on MIYCAN to AYUSH Practitioners through the IIPH-D hosted eLearning course, whilst raising awareness on recommended Ayush diet for mothers, children, and adolescents.

A&T presented an overview of its Systems Strengthening Efforts at the State Level during the PHN Workshop by CCDC, Delhi

A&T has been invited to the four-day workshop on Public Health Nutrition (PHN) hosted by the Centre for Chronic Disease Control (CCDC) and supported by IFPRI in New Delhi between 9-11 October 2023. A&T was excited to present an overview of technical assistance to states including ideation, evidence generation, co-creation, and collaborative and partnership-based approaches to design, and support evidence-based policy and programming using both systems strengthening and SBCC methodologies at state (UP & Bihar) and national level. The course was joined by 25 motivated professionals from diverse backgrounds and geographies. A&T had a didactic and interactive session and shared cutting-edge knowledge and evidence on nutrition. After celebrating our 10 successful years of starting an annual series in capacity building for public health and nutrition (PHN), this was the 11^th year edition of the course with a theme on “Understanding Nutrition Policy and Action”. A&T was invited for its knowledge and expertise on maternal nutrition, system strengthening approach, and SBCC for improving nutrition outcomes.

Change Management Workshop for System Strengthening held in Gujarat for ICDS Officials 

Senior officials from Integrated Child Development Services (ICDS) attended a workshop on Change Management for System Strengthening organized by Alive & Thrive, FHI 360 in collaboration with the Directorate of Women and Child Development (DWCD), Gujarat in October 2023. Change management is a strategy that supports individuals, teams, and departments in managing changes from one point to the next with tools, techniques, and mediated interventions for achieving desired goals.

The workshop was conducted as a part of the ongoing implementation research in Gujarat, where Alive & Thrive collaborated with DWCD Gujarat to test a bundle of interventions strengthening supportive supervision and strategic use of data in three districts. The workshop was meant to equip senior state-level and district-level officials with relevant tools and techniques of change management to shore up adaptability mechanisms and mitigate barriers to change while introducing digital transformations, changing work processes, or affecting innovations to government welfare programs and schemes.

Shri K K Nirala, Secretary, DWCD gave a keynote address on the occasion, while Dy Secretary, Dr Jasmine Hasrat shared her views. “Change always starts from the individual and leaders can bring about change by presenting their teams with clear vision, direction, and support. Logic and data play a crucial role in making people realize why change is important and how they should go on about it," said Shri Nirala. He emphasized the need to change mindsets and bring about convergence among various departments to ensure sustainable change and better outcomes for nutrition services.

Sessions of the workshop focused on experiential learning anchored in principles of change management for changing behaviors, attitudes, and work processes to increase chances of success.

Beginning with an ice-breaking session, the instructor-led workshop delved into areas such as setting clear vision, direction, teamwork, joint problem solving, open communication and continued information flow, identification and resolution of issues, stakeholder engagement, and regular evaluations. The theme of 'Leading the change and working together towards a shared vision and goals' was incorporated throughout the workshop. 

Scaling Up of Community-Level Quality Improvement Initiative for MIYCN Services in Bihar

The community-level pilot initiative serves as an extension of A&T's ongoing collaboration with government medical colleges, allied hospitals, and secondary-level healthcare facilities in Bihar. This initiative aims to enhance and elevate the quality of facility-based Maternal, Infant, and Young Child Nutrition (MIYCN) service delivery, utilizing the Point of Care Quality Improvement (POCQI) approach. The success observed in these healthcare facilities prompted A&T to explore the application of quality improvement (QI) methods at the community level.

Following interventions at the community level in Wazir Ganj and Bodhgaya blocks, focusing on child malnutrition and maternal anemia respectively, the positive response from the panchayats in both blocks led to the decision to expand the initiative across all Panchayats, covering all Anganwadi Centers (AWCs) in both blocks. Comprehensive training sessions on Quality Improvement were conducted for Anganwadi Workers (AWWs), Auxiliary Nurse Midwives (ANMs), and Accredited Social Health Activists (ASHAs) from both blocks. The training encompassed issues specific to the blocks, technical input, and reporting procedures. It was decided that monthly block-level meetings would be conducted to review progress, involving leaders from each Panchayat.

On June 28th, 2023, a district-level workshop was organized to disseminate the learnings from the Wazir Ganj and Bodhgaya blocks and plan the expansion of these efforts to other blocks. A presentation was delivered on the quality improvement approach and the initiatives undertaken in collaboration with medical colleges, district health facilities, and at the community level in Bihar. The team leaders from both Panchayats presented the outcomes and processes adopted. Subsequently, the Child Development Project Officer (CDPO) and Medical Officer-In-Charge (MOIC) of the concerned blocks shared their experiences and urged everyone to adhere to the outlined steps for goal achievement. District-level officials affirmed their commitment to scaling up the approach.

The scaling-up process of quality improvement is being executed in collaboration with the Piramal Foundation, ensuring sustained support to uphold the quality standards. This approach has been communicated at the state level, involving engagements with the Department of Integrated Child Development Services (ICDS) and the Health Department, to share insights and experiences for broader dissemination and implementation.