Impact on the Ground: Rajasthan, India

Women in rural India register dramatic gains in nutrition, food security, health

The problem: malnutrition, anemia and poor health
In India, half of children under three are either stunted or underweight due to malnutrition, and 79 percent are anemic, and anemia is the leading cause of maternal deaths. In young children, severe malnutrition can permanently impair physical and cognitive growth.

The solution: Self-help groups and Community Nutrition Advocates
Improving the nutrition and health of poor rural women requires reaching across sectors -- health, finance and agriculture -- to address the complex drivers of hunger and poverty. Women’s self-help groups provide an ideal platform to do so, in ways that strengthen women’s knowledge, self-agency and autonomy.

To achieve impact on the ground Grameen Foundation and Freedom from Hunger India Trust brought together local partners to train a new type of local leader: Community Nutrition Advocates (CNAs), drawn from the members of women’s self-help groups.  In partnership with CHETNA, we developed a pictorial-based curriculum for the mostly illiterate local women. Then, we worked with PRADAN and Vaagdhara to trained 1,250 CNAs. They became experts in nutrition, health practices, local health resources, and household financial management.

The CNAs trained 8,131 women’s group members, who in turn reached 30,000 family members. The vast majority were from vulnerable tribal communities. The CNAs linked women to government agencies and health providers.  And, they brought husbands and wives together for “gender dialogues” that explored how better household decision making could improve food security and nutrition.

“I use to not leave the house. My husband wouldn’t let me leave. Now, I go to my Self-Help Group meetings…  I’m doing good for the family.”

—Kankuri, participant in Rajasthan Nutrition Program, Uplaghar village

In just two years, the Rajasthan Nutrition Project succeeded in:

  • Increasing joint decision-making by husbands and wives: Sole decision-making by husbands on whether their wives could visit family and friends declined from 64 to 25 percent; joint decision-making increased from 32 to 52 percent; joint decision-making on food purchases increased from 27 to 55 percent.
  • Sole decision-making by husbands on food purchases declined from 69 to 28 percent, and joint decisions increased from 27 to 55 percent.
  • Increasing food security for female heads of households (from 21 to 53 percent) and for children (from 23 to 53 percent).
  • Increasing dietary diversity by an average of three additional foods a day, especially milk, vegetables, and roots and tubers--now grown in home gardens.
  • Increasing the percentage of new mothers who breastfed their infants within the first hour of birth from 47 to 83 percent.
  • Encouraging more health savings: more than half of women (52 percent) reported setting aside more savings in the past six months, and those saving for health increased from 65 to 80 percent.
  • Prompting greater utilization of health services: the number of women accessing the government’s Integrated Child Development Services rose by 30 percentage points.
  • Improving treatment of childhood diarrhea: The percentage of mothers who gave their children more to drink when they were sick increased from 7 to 42 percent; the percentage who used Oral Rehydration Solution increased from 34 to 84 percent.