Impact of Community-Based Mitanin Programme on Undernutrition in Rural Chhattisgarh State, India

Vir, Sheila C.; Kalita, Anuska; Mondal, Shinjini; Malik, Richa

doi:10.1177/156482651403500110

Cited by 24 publications

(21 citation statements)

References 7 publications

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“…In India, community‐level education counselling through women's groups combined with community mobilization that addressed several health and nutrition issues showed no effect on breastfeeding practices (neither EIBF nor EBF at 4 weeks; More et al, ; Vir et al, ). A programme that used community volunteers to conduct family‐level counselling and community mobilization also reported no impact on EBF at 4–5 months (More et al, , Vir et al, ). There was no effect on EBF of training community volunteers and traditional birth attendants to deliver education and counselling services to women at home in Bangladesh; however, the number of visits following delivery was irregular (Talukder et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Several studies reported multiple breastfeeding practices. In some cases, effectiveness was reported for one breastfeeding practice, but no significant effect was reported for other breastfeeding practices (Carvalho et al, ; More et al, ; Sikander et al, ; Talukder et al, ; Vir et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Education and counselling in the home/family environment was effective in improving EIBF outcomes in Bangladesh (Haider et al, ; Talukder et al, ) and India (Vir, ), and in combination with community mobilization in India (Vir et al, ) and Pakistan (Bhutta et al, ). However, a cognitive‐behavioural counselling intervention offered to pregnant women during home visits in Pakistan was not effective in improving EIBF (Sikander et al, ); although women received a total of seven visits, only one session was delivered before birth and one session was delivered immediately after delivery (Sikander et al, ).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of programmes and interventions to support optimal breastfeeding among children 0–23 months, South Asia: A scoping review

Benedict

Craig

Torlesse³

et al. 2018

Maternal & Child Nutrition

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Most children in South Asia are breastfed at some point in their lives; however, many are not breastfed optimally, including the early initiation of breastfeeding (EIBF) within 1 hr of birth, avoidance of prelacteal feeds (APF), exclusive breastfeeding (EBF) for 6 months, and continued breastfeeding (CBF) up to 2 years of age or beyond. This review identifies and collates evidence on the effectiveness of interventions to support optimal breastfeeding in five countries in South Asia: Afghanistan, Bangladesh, India, Nepal, and Pakistan. A scoping review was conducted of peer‐reviewed and grey literature. The 31 eligible studies included randomized trials and quasi‐experimental designs that were conducted between 1990 and 2015. Data were collated regarding intervention design, characteristics, and effectiveness to support EIBF, APF, EBF, and CBF. Most studies reported a positive impact on breastfeeding outcomes, including 21/25 studies that examined EIBF, 15/19 studies that examined EBF, and 10/10 studies that examined APF. The only study that examined CBF reported no effect. Education, counselling, and maternal, newborn, and child health initiatives were common intervention types with positive effects on breastfeeding outcomes. Interventions were delivered in health facility, community, and home/family environments. Programmes and interventions that reached women and their families with repeated exposure and beginning during pregnancy were more likely to improve EIBF and EBF outcomes. Interventions with no impact on breastfeeding were characterized by short duration, irregular frequency, inappropriate timing, poor coverage, and targeting.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effectiveness of programmes and interventions to support optimal breastfeeding among children 0–23 months, South Asia: A scoping review

Benedict

Craig

Torlesse³

et al. 2018

Maternal & Child Nutrition

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“…Chhattisgarh state has implemented a Community Health worker (CHW) programme since year 2001 [5]. It has 69,991 women CHWs known as 'Mitanin', covering a rural population of around 19 million and urban slum population of 2 million [6].…”

Section: Introductionmentioning

confidence: 99%

Coverage of Community Case Management for Malaria through CHWs: A Quantitative Assessment using Primary Household Surveys of High-burden Areas in Chhattisgarh state of India

Garg

Gurung

Dewangan

et al. 2020

Preprint

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Background Community case management of malaria (CCMM) has been implemented through community health workers (CHWs) in many countries. Existing studies have shown that CHWs can be viable means of implementing CCMM. However, not many studies have examined the coverage under large-scale CCMM programmes. India is a big contributor to global malaria burden. Chhattisgarh is a leading state in India in terms of malaria incidence and mortality. CCMM was implemented on a large scale through the ‘mitanin’ CHWs in rural Chhattisgarh from 2015. Under CCMM, 37696 CHWs in 84 high-burden administrative blocks of the state were trained and equipped with rapid diagnostic tests (RDT), artemisinin-based combination therapy (ACT) and chloroquine. Methods This descriptive quantitative study assesses coverage of CCMM in detection and treatment of Malaria over three rounds of household surveys - 2015, 2016 and 2018. Household-interviews covered more than 15,000 individuals in each round, using multi-stage random sampling across the 84 blocks. The main objectives were to find out the coverage in identification and treatment of malaria and the share of CHWs in them. A 15-days recall was used to find out cases of fever and healthcare sought by them. Results In 2018, 62% of febrile cases in rural population contacted CHWs. RDT, ACT and chloroquine were available with 96%, 80% and 95% of CHWs, respectively. From 2015 to 2018, the share of CHWs in testing of febrile cases increased from 34% to 70%, while it increased from 28% to 69% in treatment of malaria cases. CHWs performed better than other providers in treatment-completion and administered medication under direct observation to 72% of cases they treated. Conclusion This study adds to one of the most crucial but relatively less reported area of CCMM programmes, i.e. the extent of coverage of the total febrile population by CHWs, which subsequently determines the actual coverage of case-management in malaria. Mitanin-CHWs achieved high coverage and treatment-completion rates that were rarely reported in context of large-scale CCMM elsewhere. Close to community, well-trained CHWs with sufficient supplies of rapid tests and anti-malarial drugs can play a key role in achieving the desired coverage in malaria-management.

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“…Although it is not possible to attribute these gains narrowly to the Mitanin Programme, it has been the most significant health intervention in the state, targeting specifically maternal and child health (MCH). A recent quasi-experimental evaluation of a nutrition intervention in Chhattisgarh suggested that the Mitanin Programme was responsible for 4.22% and 5.64% annual average reductions in underweight and stunting, respectively, which were higher than the national averages ( Vir et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India

Nandi

Schneider

2014

Health Policy and Planning

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The Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme-specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organizational factors. A qualitative comparative case study of successful action by Mitanin was conducted in two ‘blocks’, purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women’s collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the explanatory framework may provide general lessons for programmes in similar contexts.

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Impact of Community-Based Mitanin Programme on Undernutrition in Rural Chhattisgarh State, India

Cited by 24 publications

References 7 publications

Effectiveness of programmes and interventions to support optimal breastfeeding among children 0–23 months, South Asia: A scoping review

Effectiveness of programmes and interventions to support optimal breastfeeding among children 0–23 months, South Asia: A scoping review

Coverage of Community Case Management for Malaria through CHWs: A Quantitative Assessment using Primary Household Surveys of High-burden Areas in Chhattisgarh state of India

Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India

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