Matching Intent With Intensity: Implementation Research on the Intensity of Health and Nutrition Programs With Women's Self-Help Groups in India

Hazra, Avishek; Das, Aikantika; Ahmad, Jaleel; Singh, Shivani; Chaudhuri, Indrajit; Purty, Apollonius; Prost, Audrey; Desai, Sapna

doi:10.9745/ghsp-d-21-00383

Cited by 4 publications

(1 citation statement)

References 39 publications

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“…However, the frequency of participation was low. These findings are in line with a few recent studies that reported participation of women in such group meetings was a challenge [ 37 , 38 ]. Moreover, it is reported that the participation is context specific and a host of factors such as time, accessibility and socio-economic factors determine participation [ 37 , 38 ].…”

Section: Discussionsupporting

confidence: 92%

Evaluation of impact of engaging federations of women groups to improve women’s nutrition interventions- before, during and after pregnancy in social and economically backward geographies: Evidence from three eastern Indian States

Kumar,

Sethi,

Wagt

et al. 2023

PLoS ONE

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Background Undernutrition–before, during and after pregnancy endangers the health and well-being of the mother and contributes to sub-optimal fetal development and growth. A non-randomized controlled evaluation was undertaken to assess the impact of engaging federations of women’s group on coverage of nutrition interventions and on nutrition status of women in the designated poverty pockets of three Indian states—Bihar, Chhattisgarh, and Odisha. Method The impact evaluation is based on two rounds of cross-sectional data from 5 resource poor blocks across 3 States, assigning 162 villages to the intervention arm and 151 villages to the control arm. The cross-sectional baseline (2016–17) and endline survey (2021–22) covered a total of 10491 adolescent girls (10–19 years), 4271 pregnant women (15–49 years) and 13521 mothers of children under age two years (15–49 years). Exposure was defined based on participation in the participatory learning and action meetings, and fixed monthly health camps (Adolescent Health Days (AHDs) and Village Health Sanitation and Nutrition Days (VHSNDs)). Logistic regression models were applied to establish the association between exposure to programme activities and improvement in coverage of nutrition interventions and outcomes. Results In the intervention area at endline, 27–38% of women participated in the participatory learning and action meetings organized by women’s groups. Pregnant women participating in programme activities were two times more likely to receive an antenatal care visit in the first trimester of pregnancy (Odds ratio: 2.55 95% CI-1.68–3.88), while mothers of children under 2 were 60% more likely to receive 4 ANC visits (Odds ratio: 1.61, 95% CI- 1.30–2.02). Odds of consuming a diversified diet was higher among both pregnant women (Odds ratio: 2.05, 95% CI- 1.41–2.99) and mother of children under 2 years of age (Odds ratio: 1.38, 95% CI- 1.08–1.77) among those participating in programme activities in the intervention arm. Access to commodities for WASH including safe sanitation services (Odds ratio: 1.80, 95% CI- 1.38–2.36) and sanitary pads (Odds ratio: 1.64, 95% CI- 1.20–2.22) was higher among adolescent girls participating in programme activities. Conclusion Women’s groups led participatory learning and action approaches coupled with strengthening of the supply side delivery mechanisms resulted in higher coverage of health and nutrition services. However, we found that frequency of participation was low and there was limited impact on the nutritional outcomes. Therefore, higher frequency of participation in programme activities is recommended to modify behaviour and achieve quick gains in nutritional outcomes.

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Section: Discussionsupporting

confidence: 92%

Evaluation of impact of engaging federations of women groups to improve women’s nutrition interventions- before, during and after pregnancy in social and economically backward geographies: Evidence from three eastern Indian States

Kumar,

Sethi,

Wagt

et al. 2023

PLoS ONE

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Changing maternal and child nutrition practices through integrating social and behavior change interventions in community-based self-help and support groups: literature review from Bangladesh, India, and Vietnam

Verma,

Nguyen,

Purty

et al. 2024

Front. Nutr.

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IntroductionSelf-help groups (SHGs) and Support Groups (SGs) are increasingly recognized as effective mechanisms for improving maternal and young child nutrition due to their decentralized, community-based structures. While numerous studies have evaluated the outcomes and impact of SHGs and SGs on nutrition practices, there remains a gap in the literature. To address this, we conducted a literature review to examine the role of SHGs and SGs in improving health and nutrition outcomes, focusing on marginalized women, especially pregnant and lactating women (PLW), in India, Bangladesh, and Vietnam, with an emphasis on programs supported by the international non-governmental initiative, Alive & Thrive.Methods and materialsWe conducted a literature review to assess various models, summarizing findings from 34 documents, including research studies, evaluation reports, program materials, strategies, annual reports, work plans, and toolkits. Relevant information from these documents was extracted using predetermined forms.ResultsIn India, the models used SHGs with 10–20 women, federated into larger village and district organizations. Bangladesh and Vietnam SGs have similar structures but with local leaders and committees playing key roles. In all three countries, interventions aimed to improve health and nutrition practices through social behavior change (SBC) interventions, including peer-to-peer learning, interpersonal communication, home visits, and community meetings. Outcomes of the interventions showed that SHG members had increased knowledge of breastfeeding, complementary feeding, and improved dietary diversity compared to non-SHG participants. Interventions helped improve infant and young child feeding practices. Common challenges included sustaining the SHGs, ensuring adequate participation, socio-cultural barriers, and logistical difficulties in reaching PLW in remote areas. Limited time for health topics during SHG meetings and the dissolution of older SHGs were also significant issues.ConclusionSHG and SG models demonstrate success in improving health and nutrition outcomes but face challenges in scale, sustainability, and participation. Integrating nutrition-focused SBC interventions into SHGs and SGs requires significant capacity building for technical and counseling skills. Ensuring comprehensive coverage and robust quality assessment during community-based rollouts is essential. To sustain these interventions, it is crucial to prevent group dissolution, allow time for maturation, and secure strong stakeholder engagement and political support.

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Are We Underestimating the Success of Self Help Groups in India? A Systematic Review

Sultania

2024

OJBM

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This paper offers a comprehensive analysis of Self-Help Groups (SHGs) in India, focusing on their non-financial and indirect impacts that eventually lead to significant financial gains over the long term. Through an in-depth review of the literature on SHGs in India over the past 25 years, the paper explores the influence of SHGs on social capital, political capital, girl child education, healthcare and sanitation, and domestic violence. These factors contribute not only to women's empowerment but also to community and socio-economic development. As such, even groups with limited financial returns, underestimated in capacity, and often labelled as unsuccessful, can be assessed for their potential to drive substantial long-term changes in their communities. Most studies have measured only the short-term impacts of these groups; however, these factors are often impacted over the longer term and thus it becomes important to examine the success of SHGs over a longer time frame. This paper contributes to a more panoramic understanding of SHGs, measured over the long term, and highlights the need for metrics that capture their multifaceted impact on women's holistic empowerment beyond financial outcomes.

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Matching Intent With Intensity: Implementation Research on the Intensity of Health and Nutrition Programs With Women's Self-Help Groups in India

Cited by 4 publications

References 39 publications

Evaluation of impact of engaging federations of women groups to improve women’s nutrition interventions- before, during and after pregnancy in social and economically backward geographies: Evidence from three eastern Indian States

Evaluation of impact of engaging federations of women groups to improve women’s nutrition interventions- before, during and after pregnancy in social and economically backward geographies: Evidence from three eastern Indian States

Changing maternal and child nutrition practices through integrating social and behavior change interventions in community-based self-help and support groups: literature review from Bangladesh, India, and Vietnam

Are We Underestimating the Success of Self Help Groups in India? A Systematic Review

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