Bill & Melinda Gates Foundation

Waves of transformation: How adolescent girls and young women in Bihar are orchestrating better nutritional behaviours

October 16, 2019

‘No one can whistle a symphony. It takes a whole orchestra to play it.’

H.E. Luccock’s quote best describes the scene I recently had the privilege of witnessing in rural Bihar, where the celebrations of National Nutrition Month were underway. Being implemented in the month of September every year under the umbrella of the National Nutrition Mission (NNM), it seeks to encourage communities to improve their diets and be more aware of the ramifications of poor nutrition. The issue of undernutrition in the country is fraught with several underlying causes including inter alia lack of awareness, paucity of access, anaemia and diarrhoea. The Nutrition Month was orchestrated with the objective of mobilizing communities, to create a people’s movement that can help achieve a malnutrition-free India at a faster pace with more sustainable transformations on ground.

What we saw in the community was nothing short of a revolution, a wave of change, driven by the aspiration to make the future generations stronger and more empowered. Across villages, people now equipped with knowledge are joining hands, hoping to fight malnutrition through conscious behaviour change and promoting preventive measures for better nutritional outcomes for their children.

After driving past the vast green expanses in the outskirts of Patna, we turned into a rather narrow road, meandering through which, led us to arrive at a local school. In it was a classroom full of women – young and old, dressed in colourful sarees, seated with the discipline exhibited by school students. In the front, was laid out a platter of food and several kinds of grains, pulses and vegetables. These were not for us, but the children in the village aged 6 to 23 months. The women were members of a local self-help group (SHG) and had gathered together for a community activity for the Nutrition Month.

In contrast to the coy and bashful persona oft synonymous with the rural woman, what we saw were women brimming with confidence and eager to transfer their knowledge gained from interventions of government departments and organizations. Sensitized on the need for introducing complementary feeding practices (to be introduced in the diet of infants soon as they cross 6 months) for ensuring holistic physical and cognitive development, these women are working tenaciously to inform every woman in the village on the criticality of the child’s first 1000 days. As each woman took turns to speak about what she had learned, it presented before me a picture of a rising tide where each mother was making a commitment to safeguarding the health of her child by making the promise of feeding them nutritional foods. One of SHG women admitted that she never gave her child the critical nutrition till he turned two because she was unaware that the child could be fed these food items. Today, she ensures her little nephew receives all the key nutrients every day from all the critical food groups. When asked if she noticed any difference through complementary feeding, she quipped, “My child is very dull, shorter in height and not active for his age. My nephew on the other hand is taller and extremely active. He creates a mess everywhere, but that is the essence of a child. Since my son was deprived, I want to make sure that I bring about some difference, so no other child is left wanting for the essential nutrition.” Every woman in the room demonstrated similar passion and enthusiasm, and had knowledge of the benefits of every item displayed from all the food groups in front of them.                                                                             

The next stop was the local Panchayat office, where a group of adolescent girls had assembled, unable to hide their keenness and excitement about meeting with us, requesting to take a picture. They were quizzed on weekly Iron and Folic Acid (IFA) supplementation, anaemia, and every question was received with prompt answers. Through the interaction, they gradually unravelled the true strength of the grassroots, busting the myths that they somehow need external interventions to empower them. They are empowered enough, perhaps far more than we think we are. What they need is knowledge, information, and they are awaiting these with incredible curiosity and a mind wide open. When asked what they thought were the barriers to adolescent girls, and pregnant and lactating women getting sufficient nutrition, one of the girls was quick and uninhibited in responding, “There is a gross lack of awareness. More importantly, the man in the house is always kept on a pedestal. He ends up being the first to eat, and receives most of the nutritious food.” The recognition of patriarchy entrenched in their lives was existent, perhaps without the vocabulary used commonly by us. As the girls ran to the bicycles stationed outside with posters and messages on nutrition – for the bicycle rally – it was a vision of an empowered future that was raring to go, all it lacked was the information that is now being consistently meted out to them through the efforts on ground. By the end of this session, we were the ones clicking away on our cameras as the young girls rode away through the narrow roads even as little children ran after them with joy. It was the reassurance that this generation of young women was turning into the inspiration and role models the forthcoming generations will need and look up to.

The short visit to communities in Bihar was a lesson learnt on one key thing: nothing is impossible if people come together to act towards a certain cause. Bihar is witnessing both political will and the people’s commitment on nutrition. The foundation has been laid for achieving better maternal and child nutrition outcomes through the several interventions, and the ripples of transformation are manifesting themselves in every individual’s voice we met. Here’s hoping every voice reverberates through the future and we can truly motor towards a malnutrition-free India!

 
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