Sreeparna Ghosh Mukherjee Dr. Ipsita Bhattacharya CINI

1. DELIVERING FOR NUTRITION IN SOUTH ASIA
Implementation Research in the Context of COVID-19
1st December 2021
Sreeparna Ghosh Mukherjee
Dr. Ipsita Bhattacharya
Efforts in Ensuring pregnancy weight gain in
times of COVID
The consequences of pandemic
on pregnancy outcomes

2. Strengthening Maternal Nutrition
Interventions in ANC
• Depleting nutrition situations both among
women and children got evident from the results
of NFHS 5
• Need for focusing on maternal nutrition in order
to address the intergenerational cycle of
malnutrition
• With the hitting of the pandemic, issues of food
security and hunger has bounced back manifold
Objective & Rationale

3. • The programme is implemented in three backward
blocks of West Bengal with the objective of improved
health and nutrition status among women and
children
• While all pregnant women in these three blocks
received the standard package of RMNCHA services,
a pilot intervention was done with 312 women who
received additional inputs which included:
 Assessing BMI during pregnancy registration
 Following up on BMI-wise pregnancy weight gain
 Monthly weight monitoring at VHNDs
 Additional and joint home visits for high risk & nutrition risk pregnancies
 Nutrition counselling and counselling on COVID protocols
The Intervention
Jalpaiguri
Murshidabad
South 24
Parganas

4.  Assessing BMI during pregnancy registration
The process
 Monthly weight monitoring at VHNDs

5.  Differential nutrition counselling as per BMI
(Telephonic and on-site)
The process
 Additional home visits for high risk &
nutrition risk pregnancies

6. • Online training of AAA
Adopting to COVID situations
• Use of digitized IEC Materials

7. COVID Sahayata Kendra (CSK) or COVID help
Desks for awareness
- COVID IEC materials
Other COVID initiatives

8. Review and Monitoring:
High risk
pregnancy tracker
Joint visit with
Health Officials
Joint review in
convergence meetings

9. Results: Intervention vs Non-intervention groups

10. Pregnancy weight gain
Intervention group : Cohort of 312 PW who availed CINI’s project interventions+ Govt ANC package
Non-Intervention group : Group of 389 PW who only availed Govt ANC package
31
23.8
Intervention group Non intervention group
Pregnancy weight gain above 10 Kg
Pregnancy weight gain above 10 kgs(%)

11. Low Birth Weight
Intervention group : Cohort of 312 PW who availed CINI’s project interventions+ Govt ANC package
Non-Intervention group : Group of 389 PW who only availed Govt ANC package
10
17
Intervention group Non intervention group
Low birth weight of children in Intervention vs Non-intervention
group (%)
Low birth weight of children(%)

12. Pregnancy weight gain was higher among PW prior to COVID
(2018-20) than PW during COVID (2020-21)
2020-21 COHORT: Cohort of 312 PW who availed CINI’s project interventions during April 2020 to 2021 June
2018-20 COHORT: Group of 406 PW who availed CINI’s project interventions during 2018, 2019 and 2020 (Upto March)
40.8
31
2018-20 Cohort 2020-21 Cohort
Pregnant woman with weight gain above 10 kgs
Pregnant woman with weight gain above 10 kgs(%)
Discontinuation of ICDS
services hard major impact on
nutrition situations of both
women and children
The hot cooked meal at ICDS
was replaced by dry THR
limited to mostly
carbohydrates
The personal touch entrusted
in group meetings, home
visits, spot feeding etc could
not be replaced by electronic
mediums

13. • Nutrition services should be considered as emergency service just as public health and
continuity must be ensured during crisis situations like COVID
• Integrating nutrition with health interventions in ANC helps to address issues of LBW more
holistically
• Including components of maternal nutrition in state PIPs would help in addressing this
issue
• BMI assessment and gestational weight gain to be prioritized-Monthly weight monitoring
can be institutionalized through VHNDs
• BMI assessment in PMSMA clinics and categorizing severe malnourished cases as high risk
• Inclusion of BMI data in HMIS portal and MCP card
• Counselling guidelines for overweight/obese pregnancies
Learnings and Policy Implications

14. THANK YOU