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Background With poor knowledge and existing
practices of inappropriate infant and young
POSHAN Abhiyaan aims to reduce malnutrition, through a life-cycle child feeding, nutrition and care during
concept, adopting a synergised and result-oriented approach. Implemented pregnancy and adolescence, an important
by the Ministry of Women and Child Development (MWCD), focus of the POSHAN Abhiyaan has been
Government of India, the target of the mission is to bring down stunting Behaviour Change Communication (BCC).
in children 0-6 years of age from 38.4% to 25% by 2022. It also aims to This learning note highlights the approach
reduce anaemia among women and adolescent girls in the age group of adopted and experience of implementing a
15-49 years and reduce low birth weight. BCC and community mobilisation strategy
for improving nutrition outcomes.
INDIA’S POSHAN ABHIYAAN
TE Behaviour Change Communication
and Community Mobilisation for
LEARNING NO4Improved Nutrition Outcomes
Creating a Aspirations
Communications Strategy Creating a sense of aspiration, tapping into people’s inherent
goals and ensuring motivation, thus closing the “say-do” gap.
Jan Andolan (or People’s Movement) Collective identity
Creating a perception of shared status for nutrition and a
The POSHAN Abhiyaan places immense focus on sense of collective identity.
convergent actions for nutrition and in line with this, a Nudges
new strategy termed Jan Andolan was developed. The Creating simple, doable actions and nudges for people to
strategy focusses on developing and operationalising media convert intent to action, thus making it easy for people to
campaigns to create awareness on 12 key themes (Figure join in and participate. For example, asking them to make a
1), using communication materials disseminated through pledge or a commitment.
multiple platforms (Figure 2) involving multiple stakeholders
such as the ministries of health and family welfare, drinking Rewards
water and sanitation, school education, rural development, Creating appropriate rewards-recognition among peers,
panchayati raj institutions/ village organisations/ self help appreciation letters from government - for spurring frontline
groups (SHGs) ensuring wide public participation. workers, peer leaders and local champions to get involved
In its operationalisation it adopts the following principles: with highest level of engagement.
Figure 1: Twelve Themes Under Jan Andolan 8LI½VWXWIX[EWTVIXIWXIHEGVSWWXLIIMKLXTMPSXWXEXIW
Antenatal checkup, (Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan,
Overall Nutrition diet of pregnant Maharashtra, Andhra Pradesh and Uttar Pradesh). The pre-
(Malnutrition, low-birth women, calcium
weight, good nutrition/ supplementation, test revealed that the TV spots scored more than 80% for
01 healthy foods - WHAT 02 institutional delivery
and WHY) and early initiation of
breastfeeding spontaneous recall, good comprehension, likeability and
intention to act. The radio spots demonstrated a greater
than 90% understanding and likeability. The full length and
Optimal breastfeeding Complementary food WLSVXIHMXZIVWMSRWSJIEGLSJ½ZI8:WTSXW *MKYVI
ERH
03 04 & feeding
VEHMSWTSXW[IVI½REPMWIHMRGSVTSVEXMRKJIIHFEGOJVSQXLI
pre-test and were translated into 12 regional languages.
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Full immunisation Growth monitoring
05 and Vitamin - A 06 and promotion characters, a second set was developed using cartoon
supplementation characters, which elicited even greater appreciation and
attention from communities. These were also translated into
12 regional languages.
Anemia prevention in
children, adolescent Food forti¼cation and
07 girls and women – diet, 08 micronutrients
IFA, deworming Mid Media
The mid media component of the communication plan was
Girl’s education,
09 Diarrhoea management 10 diet and right age at HI½RIHF]TVSKVEQQIRIIHW-XGSQTVMWIHXLIJSPPS[MRK M
marriage ½ZIZMHISWJSVXLIQSFMPIFEWIH-'(7'SQQSR%TTPMGEXMSR
7SJX[EVI '%7
MM
½ZIZSMGIERHXI\XQIWWEKIW MMM
TVMRX
content for posters (Figure 4), bus back panels, posters
Hygiene, sanitation and Early Childhood Care JSVFYWWLIPXIVWERHTVIWWEHZIVXMWIQIRXW MZ
¾MTFSSOJSV
11 safe drinking water 12 and Education (ECCE)
use by AWWs (Figure 5); and (v) a street play script. These
outreach materials were developed in nine languages. While
XLI'%7ZMHISWERH¾MTFSSOW[IVIHIZIPSTIHXSFYMPH
Development of
Communication Content Figure 2: Platforms for Dissemination
unication Videos, Interactive
l Comm Radio P
The MWCD focused on developing communication rsona rogram
rpe me
products supporting key messages on maternal, infant and Inte s*
ds/
young child nutrition, with the objective of improving ar
e C CELEBRITY CBE, VHSN DCCCCBE, VH ay, DAY-NRLM, Gram
gu Sabha, School ManagemenSabh t
RYXVMXMSRHYVMRKXLI±½VWXHE]W²ERMQTSVXERX lo Com
ia Entertainment Industry, Committee, Children’s School
D Cabinet, NSS, NYKCabi S, Scouts & TTTT
window for healthy growth and development. The oks, Sports, Politics Guides, Cooperatives wweeee
primary target audiences for these messages were lipbo Com ts, V
pregnant women and mothers/ caregivers s, F Gr muni ide
ter ers oups ty os
of children 0 to 24 months while the Pos INFLUENCERS enc SOCIALSOC MEDIA , M
secondary target were service-providers ge, Local Leaders, Faith Leaders, flu Twitter, Facebook, ess
ed Social-cultural Leaders, In WhatsApp, YouTube age
including Anganwadi workers (AWWs), ICDS l Panchayat Leader /
supervisors and Child Development Project ers, P uals s
ay d
3J½GIVW '(43W
r i
P , vi PLATFORMS
sg d n
no I
Mass Media S ,s FRONTLINE COMMUNITY
e WORKERS
ma ia MEDIA ies s
G d or e
* e t m
* M , S m
8:ERHVEHMSWTSXWJSVIEGLSJXLI½ZIOI] sl Lady Supervisor, AWWWW Nukkad Nataks + Local Folk ics ra
ai Teacher yr og
r e ANM, ASHA, Teacher Songs, Drama, Dance, L Pr
nutrition messages were developed by a t a Story-telling ng io
M So ad
media agency. This includes: (i) importance of / sl olk y R
oo , F nit
ooTTTT ts u
consumption of at least 100 Iron and Folic Acid ** rip m
OUTDOOR MEDIA MASS MEDIA Sc om
(IFA) tablets during pregnancy; (ii) a diverse and C
Wallpaintings, Hoardings, Television, Radio,
nutritious diet during pregnancy; (iii) early breastfeeding Bus Panels, Led Scrolls Mobile, Print ials
P erc
rot mm
o o es
within one hour of birth; (iv) exclusive breastfeeding for H typ TV C m
oar e D es, Ga
din esig mm bile
six months; and (v) age-appropriate complementary feeding g, B ns o rogra , Mo
us f W dio P one
Panels all Painting ammes, Ra , Ringt
for infants over six months of age. , LED S , TV Progr rts, SMS
crolls Radio, Spo
Figure 3: TV Spot and the ICDS-CAS software described in the other notes,
support this extensive focus on home visits.
“Anganwadi didi comes more often now, as compared to before.
Even though I meet her many times in the village, she still comes
home, sits with me, my mother-in-law, and sometimes with my
husband also…. She provides good information, for example about
my child’s food, immunisation, and hand-washing.” – Mother of
9-month-old child
Implementation of the Strategy
Figure 4: Poster On Appropriate
Complementary Feeding Mass and Mid Media
The MWCD, through the government media agency,
Directorate of Advertising & Visual Publicity (DAVP),
Figure 5: Flipbook for broadcasted three TV and radio spots on nutrition in 12
AWWs regional languages from February to April 2018.These
included spots on: (i) importance of iron and folic acid
consumption during pregnancy (ii) early breastfeeding,
and (iii) exclusive breastfeeding. Subsequently, TV spots on
dietary diversity for pregnant mothers, and appropriate
complementary feeding was broadcast from September 1
to 30, 2018. The radio and TV spots were available in public
domain on the MWCD website. The ICDS-CAS videos,
TVMRXQEXIVMEPMRGPYHMRK¾MTFSSOW[IVIWLEVIH[MXLWXEXIW
for use by the AWWs.
skill and understanding of service providers, the print, text, Community Based Events
voice messages and the street play were designed to elicit
FILEZMSYVGLERKIMRFIRI½GMEVMIWERHXLIMVJEQMPMIW8LI
¾MTFSSOERHWXVIIXTPE]WGVMTX[IVITVIXIWXIHMRXLIWXEXIW Monthly CBEs are being organised across 31 states/ UTs
SJ6ENEWXLERERH9XXEV4VEHIWLERHXLIGSRXIRXQSHM½IH currently. When the CBEs were initially rolled out under
accordingly. Deployment guidelines for the mid media the earlier ICDS Systems Strengthening and Nutrition
content were also developed. Improvement project phase in late 2015/ early 2016, key
messages from AWWs on maternal nutrition, institutional
Community Based Events (CBEs) and deliveries, and complementary feeding often got lost in
the din of gatherings. Under POSHAN Abhiyaan, additional
Home Visits GSQQYRMGEXMSRXSSPWWYGLEWXLIZMHISWSV¾MTFSSOW[IVI
WTIGM½GEPP]HIWMKRIHJSVXLIWIIZIRXWXSEHHVIWWXLMWMWWYI
A key component of changing nutrition practices is holding and help get the message across better. The AWW checklist
CBEs to celebrate critical milestones in the life of pregnant was also developed to help improve the organisation and
women and children below two years of age. The gatherings counselling during CBEs.
serve as a platform for disseminating essential messages
and to counsel pregnant and lactating women, and their Home Visits
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SRETTVSTVMEXI
nutrition and health behaviours. The events are organised at Greater emphasis has been placed on home visits to
least once every month at every Anganwadi centre (AWC) promote maternal, infant and young child nutrition practices,
and primarily focus on promotion of maternal nutrition which is now being systematically tracked through the ICDS-
(Godhbharai) and/ or initiation of appropriate complementary CAS. According to the Polling Booth surveys conducted
feeding (Annaprasan). Checklists have been developed to in the programme areas, 46% of the pregnant and lactating
facilitate organisation and supervision of these events. women reported being visited once or twice in the past
There is also an explicit focus on home visits during the three months in May-June 2018 as compared to 39% in
critical period from pregnancy till a baby turns two years August-September 2017. The percentage of no home visits
of age, to enable counselling, problem solving and create a reported by the pregnant and lactating women also reduced
demand for services. Both the incremental learning approach from 14% to 9%.
Poshan Maah (Nutrition Month) rallies, feeding demonstrations were organised across the
country reaching over 270 million people during the month.
To provide an impetus to the communication strategy under Field observations reveal that the Poshan Maah sensitised
the POSHAN Abhiyaan, the month of September 2018 was communities on the importance of good nutrition and
declared the Poshan Maah (nutrition month) with states achieved convergence across various schemes.
encouraged to systematically roll out a month-long campaign “With the help of my team I was able to organise different
on nutrition, engaging multiple departments, such as the community programmes during the Poshan Maah. The main part
health and family welfare, human resource development, was involving children and their family members
rural development, panchayati raj, water and sanitation and innovatively so that they feel a part of the programme and not
youth affairs. About 23 lakh activities on nutrition including consider themselves as Must ²targets’ or bene¼ciaries of the
community-based events, nukkad nataks (street plays), programme.” - 'istrict 'evelopment of¼cer, Surendranagar,
Gujarat
Lessons Learnt to communicate and re-enforce key messages. Simple
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support home visits and CBEs.
-REHHMXMSRXS½RIXYRMRKXLIGSQQYRMGEXMSRWWXVEXIK]EWMX 8LI¾S[SJJYRHWRIIHWXSFIWXVIEQPMRIHWS%;;W
was rolled out, some lessons were learnt in the process: can undertake regular CBEs.
1. Strategy development The counselling videos embedded as part of the AWW
mobile application of ICDS-CAS has been a great
Pre-testing of outreach materials adds value in terms enabler for interpersonal messaging during home visits.
of adapting messages to the community’s perspective Drawing upon lessons learnt in the implementation
ERHHIZIPSTMRKWTIGM½GXEVKIXIHGSQQYRMGEXMSRW-XMW of CBEs, the MWCD improved and issued revised
essential to work with creative agencies experienced in guidelines under the POSHAN Abhiyaan. These include
public health/ nutrition, as educating an agency, which enhancing messaging with a focus on male participation
lacks nutrition experience, takes time. MR'&)WERHHIZIPSTMRKWTIGM½GGSQQYRMGEXMSRQEXIVMEP
As interventions are addressed across programmes it is to support the AWWs.
important to ensure common and consistent messaging. It is essential to monitor BCC interventions like home
MWCD led the effort of collating all materials on the visits. Home visits require strengthening in terms of
MHIRXM½IHXLIQIWEGVSWWOI]PMRIHITEVXQIRXWERH communicating appropriate content and problem solving.
partners. A Google drive was used to provide all states Indicators to monitor home visits through the ICDS-
with access to these materials. New materials, such as CAS and AWW incentives linked to home visits have
EWLSVX½PQERHEVMRKXSRISRXLI437,%2%FLM]EER recently been introduced under the Abhiyaan.
were also developed.
4. Jan Andolan strategy
2. Mass media campaigns The Jan Andolan strategy focuses on several nutrition
Broadcasting TV and radio spots for a period of three themes. However, it is imperative to focus and deepen
months, followed by a brief period in the month of the work on maternal and child nutrition, and key
September, helped sensitise communities to the key QIWWEKIWHYVMRKXLI½VWXHE]WEWXLI437,%2
messages. However, these spots should be repeated at Abhiyaan is operationalised.
planned, regular intervals to reinforce messages. This
I saw Meena (name changed) sitting against the wall of the AWC.
“
needs to be factored into the larger annual media plan.
1eatly dressed in a ½owered saree, hair tied in a bun. She was
3. CBEs and home visits silently and con¼dently breastfeeding her infant. The baby was
one and half months; I asked her, “Where was the child born?”
In a recent third party survey carried out across 27 “In the district hospital” - she replied. “What are you feeding the
districts by MWCD, it was found that home visits and baby?” “My milk” - she replied. “Anything else? Water or any other
community events are the most effective platforms for milk?”. “No, why would I? Only breast milk is what she needs to
message dissemination. grow well”. She said this is what the AWW didi had told her when
8LI½IPHZMWMXSFWIVZEXMSRWHYVMRK'&)WVIZIEPXLEX she visited her house when she was pregnant and after she came
while the focus on messaging during CBEs has improved, home from the hospital. This is also what they were taught in
community gatherings particularly during the Godhbarai event.
messages on complementary feeding, and importance of “Has she been immunized?” - I asked further. “Yes she has. The
engaging the child while feeding require greater emphasis card is at home” she said as she effortlessly put her baby back
in all counselling and communication efforts. to breastfeed”. - Village Loharsi, Block Dhamtari Gramin, District
%QMRMQYQSJJSYVXS½ZIGLERRIPWWLSYPHFIHITPS]IH Dhamtari, Chattisgarh
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