Save the Children launch their breastfeeding campaign today as they publish their report “Superfood for Babies” http://www.savethechildren.org.uk/resources/online-library/superfood-babies and it is fortuitous that this blog concerns the very same topic.
Following on from my previous account we were in Tonk District of Rajasthan state, and our afternoon activities included viisiting our first Anganwadi (see future blogs) and meeting with religious leaders so they could explain to us more about their work as Health Advocates. Through their local partners Save the Children support the training and engagement of influential community members such as these religious leaders in promoting institutional delivery, immunisation and early breastfeeding. These men have been instrumental in bringing about a crucial behavioural change when it comes to pre-lateal feeds, or ghutti (see previous blog) which when given can lead to declining health for the newborn and restrict the mother from producing enough milk. It is concerns such as these which contribute to India’s astoundingly high neonatal mortality rate, roughly 1:30 babies, and the tragic statistic that more children in India die before their 5th birthday than any other country in the world.
That’s where interventions such as these play such a vital role. Here’s how it works: Save the Children work with their local partners to train health ambassadors such as these religious leaders, who then regularly share this information about child health with the local community attending prayers. These men then take these messages back to their homes and discuss with their wives, relatives and neighbours, and hence the valuable information is then passed throughout their areas. As with many cultures it is the men in society and respected religious leaders who have vast influence over their community and cultural practices, so here was a fantastic example of these community structures are being catalysed to promote positive behaviour change that literally saves lives. A near impossible task, or at least a tremendously long one from all the projects I have witnessed or been involved in in other cultures, yet here it is working, is sustainable and highly effective. To say our group was impressed is an understatement. What a simple cost effective way to promote health and reduce morbidity and mortality!
In the resource centre of the local partners the leaders were hugely proud and outspoken regarding their achievements, and it was fascinating to hear them talk of their work. Over chai (and rather fabulous samosas) they were all so keen to talk to us, share their successes and they told us how together with the Community Health Workers in their areas they have taught their community that there is an alternative to giving the pre-lacteal feeds or ghutti, and waiting for the prayers to be said at the Masjid. Now the community have learned that the prayer can be whispered by others to the infant as soon after birth as possible, rather than delaying the first vital breastfeeds for the baby. They all recognise the importance of the first breastfeed within the first hour following birth and are literally spreading the word. They also explained how due to the difficulty in reaching the women in their areas they address this by focussing on teaching the husbands, who then in turn return these messages back to their homes.
Issues such as family planning continues to remain controversial however the local partners informed us how they have seen an increase in institutional deliveries, immunisations and the use of anganwadi centres, which will feature in a future blog.
Thanks to Save the Children and their implementing partners more than 26 religious leaders in Tonk have been trained in health, sanitation and nutrition issues in their communities, and are well aware of the vital role they play in sharing their knowledge. Due to their status as highly respected influential public leaders they are listened to avidly and hence behaviours change. For Tonk, whose population is around 70% Muslim, these kind of initiatives have surely reached more people than conventional health workers could. And with a 2.2 million deficit in trained health staff the children of India can only benefit from such programmes. How this would continue now that funding has been cut to India from 2015 is anyone’s guess, yet for now the great work of these individuals continues, breastfeeding education and support is promoted and concerns regarding malnutrition are tackled effectively. Diarrhoea alone is responsible for 20% of the worlds under fives deaths. Breast milk is free, sterile, available and nutritionally tailored to each child. Thanks to these religious leaders and community health workers more and more babies are thriving on it. Literally.