Integration of Health and Nutrition interventions with women’s SHG platforms formed under the State Rural Livelihood Missions (SRLM) is one of the unique approaches conceptualized and implemented by PCI in India. With time, this model has shown outstanding results and has been taken by the Government to a very large scale implementation across various states in India and influencing millions of marginalized families throughout the country. This is considered as one of the most effective and proven scale-approaches for community-centric and demand-side intervention for Health and Nutrition (HN), which has scientific and robust evidence of bringing outcome-level changes at scale.
PCI’s efforts began in 2012 in Bihar, the poorest state in India, with the grant-in-aid support from the Bill & Melinda Gates Foundation (BMGF). The project called ‘Parivartan’ was a pilot to understand the efficacy of layering health and nutrition interventions on the SHG platform to increase the adoption of HNS behaviors among the most marginalized communities. PCI tested the approach of layering HN interventions on SHGs by working with 18,000 SHGs which showed phenomenal results as captured through an external evaluation done by the Population Council.
To test the feasibility of implementing similar interventions among JEEViKA groups, a health layering pilot was carried out by PCI in 9,089 JEEViKA SHGs in 9 additional blocks. The successful layering of HN interventions in JEEViKA SHGs enhanced the Government of Bihar’s interest in scaling-up and leveraging community platforms to move the state’s health agenda forward. In response to JEEViKA and the World Bank’s request, PCI conceptualized JEEViKA Technical Support Program (JTSP) in 2015 to improve key reproductive, maternal, newborn and child health (RMNCH), nutrition, and sanitation behaviors by layering interventions onto JEEViKA’s community platforms. JEEViKA with the technical support of JTSP brought a substantial change in the lives of women and children of millions of marginalized families by bringing significant difference in multiple critical outcome indicators related to HN. The two approaches increased adoption of key maternal, newborn and child health, nutrition, and sanitation behaviours among women of reproductive age through sustained social and behaviour change (SBC) and convergence with other departments have created a pivotal opportunity to accelerate progress towards achieving results in multiple HN indicators. Among various encouraging outcomes, results from 3 independent evaluations of this initiative have attributed more than a two-fold increase in dietary diversity in child feeding – a ‘sticky indicator’ that has not seen improvements to this degree through any other interventions at scale in India. PCI’s technical support to integrate HN with the JEEViKA’s core mandates has been proven as one of the most successful demand-side interventions in terms of positive results measured through outcome-level changes in RMNCHN indicators, integration of HN mandate and scale-up of interventions through the Government system, and leveraging and unlocking new Government resources for HN.