ASPIRATIONAL DISTRICT Program

Vriddhi is providing technical assistance to the Aspirational Districts (ADs) Program at the national, state and district levels. The project provides Program Management Unit Aspirational Districts to the Ministry of Health and Family Welfare. At the national and state levels the Program provides support to 25 Aspirational Districts in the states of Jharkhand, Uttarakhand, Haryana, Himachal Pradesh, and Punjab. The Program Management Unit Aspirational Districts spearheads the program and coordinates the activities across the states and ADs of the country. The state level support focuses on translating policy to action, helping the respective states to develop a road map and plan out activities for the Program. The district level support involves working closely with district health teams to implement the operational plan for the Aspirational Districts.

A systems-based approach for mobilizing frontline workers to reach out to families of young children in their homes is a scalable implementation model

Home based care of the young child (HBYC) is a novel initiative of the Government of India (GoI) to improve health and nutrition of young children through home visits by frontline workers throughout the critical first 1000 days. In continuation to the Home-Based Newborn Care Program wherein community health workers make 6/7 home visits to newborn in the first 6 weeks, the HBYC envisages additional 5 home visits to families of under twos to maintain the continuum of care from birth till 2 years. The objective of the HBYC program is to reduce child mortality and morbidity, improve nutrition status, growth and early childhood development of young children through structured, focused and effective home visits by frontline workers. HBYC has been envisaged as a convergent platform that promotes complementary feeding, growth monitoring, vaccination, water sanitation and hygiene (WASH) practices and care during sickness through focused counselling. The program attempts to plug the design gaps in the health and nutrition programs for children.

The state of Jharkhand has prioritized HBYC as a critical intervention to help improve infant and young child survival for all its 24 districts. Vriddhi project, as technical partner to the state, has been helping the state to operationalize the program. While the project is committed to support state wide roll out of the program it will support 3 Aspirational Districts - Lohardaga, Simdega and West Singhbhum more intensively. Learnings and lessons from the three districts will be used to develop and refine an implementation model for scaling up the intervention within and outside the state.

A detail operation plan, hand book for home visit and training module has been developed and is in place for the implementing HBYC. The 3 days TOTs were organized in last quarter of 2019 and planned to expand to sub district levels in 2020. HBYC training module is of 5 days duration. The training consists of lectures, demonstrations and skill stations.

In March, 2020 COVID 19 pandemic disturbed the entire training process. The training program has become a challenge due to CORONA pandemic as the resource persons travel has become a problem. This is affecting the program and subsequently the objective of HBYC to address nutrition and ECD concerns.

USAID Vriddhi project has prepared an Electronic Version of this 5 days training which can be imparted by trainers from remote control – sitting at state NHM or from their residence. The IMNCI videos are part of this E IMNCI module.

The E sessions are prepared based on the ASHA training handbook and the training schedule. The E sessions will be done in 3 days and each day sessions will be of 6 hours. The trainers/facilitators will use zoom /any other platform to share the session.

The participants will get hard copy of module and other materials. They can gather at block HQ or any other training site for the training and someone like BPM or Block Training Team (BTT) will facilitate the sessions there with help of a TV monitor or screen. This app/e-module can also be downloaded to individual ASHAs in their smartphone also.

Link to E-HBYC Module: https://cdn-esim.contentservice.net/adapt-ss/LGH/courses/HBCY-Hindi/latest/index.html#/

At national level the Program Management Unit Aspirational Districts coordinate multi-stakeholder consultation to finalize a supportive supervision checklist. The project teams in the states initiate Supportive Supervision visits across the project supported Aspirational Districts. The project is also supporting the development of the Aspirational Districts supportive supervision software to facilitate data collection and analysis of supportive supervision from all the 117 Aspirational Districts of the country.

Worldwide, pneumonia remains a major cause of child mortality. A major bottleneck in improving pneumonia outcomes is related to the identification and appropriate referral or management of children at the peripheral health outposts. While recording blood oxygen saturation through SpO2 measurement is globally recommended, pulse oximetry devices used to measure SpO2 are not widely implemented, more so in the peripheral health centers. The current practice is observation of clinical signs and counting of respiratory rate is prone to observer bias and error. Vriddhi introduced a niche point of care device to deliver rapid, reliable, non-invasive measurement of SpO2 as well respiratory rate. This helps in accurate and faster classification and management of pneumonia cases. The project is collaborating with “Masimo” (A global biomedical manufacturing company) and has introduced the RAD-G pulse oximeter for the first time within the public health care system in India. The device is being introduced at select Health and Wellness Centres in project states, targeting Auxillary Nurse Midwives (ANMs) and AYUSH doctors. The aim is to generate evidence on feasibility, acceptability, usability, impact, and cost-effectiveness pulse oximeter and its potential for scale up.

Vriddhi is introducing evidence-based program planning for Aspirational Districts to achieve RMNCAH goals. The program review process is building capacity of health planners and programers to use evidence in health action planning. Coinciding with the annual financial cycle, the project conducts planning workshops for select states to measure progress toward RMNCAH program goals and objectives using available data on reproductive, maternal, newborn, child and adolescent health status, assess where and how the states and aspirational districts have implemented reproductive, maternal, newborn, child and adolescent health interventions and identify the interventions with low coverage and the causes of low coverage, assess how well program activities are being implemented- prioritise key problems, develop solutions and recommendations and decide on next steps for incorporating recommendations into RMNCAH plans. It is envisaged that the program review will build upon strengths and identify program priorities that need immediate attention.