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Indias public health and nutrition efforts are differentiated by an enterprising early start going as far back as 1975 with the beginning of Anganwadi centres and Integrated Child Development Services (ICDS). Lauding this strong, continued focus on maternal and child nutrition, experts specialising in India’s nutrition space prescribe integration of three key factors like quality of services, convergence of healthcare services at the household level, and strategic use of data at various levels to improve program implementation, that could further advance public nutrition service delivery in India.
Committed to a malnutrition-free India, the country’s robust public health and nutrition infrastructure has positioned dedicated frontline workers as its pillars, making it one of the few countries to achieve this scale and intensity of human resource support. For every 1000 population, there is one Accredited Social Health Activist (ASHA), one Anganwadi Worker (AWW) and one Anganwadi helper, and one Auxiliary Nurse Midwife (ANM) for approximately every 5000 population. Under the Poshan Abhiyaan, key public programs and outreach schemes make nutrition-based interventions to lift nutritional well-being for all.
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“India has a well-funded program for various nutrition-specific and sensitive interventions covering the entire country. During the POSHAN Maah (Nutrition Month) there was reiteration to continue focusing on the basics of prevention of maternal and child undernutrition and focus was also brought on new areas, such as children with Severe Acute Malnutrition (SAM) and promotion of locally-sourced nutrient-rich foods grown in kitchen gardens. Food fortification, too, has gained good momentum in India over the last few years. I feel a larger number has been added to the people consuming fortified products in the world from India, than any other country in the last few years. India has almost everything (policies, human resource, funding and political will) in place in terms of what needs to be driven and the focus now more than ever before has to be on strengthening the implementation,” shares Dr Alok Ranjan, Country Lead (Nutrition), Bill and Melinda Gates Foundation.
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Setting foundations of health and cognitive development in a child, the first 1000 days (from pregnancy to first two years of life) are often neglected, visible in the abysmally low levels of minimum adequate diet received by children between 6-23 months of age, as shown by the 2016-18 Comprehensive National Nutrition Survey (CNNS). Failure to nourish the mother-child dyad in accordance with the five components of Poshan — the child’s first 1000 days, anaemia prevention, diarrhoea management, nutritional foods and WASH (water, sanitisation and hygiene) — can set back the healthy physical and cognitive development of a child. At the macro level, undernutrition impairs public health levels and the future of a nation.
Highlighting the multi-sectoral aspect of nutrition, Dr Ranjan builds on his experience like the Polio, Routine Immunization and Vitamin A supplementation work in states like Bihar and Uttar Pradesh, and points out that the nutrition program implementation can borrow few key factors from successful public health programs like polio, routine immunization and vitamin-A that could aid transforming India’s nutrition landscape – such as improving the quality of services and using data for improving program implementation, along with ensuring the convergence of service delivery for the core target of mother and child.
“In the maternal and child health program, globally as well as in India, quality of intervention is already a priority focus area. There’s no similar momentum around quality of nutritional intervention globally or in India. As the coverage numbers are increasing with the Poshan Abhiyaan, we need to start looking at it, right from the quality of training frontline workers, to quality in food supplementation as well as quality of the counselling sessions at anganwadi centers or during home visits. Thus, focus on improving the quality at all levels would go a long way in helping us achieve our nutrition targets,” says Dr Ranjan. As an instance, the expert points to ensuring quality of counseling the mother receives, from the day her registration is done under both Health and ICDS systems for various Antenatal services.
“Community and household counselling, if not done properly, will not lead to the kind of impact we are aiming for. For instance, if iron and folic acid (IFA) supplementation tablets have been made available till the last mile in a village and are distributed to pregnant women then they must also be counselled adequately around how and when to consume those tablets, what side effects they should be aware of, what is the benefit of these tablets for them and their next generation. Just the way we expect focused and detailed counselling when we take any of our family members to a private practitioner, similarly in the public health setup, just ensuring supply is not enough. Counselling with time and quality can have a profound impact,” he shared.
Want to read more in Hindi? Checkout: डीडीएलजे के 25 साल पूरे होने पर शाहरुख ने कहा कुछ ऐसा
According to Thomas Forissier, Director Programs, South Asia, Alive & Thrive (FHI 360), increasing the coverage of nutrition-related services and benefits is often the first step, but increasing the coverage of high quality services and benefits is the necessary second step.
“There is no alignment on a simple definition of quality. Most experts would agree that quality involves the right inputs: infrastructure, training of frontline workers, commodities, etc.; the right processes: providing key advice to families on how to nourish pregnant women and children, weight and height measurements, provision of various foods and micronutrients, etc.; and the right outputs: starting with client satisfaction. But none of those experts are likely to agree today on how all of those items fit together, which ones are more important. It is critical for the nutrition community to define what is the quality of nutrition services and benefits and how to measure it as soon as possible. And then to start using those measures in the field,” says Thomas Forissier.
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Dr Ranjan also emphasises on strategic use of data, such as data from supervisor’s field visit, regular MIS systems of various departments, national surveys like National Family Health Survey etc. and to use these data for identifying actionable next steps at various levels like at national, state, district, project, village and household level. Also given the fact that most of the nutrition focused messaging is around behaviour change (like breastfeeding, diet diversity, IFA consumption etc) it is important to go beyond one-time messaging for high impact and effective social-behavioural change. “The same messaging needs to be delivered repeatedly to the household, through all touchpoints – mass media, radio, advertisements, local newspapers, self-help groups, opinion leaders, Anganwadi workers, helpers, ASHAs, and ANMs.”
For convergence of health and nutrition services at the household level for the mother-child, Dr Ranjan suggests the dyad should get easy access to services like including immunisation, take-home ration, PDS ration, IFA tablets, safe drinking water, proper hygiene, counseling on maternal diet and best feeding practices, during the golden 1000-day window of opportunity (from conception to her second birthday). “For improved nutritional status and to meet Sustainable Development Goal 2: ï¿½Zero Hunger’, it is crucial to converge all efforts at the household level. The convergence action plans at national, state, district, block and even community levels, must put convergence at the household level of all mother-child nutrition services at the centre of these plans. If we do all this with quality, we’d have an accelerated improvement in the nutrition indicators and reduction in undernutrition.”
“Convergence of services starts to matter when you look at it from the perspective of households. Did they get all the nutrition-related services and benefits that they are eligible for? Did they get antenatal care services from health, take-home rations from ICDS, nutrition counseling from both, food from the PDS, employment benefits from MNREGA, IFA from Health or at school? Do they have running water and hygiene facilities? Today, few families get the full set of nutrition-related services and benefits they should receive. The only way to change that is to stop thinking about services, and start thinking about families. In mature states, measuring and acting on household convergence should be prioritized at all administrative levels. In less advanced states, involving Panchayat Raj Institutions or other groups to drive accountability of the system to collectively service individual families is a good start,” opines Dr Forissier.
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Another expert, Dr Shailesh Jagtap, Senior Technical and Program Advisor with Alive & Thrive, concurs that a paradigm shift on use of data for decision making for systems improvement at each level of system, would be a game changer.
“There is an important saying that – that which gets measured gets implemented. There was a time when data on nutrition was scarce and now with investments in POSHAN Abhiyaan we are moving towards abundance. Administrative data from ICDS and Health departments presents real time data on POSHAN Abhiyaan program interventions and HMIS (Health Management Information System) from the health department having nutrition indicators provides an opportunity for improving the nutrition program service delivery. Apart from the routine data collection systems which focuses on outcome data it is important to have data on the quality components of service provision through regular Quality Assessments of the POSHAN Abhiyan program which provide valuable insight for service delivery improvements. The system now needs to gear up on how this data is being used,” Dr Jagtap shares.
Under the POSHAN Ke 5 Sutra’, the focus has been on the absolute critical components for prevention of undernutrition. And one cannot overemphasize the need to prevent mother and child from getting undernourished, because once they become undernourished we will always be busy treating them rather than fixing the problems that led them to become undernourished in the first place. Unless we fix those underlying factors mother and child will continue becoming undernourished. Giving the example of an open tap, our first focus has to be to close the tap first (prevent mother and children from becoming undernourished) or else we will keep mopping the floor for years to come (keep treating those who have become undernourished) as more and more mother and child will keep getting undernourished unless we prevent them from getting to that stage, concludes Dr Ranjan of BMGF. (IANS)
Along with the undeniable natural beauty, the Kashmir valley has developed a reputation for adventurous activities like trekking, hiking, and river rafting. Kashmir has maintained its charm, allowing us to time-travel into beautiful destinations which make one forget about the stress and worries of life. The hikes in Kashmir offer adventurers to go on a self-discovery trip through nature's lap over the mountains while taking in the breathtaking scenery that surrounds them on their journey. In addition to the hikes, there are many thrilling adventure activities, like rock climbing, rope climbing, etc. Trekking across the region of mountains and lakes will allow you to experience living in the "Paradise on Earth," and you wouldn't want to return to your regular life after that.
The following are some of the finest hiking destinations in Kashmir:
#1: Kashmir Great Lakes Trek: You will be transported to a heavenly and unseen aspect of Kashmir on the Kashmir Great Lakes Trek. In addition to three high-altitude passes and five river valley crossings, this is the only trip in the Himalayas that includes seven alpine lakes, each of which is a stunning shade of green, blue, or turquoise. The extravagance is limitless and breathtakingly stunning every day: infinite blue sky, a larger-than-life backdrop of the Rocky Mountains, colourful meadows overflowing with wildflowers, river crossings are just a few examples of what you will encounter during the trek.
You will be transported to a heavenly and unseen aspect of Kashmir on the Kashmir Great Lakes Trek. | Photo by prayer flags on Unsplash
#2: Sonamarg-Vishansar-Bandipora Trek: The Sonamarg-Vishansar-Bandipora trek is a one-of-a-kind experience that provides a glimpse into Kashmir's undiscovered regions. Sonamarg, famously known as the Meadows of Gold, is the starting point for this fascinating journey that is the perfect experience for anyone looking to get away from the frantic tourist rush. This trek is a fascinating journey that allows nature enthusiasts to bask in the splendour of nature's grandeur. The trek goes over many high mountain passes, some as high as 4000 metres in elevation. The hiking route, in addition to providing breathtaking views of the magnificent Vishansar Lake, provides visitors with the chance to see more than 50 alpine lakes.
Sonamarg, famously known as the Meadows of Gold, is the starting point for this fascinating journey. | Photo by YASER NABI MIR on Unsplash
ALSO READ: Top 10 Beautiful Sights To VIsit In Kashmir
#3: Tral-Narastan-Marsar Trek: The Tral-Narastan-Marsar trek is filled with a range of exciting experiences from beginning to end. The hiking trail passes past a waving saffron field, beautiful meadows, and several streams. The path also crosses the Dachigam National Park, where there is an opportunity to see various animal species. Trekkers may take in spectacular views of the high mountains running parallel to them as they cut and pass through Narastan, a Hindu pilgrimage place.
The Tral-Narastan-Marsar trek is filled with a range of exciting experiences from beginning to end. | Wikimedia Commons
#4: Chhatargul-Mahlish-Gangabal: The journey, which passes through beautiful locations such as Chattargul, Mahlish, Kolsar, and Trunkul, provides a peek into an utterly uninhabited wilderness of Kashmir. There are lakes and meadows adorned with flowers along the route as one trek into the alpine wilderness. Trekkers can also enjoy fishing in the crystal clear lakes, camping, or just seeing towering snow-capped mountains while on their journey.
There are lakes and meadows adorned with flowers along the route as one treks into the alpine wilderness. | Wikimedia Commons
#5: Kolahoi Base Camp Trek: The Kolahoi Base Camp trek in Kashmir has been famous since the early 1900s and has been a goal for many seasoned hikers from across the world. While Srinagar serves as the beginning point for the trip, it is in Aru Valley that the actual hiking begins. The Kolahoi Base Camp Trek is a gentle adventure that is ideal for novices and families with children. The breathtaking sight of the peaks rising into the sky on the horizon of the Pirpanjal and Karakoram ranges is certainly worth capturing. It is considered to be one of the most popular treks in the Kashmir valley.
The Kolahoi Base Camp Trek is a gentle adventure that is ideal for novices and families with children. | Wikimedia Commons
Kashmir's natural splendour, with its beautiful valleys and towering mountains, is really unlike anywhere. Trekking through various valleys and peaks while taking in the scenic beauty is something that always calms the heart and provides us with memories that we will remember for a lifetime.
Keywords: Kashmir, Lakes, Alpine, Hiking, Trekking, Treks, Sonamarg, Gangabal, Kolahoi, Chhatargul, Mahlish, Tral, Narastan, Marsar
The Pitru Paksha starts after the Full Moon day, and this day marks the beginning of the waning phase of the Lunar cycle. This event is roughly of 15-day period, and is of great significance. From this day, rituals like Tarpan or Tarpanam and Shradh are carried out to pay respects to dead relatives and ancestors.
It is believed that from the very first day till the last day, the unhappy souls of the deceased return to the Earth to see their family members. So, in order to ensure that the dead attain Moksha, i.e. to get liberation, family members of these souls quench their thirst and satisfy their hunger by performing the Pind Daan, which includes offering food consisting of cooked rice and black sesame seeds. The literal meaning of Pind Daan is the act of satisfying those who no longer exist physically.
For fifteen days, prayers are offered in temples and rituals are performed to help the souls get free from the cycle of birth, life, and death, and attain salvation.
At the same time, the Pitru Paksha is also an important period for people with Pitru Dosha, which means the curse imposed by the ancestors. Hence, in order to ask forgiveness, people perform Shradh rituals and offer food to the crows, who are considered as living beings that represent the dead. It is believed, if the crow eats the offered food, the ancestors are happy and pleased. But, if the crow doesn't eat the offered food and flies away, the ancestors are not happy.
The event of Pitru Paksha is widely observed by Hindus from all over the world, and they perform prayers and rituals in order to gain their ancestors blessings.
At the heart of Bangalore city, a large 300-acre space of lush greenery and heritage stands as a symbol of the city's past, present, and future. Cubbon Park is every child's favourite park, every Bangalorean's haven of fresh air, and altogether, the city's pride.
It stands testament to the past, in terms of the diversity of flora it houses. Bangalore traffic in the recent past has grown into a menace, but the stretch between MG Road and Cubbon Park is always a pleasurable place to stop and wait for the signal to turn green. The gust of wind that blows here, and the smell of mud, coupled with floral scents instantly transports citizens to Old Bangalore, where the weather was fine, and the trees loomed over roads with thick canopies that did not even allow rainwater to penetrate. Cubbon Park is also a historical site, and one of the few remaining monuments of colonial heritage in Central Bangalore. It houses many statues and among them, the most famous is that of Queen Victoria, which faces the St. Mark's Square.
The stretch outside Cubbon Park is cool and well-shaded from the canopy of trees over it. Image source: wikimedia commons
At present, Cubbon Park is known for the cultural hub that it is. It houses Jawahar Bal Bhavan, which is a large theatre that hosts film festivals through the year. Festivals, poetry open mics, and other such shows are conducted on the lawns every Sunday. A small stream runs through the park, where boat rides are held occasionally when the water level is high enough. There is a children's park on one corner, and a government-maintained aquarium, two-storeys tall, with exotic fish.
The Park has been renamed many times in the past. It was originally named Meade's Park, after Sir John Meade, the acting commissioner of Mysore in 1870. It was later changed to Cubbon Park after Sir Mark Cubbon, who was the longest-serving commissioner of the Mysore state. In 1927, the park was renamed after the Mysore Maharaja Sri Krishna Wodeyar, to celebrate his silver jubilee, since the park was developed during the reign of his ancestors. Even though it is officially named Sri Chamrajendra Park, it is still known as Cubbon Park all over the city. In fact, Bangalore was alluded the sobriquet of 'Garden City' because of the rich botanical diversity of this park.
Art Installation at Cubbon Park Image source: wikimedia commons
In many parts of the country, governments have renamed structures, places, and cities to remove traces of colonialism. But, in a city like Bangalore, there is too much evidence of the British rule. Many of the most prominent attractions of the city are known by their British identities despite the change in name. Even the city's name continues to be Bangalore, despite having been changed to Bengaluru. Last year, the British era and its achievements were celebrated in Cubbon Park when Sir Mark Cubbon's statue was moved from the grounds of the Karnataka High Court and placed in the Park.
Keywords: Cubbon Park, Mark Cubbon, British Colonialism, Cultural hub, Garden City