New innovations/good practices that have proven evidence to show results with detailed costing of such interventions and their scalability :

Improving IYCN and nutrition practices during pregnancy

1. Pratham Ahar Diwas (Annaprashan): To promote initiation of complementary food after completion of 6 months of a child with the view of preventing malnutrition and support proper development, Pratham Aahar Diwas was celebrated in some selected districts of Assam. This is done under the initiative of an NGO (NEDSF) under the Project “Manthan, Child Development & Nutrition” supported by UNICEF in collaboration with department of Social Welfare. 
2. Matri Amrit Ahar: Matriamrit is introduced by NGO – NEDSF with UNICEF support in five districts of Assam, namely Morigaon, Kamrup, Barpeta, Goalpara and Darrang in collaboration with department of social welfare. This ceremony is organized for pregnant women in last trimester and comprise of providing nutritious food like locally available fruits, pulses etc, and imparting messages and care to be taken during pregnancy. AWWs and other health functionaries counsel pregnant women by interacting personally with them and motivate them for institutional delivery.
3. Kitchen gardens: Kitchen Garden is an innovative approach for promoting nutrition security and food diversity to fulfil the additional nutritional requirements of adolescence age and also adding micronutrients in hot cooked meal to children 3-6 years served at AWCs. Kishori Samooh (under SABLA) and Adolescent girl clubs (under UNICEF supported child protection program) formed are trained to develop and maintain kitchen gardens. It is also propose to organise cooking demonstration and recipes contest to teach the adolescents and MSG members for preserving nutrients through with the help of home science colleges and FNB (food and nutrition board, government of India).  
4. Combating Malnutrition and Under-5 mortality in children

Nutrition Surveillance to strengthen Nutrition Rehabilitation Centers (NRC)

Nutrition Rehabilitation Centre (NRC) is a facility based care center to manage children with severe acute malnutrition –SAM (under 5 years) through

• Therapeutic diets 
• Medical care 
• Counseling of mothers for better feeding & care practices at home 

Objectives: 

1. To reduce malnutrition among under five children.
2. To treat severe malnutrition among the children aged 6 months to 60 months in the state.  

Improving service delivery through peer learning/education sessions

Creating field learning sites:

Background: NEDSF (an NGO) in partnership with UNICEF under the project ‘MANTHAN, CHILD DEVELOPMENT & NUTRITION’ in collaboration with department of Social Welfare has been successfully conducting community based innovation for child growth, development and nutrition since 2008 focusing ICDS blocks of five districts namely Barpeta, Morigaon, Darrang, Kamrup and Goalpara. NEDSF’s presence in the field has supported the AWWs of selected AWCs for community based innovations, use of tracking tool and organizing community gatherings to improve beneficiary coverage and adoption of infant care and feeding practices. In 2012, NEDSF under the same project has undertaken an initiative in developing their focus AWCs as ‘Field Learning Sites’ (FLS). These AWCs adopted as FLS had capacitated the nearby AWWs (10 AWCs per focus AWCs) focusing in the areas of their service delivery. The activities under FLS are undertaken with active involvement of concerned Supervisors and CDPOs under the guidance and support of the Directorate of Social Welfare, Assam.   

Objectives

• Developing selected AWCs as FLS (Field learning site)
• Organize activities in the AWCs to train up their peer AWWs on various topics pertaining to service delivery.
• Once capacitated, these AWCs will be turned into satellite FLS and they will be involved in training their peer AWWs of the nearby AWCs.

Coverage:

Model AWC (adoption of 10 AWC by CDPOs) Background: With the view of developing AWCs provided with all facilities, it was initiated to create model AWCs in all the ICDS blocks. These AWCs will be developed focusing on effective delivery of services by upgrading the skills of the AWWs and AWHs through need based trainings and making available all the TLM/Charts and IEC materials/facilities in the centres. Adoption of AWCs will be done in a phased manner. 

The ECCE curriculum has been presented for pilot testing in two ICDS projects. One in an Urban project and another in Rural project namely Guwahati (U) ICDS project (Kamrup district) and Bhurbandha ICDS project (Morigaon district) in 2012 under the technical guidance of NIPCCD and UNICEF, Assam.

Objectives: To capacitate CDPOs to develop AWC as model AWCs.

Activities

• 10 AWCs will be adopted from each project by the concerned CDPOs and efforts will be put to develop them into model centres. 
• These centres will be provided all the required facilities viz TLM/Charts and IEC materials
• Up gradation of skills of the AWWs and AWHs will be done for ensuring effective and smooth delivery of all the services under ICDS with the support from other departments and development partners like NRHM, UNICEF, SSA, etc. Some NGOs working in the field of women & Child Development can also be supportive in the building capacity of the functionaries.
• Regular monitoring and supervision will be done in these centres.
• Financial requirement: Flexi funds will be used for the purpose.

Improving supervision and monitoring

Group supervision in difficult areas: 

Background: As Assam is widely diverse and complex in its topography from hilly terrain to uneven valley including hilly areas, char areas, tea garden areas, forest and border areas, riverine areas etc., AWCs located in these areas are not easily accessible for regular supervision by ICDS Supervisory cadre (Supervisors, CDPOs and DSWO). Therefore, regular supervision of these AWCs has posed a major challenge for the ICDS functionaries. To address this challenge, Group Supervision was initiated. This practice has been proved to be rewarding. 

Objectives: To cover all the AWCs in difficult blocks/areas for regular supervision and ensure effective implementation of ICDS services.

Activities

• Joint visits were conducted by two or more Supervisors to the difficult to reach AWCs under one circle.
• Joint visit were also conducted by Supervisors with health staff to river island by using boats provided by NRHM especially to those centres which were cut off during monsoon due to rain/flood. 
• In rural areas of many districts with poor road connectivity, mobile units are arranged by NRHM for delivery of health services to the areas where the AWWs and concerning Supervisors could make joint visits. 
• Group monitoring : One AWC is selected where AWWs of the nearby AWCs (around 10 nos.) are asked to attend with all their records and registers and record review and supervision of all the AWWs is done in group. This has also helped and promoted peer learning among the AWWs. 
• Financial requirement: Regular ICDS funds for supervision will be used for the purpose. Essentially the NRHM resources/facilities viz boat clinic/mobile clinic/mobile health unit will be used for transportation 

Involving communities for creating social pressure groups and institutionalise social audit system

Mother’s Support Group or Matri Sahayak Gut

Background: With the objective that the programmes and schemes focusing the development of Women & Children are implemented effectively through the Anganwadi centres, it was felt that mothers of the primary beneficiaries i.e. children below 6 years of age of the locality can be involved in management and operation of these schemes. Against this backdrop, the State Government have initiated, vide notification no. SWD.617/2011/61 dated 2nd March 2012, the constitution of ‘Mother’s Support Group (MSG) or Matri Sahayak Gut’ in each of the AWCs in all the ICDS projects of Assam w.e.f. 1st April, 2012.

Rationale: The mothers as stakeholders will be fruitful if involved in management and supervision of the scheme, mobilisation of beneficiaries and counselling. 

Objectives: To involve mothers as the primary stakeholders in the management and supervision of the AWCs in addition to the Anganwadi Centre Management Committee. 

Activities:

Mothers of all the children registered at AWC, together form a group, designated as “Matri Mandal”. This matri mandal elect 7 mothers out of their group to constitute “Matri Sahayak Gut” (MSG). The president and the secretary will be made ex-officio members of VHSNC (under NRHM), and AWCMC.

The Matri Mandal meeting is to be held on 5th of each month, where MSG will discuss issues relating to AWC & performance of AWW. The secretary of MSG shall be responsible to keep record of proceedings of meetings. State resources will provide necessary funds for Matri Mandal meetings & events. Reports of performance of AWC shall be presented and discussed at Gaon sabha, VHSNC, AWCMC meetings. Performance of AWW & AWH to be assessed on parameters relating to attendance of AWC, timely opening of AWC, provision of good quality morning snacks, hot cooked meal & THR, maintenance of growth card/registers, VHND, RI etc on scale of outstanding, good and poor, and reports shall be submitted to CDPO/DSWO through concerned supervisor by 10th of each succeeding month.

Main responsibilities of MSG

• Management and supervision of ICDS scheme and mobilization of beneficiaries. The total beneficiary houses will be divided among the MSG members to share responsibility of mobilization of beneficiary for registration and availing services under AWC. 
• MSG members will also support AWW to organize monthly meeting of Matri Mandal and events viz. PrathomAahar at every 2nd month, Matri Amrit quarterly and bi annual demonstration of recipes will be organise to cover 12 months of year for one event every month. 
• MSG members also coordinate with ASHA & AWW to ensure attendance of beneficiaries in VHND, RI, NHED and make people aware about facilities provided under ICDS through interpersonal communication & IEC via songs, street play etc. 
• They will advise villagers on the matters like anaemia, malnutrition, ARSH, early marriage & pregnancy.

MSG members are provided training under Sensitization programmes organized by ICDS supervisors, CDPOs, DSWOs by end of April, each year. The training programmes are interactive and cover topics viz. supplementary nutrition, Growth monitoring & use of MCP cards, , PSE and TLM from low cost no cost materials, common health problems pertaining to that area, personal hygiene, nutritional value of different local foods, orientation to performance assessment of AWW etc.

At the end of year MSG will assess their own performance, based on attendance of matri mitra, beneficiaries in VHND, RI etc, participation of president & secretary in Gaon Sabha and AWCMC meetings. The DSWO on basis of self assessment report submitted by MSG will recommend top 5 best performing MSG for citation and recognition by Deputy Commissioner on 15th August of each year.