Maternal Undernutrition and Adolescent Girls
During the recent Woodrow Wilson International Center policy dialogue on maternal undernutrition both speakers highlighted the importance of including adolescent girls as targets and beneficiaries of maternal nutrition programs. After all, around the world girls under the age of 18 may be married as well as mothers. If they are not mothers already, reaching out to adolescent girls ensures that they will have necessary nutrition information and tools they need before they even become pregnant.
Bhavishya Alliance is a Mumbai based multi-sector partnership with a focus on reducing undernutrition in Maharashtra, India. The Girls Gaining Ground (GGG) program is Bhavishya Alliance’s pilot nutrition and health intervention which focuses on adolescent girls as future mothers. GGG combines a strong focus on maternal nutrition and health along with a girl’s empowerment component, benefiting groups of girls in some of the most underserved tribal communities in Maharashtra state.
The program itself focuses heavily on nutrition and health information, as well as giving girls the knowledge to access government health services. This includes information in accessing services such as iron supplements and access to facilities when giving birth. The groups take part in community mapping exercises which identify health and nutrition services near their communities.
Local women serve as role-models and facilitators for each of the GGG groups, leading the curriculum on reproductive and sexual health, the importance of iron supplements, dispelling myths relating to foods during pregnancy, and the importance of delayed marriage and pregnancy for health. Storytelling, local songs and myths are emphasized in order for the curriculum to make an impact in the lives of the girls. For example, girls may enact plays, where the lead character, an adolescent girl, dies in childbirth after an early marriage and a difficult, unattended pregnancy.
There is a special emphasis in the program on preparing girls nutritionally to become mothers. Facilitators chart hemoglobin levels and iron supplement intake and girls enrolled in the program use food diaries to record and discuss their daily intake of food. Where illiteracy is a challenge, facilitators use the girls’ verbal history to take down the diary. Along with a focus on quantity, facilitators use the colors of the Indian flag (green, orange and white) to ask girls and their families to diversify their food intake using locally available food sources. Some NGOs have supplemented the GGG program with seed distribution for families to start agricultural plots for food to be consumed within the family, rather than exported for sale outside the community.
This innovative and exciting program may provide a model for other maternal nutrition programs that recognize the importance of including adolescent girls as beneficiaries of maternal nutrition programs.