Leveraging the power of women’s self-help

groups to deliver nutrition outcomes

Kalyani Raghunathan

(on behalf of the WINGS and JEEViKA teams at IFPRI)

Poverty, Health and Nutrition DivisionInternational Food Policy Research Institute

The studies

• Evaluation of the provision of nutrition BCC using SHG platforms in 2 projects

• PRADAN: Agriculture + Health and Nutrition BCC

• JEEViKA: Nutrition BCC + convergence & coordination among service providers

Ways in which SHGs can impact nutrition

Black et al., Lancet, 2013.

(framework for women’s nutrition is broadly similar but needs refining)

JEEViKA

GPs (N=24)

PSU(N=120)

Households(N=2400)

20 HHs per PSU such that at least one woman in the HH is an SHG member, and the respondent woman has a child <2 yrs

Wave 1(2016)

Process evaluation (2017)

Wave 2(2018)

HH quantitative panel survey; Community/SHG survey, Frontline worker surveys, Jeevika CM survey

Qualitative and quantitative data; cost data will also be gathered

HH quantitative panel survey; Community/SHG survey, Frontline worker surveys, Jeevika CM survey

=12 Treatment GPs

5 PSUs per GPN=60

12 Control GPs

5 PSU per GPN=60

WINGS

Blocks(N=24)

Villages (N=136)

Households(N=2720) 20 randomly chosen ever married women 15-49 years of age per village

8 PRADAN “standard” SHG-blocks

5 PRADAN SHG villages per block

(n=40)

8 PRADAN “nutrition intensification” (NI) SHG blocks

5 PRADAN SHG villages per block

(n=40)

8 non-PRADAN blocks

7 Non-PRADAN villages per block

(n=56)

HH quantitative panel survey; Community/SHG survey

Qualitative and quantitative data; HH quantitative panel survey; Community/SHG survey

HH quantitative panel survey; Community/SHG survey

Wave 1(2015)

Process evaluation & Wave 2 (2017)

Wave 3(2019)

JEEViKA

2 pronged intervention:– Health and nutrition BCC

– Convergence and coordination between frontline workers

• BCC materials developed by JTSP

WINGS

• Provision of health and nutrition BCC via change agents to SHG members

• BCC materials developed by PHRN

Intervention description

JEEViKA

• Impact of JEEViKA-MC versus JEEViKA on women’s BMI and child dietary diversity (primary) and child anthro and mother’s DD (secondary)

WINGS

• Impact of PRADAN’s standard and NI interventions versus non-PRADAN - on women’s BMI and diets (primary) and child anthroand diets (secondary)

• Added impact of NI interventions versus the standard PRADAN model on the above outcomes

Main research questions

OUTCOMES

45

52

4

4750

3

24.0

71.0

5.0

0

10

20

30

40

50

60

70

80

Underweight Normal Overweight

All women Non-pregnant women Pregnant women

Women’s BMI

44

54

2

47

52

2

30

68

2

0

10

20

30

40

50

60

70

80

Underweight Normal Overweight

All women Non-pregnant women Pregnant women

JEEViKA WINGS

Child dietary diversity (6-23.9 months)

0.3

3.4

24.3

40

40.1

60.3

78.6

0 10 20 30 40 50 60 70 80 90

Eggs

Flesh foods (meat, fish,poultry)

Vitamin A rich fruits andvegetables

Pulses

Other fruits and vegetables

Dairy

Grains

N=2246

2

2

41

40

35

10

88

0 20 40 60 80 100

Eggs

Flesh foods (meat, fish,poultry)

Vitamin A rich fruits andvegetables

Pulses

Other fruits and vegetables

Dairy

Grains

N=2744

JEEViKA WINGS

USE OF THE PLATFORM

38.3

77.9

88.3

74.9

0

10

20

30

40

50

60

70

80

90

100

Currently amember of an

SHG

Activemember

SHG has S&Cactivities

Participate inS&C activities

N=2744

Participation in SHGs

71 70.2

89 91.5

0

10

20

30

40

50

60

70

80

90

100

Currently amember of

an SHG

Activemember

SHG has S&Cactivities

Participate inS&C activities

N=2246

JEEViKA WINGS

15.9

31.1

5.8

25.1

0.3

0 5 10 15 20 25 30 35

None available in thecommunity

Never interested

Previously involved and quit

No time

Religious/cultural reasons

N=1694

Reasons for not being part of an SHG

7.8

20.5

2

12.2

24.4

0.3

10.9

0 5 10 15 20 25 30

None available in thecommunity

Never interested

Previously involved and quit

Husband doesn't allow

No time

Religious/cultural reasons

Another HH member isalready active

N=655

JEEViKA WINGS

2.3

2.6

5.7

8.9

11.6

13.5

14.4

15.2

17.9

81

0 20 40 60 80 100

Home cultivation

Gender

Rights/entitlements

Nutrition

Ag-related

Health

Education

Livelihoods

WASH

Savings and loans

N=2246

2.8

3.2

3.0

26.4

11.2

15.8

31.5

9.4

63.4

0 20 40 60 80 100

Gender

Rights/entitlements

Nutrition

Ag-related

Health

Education

Livelihoods

WASH

Savings and loans

N=2744

Topics discussed in the SHG

JEEViKAAverage tenure: 2.25 years

WINGSAverage tenure: 4.11 years

• Baseline data has been collected

• Baseline results disseminated to WB audience, to be presented also to JEEViKA & state partners (Patna)

• Process evaluation (March-May 2017)

• Endline data in 2018

• Baseline data has been collected

• Baseline results were disseminated in May to PRADAN and PHRN

• Process evaluation and midline surveys are planned for Sept-Dec 2017

• Endline data in 2019

Current status and next steps

JEEViKA WINGS

THANK YOU!