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Open Access

Matching Intent With Intensity: Implementation Research on the Intensity of Health and Nutrition Programs With Women's Self-Help Groups in India

Avishek Hazra, Aikantika Das, Jaleel Ahmad, Shivani Singh, Indrajit Chaudhuri, Apollonius Purty, Audrey Prost and Sapna Desai
Global Health: Science and Practice April 2022, 10(2):e2100383; https://doi.org/10.9745/GHSP-D-21-00383
Avishek Hazra
aPopulation Council, New Delhi, India.
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Aikantika Das
aPopulation Council, New Delhi, India.
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Jaleel Ahmad
aPopulation Council, New Delhi, India.
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Shivani Singh
aPopulation Council, New Delhi, India.
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Indrajit Chaudhuri
bProject Concern International, New Delhi, India.
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Apollonius Purty
cBihar Rural Livelihoods Promotion Society, Patna, India.
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Audrey Prost
dUCL Institute of Global Health, London, United Kingdom.
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Sapna Desai
aPopulation Council, New Delhi, India.
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  • For correspondence: sdesai@popcouncil.org
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  • FIGURE 1
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    FIGURE 1

    Intervention Channels and Corresponding Intensity Measures Within Self-Help Groups-Based Programs

    Abbreviations: SBC, social and behavior change; SHG, self-help group.

  • FIGURE 2
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    FIGURE 2

    Percentage of Women Who Received Messages Outside of Group Meetings Among Women in Self-Help Group Households With Children Aged Younger Than 2 Years

    Abbreviations: JTSP, JEEViKA Technical Support Program; UPCMP, Uttar Pradesh Community Mobilization Program.

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    FIGURE 3

    Social and Behavior Change Techniques Identified in Interventions Within Self-Help Group Programs in 2 States in India

    Abbreviations: JTSP, JEEViKA Technical Support Program; UPCMP, Uttar Pradesh Community Mobilization Program.

Tables

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    TABLE 1.

    Description of Maternal and Child Health Interventions Implemented With Self-Help Groups in 2 States in India

    InterventionCoverageIntervention Description, As Planned# Meetings ObservedSurvey Respondents
    Parivartana pilot (2013–2014) to improve RMNCH behaviors17Bihar, 8 Districts, 55 blocks
    • Groups formed to focus on health and nutrition along with savings and credit

    • Structured health modules

    • Weekly health discussion

    Meeting observations not reportedWomen SHG members with child aged 0–11 months
    Parivartan pilot (2013–2016) to improve RMNCH behaviors32Bihar, 11 districts, 64 blocks
    • Same interventions as above, with SHGs formed by the government to focus on savings, credit, and livelihoods, expanded into a larger geography with health and nutrition discussions held monthly

    Meeting observations not reportedWomen SHG members with child aged 0–11 months
    JEEViKA multisectoral nutrition pilot (2016–2018) to improve anthropometry and dietary diversity33Bihar, 1 district, 3 blocks
    • Maternal and child nutrition discussions in bi-monthly meetings

    • Home visits, peer, and community meetings

    30Women from SHG householdsb with child aged 6–23 months
    JEEViKA-JTSP nutrition pilotc (2017–2018) to improve nutrition behaviors (unpublished)Bihar, 1 district, 4 blocks
    • Nutrition discussion in at least 1 of the 4 weekly meetings in a month

    • Home visits and community events

    60Women from SHG households with child aged 6–23 months
    JEEViKA Mobile Vaani pilot,d JTSP (2017–2018) to improve RMNCH knowledge (unpublished)Bihar, 1 district, 6 blocks
    • Interactive voice response based platform

    • Information on nutrition, family planning, diarrhea, and entitlements in at least 1 monthly meeting

    • Home visits and community events

    172Women from SHG households with child aged 0–23 months
    UPCMP (2014) to improve RMNCH behaviors34Uttar Pradesh, 1 district, 1 block,
    • Discussion on home-based newborn care and maternal health in 1 or 2 SHG meetings in a month

    49Women from SHG households
    UPCMP (2015–2017) to improve RMNCH behaviours35Uttar Pradesh, 37 districts, 120 blocks
    • Health discussion in at least 1 monthly meeting

    • Home visits, community events

    108Women from SHG households with child aged 0–11 months
    UPCMP (2015–2019) to improve RMNCH behaviors (unpublished)Uttar Pradesh, 41 districts, 203 blocks
    • Same intervention as above, expanded to larger geography with more focus on household level discussion and community events (campaigns)

    Meeting observations not reportedWomen from SHG households with child aged 0–11 months
    • Abbreviations: JTSP, JEEViKA Technical Support Program; RMNCH, reproductive, maternal, newborn, and child health; SHG, self-help group; UPCMP, Uttar Pradesh Community Mobilization Program.

    • ↵a Parivartan was a community mobilization project implemented by Project Concern International (PCI) to understand the efficacy of layering health and nutrition (HN) interventions onto the SHG platform to increase the adoption of HN behaviors among the most marginalized communities in 8 districts in Bihar.

    • ↵b Either respondent or anyone from her family is an SHG member.

    • ↵c JTSP is a technical assistance program to JEEViKA by PCI on HN integration in its livelihood framework in 101 blocks across 11 districts since 2015. JTSP identified 4 blocks of Nalanda district as learning blocks, in which all the HN interventions were pilot tested before scaling up to other geographies.

    • ↵d JEEViKA Mobile Vaani pilot was implemented as a part of JTSP by Gram Vaani and PCI in 6 blocks of Nalanda district to assess the efficacy of a mobile-based voice-media communication platform in accelerating the pace and sustainability of behavior change and achieving higher outcomes in HN indicators.

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    TABLE 2.

    Implementation Intensity of Health and Nutrition Interventions With Self-Help Groups at the Group and Community Level, 2 States in India

    Group LevelCommunity Level
    Study DetailsFrequency of HN Meetings (Per Month), Based on ObservationsLength of HN Discussion, as Observed Per Meeting, MinutesWomen Members (With Child Aged Younger Than 2 Years) Reported Participation in HN Meetings, %Program Duration, MonthsGroup Dissolution Over Intervention Period, %
    Parivartan pilot (2013–2014)174Not reported80.3a1227b
    Parivartan pilot (2013–2016)321Not reported65.1a363b
    JEEViKA multisectoral pilot (2016–2018)33210Na30Not reported
    JEEViKA-JTSP nutrition pilot (2017–2018)12726.9c12Not reported
    JEEViKA Mobile Vaani pilot, JTSP (2017–2018)12018.7c12Not reported
    UPCMP (2014)341Not reported37.94Not reported
    UPCMP (2015–2017)3512344.2c2424
    UPCMP (2015–2019)12018.9c4833
    • Abbreviations: HN, health and nutrition; JTSP, JEEViKA Technical Support Program; UPCMP, Uttar Pradesh Community Mobilization Program.

    • ↵a Based on calculation using questions on (1) participation in group meetings and (2) “Does your group ever discuss health topics related to pregnant women and young mothers?”

    • ↵b Parivartan groups merged into JEEViKA during 2016–2017; many members joined JEEViKA SHGs.

    • ↵c Based on calculation using questions (1) participation in group meetings and (2) “How many times in a typical month are health issues discussed during SHG meetings?”

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Global Health: Science and Practice: 10 (2)
Global Health: Science and Practice
Vol. 10, No. 2
April 28, 2022
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Matching Intent With Intensity: Implementation Research on the Intensity of Health and Nutrition Programs With Women's Self-Help Groups in India
Avishek Hazra, Aikantika Das, Jaleel Ahmad, Shivani Singh, Indrajit Chaudhuri, Apollonius Purty, Audrey Prost, Sapna Desai
Global Health: Science and Practice Apr 2022, 10 (2) e2100383; DOI: 10.9745/GHSP-D-21-00383

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Matching Intent With Intensity: Implementation Research on the Intensity of Health and Nutrition Programs With Women's Self-Help Groups in India
Avishek Hazra, Aikantika Das, Jaleel Ahmad, Shivani Singh, Indrajit Chaudhuri, Apollonius Purty, Audrey Prost, Sapna Desai
Global Health: Science and Practice Apr 2022, 10 (2) e2100383; DOI: 10.9745/GHSP-D-21-00383
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