Organised during March 4 – 5, 2003, this workshop aimed to understand the efficacious interventions for reducing intrauterine growth retardation (IUGR) as a cause of low birth weight; to discuss the innovations undertaken by civil society groups in this area; and to evaluate the feasibility of operationalising these at the level of scale through public systems. With specific focus on the strategy of training an additional health worker at the community level to impact IUGR, the workshop analysed the various models that have been initiated by NGOs across the country, the factors leading to their effectiveness in impacting health outcomes, and the processes to up scale these models through the public health and nutrition systems. The ultimate objective of the workshop was to inform current and planned scale ups of additional health worker models, thus reducing low birth weight incidence.
Nutritional status at a given point is not only a function of intake, but of several other factors such as the frequency with which an individual falls sick and the duration of illness. Any attempt to reduce IUGR incidence must take all critical factors into account. The public health system and Integrated Child Development Services (ICDS) Programme are collectively mandated to provide the complete basket of maternal and child health, and nutrition services required to reduce low birth weight incidence. The functioning of the Auxiliary Nurse Midwife (ANM) and the Anganwadi Worker (AWW) is crucial if this reduction is to be achieved. However, for a variety of reasons, they are unable to satisfactorily carry out the responsibilities allotted to them, which in turn translates into gaps in the coverage and quality of services rendered with consequent implications for outcomes. NGOs in India have been experimenting with community- based ‘solutions’ to improve the access to and quality of primary health services with a specific focus on the poor. This history of innovation has meant that there are a number of likely strategies that could be understood in terms of their potential for larger impact when integrated into the public health system. The ‘additional health worker’ view has been a subject of interest for some time now in both the government and voluntary sector. There has been a significant degree of difference among the different ‘models’ adopted across several parameters.
This workshop was organised to analyse the experience the sector has had with additional health worker programmes; the success or failure of large-scale programmes and the contributing ‘systems’ to operationalise, implement, support and monitor the grassroots health worker.
For more details on the Workshop on Reducing IUGR Incidence in India: Additional Health worker Strategies, see .
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