Table 1. Overview of health integration intervention.
Session | Intervention content focus | Anticipated outcomes | Mode of delivery |
---|---|---|---|
1 | Introduction Module | • Interrelation between Health and Livelihoods | • Banner with key messages and story of two women who had to invest loan amount on health emergency at the household level. • Consent letter by the Self- Help Groups to continue the discussion on Health, Nutrition and Sanitation |
2 | ANC and birth preparedness | • Early registration for ANC • Receipt of IFA tablets • Consumption of IFA tablets • Delivery in an institution |
• Message Card and a story of a Musahar pregnant lady |
3 | Post natal care Focus of this module is on early breastfeeding and neonatal behaviors (delayed bathing, skin-to-skin care, clean cord care) |
• Early initiation of breastfeeding • Not apply anything on the cord • Delay bathing for at least 72 hours • Practice skin-to-skin care |
• A story a lady named Sarita who has just delivered |
4 | Exclusive breastfeeding and supplementary nutrition | • Exclusive breastfeeding for at least 6 months • Children above age 6 years given cereal based semi solid food |
• Message Card and Picture Puzzle card |
5 | Routine immunization | • Children receive appropriate doses of intervention and in time • Children complete the receipt of DPT3 vaccine |
• Banner with key messages and song (sohar–it’s a style of singing in Bihar which is sung on the occasion of birth of a child) |
6 | Family Planning | • Women use postpartum contraception Women continue to use contraception to prevent unwanted pregnancies |
• Story Card with pictures |
7 | Personal Hygiene and safe storage if water at the household level | • Water borne diseases • Safe storage practices at household level • Hand washing during critical time |
• Picture Cards and Song |
8 | Usage of Toilet and Garbage Management | • Use of toilet • Safe disposal of child’s stool |
• Faeces mapping (participatory mapping process where in the areas where the villagers go for open defecation were marked using yellow colour; after pouring water, villagers were able to visualise which all places could be contaminated due to open defecation). Picture Card and Song |
Note: Example of a story from Session 4: Meena went to deliver her baby at the local hospital with her husband and mother-in-law. Shortly thereafter, she delivered a healthy girl. The nurse put the baby on Meena’s chest immediately and the baby had her first breastmilk. The baby was named Khushboo. At three months of age, Khushboo’s aunt came to visit her. As it was the middle of summer, the aunt encouraged the mother to begin feeding the baby water as breastmilk exclusively would not be sufficient. Meena explained to the aunt that Khushboo doesn’t need any supplement besides her own milk for the first four months.