ABSTRACT
Bihar is the third most populous state in India. Children account for almost half of the state's total population, the highest for any state in India, and account for 11% of India's child population. The latest round of NFHS reveals disturbing data with respect to this segment of the population, with 43% of them being stunted and 23% being wasted. One of the key reasons for this dismal performance is poor dietary practices among children. To address the malnutrition problem, the government has collaborated with NGOs and bilateral partners to implement large-scale nutrition programmes through a multipronged approach. The chapter presents the learnings from a large-scale intervention in Bihar that leveraged JEEViKA's (the Bihar Rural Livelihood Promotion Society—BRLPS) platform to improve nutritional outcomes among children and other vulnerable groups, including pregnant and lactating women. An impact assessment was conducted in three rounds (baseline 2017, midline 2019, and endline 2021) using a cross-sectional design to measure the improvements in nutritional outcomes. The results were overwhelmingly positive, with gains in child dietary diversity and maternal dietary diversity, including pregnant women, lactating women (mothers of children 0–6 months old) and mothers of children 6–23 months old. Despite positive outcomes, challenges related to scalability to large geographies and multiple cohorts persist. Sustaining the motivation of the community cadre remains another challenge. Nevertheless, the lessons from JEEViKA are an indispensable source of insight into the integrated management of health and nutrition through collaborative efforts, including community participation, which can lead to significant behavioural change.
