ABSTRACT
Adequate and appropriate nutrition is imperative for the growth and development of children under the age of three years, as any deficiency during this period has long-term impacts. Some of the critical challenges to achieving the required level of nutrition are insufficient food at the household level, the triple burden of workload on mothers, poor child feeding and care practices, malnutrition among women, lack of childcare services for children below three, and lack of quality healthcare services in tribal and underserved areas. According to the National Family Health Survey (NFHS-5) for India in 2020–2021, 35.5% of children under five are stunted, while 19.3% and 32.1% in the same age group are wasted and underweight, respectively. The chapter outlines the case study of the Public Health Resource Society's experience in combating malnutrition through community-based interventions for children under three in rural areas, with a special emphasis on tribal and Particularly Vulnerable Tribal Groups (PVTG) populations. The intervention design included three broad components—establishing and running daycare centres/creches, mobilising the community through Participatory Learning and Action (PLA) meetings, and systems strengthening and policy advocacy to support health and Integrated Child Development Services (ICDS). Creches are decentralised community-based centres where mothers leave their children when they go to work. The creches provide a safe and secure environment for the overall growth and development of children through care, feeding, and health promotion. The creche also helps elder siblings attend school and supports women's work, leading to an increase in household income. The PLA meetings and home visits were carried out by community-based facilitators to provide counselling to mothers of children under three. The programme has helped creche children retain or attain normalcy; 92.5%, 81.2%, and 70% of children maintained their normalcy in the categories of weight-for-height, weight-for-age, and height-for-age, respectively, while 64.6%, 33.3%, and 27.8% of children, respectively, improved their grades under different indicators.
