Mobile Creches

Mobile Creches - Transcript

A Case Study on Migrant Construction Workers
Children – Addressing Malnutrition through Practice
Context
• Construction workers children:
Subset of seasonal migrants: brick
klins, quarries, saltpans, seasonal
agricultural labour
• Asset less poor, survival migration,
uncertain wages, poor living
conditions, frequent movement,
exploitative wages
• Women- 3cr. 6 cr children – half
under six. (Guesstimate)
Profile of Child on Construction Sites
• Working mother/ absence of support
systems
• Frequent movement
• Brest feeding affected/
complementary feeding difficult/
immunization incomplete
Infections/ poor access to health care/
Stimulation and learning
opportunities missing
• Older children/ school entry affected/
schooling interrupted / constant
disruption of friendships
Dr. Vandana Prasad, ”for the migrant child, survival is a miracle.
Development is another matter altogether.”
MC models for care, develop and malnutrition
intervention
Model One: Construction Sites Daycare/ Creche-

Infant to 12 years

40 years experience
Model Two: Urban poor settlements – 2003-….

Focus pregnancy to three years

Community Health Worker intervention

Positive intervention in childcare practices/growth
monitoring/measuring impact

Community awareness to create supportive
environment

Linkage to Health services/ ICDS/ GRCs
Daycare/Creche for Migrant Workers Children
Status of Malnutrition
1. Sample of 450 HHs of migrant construction workers ( 07-08)
Age group: 0 -6
2/3 children malnourished.
32% had received exclusive breast feeding
32% had received complementary food at six months.
Young mothers
48 % married before 18 yrs
46% had a child before 18 yrs.
Most deliveries at home.
2. Sample: 463 children under 3 (April 09) Mobile Creches
Construction site centres
Grade I 31%
II 16%
III 8%
IV 1%
Normal 44%
Day care / Creches on Construction Sites

All children – infants to 12 years

Comprehensive strategy:
Care / nutrition/healthcare/growth monitoring/
learning activities for different age groups
including 1-3 years/
Day care / Creches on Construction Sites
Linkage of families to PHCs, hospitals, if available
A communication programme for the community
(Average stay of child) : 4 months
Staff child ratio: 1:10 + Helper for 0-3; 1: 25 for 3-6+
Employer/ NGO collaboration
Some guiding principles

Creche an essential strategy: to facilitate breast feeding.

Principle of integrated inputs:
Nutritional inputs and medical strategies must be accompanied by the care
and stimulation.
Sound scientific research :
“ The importance of sensitive periods in early childhood when experiences
connect neural pathways and brain and biological development can “set
trajectories in health ( physical and mental), behaviour, and learning that last
throughout the lifecycle. “ (J Frazer Mustard).**
Studies which stress
“interventions that are directed to improving nutritional status of children must
be combined with those that improve the quality of their socio-emotional
interactions with the environment. (Sharma and Mehta, 1997).

Significance of Training/ An aware adult care giver

Remuneration and Social Security of Child Care Workers
The Nutrition Programme
0-3 years : Mornings: Milk+ suji ki kheer;
Lunch (9 months onwards): khichdi – oil,
with vegetables
Evening snack : milk with soya cereal
3-6 years : Morning :- suji ka halwa
Lunch: Khichdi
Evening snack: roasted chana,
sprouted mong, moth, soya nuts, and
peanut chikki and bananas in winter
Cost: Rs 10/- per child per day.
Malnutrition
Special Diets for Grades II, III, IV

Diet : ½ egg + 1,½ banana;
Grade III and IV, a spoon of oil is added.
Iron, Multi vitamin drops (5 drops under 1 yr,
10 drops above 1 year) on alternate days

Monthly check-ups, Immunization
Growth monitoring (use of UNICEF Health Chart),
Pregnant women: Diet + Iron Tabs
Scaling up and Sustainability
Elements of Mobile Creches Strategy can be scaled up:

Training

Awareness building

Home based Counseling

Linkages with Services
(But multiple causes underlie Malnutrition Livelihood,
gender, access to services etc)
Two Studies
Study 1
Model of intervention without daycare and Nutrition
Impact on Childcare practices but less on exclusive
Breastfeeding and prevention of Malnutrition
Study 2
Model of comprehensive strategies – most significant
impact on Malnutrition
Tackling Malnutrition For Children Under Six – Dr. Vandana Prasad
Comprehensive Strategy: Impact
6-12 months intervention - 205 children
Comparison of base line status and after six months
30%
47%
30%
40%
50%
26% 28%
17%
12%
5% 4% 1%
0%
10%
20%
30%
Normal Grade I Grade II Grade III Grade IV
Baseline data Status after 6 months
State has a major role to play

State Schemes to include migrant children:
Existing schemes are for stable populations. Extension modules required in
ICDS/ SSA . New models required.

Creches at workplaces
Anganwadi-cum crèche
Rajiv Gandhi Creche Scheme revamped

Maternity Entitlement for 6 months for unorganized sector (Removal of BPL
restriction and two child norm).

Other strategies:
Implementation of Labour Laws
Implementation of NREGA provision re creches
Training of Creche Workers,
Capacity building of Panchayati raj / Local Urban Bodies functionaries
Awareness on Early Childhood Care and Development on a mass scale
Data collection on Migrants and Special Needs Groups
Basic Services/ Food security
The challenge of malnutrition
cannot be simplified and must
be dealt with head on