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Connecting the dots: factors influencing poor child nutrition after floods in Orissa, India

*Irvine, Laura **Dash, Shisir **Kanungo, Itishree *Rodriguez, Jose and *Guha-Sapir, Debarati

*Centre for Research on the Epidemiology of Disasters (CRED), Université catholique de Louvain, Belgium **Voluntary Health Association of India

Symposium on Disaster Impacts and Assessment in Asia Hue, Vietnam – August 26, 2010

BACKGROUND: MICRODIS PROJECT

4 year project funded by the European Commission’s

6th Framework Program

Integrated social, health and economic impacts of

disasters in Asia and Europe

19 partners from academic institutions and

grassroots organizations

10 field sites in Philippines (2), Vietnam (2), India

(2), Indonesia, United Kingdom (2) and Italy

Training and capacity building, information

dissemination, scientific papers, website, etc. www.microdis-eu.be

STUDY SITE: JAGATSINGPUR, ORISSA, INDIA

Seasonal floods, affected

by cyclones

Area: 1914.6 Sq. Km Population: 11,39,126 MICRODIS event in

focus: 2008 severe flooding

OBJECTIVE OF STUDY

Find more in-depth and descriptive

information about factors influencing poor child nutrition in flooded and non flooded communities.

Nutrition: perception, reality and awareness Water and sanitation ICDS centre experience SHGs and Micro-Credit Access to health care facilities

METHODOLOGY

Sample area for quantitative study used to

chose groups for qualitative study (of 4 blocks, 2 per block)

9 Focus Group Discussions (5 flooded, 4 non-

flooded)

Women, SHG members, ICDS workers,

mothers, 1 group of fathers

Semi-structured questions for each group Participatory activities (community mapping,

decision table, food pyramid diagram, seasonal vegetable yield patterns)

1 facilitator, 1 observer, 1 note taker, video 10-12 participants per group

RESULTS: NUTRITION PERCEPTION & REALITY

Nutrition poor in all but 1 village Negative impacts on health and nutrition level in

children in post-flood period reported by all

Lack of awareness of what malnutrition is and

what foods are nutritious

Sell before consume

= poor quality of foods

Washed out crops Skinny vs fat conclusion

RESULTS: WATER AND SANITATION

Water sources contaminated (iron and salt),

especially in flood

No treatment of water Water storage a concern No hand washing, no soap Bathing (not thorough, in contaminated water,

privacy)

Awareness good but no action Floods amplifying these sanitation concerns Open defecation Cause and transmission routes of environmental-

related diseases*

Water Engineering and Development Centre (c) Rod Shaw

RESULTS: INTEGRATED CHILD DEVELOPMENT SERVICE SCHEME (ICDS) CENTER EXPERIENCES

Poor quality and quantity of food rations Dry rations given, cooked food unsatisfactory Poor knowledge and training for scientific

thresholds for malnutrition and methods

Lack of equipment and know-how to use it,

inappropriate equipment

Positive programs for

awareness and community involvement at different levels (hand washing, stick figure attendance, etc.)

RESULTS: SHGS AND MICRO-CREDIT

Community members who deal with micro-credit Present in almost every village Mainly credit for social events, education,

construction, not for nutrition

Support service to individuals, even the most

poor (with guarantee from other)

SHGs help with the ICDS centers sometimes,

and could help with credit for medical expenses

RESULTS: ACCESS TO HEALTH CARE FACILITIES

Access is a nagging problem – even without floods Access to health care facilities disrupted for flood

affected areas: centres closed (flooded or not able to access), immunizations and rations not available

Some good rotation or mobile help during floods

ALL GROUPS

Wages vs Health Care Neglecting non-obvious health problems

DISCUSSION AND CONCLUSIONS

Child nutrition is poor, and could even be

underestimated based on reported perceptions

Public health awareness can improve, but the

bigger problem lies in implementation of already known good practices

Connecting sanitation practices with other public

health concerns as a root cause for many

Education, awareness, training for infrastructure ICDS centers – quality and quantity of food,

education programs, ensuring access during floods

DISCUSSION AND CONCLUSIONS

Economic disparity as an intertwined cause of

many child health issues

Crops washed away Sell then consume low quality items Cant afford healthier foods Preparation lacking taste Wages vs. health care Gender aspects also could influence nutrition in

• ur sample

Order of taking food, decision-making power, social

misconceptions about eating when pregnant, etc.

RECOMMENDATIONS

Cross check with quantitative data Learn from programs that are working

(awareness, communication strategy, SHG loans, rotation of ICDS services)

SHGs can be mobilized to combat

malnutrition

Re-evaluate the quality and quantity of food

rations and functioning of the ICDS centres

RECOMMENDATIONS

Education and awareness programs for

nutrition and sanitation – water use and

• pen defecation

Looking at the root behaviour Teaching mothers nutritious value of local

goods, shaking the skinny-fat perception of malnutrition

Encourage continued SHG support for

economic limitations leading to lack of health care or proper nutrition

THANK YOU FOR YOUR ATTENTION

www.microdis-eu.be

Information given in this presentation reflects the authors' views only. The Community is not liable for any use that may be made of the information contained therein.