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Our work in education builds on the foundations laid in ensuring adequate nutrition and health status throughout the critical period of the child’s growth and development that take place during the first 1,000 days of life. Experience has shown that every child who may have achieved appropriate nutrition and health standards, if not sent to school, may end up in child labour, trafficking, early marriage, or exploited and abused otherwise, thus perpetuating the vicious cycle of poverty, ill health, malnutrition and illiteracy that trap deprived communities.CINI supports the Right to Education Act, 2009, with the aim of achieving universal enrollment, increasing school retention and improving the quality of education. In particular, we are concerned with deprived children, those who are denied access to education as a result of traditional or social barriers, such as caste, poverty, gender or ability. Evidence shows that children who are in school, not only are empowered with education, but also tend to be more protected from abuse and exploitation. To strengthen our efforts in the education sector, we have established an Education Resource Centre (ERC) with the mandate of distilling innovation, guiding policy development and contributing to the unprecedented education reform underway in the country.
We strive to identify children who are out of school, or at risk of leaving it. We partner with school authorities and teachers, school committees, families, children’s groups and local elected representatives – Rural Panchayat Institutions and Urban Local Bodies – to map out-of-school children, motivate the school system and families to get them back to school, and prevent dropping out. We promote the creation of Child Friendly Schools – where school authorities are willing to participate in this transition – by facilitating better school management for upgrading the school environment, building separate toilets for girls and introducing education methodologies that are child-centered. Through social auditing, adult and child education service users can claim their entitlements and suggest ways to improve the school system. We are working to foster the establishment of Child Friendly Schools to stand as primary institutions for education and child protection at the core of Child Friendly Communities.
To prevent dropping out, we offer supplementary education support through learning centres for children, being run on school premises or in the community. Services are in operation prior or after school hours to help students who may be first generation learners, or deprived of a conducive home environment for continuing study. A network of CINI frontline workers and Self-Help Group members partner with government, municipal schools and communities, and engage in a dialogue with families to highlight how the benefits of education would, in the long term, outweigh the loss of foregoing a low and temporary wage which a child may earn by leaving school.
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In India, only 61% of children between 12-23 m onths are fully immunised against the six major preventable diseases (Coverage Evaluation Survey 2009). Nearly 70% of children under 5 years of age suffer from anaemia. Only 51% of women undergo at least three ante natal care visits. Less than 40 percent of births take place in health facilities. (NFHS 3, 2005-2006)
As India’s investments in health have been growing over the past decade and the National Health Mission has been seeking to expand availability of healthcare, the main challenge remains to ensure access in service utilisation by all, especially the poor. CINI works at the family, community, institutional and government levels to bridge the gap between service providers and service users. It helps deprived communities acquire information, knowledge and capacity to access healthcare services. In parallel, CINI trains health service providers, such as government frontline community health ASHA workers, to act as effective healthcare agents as mandated by the National Health Mission, which has entrusted CINI to function as the West Bengal State Nodal Agency (SNA).
Trained and motivated local women, organised in Self-Help Groups or acting as community-level workers, interact with families to facilitate access to primary health care services for women and children residing in villages and slum areas. With the help of community mapping and Mother and Child Protection (MCP) Cards, we make sure that no one is left unserved.
We educate communities in issues relating to child health, reproductive and sexual health, including HIV/AIDS, and appropriate hygienic practices to prevent common illnesses at home. We motivate families to seek full immunisation coverage, periodic ante-natal check-ups and diagnostic tests during pregnancy, and early treatment in case of illness. We pay special attention to adolescent health, addressing reproductive and sexual health to prevent sexually transmitted diseases, early and unwanted pregnancy, and Reproductive Tract Infections (RTI). We mainly seek to empower young people with knowledge on the physical, psychological and emotional changes that take place during puberty and adolescence.
At the daily and weekly clinics, such as the Thursday Clinic conducted on our main campus in Daulatpur on the fringes of Kolkata, woman and child clinics are run to provide outpatient care, nutrition and health counselling and treatment of reproductive tract infections. Pregnant women and women with children up to the age of five can consult doctors and health workers about ante-natal care, breastfeeding, nutrition, vaccination and childhood illnesses.
Fighting HIV/AIDS has been a core activity in recent years by the HIV/AIDS Division. We identify positive cases in the community and in high risk population, and offer voluntary counselling and testing while maintaining confidentiality. We collaborate with HIV/AIDS Positive Networks for training and project implementation to protect orphans and children of HIV-positive patients. The National Aids Control Organisation (NACO) and the West Bengal State Aids Control Society (WBSACS) have entrusted us with training Link Workers responsible for identification, voluntary counselling and testing (VCT) and referral for treatment of HIV cases in the community.
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Malnutrition is more widespread in India than in Sub-Saharan Africa. One in every three malnourished children in the world lives in India. About 50% of all childhood deaths are attributed to malnutrition, according to UNICEF. As many as 48% of Indian children under the age of 5 are stunted, a sign of chronic malnutrition. Girl children are more vulnerable than boys to malnutrition and mortality (NFHS 3, 2005-2006).
From its inception, CINI’s work with deprived communities has focused on nutrition, an issues that remains key in India till the present day despite the country’s progress and exponential economic growth. A child who is malnourished in the womb and in her first two years of life is unlikely to grow to its full physical and mental potential. Lack of proper nourishment in the womb can cause brain damage, still birth and neo-natal death. A malnourished child is more susceptible to illness and may experience a restricted capacity for education. In a child, proper nutritional status is a prerequisite to attaining adequate health, education and protection.
The problem of malnutrition is not always as straightforward as simply lack of food. Many families do not always share food equally among their members. Mothers and infants, especially girls, are rarely given priority. Traditionally, in Indian families, women eat last. When food is scarce, men may receive more than women, boys more than girls, older children more than younger children. Diet may be imbalanced owing to limited understanding of nutrition as much as lack of food availability. For example, less than half of Indian children under six months are exclusively breastfed (NFHS 3, 2005-2006). CINI’s nutrition projects focus on educating women, especially pregnant and lactating mothers, to make the best of what is available. This process is usually entrusted to health workers, local women who are trained by CINI and can approach women in their homes in villages and slums.
Our ultimate aim is to ensure full physical and mental growth and development in children by ensuring appropriate nutrition throughout the critical periods of the life cycle. Our interventions seek to address a variety of determinants of malnutrition in children, adolescents and pregnant women, as they relate to healthcare, hygiene and sanitation, child care, appropriate feeding practices (including breastfeeding), growth monitoring and promotion, adoption of low-cost home available foods, promotion of gender equality.
In addition to promoting community-based nutrition interventions, we care for severely malnourished children in our previously run Nutrition Rehabilitation Centre (NRC), where balanced food was provided in small but frequent amounts in order to increase a child’s weight safely over a period of several weeks. We presently run a day care NRC. Our low cost model to rehabilitate severely malnourished children has been adopted in a number of state governments interventions as part of the National Rural Health Mission effort to reduce severe malnutrition.
In the early ’70s, CINI developed Nutrimix, a low cost nutritious food made from locally-available cereals (rice/wheat) and legumes (dal – lentils), which has have been promoted at the home and community level, as well as in Government health and nutrition programmes. With the help of a World Bank grant, Nutrimix has been commercialised as a social business venture by women’s Self-Help Groups to offer a socially-appropriate alternative to industrially-produced weaning foods.
To address iron deficiency anaemia, in addition to nutrition education, CINI has partnered with the Government and international NGOs to provide iron supplements to children and women.
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