Healthy beginnings, hopeful futures Integrating Health, Nutrition, Wellbeing at Neighborhood

Author: Shyamal Santra , Associate Director and Co-designer of ‘Neighborhoods of Care’ (NoC), TRI

From the moment a child is born, their pin code can determine their health. Yet, many rural and tribal areas often face inadequate healthcare infrastructure.

Experts agree the best start of life —from conception to a child’s second birthday and beyond—are crucial for lifelong health, development, and well-being. Brain development is particularly rapid during the first 1,000 days, with millions of neural connections forming every second. Proper maternal nutrition during pregnancy supports ‘fetal’ development, reducing the risk of low birth weight and associated health complications. After birth, breastfeeding provides essential nutrients and strengthens immunity, protecting infants from infections.

Positive interactions with caregivers, responsive stimulation, and a secure environment foster emotional well-being and cognitive skills. Conversely, exposure to neglect, stress, or malnutrition can impair brain architecture, affecting learning capabilities and social-emotional development. Investment in early childhood health and nutrition yields long-term benefits. Children who receive appropriate care during this critical period are more likely to succeed in school, have better economic opportunities, and contribute to society.

Yet rural and underserved tribal areas often face inadequate healthcare infrastructure, leading to limited access to maternal care, neonatal services, and immunization, face higher risks of malnutrition, low birth weight, and preventable diseases. ACCROYNUM NFHS-5 data reveals that 35.5% of children under five are stunted (low height-for-age), 19.3% are wasted (low weight-for-height), and 32.1% are underweight. Notably, some states have reported increases in severe wasting among children under five, underscoring the severity of the issue. Malnutrition adversely affects cognitive abilities, leading to poor academic performance. Additionally, limited access to quality early childhood education in rural and tribal areas hampers skill development, perpetuating cycles of poverty and underachievement.

This suggests the need for continued efforts and innovative approaches and making this year’s World Heath Day theme relevant. This year’s campaign urges governments, donors and the health community to invest in proven, high-impact interventions, as part of efforts to improve overall quality of care. These include pregnancy related services to detect complications and lifesaving emergency obstetrics – noting that the vast majority of maternal and newborn deaths happen during or shortly after birth – as well as special care for small and preterm babies. The efforts will required action to address the particular risks of climate change for pregnant women, mother and newborns as they are highly vulnerable to climate-related health risks.

Creating neighborhoods of caring and health-aware people, who can act as first-responders and wellness ambassadors - especially in marginalized communities - is a way to fill this vast gap.

There is a need to shift from a ‘system’ based solution to ‘eco-system’ based approach that keeps the individual and family at centre of care at home, habitation and health system level. This requires nudging communities to define their localised priorities and institutionalization of processes for improved health outcomes and life experiences of their children. Transform Rural India (TRI), a development design organization, calls this approach Neighborhoods of Care (NoC) .

The policy makers should recognize that health and wellbeing are best achieved through interactions and connecting dots of the interconnected network of individuals, organizations, and resources in the health ecosystem, emphasizing the importance of family, community, and other components include supportive networks, service platforms, and knowledge systems, where addressing poor living conditions, unsafe water, inadequate sanitation, and other health risks prevalent among marginalized groups are core by integrating government schemes and community-based efforts to ensure better quality of life and effective use of available resources to ensure ‘healthy beginning’ for each child. It is possible to achieve by:

• Trained Frontline workforce (ASHA-ANM-AWW) at village level capable of delivering comprehensive care and managing community health programs, collaborating with committed individuals and groups from within the community supplemented by their skills that saves lives.
• Community’s readiness and ability to engage with and sustain health interventions, building capacity of local influencers, mandated actors and institutions and streamlining existing processes like VPRP-GPDP. Thus, a major set of engagements will be around building perspective of ERs or Panchayats, Leader of the CLF-VOs, local influencers, etc.
• Coordination among diverse stakeholders—including local governments, community organizations, healthcare providers, and private sector partners.
• Various departments have vertical programs that are designed to support segmented requirements of an individual’s needs. The focus will be to build local leadership for coordinated action. Effort should be on streamlining and strengthening processes for coordination at the locality level to amplify overall impact, led by leadership of the women’s collectives, supported by the Elected Representatives and block level officials.
• Addressing deep-rooted cultural and social norms and practices that impede the adoption of new behaviors and health practices through ‘whole of society-whole of government’ approach’.