https://medium.com/@lenin_75290/from-crisis-to-care-a-case-study-of-malnutrition-and-healthcare-intervention-in-varanasi-ae671ca42197
Malnutrition and lack of healthcare access remain critical challenges for marginalized communities in India. This research examines the intervention of JanMitra Nyas (JMN), with support from Child Rights and You (CRY), in addressing these issues through a case study involving a malnourished child and a laborer from the Musahar community. Led by renowned social worker Shruti Nagvanshi, JMN has successfully bridged healthcare gaps in Varanasi through the utilization of public health schemes like the Nutrition Rehabilitation Center (NRC) and the Ayushman Bharat Health Scheme. This paper analyzes the processes, challenges, and outcomes of these interventions, which have significantly improved access to healthcare and nutrition for vulnerable populations.
Keywords: Malnutrition, Public Health, Nutrition Rehabilitation Center, Ayushman Bharat, JanMitra Nyas, Child Rights, CRY, Shruti Nagvanshi, Community Health, India
Introduction
In India, malnutrition and limited access to healthcare continue to pose significant public health challenges, particularly among marginalized communities such as the Musahar, weavers, and daily wage laborers. Addressing these issues requires a holistic approach that includes both immediate health interventions and long-term community education. JanMitra Nyas (JMN), under the leadership of social worker Shruti Nagvanshi, and supported by Child Rights and You (CRY), has been at the forefront of such efforts in Varanasi and nearby districts. This paper focuses on two significant interventions by JMN that highlight the critical role of civil society in public health.
Case Study 1: Malnutrition Intervention in a Child (M.S.)
Child’s Pseudonym: M.S.
Age: 1 year, 1 month (as of July 2024)
Weight at Admission (4 July 2024): 6.2 kg
Weight at Discharge (September 2024): 7 kg
Mother’s Name: Gulfsa (Pseudonym)
Father’s Name: Samsuddin (Pseudonym)
Residence: Ahmednagar Murgyiatola, Bajardiha, Varanasi
A blurred photo of a child from Bajardiha
to protect the child’s identity while highlighting the community’s
context. This approach ensures privacy in compliance with child
protection laws, while also offering a visual connection to the setting
where the intervention took place.
M.S., the second child of a weaver family in Varanasi, was suffering from acute malnutrition when JMN fieldworkers identified his case during routine health and nutrition mapping. At just 13 months old, M.S. weighed only 6.2 kg and exhibited severe symptoms, including persistent diarrhea and extreme weakness, requiring urgent medical intervention.
Despite the child’s critical condition, the family initially resisted seeking treatment, citing economic challenges and their inability to manage household responsibilities. This reluctance reflects a common socio-economic barrier in healthcare access among marginalized communities, where daily survival often takes precedence over long-term health concerns.
After intensive discussions, JMN worker Jyoti successfully convinced M.S.’s mother to seek treatment at the Nutrition Rehabilitation Center (NRC). However, due to a lack of available beds, M.S. was transferred to Durgakund CHC, where he received immediate care. Over six days, M.S. gained 800 grams, marking a significant improvement in his health.
This case underscores the importance of persistent advocacy, community engagement, and effective use of government healthcare programs in addressing child malnutrition.
Ayushman Bharat Card Saves a Life: The Story of Roshni
Another poignant story of JMN’s intervention comes from the Musahar community in Sajoee, where Roshni, a laborer at a brick kiln, experienced severe abdominal pain. Through the efforts of JMN worker Somaru Patel, Roshni was taken to Savitri Hospital and diagnosed with gallstones. Despite the need for immediate surgery, inflammation prevented the operation. However, the costs of her treatment were fully covered under the Ayushman Bharat Health Scheme, which offers up to ₹5 lakh annually for eligible families.
Roshni’s situation was critical not only due to her health but also because her livelihood as a daily wage earner was at risk. The Ayushman Bharat card ensured that she received timely medical care without bearing the financial burden, and her surgery was scheduled once her condition stabilized. This intervention has not only saved Roshni’s life but has also raised awareness among other laborers in her community about the benefits of enrolling in the Ayushman Bharat scheme.
Through this case, JMN has demonstrated the potential of public health schemes like Ayushman Bharat to alleviate healthcare challenges for India’s poorest communities. Roshni’s case led to a surge in enrollments for the health card among her fellow laborers, significantly expanding healthcare access in the region.
Discussion: Bridging the Healthcare Gap Through Civil Society Leadership
Both case studies highlight the critical role of JanMitra Nyas (JMN) in providing healthcare access to marginalized populations. Under the leadership of Shruti Nagvanshi, a pioneering social worker known for her commitment to human rights and child welfare, JMN has developed an effective model for healthcare interventions that combines grassroots advocacy, government schemes, and community-based awareness programs.
The Role of Shruti Nagvanshi’s Leadership
Shruti Nagvanshi, a widely respected activist and founder of Savitri Bai Phule Mahila Panchayat and People's Vigilance Committee on Human Rights (PVCHR), has been instrumental in shaping JMN's approach to healthcare access. With a strong commitment to Dalit rights, gender equality, and children's health, Nagvanshi's leadership has led to impactful interventions that address not only malnutrition but also broader healthcare challenges faced by marginalized communities. Her leadership has garnered international recognition, including awards like the Rex Karmveer Chakra and the Public Peace Prize, and has influenced policy discussions on healthcare and human rights both in India and internationally .
Effective Use of Public Health Schemes
The success of JMN's interventions can also be attributed to its strategic use of public health initiatives such as the Nutrition Rehabilitation Center (NRC) for treating malnourished children and the Ayushman Bharat Health Scheme for ensuring financial coverage of healthcare costs. These interventions provide a framework for addressing some of India’s most pressing health challenges, including infant mortality, child malnutrition, and healthcare access in economically deprived areas.
Sustained Community Engagement
One of the key strengths of JMN’s approach is its focus on sustained community engagement. In both cases, JMN fieldworkers not only facilitated immediate medical treatment but also provided long-term follow-up and counseling. By educating families on nutrition and healthcare and helping them navigate public health systems, JMN has created a model that empowers communities to take ownership of their health and well-being.
Conclusion
The work of JanMitra Nyas, supported by Child Rights and You (CRY) and led by Shruti Nagvanshi, offers a compelling example of how civil society can play a transformative role in addressing malnutrition and healthcare access in India. Through strategic use of public health programs, community mobilization, and strong leadership, JMN has significantly improved health outcomes for vulnerable populations in Varanasi. This study demonstrates the effectiveness of a multi-pronged approach that combines immediate health interventions with sustained community engagement and advocacy.
Future interventions must continue to focus on inculcating the best Knowledge, Attitude, and Practice (KAP) among different stakeholders to maximize the delivery and utilization of healthcare services for marginalized communities. This includes reducing socio-economic barriers to healthcare and ensuring equitable access to essential resources. By fostering collaboration and enhancing stakeholder capacities, these efforts will align with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 1 (No Poverty), and SDG 10 (Reduced Inequalities), contributing to a more inclusive and resilient healthcare system for all.
References
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