Page 2 - Public Eye Newsletter Volume 7 Issue 3

September 2023 Volume 7 Issue No. 3

Stakeholder Interview ic acid fortification (WIFS) programme in schools. This time
around we built a component of behaviour change campaign,
to engage students on the need for iron fortification and sup-
plementation. I was actively involved in the field activities,
and what made a lasting impression was the impact of our
behaviour change campaign. While the biscuits were a defi-
Dr. Anupama Shetty nite draw at schools, the nukkad natak or street plays which
Mission Director,
Biocon Foundation we launched, struck a chord with the students and the wid-
er community. Attendance levels rose and compliance levels
for consumption of the biscuits reached more than 80%. Re-
Q: Tell us something about yourself and one experience peated surveys across the 100 days of distribution found a
that you would like to share in the area of nutrition for significant rise in the mean haemoglobin levels across both
all? male and female students. There was an overall decrease in
A: Coming from a family of doctors, I always thought a busy prevalence of anemia by more than 35%.
practice in the suburbs would be my final and only calling. This programme and its unique challenges influenced my
Little did I imagine that in my professional journey, I would outlook towards nutrition programmes and their intricacies.
take up diverse roles in hospital administration, public health From engendering traction on new models of healthcare de-
research and strategic corporate social responsibility. A phy- livery to securing a credible evidence base; from addressing
sician by training, following a few years in private practice, I cultural barriers to getting the stakeholders and commu-
undertook Masters in Hospital administration in TISS. After a nity to own the programme; there were several contextual
stint in tertiary care settings, I decided to pursue a doctorate insights. I also believe that public healthcare concerns in
in health systems studies from my Alma Mater again, hoping general lend themselves beautifully to the Complex Adaptive
to engage in the field of public health. Fortunately, I had the Systems approach . By applying the principles of Complex
opportunity to lead a Pan-India telemedicine programme, as Adaptive Systems theory, I believe we can move beyond linear
part of a CSR initiative at Narayana Health. Thus, began my approaches and address multifaceted challenges in a more
journey in public health and an evolving CSR landscape, un- holistic and effective manner. This approach encourages a
der the guidance of Dr Devi Prasad Shetty. After a wonderful deep understanding of the system’s dynamics and empowers
tenure in NH, I transitioned to Biocon Foundation, reporting stakeholders to collaboratively create sustainable solutions.
to Dr Kiran Mazumdar Shaw. I believe I have the unique hon- Recognising that complex systems are prone to disturbanc-
our and privilege of being mentored by two legends in the es, its essential to create resilient systems that can adapt to
healthcare and entrepreneurship domain. changes.
My experience in nutrition within the CSR domain, began Q: In your opinion what should the Government focus
with a challenging maternal health programme in an aspira- on with regards to health and nutrition?
tional district in Karnataka. Set against the backdrop of low A: As per recent estimates, wasting in children under-five in
human development indices, patriarchal mind-sets and poor India is higher compared to international standards, with
literacy rates, the pilot initiative on maternal health obstetric one in five being wasted . Studies have compared nutritional
monitoring was besieged by several challenges. High parity indicators in under-five population across National Family
levels, teenage pregnancies and birth spacing issues had im- Health Survey 4 (NFHS 4) and National Family Health Survey
pacted maternal health adversely. What was starkly evident 5 (NFHS 5). Worsening of severe acute malnutrition (SAM)
was the lack of agency and awareness amongst women on were noted across several hot spots in various districts. As
malnutrition and anaemia as a risk factor leading to adverse per NFHS 5, the prevalence of SAM is 7.7%, compared to a
outcomes in pregnancy. prevalence of 7.4% in NFHS 4. Although the prevalence seems
At this juncture, we had the privilege and wonderful opportu- stagnant, what the national average hides is the worsening of
nity of partnering with a renowned nutrition partner, who too SAM in individual districts . Various factors influence chron-
were seeking to address the issue of malnutrition & anaemia ic malnutrition in children, with maternal nutritional status
through an innovative programme. Thus, an ambitious pilot being a prime factor. Several events predate malnutrition, in-
was rolled out in Rajasthan as a private-public partnership. cluding teenage pregnancies, maternal undernutrition, close-
The programme was modelled as an action research study, ly spaced births and high parity levels being major factors.
aimed at introducing iron fortified biscuits which would be Studies have indicated an intergenerational perpetuation
an adjunct to the existing government led weekly iron & fol- with one third of women in their reproductive age group be-

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