INTRODUCTION : The theme ‘First 1000 Days of Life’ begins with pregnancy planning and goes up to when the child reaches his/her second birthday. The major components for a healthy 1000 days’ survival of a child includes adequate health care, nutrition, stimulation for early childhood development, quality childcare practices and a clean, safe environment which will have an influence in the future of a child. Eleven low performing districts in women and child health and nutritional status were selected by State Planning Commission namely Perambalur, Karur, Thiruchirapalli, Ariyalur, Sivagangai, Villupuram including Kallakuruchi, Pudukottai, Thiruvannamalai, Vellore (Integrated) and Thirunelveli and Tenkasi. 23 Blocks identified from the above districts were included for this program.
The conditional cash transfers in developing countries reduces poverty and increases consumption especially in a short term and this window can be used as an opportunity for improving health seeking behaviour, Prevention of Anemia and improved Weight gain of pregnant mother and early childhood up to 2 years.
1. Health seeking behaviour should be improved through health facilities by sensitizing the mother and her spouse, which in turn the quality of health services can be improved on demand creation,
2. The weight gain during the pregnancy,
3. Prevention and management of Pregnancy induced Anemia.
The Maternal Weight Gain should be 9-11 Kgs for an average Indian woman. The minimum weight gain should be 2 Kg at 18-20 weeks, 3+ kg in the 26-28 weeks and 4 kg in the 37-40 Weeks. If the mother gains weight of the said minimum level in the specified trimester, then only the cash benefit was awarded.
Regarding Anemia, a minimum haemoglobin concentration of 11 gm% is considered normal and because of increased fluid volume, mid-trimester dilutional anaemia is expected. Hence a minimum value of 10 gm% may be considered normal in the second trimester and 11 gm% is considered normal in third trimester.
First Incentive of Rs.1000/- at 18 – 20 weeks, Second Incentive – Rs.1000/- at 26 – 28 weeks, Third Incentive – Rs.1000/- at 37– 40 weeks, First incentive for Baby - Rs.500/- at 6th month, Second Incentive for the Baby Rs.500/- at 12th month, Third Incentive for the Baby Rs.500/- at 18th month, Fourth Incentive for the Baby Rs.500/- at 24th month.
AIM : To measure the initial impact of ‘First 1000 Days of Life’ program on health seeking behaviour, Prevention of Anemia, and Weight gain of pregnant mothers in 23 blocks of Tamil Nadu.
METHODS : A retrospective PICME secondary data-based study was conducted in 23 blocks of Tamil Nadu during October 2023.Data was collected from PICME data base by using state login ID comprised details of pregnant mothers registered, treated, and provided with cash benefits under ‘First 1000 Days of Life’ program from November 2022 to February 2023.
RESULTS : The baseline maternal health indicator - Early registration of pregnancy (within 12 weeks) was improved from 79 % during 1st instalment period to 86 % and 85 % during 2nd and 3rd instalment period respectively. Mothers getting eligibility of conditional cash transfer after receiving proper treatment for anemia and weight gain improved to 72 % during 1st instalment period, 66 % during 2nd instalment period and 58 % during 3rd instalment period comparing to their eligibility at their first visit to PHC 64 % during 1st instalment period, 64 % during 2nd instalment period and 51 % during 3rd instalment period.
CONCLUSION : Indicators revealing the health seeking behaviour of pregnant mothers such as mothers getting eligibility after proper treatment for underlying cause shows the impact of conditional cash transfer programme. These findings help us to generalize the activities to all the 388 blocks in the future.