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Home-based Care

Seva Mandir has trained a cadre of Balsakhis (literally, children’s friends), community health workers who visit homes to provide neonatal and infant care. They adopt the 1,000-day approach, working with pregnant women, lactating mothers and children from birth to two. The Balsakhis come from the same communities as the families they work with, so they are trusted and respected, and are ideally placed to offer help and support in the home.

Advice for caregivers

Balsakhis advise mothers about their own health and nutrition, and proper

infant and young child feeding practices (IYCF: exclusive breastfeeding up to six months and appropriate weaning), and proper hygiene (from hand-washing and toilet hygiene to hygiene in the kitchen, including proper treatment of drinking water). They also encourage mothers to ensure that they and their children receive complete immunisation. They also regularly monitor children’s growth, and, where necessary, refer children with severe acute malnutrition (SAM) to the Malnutrition Treatment Centre (MTC) for appropriate treatment and then follow up on their care.

Balwadi Sanchalikas, Anganwadi workers, Traditional Birth Attendants and women community leaders are also trained by Seva Mandir’s technical team in Infant and Young Child Feeding (IYCF) practices. We have also been collaborating with the government to ensure provision of quality healthcare services, increase the number of families served and strengthen the quality of work of their healthcare providers such as the ASHAs and ANMs. These initiatives all ultimately improve the status of maternal and child health in our work area.

Kitchen gardens

Our nutrition experts, and other external specialists, have identified a range of vegetables and fruits which will help supplement the diets of families. Balsakhis encourage families to grow nutrition-rich vegetables and then incorporate them into their diets. Seva Mandir’s agriculture team trains Balsakhis and Krishi-karyakartas (agricultural workers) in plantation and upkeep so that they can advise families.

Recipe demonstrations

Our nutrition experts create new recipes using locally available food or modify local recipes to make them nutritious. The Balsakhis are trained to produce these dishes and then demonstrate the recipes for mothers, teach them healthy cooking techniques, and at the same time talk to them about the importance of hygiene in cooking. We also produce and distribute booklets featuring the recipes.


Since our integrated approach to combating malnutrition began, 100 Balsakhis have provided home-based care and advice to 8,000 children under 5 years of age, and now 74% of children in families under their care are well nourished. Nearly 80,000 women have received advice and support on maternal and child health from Balsakhis and Traditional Birth Attendants (TBAs). We have helped 9,600 families to plant kitchen gardens so that they have fresh fruit and vegetables readily available to eat.

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