Evaluation of a multi-component intervention consisting of diversified Government institutional feeding programs for improving dietary diversity of children with environmental co-benefits.

Present study is a part of the NIHR Global Health Research Centre on Non-Communicable Diseases and Environmental Change which focuses on co-developing, implementing and evaluating a Food Systems intervention in selected district of Chhattisgarh, India. In the formative phase of the study, we explored components of Government institutional feeding programs for children, the local food environment at the household level, and dietary diversity among women of reproductive age in selected villages across two blocks of Surguja district, Chhattisgarh. This was followed by collating the study findings of the formative phase along with a proposed basket of interventions. Furthermore, a co-production phase where the basket of interventions was then presented to the program and community level stakeholders at village, block and district levels. Their insights and suggestions were utilised to make necessary modifications and develop a potentially implementable multicomponent intervention package. The package will utilize government institutional feeding program complemented with a supply of vegetables from the community managed nutri-gardens and nutrition education to diversify diets of children in selected villages of two blocks of Surguja district, Chhattisgarh with environmental co-benefits. This intervention package thus developed will be implemented and evaluated using a Quasi experimental field trial. The various components of the intervention package include:

1. Establishment and management of community-managed nutri-gardens to support the supply of fresh vegetables to schools and Anganwadi centres in specific areas across 2 blocks of Surguja district

2. Developing and implementing revised, diversified, seasonal cyclic menus for Schools and AWC utilizing culturally acceptable, local recipes using local produce.

3. Capacity building and enabling the schoolteachers, cooks and Anganwadi workers, Anganwadi helpers, for managing the local supply chain and bulk preparation of the cyclic menu in the schools and AWCs using sound principles of food preparation for nutrient retention and food safety

4. Enhancing the competency of frontline workers and teachers in providing nutrition education on healthy eating, sustainable diets, and diets for the prevention of NCDs and management of noncommunicable diseases (on a need basis by frontline healthcare workers) to the program beneficiaries and the community in general to enhance healthy eating and dietary diversity at household level.