Civil society meets governance: How Kaushambi turned the tide on child health and malnutrition

“It might sound a little stretched to narrate, but I should,” said Babulal, a daily wager from Sirkundapur village — a tiny speck of a settlement in Mooratgunj block of Kaushambi — as he recalled the night his son Priyansh was born, but didn’t cry at birth. “My world expanded with joy, but underneath, a terrifying question stirred — will this moment last?”

Babulal’s voice echoed emotions of an overwhelmed father, as he kept on narrating the story. Priyansh was born with extremely low birth weight and acute breathing complications and had to spend four critical days in the neonatal care facility. When the new-born was finally taken to home, a new crisis emerged — Babulal’s wife was diagnosed with tuberculosis.

What could have been a tragic story fortunately turned into one of resilience. Supported by nonprofit Child Rights and You (CRY) and its field partner Doaba Vikas Evam Utthan Samiti (DVEUS), the family was guided through every medical step one after another — from ambulance arrangements to nutritional care at the nearest nutrition rehabilitation centre at Manjhanpur. 

If Babulal’s was a story from the demand side, Sunita Devi’s was from the service delivery side. A dedicated Accredited Social Health Activist (ASHA), popularly known as Asha Didi in her village, Devi’s day begins before the dawn breaks at Manjhanpur. Some years back, she used to carry a register in her hands wherever she went, but now, along with the register, she carries a strong sense of purpose.

Armed with a flipbook on maternal care and a smartphone linked to a digital learning system, she visits expectant mothers, tracks high-risk pregnancies, and ensures that iron and folic acid supplements are taken on time. “Earlier, I used to merely pass on information. But now, I educate,” she said with confidence, adjusting her dupatta as she prepares for her next visit.

The experiences of Babulal and Devi reveal a rudimentary truth of social change: Transformation is possible when communities are supported and systems are responsive. Their stories put a human face on the progress Kaushambi has achieved in recent years.

The Kaushambi model shows the way

The two aspirational blocks in the district, Manjhanpur and Kaushambi, are among the most under-resourced in the state. They’ve long suffered from poor infrastructure, limited administrative reach, and hard-to-access health services.

The turnaround for the blocks has been remarkable. Between 2022 and 2024, the Infant Mortality Rate dropped from 30.25 per cent to 20.76 per cent. Severe Acute Malnutrition fell from 6.4 per cent to 5.67 per cent. Exclusive breastfeeding rose from 44.82 per cent to 68.15 per cent. Immunization coverage reached 94.33 per cent, well above the district average. Participation in Janani Suraksha Yojana jumped from 54.14 per cent to 71.01 per cent.

These aren’t just numbers — they reflect increased awareness, better access and community-driven action.

Kaushambi’s turnaround was no accident. It was nurtured over time through focused work, where CRY worked with more than 30,000 children and families. The district faced deeply embedded challenges including seasonal migration, child and maternal health and nutrition and systemic gaps — but the change began with trust.

That trust was built from the ground up. Frontline workers were trained. Awareness campaigns took root. Traditional beliefs were challenged with respect and persistence. Practices like discarding colostrum were replaced with better understanding of new-born nutrition. Vaccines, once feared, are now in demand.

District leadership and collaboration at every level

Under District Magistrate Madhusudan Hulgi, Kaushambi launched the Viksit Kaushambi Abhiyan in July 2024. The initiative, aligned with central think tank NITI Aayog’s Aspirational Blocks Programme, focused on convergence between sectors. With MicroSave Consulting and ARMMAN as technical partners and CRY leading community outreach, the programme harmonised efforts across health, education, nutrition and rural development.

“The idea wasn’t to push for compliance. It was to build trust in systems — among frontline workers, officials, civil society and communities alike,” said Hulgi.

With institutional deliveries in the district rising to 68 per cent from 44 per cent within a span of just 10 months (from June 2024 to March 2025); maternal mortality rate dropping by nearly 90 per cent and infant mortality rate reducing by 52 per cent; and number of Severely Acute Malnourished children reducing from 550 to 114 within the same period of time — the outcomes speak volumes. 

This went beyond just a makeshift patchwork of projects — it was a seamless model of multi-level collaboration. At the top, government agencies, civil society groups like CRY and grassroots-level partners like DVEUS and MicroSave designed and implemented a coherent, multi-sectoral strategy. At the grassroots, a triad of ANMs, ASHAs and Anganwadi workers operated in sync — spotting risks early, supporting families and securing timely medical help.

Just as critical was the participation of self help groups, Gram Pradhans and male family members. The change was comprehensive. Emergency care became quicker. Malnourished children were rehabilitated systematically. Antenatal and immunisation awareness became a community norm.

What made the changes possible

On a closer look, there were three core strategies that gave Kaushambi its edge. First, departmental convergence broke down the environment of silos. Departments such as health, Integrated Child Development Services, education, agriculture, rural development — all began planning together, with nodal officers overseeing thematic clusters. A robust monitoring system enabled real-time oversight and course correction.

Second, behaviour change interventions played a pivotal role. With support from the Centre for Social and Behaviour Change, district and block officials underwent targeted training, designed to trickle down to field-level workers. Frontliners gained both the skills and the confidence to shift community mindsets — from breastfeeding to better farming practices.

“After the training, I stopped just filling forms. I now explain nutrition and best practices of securing children’s health and nutrition to mothers and they listen,” said Preeti, an Anganwadi worker in Manjhanpur, beaming with pride.

And third, marrying off development actions with technology, which came as a part of the Local Administration initiative. Here, exposure to digital platforms enhanced capacity and accountability. Over 90 percent of health workers were trained via a mobile-based Learning Management System. ANMs received timely guidance through a clinical support platform. Simultaneously, community touchpoints — from parent-teacher meetings to Gram Pradhan sessions — created feedback loops.

In all, what emerged went far beyond of a government initiative. It was a collective movement owned by all.

Beyond health: A development blueprint

The ripple effect of the health success could be felt elsewhere. School attendance climbed from 54 per cent to 78 per cent, thanks to the renovation of over 150 schools and sustained parental engagement. Farmers began using less fertilizer but reaped better yields by following soil health advice. Women opened bank accounts, signed up for government schemes and began participating in financial decisions.

Behaviour change, digital tools and local accountability converged to spark a transformation that extended beyond health.

When purpose meets partnership

Kaushambi offers a blueprint for replication. It challenges the notion that structural transformation needs massive budgets. Instead, it proves that when civil society, district leadership and communities walk together, they can redefine what’s possible. This model works because it listens, acts with urgency, collaborates with compassion and finally — is owned by the people it belongs to. 

Kaushambi today stands not only as a living testament of good governance — it stands out as a case story of collective success, echoing a message that is loud and clear: Sustainable and meaningful change emerges when civil society, governance structures and the affected communities come together in collaboration and owns the change.

Soha Moitra is Director, CRY – Child Rights and You (North)

Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth