 Hello everyone welcome back to my session one part four today I'm going to talk about a capacity building as I discussed in earlier tutorials how you know we worked on one framework in one of the NGO and we got excellent results you know with the remarkable reduction of Sam man you know underweight even stenting and it became our goal to kind of replicate this model you know if not the whole model but at least the learning that we had from that NGO and once I kind of presented my data in world breastfeeding conference you know IT Bombay I think got to know about this data and you know they invited me for many of their workshops you know because one of the department was working on nutrition a sitara it's a sitara and that that's that's what I joined but even in 2017 or so one of the professor Professor Kannan he was running this program on spoken tutorial you know and he created multiple tutorials on software you know teaching children software through through online tutorials and he decided to get into health and nutrition you know tutorials and that's where we met and I you know he asked me if I could be content reviewer or the team lead and it was a golden opportunity to pass on the knowledge that I had acquired you know for so many years working in slums and I immediately grabbed that opportunity and here I am actually you know and I joined another department called sitara that's a data department it also called we call it Chinnu child nutrition center of excellence so here we have you know a few professors who are working on in child nutrition so talking about data analytics from government you know we get we do a data analytics HMI is data analytics you know a lot of other data analysis we also I take a course on maternal infant young child nutrition it's a critical issue and contemporary India another professor professor Satish at new three you know he's a data geek so he talk he takes classes on analytics for students but he's also very very passionate about nutrition for young children so he's he's just amazing professor and we have a professor methora and he works on basically you know food technology and food processing so we have a wonderful team and I'm part of it now and I've continued working at spoken tutorial because you know that project is extremely close to my heart because we are creating all this health spoken tutorial in my field and I'm going to talk about it right now but basically you know once we decided to kind of take this learning to different you know kind of districts or blocks or even state now we wanted to have a conversions approach you know I mean that was we know that you know we need the Department of Health we need Department of WCD so this is what basically you know we try to have the conversions wherever we go but many times has happened that you know Department of Health may not be talking to WCD department you know and we have difficulty but you know we try our best so here there was this one training which was done in Milgaard this is a sub district magistrate right there sitting on the main chair over there and you know she she's ice officer Dr. Mittali City one of the very charming very hard-working young ice officer and she came to Satara Bombay and said that you know I have so much of malnutrition in my Milgaard can you please help us what to do so not only she got some training in our department you know but she also you know we did online training in COVID time we could not travel so basically all the whole department you know WCD as well as the Minister of Health and Family Welfare we did training online but then she you know she also attended the training and in fact eventually she started kind of training on her own you know using a health spoken tutorial so it empowered her so much that she started taking training on her own so our goal is basically you know capacity building so what we do we try to you know get all this healthcare workers Anganwadi workers you know to come and basically learn from us this is in Thalassery and what we do is we give them breast model okay we give them baby doll we give them some material okay and then of course you know growth charts because it's very important that they learn how to plot growth charts and they see tutorials we are going to talk about I think I've already discussed a little bit of tutorial earlier but I'll be discussing a bit more about it and this is how you know we we train them actually so we do a lot of workshop and when we have access to live born babies we also invite mothers with young babies so they can get exposure to how to you know help mothers you know with breastfeeding in a workshop environment and this training is actually three to four days you know and we have so much fun because you know there's so much of interaction this was in Pitrager in one of the training and it's all Anganwadi workers and you know this Pitrager is an Uttarakhand very close to China border actually you know it took us three days to reach there and again you know there's a lot of interaction a lot of talking we insist a lot on cross-credit loan and 45 points of counseling this is again in Chandrapur Chandrapur district Maharashtra and again my goal is skill so we kind of make them very very efficient on skills you know everybody knows that breastfeeding is important you know everybody knows it but how to do it unfortunately that skill was lacking so we insisted on that this again from mail card so every every training gets is 45 point counseling brochure okay it it has become like our mantra analysis like Hanuman Chalisa this has become like cross-credit cross-credit loan Pistolisa how do we do it we do it with the help of health spoken to all because only with you know tutorial like that you know would help us to train lakhs and lakhs of healthcare workers and that's what our goal is so and I'm the content provider of the sales spoken tutorial I have some other senior doctors also who basically kind of give us you know their recommendation association time-to-time we have Dr. Ratnathar she is the nutritionist and she she gives her feedback on all the content reviewer of recipes so we have a lot of recipes videos also and so far we have created 73 tutorials they are on adult adolescent maternal infant young child feeding nutrition they are presently in 15 Indian languages they also created in Korku and Santali this are two you know tribal languages this is some of the topics many more has come come out after this you know this slide but we have topics on each and every every point you can think of you know so breastfeeding all the different points breast crawl colostrum you know breast crawl during a sizzling section and we have it on any complications of breastfeeding like generally we don't see it when we have proper breastfeeding at birth but in case if anybody has a nipple sore or breast condition breast difficult breastfeeding difficulties then we also talk about type 1 type 2 nutrient which I discussed in the last session about type 1 and type 2 type 2 are important for the growths you know for muscle development as well as lean as well as you know bone growth then we'll have recipes recipes videos for six months old seven months old eight to eleven months old in all different age group junk food is another very important tutorial because everywhere people need so much of junk food and you know it's important to show them this video to make them understand what happens to the body when they have this you know empty calories we also created tutorials on you know personal hygiene safe preparation all the different nutrients why they're important nutrients like choline vitamin B12 magnesium potassium you know all calcium with vitamin C protein you know and then we have created a recipe videos for vegetarians and non vegetarians for each nutrient okay we also have recipes for pregnant mothers lactating mothers pre pregnancy nutrition so of course I know I'll be basically asking me to watch some of these tutorials in in each of my sessions but you know definitely if you can subscribe to it and keep the notification on we have also created tutorials on growth charts because many times mothers they don't know like you know what should be the target weight of that child what even the healthcare workers they don't know you know how to plot graph graphs or whether babies gaining weight or not appropriately so we have those really good tutorials on W which are growth chart which I will be taking in detail in probably around on 12th session actually this are some of the languages that we have created tutorials in it's getting dubbed as we speak what has spoken to all they're like about 10 minutes animated tutorials and you know it is we created through screen capture and we with the running commentary script approved by a beginner's understandable so I wanted to kind of you know obviously it's it's a rule that I abide you know professor Canon is very very strict on all this spoken tutorial rules so you know he always mentioned that the script should be so simple that even the young like a youngest child I would say even the young adults and not the youngest child but the adolescents should be able to understand what we are saying you know so what we did is basically we brought science and you know skills to the last mile through this tutorials okay and our goal is that you know if somebody stuck if they want to know about certain things and if they if you suppose mother is say in somewhere and she's not been able to breastfeed she should be able to and she does not have any access to say any help then she can just switch on this tutorial and you know understand what are those 45 points and then she can learn about it you know and most of time they are very very successful because we run this you know one at one internal portion headline and that's been really kind of you know we get a lot of calls and many times we just send them this tutorials and you know mother said that oh problem is solved within 24 hours so so that's what we also kind of you know encourage mothers and help you focus to call us if there is an issue okay all these two tolls are basically you know translated in 22 languages Indian languages ours health coconut rollers are translated in 15 languages and right now many tribal area ice officers are coming to us and they want us to translate into those tribal languages so we have started that translation as well and it's in the open source we have it on a website as well as we have it on a YouTube so you can just go and watch you know whichever tutorial you want totally free of cost for everyone this is just example of you know it's taken from YouTube and we're showing how it is shown what are these two tolls or what is the tolls so I mean who are the beneficiaries of this tutorial everybody believe me you know more than urban mothers rule mothers parents urban parents healthcare workers you know including medical officers nurses pediatricians obstetricians especially and pediatrician we don't have any knowledge we didn't have it Anganwadi workers asha's a names it was just anybody because it's a life skill it's a nutrition in the life skill breast feeding complementary feeding imagine if you didn't know what like how to eat right or how to feed the child I mean child is a tremendous risk of getting into malnutrition because they don't have a store you know so it's important that you know we we learn this and I would also recommend you know adolescents and even college students college students you know undergrad post grad PhD students they should watch it you know good thing about this is that there is no dilution of knowledge because lot of what happens in TOT when you train somebody and we ask a person to go and train somebody else no long time there is some amount of dilution you know so here what happens is you know when training on the trainers trainers have this tutorial if on front of them they can train using these tutorials and then can have discussion so there is no dilution of knowledge in a same amount same kind of on to next person and goal is to really kind of train each and every help you because using our tutorials it is designed for self-learning also so as I mentioned that you know anybody can watch it and they can learn on their own okay it's easy to share a link with anybody so suppose if you have anybody in your family who is kind of struggling with breastfeeding or complimentary feeding or you know not sure whether baby can eat this or that you know you can just pass on the link and boom mother will know everything even if somebody it's it does not have smartphone okay and say the healthcare worker or the team wants to go through training you know I think Bombay used to basically provide Asha I mean Akash tablet you know and we used to do training using Akash tablet but so far we haven't had that problem because you know really we do training on the screen so so far we don't have that problem and tutorials also can be played in hospitals and government healthcare center wherever they want you know and we can also kind of do large IT kind of training you know because we have we can train like thousand people at a time or even 10,000 people at a time now we have that kind of facility at IIT Bombay so you know so we can do that we can do scaling of this training to to whole of India actually and this is our YouTube channel health spoken tutorial IIT Bombay and you know if you want you can just kind of subscribe over here and this was taken when there were only a hundred subscribers you know we didn't have this was almost five years ago and now we have almost almost 16,000 subscribe subscribers and I would want many more of course and we have different channels like English Tamil you know Hindi so we have all the different language channels we will also making a playlist playlist for example say for lactating mothers play play list would be different for pregnant mothers the playlist would be different so we will create the playlist For Munna, classroom, we will learn this is the reason for breastfeeding which was the first step to breastfeeding before breastfeeding, there were preparations for mother and to get the full breastfeeding, go ahead let's start In the world, mothers make their children stand in different situations. For a mother and her children, the best situation is when the mother and the children are at rest from the beginning. The children can connect deeply to the mother's body. Okay. So that was Hindi. Now this is breastfeeding latching. Welcome to the spoken tutorial on breastfeeding latching. In this tutorial, we will learn about breastfeeding latching and learn how many times to breastfeed. Before we start, remember that breastfeeding latching is very important for a pregnant woman. Because breastfeeding latching is wrong, it will only cause constipation from nipple. This will reduce breastfeeding latching. Welcome to the spoken tutorial on breastfeeding latching. In this tutorial, we will learn about breastfeeding latching for 6 months. We will learn about breastfeeding latching for 6 months to 24 months. So we have also created questionnaires for each and every tutorial. So what happens is whenever we go for training, depending on what thematic that they want to get trained in, we basically do pre-test and post-test. Now, a lot of this question is also there on digital media, digital platform. So if you don't want to kind of put it up on the paper or you don't want to waste papers, you can also take those exams just online. So this is the facility we have. So here in one of the training, what we are doing is we are giving exams. So they are taking exams on phone and this is pre-test exams. So they all are busy taking exams. This was in Banaskata district and we had put it up for all our questionnaires on KoboTool. So this is to understand their knowledge retention and how much knowledge. First of all, pre-test. So we want to know how much knowledge they had previously. But the thing is the skills are very much new for them. So obviously they don't do very well on pre-test, but they do amazingly well on post-test. This is in Goa actually. So the tutorials are being run in College of Home Sciences. Here, one of the Anganwadi workers is showing some mothers. There was some breastfeeding week. So they're talking about breastfeeding. So, you know, I mean, it just runs on the phone. So even if you're visiting somebody's house and if she has an issue, you just show them this tutorial and they will know what to do. So again, this is one of the training in Talaasari in Palghar. You know, they are just so captivated by it because it's so interesting for them actually, you know, normally learning about new skill, but it's like, wow, okay, I'm learning everything from online tutorials and that to something like this, which they had never heard of, you know, learning about breastfeeding from tutorials actually. This is in Bara, Rajasthan, where, you know, Action Against Hunger has a beautiful project running over there. Faitanga Foundation is called. And, you know, what we do is we show them this tutorial and then we have 10 minutes discussion on it, you know, to understand what they think about the tutorial, what did they learn, what other, you know, problems that they have, any questions, queries, you know, so all that we discuss. So this is another story I would like to share with you all because we're talking about capacity building of our MIICF for different states. So we have Dr. Fancy and he's just, I mean, of course, I have known him since 2019 now and, you know, he was a DHO at Sabarkata District. So he came to Sabarkata District. I mean, he came to our Satara IIT Bombay to meet us with his team. This is Professor Satish Fnio 3 and this is his team. And, you know, you know, Dr. Manish finds his team and they all came to Satara Bombay to see that, oh, what is IIT Bombay doing? What is it doing with child nutrition? You know, it's an engineering institute. I mean, what are they doing for, we call it CHINU. I mean, what is CHINU about child nutrition center? You know, we have a center of excellence, actually. You know, nobody knows that, but we have, it's a center of excellence on child nutrition. And he stayed there for two days, you know, and then he learned about our work. He was completely impressed. So he decided that he wanted to take this training to Sabarkata District. So immediately, you know, he came in March and he rolled out and literally in April, he rolled out the whole program. He took only four tutorials because, you know, that time he wanted to just focus on breastfeeding latching, you know, and he called it as a latching project. So he disseminated about four tutorials on latching. Okay. And this is how he did it. So what he did, he basically took exams of all the people, pre-test exam. Then he asked him to watch tutorial, ST tutorial, okay, four tutorials. So basically started with medical officers. Okay. And then he asked him to take the exams again, like a post-test. Then he basically what he did, he said that, okay, now you attend the training workshop where we had breast model and doll and all that, you know, and then basically he said, okay, now you practiced on the doll and the baby on the breast model. Now you go and practice on mothers. Okay. Because unless you practice in the field, you wouldn't know whether you are getting impact or not. Okay. And then what he did, he said, okay, now you follow a few babies. So he gave about 10 babies. And he said, now you see what is impact. And if there was any poor weight gain, he would say, go back again, watch this tutorial, take that exam, practice again. So it was like a whole circle, you know. Until each and every medical officer understood the actual skills and started showing impact, you know, by the time we were getting just amazing results and Sabar Khattar district had in NFHS 4, Sabar Khattar district had 51% stunting, 51%. Okay. And the result NFHS 5-etages came out and the stunting, I'm not saying it was just because of lacking project, but basically, you know, the results that I saw in those past, in the six months, it was just mind-blowing because what was happening, we had not touched mothers' nutrition. So a lot of these babies were born small. Okay. They were like 2.3, 2.4 kgs, you know. But just in a matter of couple of months, they would like, you know, double their weight in just one and a half month, two months, you know, fast, fast. One and a half kg, one and a half kg, one and a half kg, you know, every month. And by the time they were like three months, they were like so tall and big and we were really, really excited. So this is one of the training in Sabar Khattar where I'm training all the medical officers and nurses and, you know, all those people. We did three-day training and then we also had trained, you know, some of these, this was after we finished that project with medical officers, you know. So this was in September. Again, I went to train some of these ASHAs. One of the block, Himmat Nagar block, we wanted to train all the ASHAs, direct training, you know, face-to-face training with ASHAs. And this is the same program. ASHAs are basically learning all the skills, extremely happy, you know. And then of course, you know, medical officers who were trained earlier, you know, in month of April, they went back and trained all their ANMs, ASHAs, going back into the PhDs. And there were, you know, a lot of these medical officers are male doctors, but they were just so comfortable. And even they were so excited. Because it's a different technique, it's completely different hand, completely different way you hold the breast, you know. And then obviously they were making sure that, you know, so they were running the tutorials in the back. And at the end of the tutorial, they would basically show them direct techniques, you know. Here again, some of this, you know, see how they are learning using this tutorial. And then basically practicing on the baby dolls, you know, with mothers directly. A lot of time they don't have, you know, space. So they just sit outside in the open space, you know. There's a rural area, some of them are really remote tribal areas, you know. But it's just that, you know, we took this learning to the last mile. And Dr. Fancy is just, he is one of the very dynamic officer, you know. I really have a lot of respect for him. Again, same, you know, each and every PhD had this tutorial is running. And we kind of, you know, gave each and every important points of breastfeeding, you know. What we did is we made them latching expert. I would not call them lactation expert. I call them latching expert. Because if you have a good latch, you will not have any complication. You will not have breastapses. You don't, they don't need to be doctors to learn latch, you know. Latching is every mother needs to know. Every father needs to know how to latch the baby, you know. So this is what we did. We just made them latching expert. Here, what is happening is after, you know, taking those exams, medical officer is teaching this mother's, you know, how to hold the baby. This is, of course, on the baby doll. And here, you know, this is again in Himmat Nagar. I went to district hospital because I realized that most of the babies are born in district hospital, you know, sub-district hospital. So here, there were this bunch of nursing students. So I was teaching them how to help mother, you know, with latching. So again, trainings, you know, again, people are discussing 45 points. They discuss with each other. Okay. Because I want to make sure that once they see that at all, they can able to teach others also. So we do a lot of this training, you know, how to teach other mothers to teach other healthcare workers. Then what we did, you know, both after, you know, Banaskata and also Sabarkata, we created latching groups. Okay. So in that latching group, what would happen? Of course, this is from MailGuard because in MailGuard also had a latching group. It's in Marathi over here. And they would basically send me, you know, data of children, you know, it was very rudimentary. It was in MailGuard, they would just write it on the piece of paper and send me data, weekly data or bi-weekly data of all the children, whether they're growing well or not, you know. But, and then we know it would be, it would come on, somebody would put in our Excel spreadsheet and I would basically follow up those babies to see how they're growing. If they were not growing well, I'll put it in the red. If they are very critical in output in dark red. So we were doing everything manually actually. It was a very manual tedious job, you know, to put all this. But through those WhatsApp, you know, doctors would kind of send some of the videos to kind of make sure that latching was good, positioning was good. So there was a lot of interaction through, you know, WhatsApp. Of course, we took consent of mothers, but it was more for a learning purpose, you know. And then we used a lot of IC material, data monitoring tool also. So here, you know, with the State Institute of Health and Family Welfare Gujarat, we just had a training of 200 people, state level training. So 33 people from 33 district came and then we kind of created this IC material and, you know, we kind of gave it to them. It was four-day training, residential training, and hours or eight in the morning till 12 midnight, you know. And then, of course, these are some of the nutrition charts that we gave out. I'll be talking about this, all the different nutrients, magnesium, sulphur, all that. So you'll be learning about it. These are basically brochures that we had created, 45 points. So they took these brochures also with them. Then we have this, of course, I discussed about, you know, mothers coming to PhDs, you know. So this is one of the picture. And here, you know, once a mother gets delivered, this medical officer is teaching her how to breastfeed. And here is the tutorial running in the background. So one of the neighbor, one of the family member is actually watching the tutorial, you know, because it's important to teach her also. Because when she goes back, mother goes back, you know, she won't have medical officer in her or I'll start teaching her 24-7. You know, so we make sure that family members are taught to, you know, if husband is around, husband should learn, you know, like how to hold a baby, how to give it to the mother, you know, how to change a diaper, all that. Here is one of the beautiful picture, the RBSK doctor is teaching the mother. You know, they go for the checkup in her 40s. So they, you know, because he had attended the training, he knew exactly how to hold the baby. So he sat down on the floor, you know, and he was teaching mother 45 points. And I was just so proud of, you know, this kind of... So I feel that even India, if each and every healthcare person, okay, be it RBSK, Ayush, MBBS, staff nurse, triple A's, you know, all the facilitators, supervisors, CDPs, they all should know it. You know, once they know it, they'll know exactly what to do, you know, and they'll figure out where the problem is. So I insist that they all should. In fact, IAS officers should know too, really. What are the results of training in BK? Of course, I already kind of presented the data, but before we did the research, you know, we wanted to see that after this training, what are the results that, you know, when we told them to follow up 10 babies. So each trainee was following 10 babies. So just in a matter of, you know, a couple of months, we had data of 407 children, you know. And if you look at it, we had just amazing results. Look at this, more than 30 to 45 grams. Almost 50% children had more than 30 gram weight per day. And some more had even more than 40 grams, you know. So this is important that, you know, we must make sure that children gain good amount of weight. Here, you know, we wanted to see that at week one and week four, what was the difference, you know. So this is basically definitely children kind of curve shift to the right. You know, that means children were born small, but, you know, in the matter of just four weeks, they were coming closer to the mean, means they were becoming bigger, you know. Mean means here, it's only your average children that are on the mean, okay. This was, we wanted to see what was the data. So we had about 49 babies who were low birth weight babies. And we wanted to see what was the data at week one, week two, week three. And here, you know, in week one, there was almost 40 gram weight gain in one week, 40 gram weight gain. So this is per day weight gain data. In week two, it was 30 gram weight gain per day. Here, week three, 34 gram weight gain. So what I'm saying is that, you know, if the latching is good, then the average weight gain per day is pretty high. It's pretty good actually, you know. Here is one very nice, you know, field health supervisor. I would say actually A&M supervisor. She had, her daughter-in-law had delivered a baby, 3.1 kg. And she had, she had learned this technique from D.H. Dr. Fancy when he was D.H. over there, Baraskhata. And when he, when she learned that technique from him, you know, she said, let me try it on my daughter-in-law. There's no harm. So she tried that technique and this baby was just gaining weight like leaps and bounds. Like by 13 day, baby was only 4.3, can you imagine? Birth weight is 3.15. And 13 day, baby was 4.3. And in one month, baby was 5.6. I mean, 5.6, 5.6 kg at around two, two months of age, two, two and a half months of age. Imagine this baby gained 2.5 kg in one month. I mean, unbelievable. So then, you know, when she came to meet me in the training and she attended the training, fall training again, because when I was going to talk more about maternal infant young child nutrition, the whole thing. So she came again for the training. And here I just want to play one more video. Birth weight is 3.0 kg. And when she gained 3.5 kg, she gained 4.3 kg. She gained 4.3 kg. And in one month, she gained 5.6 kg. So leaching has a huge difference. Leaching has a huge difference. She understands and shares with other children. She shares with her mother. Even her mother has a lot of support. Her mother has a lot of support. I have a lot of FHS. But when I was in college, and my mother was with me, she shared with me a lot of support. And I used to do my work. I used to explain to other mothers. I used to tell them, if your child's weight is more important, then you are not worthy of breastfeeding. I used to have a lot of meetings with my parents. I used to have a lot of meetings with other delivery mothers. When I met her in NC, I used to teach her how to do leaching. I used to teach her how to do leaching. And I used to share with her mother and share with her mother. I used to explain the weight of this child. She has a lot of support. Does she have much weight? She used to exercise in the morning. She used to exercise in the morning. Do you like it that she uses to exercise in the morning? No. Do you think she has more resources? No. Now she is a practical woman. She has studied a lot, but if she changes, she will not get the results. But when she grows, she has the results of her children. She was educated, amazing. She's saying that, you know, she's going to take this 45 points to each and every child that she knows, you know, so that's, that's amazing. So it's the same baby, you know, her grandchild. So this is a baby at four months of age, baby's 8 kg. Okay, so by four months, if baby's 8 kg, you can imagine how beautifully that baby must have grown, okay, from 3 kg to 8 kg in just four months. This is a Sabar kata again, you know, the first display that I was talking about with Dr. Fancy was a DH, and then he moved to Banaskata. So we took that program to Banaskata. And here, you know, as you can see, the stunting rate is 51%. So we just started the latching project, nothing else. And you can see all these babies are born low birth weight, so 2.6 kg, 2.2 kg, look at the low birth weight babies. But because of the breastfeeding was so good, you know, the latching was so good, that they were, look at the weight gain 4.89, you know, in just matter of two months, this baby 2.2 to 6.6. So basically literally in three months, you know, he tripled the weight. Normally, we are told that, okay, tripling of weight is one year. So anytime when I ask in the field, when should this baby triple the weight, there's a one year. So they, they feel that, okay, one year old 6.6 is normal. No, not normal. You know, so the babies, they've gained very faster and cross-created hold. In fact, low birth weight babies, they gain such beautiful weight as mind-blowing, okay? This is some of the babies, Manaskata are just clicked in a doubling of weight, 60 gram weight gain per day. Imagine, this is 24 day old baby, okay? Beautiful, beautiful. So this I already discussed about the complementary feeding. Here are some of the BK program that, you know, just sharing some of the beautiful photographs of these babies. They grow so beautiful, you know, these are six months old babies. This is a 24 week old baby boy, you know, we tell them that buy a newer, bigger, you know, machines, because children are growing so fast. And, you know, Ashas and A&Ms can't believe it. So they just continue carrying a small weighing scale, you know, they use it till one year of age. And here, like we have 24 week, 24 week baby boy, you know, who is already reached 10 kg, okay? So this is some of the pretty much small, small children. Six kids, this is just me, three month old baby, less than three month old. This is a six month old baby girl, 9.1, exclusively breastfed mother's milk. Okay, small baby, look at the length, so fast, so tall they grow. Okay. So if you want to really tackle malnutrition and infantile young children in India, you know, you have to have this training of correct breastfeeding hold, latching and correct complementary food advice. It should go on the war footage. Otherwise, you know, war footing, I should say, you know, then only you'll see the results. Otherwise, you'll be like just maybe one or 2% here and there difference. Some of the foreign after pictures from Maharashtra, and this is actually from, yeah, so left one is from Maharashtra, right one is from Gujarat, tribal areas, both of them are tribal areas. Look at the difference. This is from Malaga, you know, we had done one training and mothers were taught correct techniques and see how beautiful they grow babies. There's some before and after babies, you know, way forward, this are some of my advice for, you know, ice officers, people in government, what can they do? Because now we have a lot of field experience. And, you know, if they take it up, you will definitely see results. They just need to know what to do. And implementation is important. So what to do is easy. It's easy to understand what to do, but how to do and how to get it done. That's another, you know, that also idea can help actually. And one important point is escalation process, I would also call mentoring process. So what happens like in India, whenever we kind of when we when we do training and when we do mentoring of all these healthcare workers, you know, so because I'm there for them on WhatsApp, anytime a baby say, don't get away, they immediately call me or they WhatsApp me, the baby is not getting what to do, you know, and I would guide them, right? But in India, I don't know where would they go? Because we don't have the system, the baby does not grow well. I, there is no system at this point. System is they do Mamta, Mamta they and then do heightened weight and if they find Sam, and they would basically admit child in this NRC. But what happens when baby is kind of going down, there is not gaining weight, there's stagnation, there is no growth failure. So there is no system like that. So we need to have a system. So here I've created a protocol for some of the projects where I say that, you know, and I we do the similar thing in US. So what happens is when the baby to discharge in US, pediatricians see this child and I'm talking about even public health. So pediatrician, the pediatricians are not there, then you know, family physician is there, or if family physician or then we have a nurse physician. So we have all these different category training children, you know, children health care. And we keep continuously this baby is a week 24 to 48 hours depending upon the weight gain. And we would not allow mother to just get out of our site, till we are confident that mother knows how to feed the baby. Okay, now obviously, in US, there is an issue of formula feeding. So in formula feeding may of course, baby will gain weight, but in breastfeed babies, we are very, very strict. So, you know, unfortunately, I don't see that of course, we have HBNC visits over here, where they do visit 3037 1421 28 or that. But you know, I feel that from zero to three, it's still too too late, you need to do zero, one, two, because those are the days when mother is learning Latin. Okay, so and if if you can teach that mother and baby diet within the next like within one hour, 10 hours, or maybe first 24, 48 hours, and when the mother is in the PNC, boom, then you will not have any problem. 90% of the babies, you know, they mothers, they and babies, they learn to latch and feed very well within next 10 days, you know, but don't let them go. I won't call them don't discharge them, but at least do frequent visits do it every 24, 48 hours, whatever it takes, because our goal is to make that latch happen, you know, efficiently. I want that milk transfer to occur. You cannot wait for 10 days, because there are there are myths, you know, that Oh, baby will gain birth weight by seven days, 10 days. No, we don't see that. You saw 2.5 kg weight gain in one month. If I waited for two weeks to for baby to gain weight birth weight, baby would have been malnourished, you know, so please do not wait, just continue every 24 to 40 hours, you know, whatever need be, carry wingscale with you, you know, ask ASHA, ANM, whoever, you know, who was staying close to the mother's house to go and check the weight. And if baby's not gaining weight, then we of course tell ASHAs and ANMs to continue teaching those 45 points. And within within, say even the next visit, baby's not getting weight, and that baby needs to be escalated. Okay, then comes supervisors, then comes medical officers, because if babies are not gaining weight with with proper flatching, then there is some other issue, right? There are organic causes of not gaining weight.