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Popfocus 2008 April June English |
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THE POPULATION FOUNDATION OF INDIA NEWSlmER
Engaging with Corporate Sector - The Journev
The Population Foundation of
India, has since its inception been
working with the corporate sector,
national and international non-
governmental organizations and the
Central and State Governments. PFI
has been playing a catalytic role to
create an enabling environment at the
national, state and local levels for
policy advocacy on issues relating to
population stabilization, women and
child welfare and by providing support
for action research programmes in
these areas.
In an event organized jointly by
Population Foundation of India and
FICCI, a Monograph titled "Engaging
with Corporate Sector, Family
Planning, Reproductive Health and
HIV/AIDS - 1970-2007", was
released by Ms. Shailaja Chandra,
Executive Director, Jansankhya
Sthirta Kosh (JSK) on May 26, 2008,
at New Delhi. The welcome address
was delivered by Mr. A.R. Nanda,
Executive Director, PFI and the
opening remarks were made by
Dr. Amit Mitra, Secretary General,
FICCI, and Prof. Ranjit Roy
Chaudhury, Member, Governing
Board, PH
Dr. Amit Mitra congratulated PFI for
having brought out the Monograph
Release of Monograph. From left: Dr. Kumudha Aruldas, Additional
Director, PFI, Dr. Amit Mitra, Secretary General, FICCI, Ms. Shailaja
Chandra, Executive Director, JSK, Prof. Ranjit Roy Chaudhury, PFI
Governing Board Member and Mr. A. R. Nanda, Executive Director, PFI
which he believes would be a very
useful document for the corporate
sector. He shared that "Companies
are now looking at ongoing
engagement with the community
towards ground level activities on
issues relating to health, education
and sanitation."
Prof. Ranjit Roy Chaudhury, Member,
Governing Board, PFI stressed on the
fact that Child Sex Ratio (CSR)needed
to be looked at with moderation and a
balanced view so as to not repeat the
same mistake as the family planning
experience where he felt we had
swung from one
extreme to the other
without any moder-
ation or balance.
Ms. Shailaja Chandra,
while releasing the
Monograph men-
tioned that the mono-
graph was truly
inspiring as it showed
that there were great
visionaries around,
way back in the seventies, is historical
and gives due credit to the corporate
sector. She emphasized that CSR
cannot be just philanthropy - it needs
to be much more involved.
Dr. Kumudha Aruldas, Additional
Director, PFI, made a brief
presentation on the contents of the
Monograph. The Monograph on
Exploring Expansion, Collaboration,
Replication of Public-Private
Partnership
... 3
Impact Assessment of RUD
in FPAI Clinics
4
MCH-STAR Project Launched
5
The Global Fund Programme on
HIV/ AIDS - Round 4 and Round 6 ... 6
Strategic Planning for Scaling Up
HBNCC
9
Traditional Media helps reach out 10
Strategic Communications Training
for Advocacy on Reproductive
Health and Family Planning
... 10
MNGO Re-orientation
in Chhattisgarh
... 11
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Increasing Focus on
Maternal and Child Health
Women of reproductive age (15-45 yrs) and children
«15 yrs) constitute 60% of the total population of
India. They comprise a vulnerable section of the population
due to the risks connected with child-bearing in case of
women; and growth, development and survivalin case of
infants and children. Reduction of child mortality and
improvement in maternal health are major goals in
Millennium Declaration, to which India is a signatory.
Another important goal for its own sake which also has a
direct impact on maternal and child health (MCH), is
promotion of gender equality and empowerment of
women.
Additionally, about one fifth of India's population is in
adolescent age group and yet to begin their reproductive
lives. It is thus expected that the reproductive age group
willcontinue to grow. For all of these reasons, maternal,
newborn and child health has become a priority area
for the policy makers, planners and professionals.
The socio-cultural determinants of maternal, newborn
and child health have a cumulative effect over a lifetime.
A correlation exists between social inequity and the status
of maternal and child health. The immediate causes of
high rates of poor maternal and child health, therefore,
are underlain by more basic determinants. These include
poor status of women in society and the roles of poverty,
illiteracy and social inequity.
While there have been some improvements in the
nutritional status of young children in several states,
nutritional deficiencies are still widespread and States
like Uttar Pradesh and Jharkhand still lag behind by a
considerable margin. Progress in family planning can
definitely improve maternal and child health significantly
in India, but it would be a grave mistake to believe that
stand-alone family planning programmes will help us
win the battle. The focus has now undergone a paradigm
shift from individualized vertical interventions to a more
holistic and integrated life-cycle approach, giving more
focused attention to reproductive health care and to give
greater emphasis to child health.
Therefore, expansion of innovative pilots based on a
holistic approach towards mother and child health and
nutrition integrating neonatal health, are the need of
the hour. The recently launched MCH-STAR programme
is a step in the right direction. The programme has a
focus on maternal nutrition, child health and nutrition
(MNCHN) and aims to build capacities of institutions in
India to be able to provide technical assistance and
strengthening areas like research and advocacy, that we
hope results in a frUitfulpartnership towards achieving
our collective goals.
PopJOcus
"Engaging with Corporate Sector, Family
Planning, Reproductive Health and HIV/ AIDS -
1970-2007" describes PFI's engagement with
corporate sector in the last four decades. It also
documents how PH and corporate sector with constant
interaction and dialogue have been able to leverage upon
each others strength and contribute to social development
and improving quality of life of society at large. The rich
experiences of the Foundation with the corporate sector,
various co-operatives and trade unions include research
studies, advocacy workshops, seminars as well as field
interventions.
Apart from raising funds from the corporate sector,
PFI has conducted a series of workshops on population
and health and promotion of girl child leading to policy
shifts within the corporate sector and the government.
The Foundation, in partnership with Corporates, has
also been implementing reproductive health, family
planning, child health and HIV/ AIDS programmes in
the neighbouring areas of their operations.
Through this Monograph, the Foundation aims to share
the decades of valuable experience of engaging with
corporate sector, various cooperatives and trade unions
and will go a long way in further strengthening ties with
the corporate sector for health, population stabilisation
and human development.
A large section of CSR in India continues to operate
within the welfare model. However, the winds of change
are evident, primarily with leadership from business
houses, young entrepreneurs and emerging Corporates.
Corporates today are vigilant towards effective utilization
of their funds. There is emphasis on ensuring that
financial support reaches the needy and that the process
of professionally managing partnerships is with credible
organizations/institutions. Along with this new and more
professional approach to CSR there is· increased
collaboration between Corporates and the other pillars
of civilsociety such as NGOs, media, legislators and the
Government. Corporate associations like FICCI,
ASSOCHAM and Cll increasingly play an important role
towards furthering collaborations by providing platforms
for the multi stakeholder dialogue and advocacy.
The corporate partnership programmes of the
Population Foundation of India reflects the changing
nature of reproductive health programmes and the
paradigm shift from a welfare model to a more integrated
approach of health service delivery. This is reflected in
the nature and type of corporate partnerships that the
Foundation supported and was part of in its early years
particula~ly in the 70s and 80s. As evident, these efforts
at development prescribed a welfare approach in
providing community services including health services.
Over the years, the health programmes reflect the
changing nature of corporate partnership i.e. from a
narrow approach of providing family planning or family
Contd. on page 11
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Pop.!bcus
Exploring Expansion, Collaboration, Replication
01Public·Private Partnership
The Karuna Trust model on Public-
I Private Partnership (PPP) has
emerged as a promising model to
improve access to health care in
backward districts in India.
Currently implemented in Karnataka
and Arunachal Pradesh, the model
includes an agreement with state
governments to undertake running of
government PHCs on contract and
upgrading their infrastructure as well
as their accessibility and availability
within their catchments. In addition
to the expected role of a primary
health centre, Karuna Trust has also
introduced various other value added
services that include community
health insurance model, empowering
the community through self help
group (SHG) formation, expert
opinion through telemedicine,
developing herbal gardens at each
PHC, and formation of farmers clubs.
While the state government offers
only 75% of its budget allocated to
run a PHC, Karuna Trust has been
able to bring in significant changes
in terms of demand creation and
supply at the community level. PH
has partnered with Karuna Trust to
include value added activities like
training of manpower.
To build evidence for scaling up
of the PPP model, PFI had
commissioned Institute of Health
Management Research (IHMR),
Bangalore for an evaluation of this
model implemented in 10 PHC
catchment areas. The findings of the
evaluationstudyare expected to support
the scaling up of the model as well as
its advocacy at various levels.
PH along with its technical partner,
Management System International
(MSI)conducted a visioning workshop
at Mysore on June 25-26, 2008.
The objectives of the workshop were
to help Karuna Trust in identifying key
components of the PPP model;
understand their capability and
capacity to take it to scale; understand
the various forces (political, social,
community, other stakeholders) in the
field acting for/against this model;
conduct stakeholder analysis for
advocacy of the model and develop the
plans to scale it up. All the key staff of
Karuna Trust along with various key
stakeholders (from government of
Karnataka) and PFI/MSI team
participated at the workshop.
A state level dissemination of PPP
model also took place on June 27,
2008 at Bangalore, where key
stakeholders from government and
non-government sector participated.
The state dissemination was chaired
by Mr. Madan Gopal, Secretary,
Department of Health and Family
Welfare, Government of Karnataka.
Mr. T. N. Srinivasacharya, Commi-.
ssioner Health, Mr. Nilay Mitash,
Mission Director, NRHM, Govern-
ment of Karnataka, Dr. Usha,
Director, Health and Family Welfare,
Dr. Karthikeyan, WHO, Dr. Devi
Shetty, Narayan Hritayala and
Ms. Rani Desai, Biocon Ltd were
some of the dignitaries present.
All the district health officials under
NRHM and RCH-II along with
eminent NGOs in Karnataka working
on health issues such as Karnataka
Health Promotion Trust (KHPT),
Christian Medical College (CMC),
Vellore, GMR Foundation, etc. were
present and participated with full
enthusiasm in the discussions.
Dr. H.Sudarshan presented the
Karuna Trust experience followed by
a presentation on the assessment of
the intervention by Dr. Kishore
Murthy from IHMR, Bangalore and
a brief presentation on the Scaling
Up Management (SUM) framework
by Dr. Rajani Ved, MSI.
A series of actions are planned over
next six months by Karuna Trust, PH,
MSI and ICMR to facilitate systematic
scaling up of the PPP model both
within Karnataka as well as in other
states of India in partnership with
Government and NGOs.
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PopJOcus
Impact Assessment of RUD in FPAIClinics
Family Planning Association of
India in partnership with
Population Foundation of India is
implementing a project "Instituting
Rational Use of Drugs in
Reproductive and Child Health"
aimed at rationalizing the drug/
medicine use in 26 clinics of FPAI
branches. The project period was
initially from October 2006 to March
2008 which has been extended to
September 30,2008.
Institutionalisation of RUD is critical
in the Indian scenario where about
one third of the population is living
below poverty line and yet more than
70 percent expenditure on health is
out of pocket . With increasing costs
of health care, such a project
becomes all the more relevant.
The project started with a baseline
survey, which revealed that none of
the 26 FPAI clinics were referring to
any Standard Treatment Guidelines
and no specific Standard Treatment
Guidelines (STGs) existed for
reproductive and sexual health services
through the clinics. On an average,
5-6 drugs were prescribed as against
national standard of 2-3. Essential
Drug List (EDL)was not available and
adhered to and there were no specific
drug storage guidelines. Bin Cards
were not there and drug procurement
system was on ad-hoc basis.
In course of the project, compre-
hensive STGs were developed
which covered all Sexual and
Reproductive Health (SRH) services
and recommended drug use under
each of these services. All Medical
Officers from the 26 clinics were
oriented on these guidelines through
workshops. Similarly, the branch
managers, store keepers and other
store persons were oriented in
procurement (right quantity at right
time), storage, indenting, issue and bin
card system of inventory manage-
ment. These workshops were followed
by briefing meetings and preparation
of action plans at the respective
branches. An essential drug list was
II
also prepared with respect to SRH
services and procedures.
The most important intervention was
setting up of a Task Force comprising
volunteers, staff and members of
medical sub-committee who kept a
record of all prescriptions by branch
doctors.
Impact Assessment
The assessment was carried out by a
team of investigators, who were
oriented by Delhi Society for
Promotion of Rational Use of Drug
(DSPRUD). The training helped in
building the in-house capacity of FPAI
and in creating the base for future
sustainability of the project.
Detailed formats developed by
DSPRUD were used for the
assessment. The following objectively
verifiable indicators were used to
assess the impact:
• Average number of drugs
prescribed per patient
• Percentage of total drugs
prescribed for generic brands
• Number and instances of
prescription of antibiotics and
injections
• Physical presence of EDL and
STGs with MO
• Percentage of patients where
STGs were followed
• Percentage of drugs prescribed
from Essential drug List
• Average consultation and
dispensing time
• Percentage of patients being
adequately briefed of drug
regimen
• Average number of days for
stock out of essential drugs
• Existence of procurement policy
and maintenance of bin cards and
stock register
A detailed impact assessment was
carried out in 5 branches of FPAI
(Lucknow, Madurai, Mumbai,
Bangalore and New Delhi). Three to
five visits per clinic were made to
interview approximately 30 clients
seeking different services in every
clinic.
The study revealed that there is an
overall improvement in the average
number of drugs prescribed. It ranges
from 2 (KSK, Mumbai) to 3.7
(New Delhi) to 5 (KNAK, Mumbai) as
against the national standard 2 to 3.
1. The percentage of drugs
prescribed by generic names
ranges from 20% (Lucknow/
KNAK / KSK) to 95% (Madurai)
as against a national standard of
more than 80%.
2. Madurai Branch is now
prescribing all drugs based on
Essential Drug List, whereas the
Bangalore branch is only
prescribing 5% from EDL against
a national standard of over 80%
(should be prescribed from EDL).
The most important intervention
was setting up of a Task Force
comprising volunteers, staff and
members of medical
sub-committee who kept a
record of all prescriptions by
branch doctors.
3. Average consultation time as per
the national standard should be
about 5 minutes. However, it
ranges from 2 minutes (Madurai)
to 13 minutes (KNAK).
It is important to note that the project
has been able to bring about
significant improvements in drug
prescription, procurement, storage
and dispensation practices. However,
this intervention would be termed a
complete success once the concept
of RUD has been imbibed and
institutionalized in FPAI clinics and
beyond.
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PopJOcus
MCH-STAR Project launched
The Maternal and Child Health
Sustainable Technical Assistance
and Research (MCH-STAR) project
was launched on 12th June, 2008 in
New Delhi. The event was presided
by Mr. Naresh Dayal, Secretary
Health, Ministry of Health and Family
Welfare, Government of India as
Chief Guest of the launch function.
Mr. Chandra Prakash, Director, ICDS,
Uttar Pradesh, Ms. Nidhi Khare,
Commissioner, Ranchi Division,
Jharkhand and Mr. D.K. Saxena,
Special Secretary, ICDS, Jharkhand
were special guests at the event.
Other dignitaries present at the
function were Mr. Santosh Srivastava,
Deputy Director, ICDS, Ministry of
Social Welfare, Uttar Pradesh,
Mr. George Deikun, Mission Director,
USAID/lndia, Dr. Marta Levitt-Dayal,
Chief of Party, MCH-STAR,
Dr. Kurien Thomas President
IndiaCLEN, Mr. A.' R. Nanda:
Executive Director, PFI and Mr. Sanjiv
Chatrath, Chief Operating Officer,
PHFI.
MCH-STAR is an initiative to improve
policies, programme approaches and
resources in the areas of Maternal
Nutrition, Child Health and Nutrition
(MNCHN) in India, particularly in
Jharkhand and Uttar Pradesh. The
MCH-STAR initiative aims to
strengthen the capacity of Indian
of the MCH-ST AR Initiative
Mr. George Deikun, Mission Director, USAIDlIndia and Mr. Naresh Dayal, Secretary
Health, MoHFW with other dignitaries
institutions to conduct meaningful
research, programmes and advocacy
that will provide technical leadership
in MNCHN matters in the long term.
The initiative will be led by selected
Indian institutions: Population
Foundation of India (PFI), Public
Health Foundation of India (PHFI)and
India Clinical Epidemiology Network
(India CLEN), and facilitated by the
MCH-STAR. Consortium (Emerging
Markets Group, Boston University
and CEDPA). MCH-STAR partners
will work to support the goals of the
National Rural Health Mission, the
Integrated Child Development
Services (ICDS)and Reproductive and
Child Health (RCH-II). The initiative
is supported by United States Agency
for International Development
(USAID).
The key note address at the launch
was delivered by the Chief Guest
Mr. Naresh Dayal, Secretary Health,
Government of India.He stressed on
the importance of addressing
MNCHN issues in the country and
stated that "We need an extended
reservoir
of professional
research, public health and
technical assistance institutions
working at global standards that
can support
government
programmes. "
He also discussed different initiatives
of the Government and shared that
"Our country is growing well in
almost all fields but our health
indicators are poor. It's a shame
to talk at international podiums
about India's health para-
meters. We are trying to better
the situation. "
Dr. Kurien Thomas, President, India CLEN, Dr. Marta Levitt-Dayal
Chief of Party, MCH-STAR and Mr. A. R. Nanda, PFI signing the contract
USAID Mission Director, George
Deikun reiterated
USAID's
commitment to improving maternal
and child health and said "Our aim
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Pop./Ocus
The Global Fund Programme on HII/AIDS
Round 4 and Round 6
Round 4 Programme -
Access to Care and
Treatment - ACT
i) Strategic Planning Meeting
A two-day strategic planning meeting
with the sub-recipients of Round 4
of Global Fund was held in Goa
during April 24-25, 2008. Key
representatives of INP+, Freedom
Foundation, cn and EHS were
present at the meeting. The sessions
on Rolling Continuation Channel
(RCC) which provides 6 years of
additional funding to strong
performing grants and Grants
Consolidation were facilitated by PH,
PMU team during the meeting.
ii) lEe Material Development
A workshop and series of meetings
on Common Minimum Programme
(CMP) and IEC was held with the
national team and state level
networks of INP+. The workshop
brought out the key activities
associated with the service delivery
points, requirement of IEC materials
for different target groups and the key
messages associated with the
materials.
PFI has decided to develop the
prototypes of IEC material keeping
in view the needs of the peer
educators and out reach activities in
the service delivery areas.
Hi)Expositions
A two day exposition in each of the
six states was planned as a part of
the advocacy activity with parti-
cipation of about 100 PLHA from
the DLNs. It was envisaged that the
event would give a better und~r-
standing of access to care and
treatment, disseminate the learning
and promote the concept of positive
living through various activities.
The programme has been conducted
in the states of Maharashtra, Tamil
Nadu, Nagaland and Andhra
Pradesh.
Maharashtra Exposition
The PH state unit of Maharashtra
along with Maharashtra Network of
People living with HIV / AIDS
(MNP+) organized an exposition to
celebrate International Women's Day
by involving Women Livingwith HIV
(WLHA). The concept was to bring
women together and provide them
a platform where they received
information on the issues related to
HIV and treatment. 100 WLHA
from the 26 districts level networks
(DLN)of Maharashtra participated at
the exposition. Many of the DLNs
enacted street plays, displayed
handicrafts and participated in the
cultural events. There were rangoli
and poster competitions held.
Ms. Surekha Salunke, City
Corporater was the chief guest.
Another
City Corporater
Mr. Banakar was also present at the
exposition. Some organizations
facilitated a few sessions - Chaitanya
and Kasturbha Ghandhi College on
Income Generation Programmes and
voca-tional trainings, Lawyers
Collective on inheritance rights and
women and NARI on treatment and
adherence.
Tamil Nadu Exposition
State programme coordination unit,
Population Foundation of India, Tamil
Nadu organized a two day programme
on ''The Power of Positive Living" on
4th and 5th April, 2008 at the
MamaIlapuram Beach Resort. Around
85 staff who are working in the field
participated in the event to disseminate
the learnings and best practices from
the project outreach team and
promote the concept of treatment
adherence, outreach follow ups and
positive living.
Eminent personalities in the field of
HIV/ AIDS shared their experiences,
knowledge and trained the parti-
cipants. The chief guest was Mr. K.K.
Abraham, President, INP+. The other
guests and resource persons were Mr.
A. Justin, DGM, Ashok Leyland,
Ennore, Dr. Devshish Dutta,
Technical Specialist (HIV/ AIDS),
UNICEF - Tamil Nadu and Kerala,
Mr. Subrat Mohanty, Sr.Program
Manager, PH, Mr. Senthil Kumar,
Project Manager- ACT, INP+ and
Mr.Karunanithi, President, TNNP+.
At the valedictory function on 5th
April, 2008, Dr. Beela Rajesh (LA.S),
General Manager, Handicrafts and
Handlooms Export Corporation of
India Ltd, Chennai, was the Chief
Guest and Guest of Honour was
Dr. P.Mahalingam, Programme
Manager, APAC - VHS.
Nagaland Exposition
A two day programme was organized
by Population Foundation of India
(PH) Nagaland in collaboration with
the Naga Network of People Living
with HIV/AIDS (NNP+) on May
29-30, 2008 at the Department of
Under Developed Areas (DUDA)
Guest House, Kohima. 85 parti-
cipants including district levelnetworks
of Nagaland, positive living centre
(PLC), Tuensang, Treatment
Counseling Centres (TCCs) and
community care centre (CCC),
Dimapur attended the programme.
Shri Menukhol John, Commissioner
and Secretary, Health & Family
Welfare, was the Chief Guest at the
inaugural session. NSACS Officials,
Church Leaders, NGOs chief
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functionaries and media personnel
were present on the occasion.
During the technical session, the topics
covered income generation avenues,
medical guidance and treatment
adherence and nutrition. Some of the
other programmes like income
generation exhibition, IEC display,
positive speaking, panel discussion,
counseling, role play, cultural activities
on folk song, dance, dramas and skits
competitions were organized and
prizes were given away to the first,
second and third positions in all.
At the concluding session,
participants brought out an action
plan on the enrolment of clients with
targets to Service Delivey Points
(SDPs), directory of SDPs, quarterly
magazine and resource mapping to
get information on public and private
health services available. The
valedictory session included a special
song by Positive Voice and concluded
with prize distribution.
Andhra Pradesh Exposition
A similar exposition was organized
by the Population Foundation of
India, Andhra Pradesh unit in
collaboration with Andhra Pradesh
State AIDS Control society on 19th
of June 2008 at Celebrity Boutique
Hotel Begampet, Hyderabad.
Dr. Rajamoulie (Joint Director, Care
and Support), Andhra Pradesh State
AIDS Control Society, was the Chief
Guest of the exposition. Representa-
tives of donors and non-govern-
mental organizations working in HIV/
AIDS sector in Andhra Pradesh were
present at the exposition. The theme
of the exposition was to bring all the
service providers in "Access to Care
and Treatment" project on a platform
to share their achievements and
challenges faced in accessing care and
support to important stakeholders.
The focus was to recognize and
appreciate the efforts made by the
service delivery points.
During the exposition, three
presentations were made by
Dr. Rajamoulie and Ms. Mekhla from
APSACS on the public sector
initiatives in Andhra Pradesh with
regard to Care and Support,
Ms. Rashmi Sharma, Sr. Program
Associate, PFI-PMU on private sector
initiative (i.e. update on Access to
Care and support project) and the
representatives of SLN and Freedom
Foundation on the project progress
with respect to care and support.
The exposition concluded with a
strong recommendation to bring
about coordination within various
project outreach teams for treatment
adherence monitoring whether the
project may be HN /TB co-infection,
PPTCT outreach program, Drop
in centers or ACT project.
Commitment from ART center staff,
CCCs as well as DLNs in serving
PLHAs was identified as another
important requirement for making
the care and treatment services more
effective.
iv) Programmatic Achievements
District Level Networks of PLHAs
(DLNs) have been strengthened in
127 districts across the six states and
have provided services to 114,454
PLHAs. 40 Treatment Counselling
Centres have been set-up and are
providing treatment adherence
counseling. Positive Living Centres
have been set-up in 10 places and
have provided services to 6888
PLHAs through counseling, medical
care, psycho-social support and
outreach acti~ities. Community Care
Centres have been set-up and are
Popfbcus
functioning from Trichy in Tamil
Nadu, Bagalkot in Karnataka and
Dimapur in Nagaland. Training in
different areas has been provided to
112 peer educators, 193 consellors
and 7 doctors. 65 NGOs have also
been trained in home based care.
Refresher training has been
conducted for 69 peer educators and
130 counsellors. Three Corporate
ART centres have been set-up and are
providing services to the larger
community. MoUs with four more
corporate centres have been signed
for setting-up corporate ART centres
in this program.
Round 6 Programme
Promoting Access to Care
and Treatment - PACT
i) Advocacy Meeting in
Jodhpur, Rajasthan
As the Global Fund Round-6, country
proposal aims to "create an enabling
environment for multi sectoral
convergence to mainstream,
converge and integrate gender, RH
and HIV/ AIDS", advocacy work-
shops with key stakeholders were
planned to be organized at the state
and district levels to mainstream
HIV/ AIDS and gender equity into
their programmes.
PFI - Regional Coordination Unit in
association with Rajasthan AIDS
Control Society (RSACS) organized
the second phase of the advocacy
meetings on 25th May 2008 in
Jodhpur, Rajasthan. The objectives of
the meeting were to:
1. Build an understanding on HIV/
AIDSissuesamong key stakeholders.
2. Explore avenues of coordination
among stakeholders at district,
block and village Levels.
3. Develop interest among PRls to
address issues around HIV/ AIDS
at various tiers of the Panchayat.
The meeting was chaired by Mr. Tara
Chand Meena, Additional District
Magistrate (ADM), Jodhpur. 48
district and block level officials and
elected representatives from Health,
Women and Child Development and
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is to bring real improvements
in the lives of women and
children. Led by USAID, our
Indian partner organizations
will help the initiative to
achieve success. Each activity
will respond directly to the
programme and policy needs
of Jharkhand and Uttar
Pradesh. It will demonstrate
policy and programme
successes that can help others
to emulate evidence based
practices. "
The civil society including key
stakeholders from the donor
community were also present at the
gathering. Duringthe launch, the MoUs
were signed between MCH-STAR and
the three STAR supported institutions
- Population Foundation of India (PA),
Public Health Foundation of India
(PHA) and India ClinicalEpidemiology
Network OndiaCLEN).
The MCH-STAR project aims
to improve policies, program
approaches and resource allocations
for MNCHN through Indian
Institutions by building capacity and
institution strengthening in MNCHN
technical leadership and technical
assistance services, policy analysis and
advocacy. It will also help the
government to fill the gaps in data
and knowledge to improve policies
and program approaches (National
Rural Health Mission), Reproductive
and Child Health (RCH-II),Integrated
Child Development Services (ICDS).
This initiative has come in at a very
good time, as improving the health
of women and children, is paramount
for India at this stage in its
development.
The major causes of under-five and
maternal deaths are preventable and
treatable. In case of children under
five, one half of the deaths occur
during the neonatal period (the first
month of life), yet the major causes
of morbidity and mortality are known
and many feasible life-saving
interventions exist. For women, the
main causes of maternal death also
reveal that saving these lives does not
require extraordinary interventions or
technology. The low use of health
services partly illustrates why these
continue to cause so many deaths.
Malnutrition plays a major underlying
role in both child and maternal health.
Malnutrition is associated with more
than 50 percent of childhood deaths
and directly affects the severity of
diseases such as measles and diarrhea.
The impact of malnutrition is reflected
in child health statistics including high
levels of stunting, anemia and
maternal under-nutrition.
Despite gains at the national level,
clear differences in child mortality
rates still exist between the states,
between gender and between
economic groups (Groups with lower
economic opportunity have the
highest child mortality rates and the
greatest needs). MNCHN problems
are especially severe in India's
Northern States. The states of
Bihar, Jharkhand, Uttar Pradesh,
Maternal
and Child H.al,h
PopJOcus
Uttarakhand, Rajasthan, Orissa,
Madhya Pradesh and Chhattisgarh
contribute significantly to the
country's poor MNCHN status.
These eight states, collectively
referred to as the Empowered Action
Group (EAG) states by the GOI,
constitute 45 percent of the
population and have similar, poor
MNCHN indices. The National Rural
Health Mission, RCH-II and their
assistance mechanisms like the
National Health Systems Resource
Center (NHSRC) are focused first and
foremost on improving basic health
indicators in the EAG states.
The MCH-STAR will look at
operations and policy research,
analysis, advocacy and technical
support and will attempt to influence
MNCHN policy at the national level
based on evidence-based research
and analysis. Nonetheless, MCH-
STAR willalso maintain a geographic
focus in the EAG states and
specifically in the states of Uttar
Pradesh and Jharkhand.
The project will employ certain
strategies to be able to make a
difference in the field of mother and
child health and nutrition, including
focusing on major causes of maternal,
neonatal, and childhood morbidity
and mortality and malnutrition, and
their proximate determinants;
promoting evidence-based programs
and policies to address MNCHN
needs thus addressing critical gaps
and constraints. It will be done
through consultative processes, state-
level technical advisory group
priorities, consensus among key
stakeholders, and reviews of
evidence; focusing on poor,
vulnerable and marginalized
populations and prioritize pro-
grammes and policies that benefit
populations with the worst MNCHN
indicators; building the capacity of
Indian institutions that can provide
sustainable technical leadership in
MNCHN; and finally working closely
and in synergy with other MNCHN
activities and partners - providing
technical assistance to NRHM,
RCH-II and ICDS at the national and
state levels on all aspects of MNCHN
issues.
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PopJOcus
Stratelic Planninlll, Scalinl UPHBNCC
The Home Based Neo-natal and
Child Care (HBNCC) model
pioneered by SEARCH has now been
accepted as the key intervention to
improve neonatal, infant and child
health indicators in the country. The
HBNCC model, delivered through a
community level health worker, is a
composite of community parti-cipation,
high quality training, intensive
supervision, well functioning
procurement and logistic structures,
and efficientmonitoring and evaluation
systems. Currently while most of the
State NRHM project implementation
plans (PIPs) include HBNCC, their
interpretation of what is required under
HBNCC and activities planned under
the intervention, vary substantially.
ASHA is expected to be the worker to
deliver HBNCC. There is also a high
level of interest from within the
Planning Commission as wellas senior
leadership of the Ministryof Health and
FamilyWelfare, necessitating the need
to strategize systematic scaling up of
the Gadhchiroli model.
PFI along with SEARCH and
Management Systems International
(MSI)organized a two day workshop
Dr. T Sundararaman, Executive Director,
NHSRC facilitating the discussion
on strategic planning to scale up the
HBNCC model. The major focus of
this workshop was to deliberate on
the following issues:
1. Identification of opportunities and
challenges for rolling out HBNCC
in various states;
2. Potential partnerships and allies at
the state and national levels to
scale up HBNCC;
3. Clearly defined roles for SEARCH
and partners in scaling up
HBNCC; and
4. Additional human and financial
resources needed to implement
the plan.
Representatives from various
premier organizations including
National Health System Resource
Centre (NHSRC), New Delhi; Public
Health Resource Network (PHRN),
New Delhi; State Health Resource
Centre ( SHRC), Chhattisgarh;
CARE India; Bill and Melinda Gates
Foundation, New Delhi; Chhatrapati
Shahuji Maharaj Medical University
(CSSMU), Lucknow; National
Institute of Applied Human Research
and Development (NIAHRD), Orissa;
Karuna Trust, Bangalore participated
at the workshop. The current status
of the HBNCC scaling up along with
the new emerging opportunities and
challenges were discussed. It was
shared at the workshop that a
majority of the states have already
included HBNCC as one of the
measures to reduce neo-natal and
infant mortality in their state Project
Implementation Plans (PIPs), though
they were not necessarily the
comprehensive model of HBNCC.
Participants from various states
expressed keen interest in adoption
and scaling up of HBNCC model in
their respective states. The group
agreed to the formation of a national
partnership for HBNCC scaling up
with the participants present at the
workshop as members. The national
partnership would contribute towards
developing advocacy strategies at the
national and state levels and creating
a resource pool to support theses
activities.
•
PRIs and NGOs attended the
meeting.
ii) Programmatic Achievements
20 District Level Networks have been
set-up by INP+ in the states of Uttar
Pradesh, Madhya Pradesh and
Rajasthan and have provided services
to 513 PLHAs. Catholic Bishops
Conference of India (CBCI) has set-
up 10 community Care Centres in the
states of Gujarat, Bihar, Orissa, and
West Bengal. Similarly, Hindustan
Latex Family Planning Promotion
Trust (HLFPPT) has set-up 6
community care centres in the states
of Uttar Pradesh, Rajasthan and
Madhya Pradesh. PH has conducted
two advocacy programmes and have
reached 142 people including Child
Development Project Officers, ICDS
supervisors, Block Medical Officers,
Janpad and Jila panchyat
representatives, sub divisional
magistrate, district in charge,
Integrated Counseling and Testing
Center in charge and local NGOs
through the advocacy
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Po p./Ocus
Traditional Media helps reach OUI...
P FI has been implementing an
advocacy project aimed at strength-
ening NRHM initiatives with special
emphasis on promoting qualityhealth care
services in selected blocks of Gaya and
Vaishali in Bihar. This project is being
supported by MoHFW, GOI and UNFPA
under the Country Programme VI.
As part of the initiatives, a series of
"Nukkad Natak" were organized in 35
project districts. To begin with, an
orientation and capacity building
workshop was organized with the street
play team in Patna. The main objective
of the workshop was to develop scripts
that address NRHM initiatives and Quality
of Care (QoC) and to orient the team on
these. In the workshop, various schemes
and initiatives under NRHM especially
Janani Suraksha Yojana (JSY) and the
roles of Village Health & Sanitation
Committee (VHSC) and Rogi Kalyan
Samiti (RKS)were discussed in detail with
a focus on quality health
care services.
Draft scripts were
developed in the local
dialect and a final script
was selected and fine
tuned by subject and
communication experts.
After finalization of the
script, the troupe staged
a series of mock shows
for practice. A planning
meeting was held with
the networking NGOs of
both the districts to chalk out a schedule
and plan for making the shows effective.
As per the schedule, street plays were held
in all the 35 project villages. On an
average, the shows attracted about
200-300 people from all age groups.
The nataks were staged at common
gathering places like Panchyat Ghar,
schools and community clubs. IEC
material like posters, banners etc. were
displayed and distributed at the venue.
The audience feedback was extremely
encouraging. Performances have
been video documented for wide
dissemination.
Strategic Communications Training lor Advocacv
on Reproductive Health and Familv Planning
Strategic communications is an
important part of health programme
implementation
especially on
reproductive and child health issues in
India. Building in communications
perspective among those planning and
implementing key reproductive health
initiatives has been recognized as essential
in order to bring about behavioural and
attitudinal change in the community.
This resulted in health programmes
incorporating strategic communications
tools, which would not only make the on-
going health education efforts more
effective but also strengthen their
advocacy efforts in order to influence key
reproductive health and family planning
outcomes. Apart from reproductive
health, those working on HIV/AIDS
related concerns have also used various
communications efforts to influence
policy and community action. There are
various tools and methods available
internationally and in country, which help
train civil society organisations,
community workers, programme
managers and policy makers on strategic
communications.
Population Foundation of India (PFI) as
part of its advocacy initiative on
reproductive health and family planning
is helping strengthen capacities of NGOs
in undertaking advocacy on the issue by
using tools that enable strategic
communication. As part of this initiative
PFI is training NGOs and population
leadership fellows (trained by the Packard
Foundation on leadership) in Bihar and
Jharkhand using the Smart Chart tool.
The Smart Chart tool was developed'
by Spitfire Strategies, a US based
communications consulting organisation.
Spitfire Strategies offers non profits and
foundations communications planning,
counseling and training to help them
create positive social change. Their
passion is to help organizations find an
effective voice to communicate their
vision.
PFI adopted the approach of developing
a group of master trainers from primarily
Bihar, Jharkhand and Delhi who would
be trained on using the Smart Chart as a
tool to further train NGOs in the two
states. A ten member team of master
trainers have been prepared who are
currently in the process of providing
further training. In the past six months
the team has trained 60 representatives
from NGOs in Bihar and Jharkhand
on the Smart Chart tool. The objective
was to find out how effective was the
tool, what were the sections that
were challenging to train, how relevant
is the Smart Chart as a training tool in
the country and what were the case
studies used in the training. Some of the
early learnings from the trainings reflect
the following:
1. The training is extremely useful in
adopting a structured process for
developing communications plan for
an organization.
2. The tool is easy to use for participants
with clearly laid out sections in each.
3. The communications plan is rooted in
the overall program objective and
strategies of the organization.
4. It helps in developing relevant case
studies which for PH are those related
to successful evidence based advocacy
efforts in the country and particularly
in Bihar and Jharkhand.
PFI over the next six months is committed
to testing the tool further with selected
individual organizations in Bihar and
Jharkhand and help them develop
strategic communications plan. The
Foundation hopes that it will then be in a
stronger position to advocate Smart Chart
as an effective tool and also identify its
limitations in strengthening advocacy on
reproductive and family planning issues.
PFI also feels that there is need to dialogue
with various agencies who use
communications tools for training and
advocate for the Smart Chart tool as a
medium.
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Pop}bcus
MNGOHe-orientation in Chhanisgarh
The Chhattisgarh State Govern-
ment has recently disbursed the
MNGO implementation fund for six
MNGOs covering 10 districts under
the MNGO scheme of NRHM.
Immediately after the disbursement,
Population Foundation of India, as the
Regional Resource Centre for the
state under RCH-II, re-oriented the
MNGOs so as to prepare them for
implementation. MNGOs are the
organizations appointed in every
district, to work on RCH-II activities
at unserved and underserved areas in
the allocated districts through the
appointed Field NGOs at the block
level. Regional Resource Centre has
the mandate to build capacities of
MNGOs, to provide technical support
as well as to facilitate programme
implementation in the state. The
overall goal of the programme is to
increase institutional delivery,
immunization, complete ANC,
modern family planning usage and
to reduce the incidence of RTI/STI
in unserved and underserved areas
notified by the District Health Society.
Population Foundation of India
Regional Resource Centre in
Chhattisgarh, has undertaken a series
of capacity building programmes for
MNGOs and has been sensitizing
them on state levelpriority issues such
as institutional delivery and immuni-
sation through thematic workshops.
The MNGO Re-orientation
programme organized at the Regional
Leprosy Training Centrre, Lalpur,
Raipur was one such strategic activity
for the capacity building of MNGOs.
Representatives of all MNGOs were
present at this five day residential
programme. While acknowledging
the importance of the programme,
Mr. V. R. Raman, Senior Programme
Officer of the State Health &
Resource Centre (SHRC) shared the
experience of Mitanin programme in
the state and explored all possibilities
of Mitanins contribution to the
programme. Dr. Kamlesh Jain, State
Programme Manager - NRHM, was
also present at the orientation,
identified the potential role of MNGOs
for the formation and orientation
of Village Health & Sanitation
Committees (VHSCs) at every village,
an important intervention under
NRHM. The programme was
organized by RRC-PFI and facilitated
by the state coordinator, RRC-Bihar.
The orientation covered all the
aspects of RCH-II activities, as
mentioned in NRHM guidelines of
and an attempt was made by the RRC
to introduce tracking of pregnant
women in the project areas. The
programme also made the MNGO
representatives conversant with the
MIS formats and reporting formats.
The FNGO representatives were also
invited on the last day, which
facilitated an experience sharing
session on various problems and
activities during implementation of
the preparatory phase. MNGOs got
the opportunity to take note of
problems faced at the grass root
levels. On the financial admini-
stration, a Chartered Accountant
invited as a resource person, guided
the MNGOs on the compliance
pattern of financial reports along with
the basic financial administration
of NGOs. 34 representatives from
MNGOs and FNGOs participated at
the programme.
•
welfare services to ensuring access
to integrated quality reproductive and
child health services. The
programmes reflect the moving away
from a provider driven approach to
an increased community centred
need based programme. Another
positive aspect of the programmes
is the inclusion of emerging concerns
in reproductive health such as
adolescent health, male participation
and HIV/ AIDS.
Interestingly, the concept of CSR
beyond corporate philanthropy is
steadily gaining ground. Social
responsibility is now being
differentiated from philanthropy. CSR
should directly address the core value
of the corporate, which in turn will
also ensure sustainability. This would
require looking beyond an efficiency
model to an empowerment model,
which integrates businesses with
community needs to add value. With
the Prime Minister's call to corporates
to invest in social responsibility to
reduce inequalities in the society, there
is a greater need for corporates to
invest in social development to help
the Country progress and develop in
the right direction.
It is all summed up in a quote by
Mr. J.R.D. Tata-
"In a free enterprise, the community
is not just another stakeholder in
business but in fact the very purpose
of its existence. "
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PopJOcus
And the Award goes to ...
The Children Education Awards
were given away by Mr. A. R.
Nanda, Executive Director at a
function organised on the 27th of
June 2008 at PH for the Academic
Year 2007-08. These awards were
constituted by the Foundation to
encourage children of PH staff to
excel in their academic performance
and motivate them to do better in
the coming years. The awards, every
year, are presented to children who
score a minimum of eighty percent
marks in their final examinations.
A three member "Children
Education Award Committee" has
been constituted, which shortlists
applications according to the
eligibilitycriteria and nominates the
winners.
In the current academic year, the
children who scored 90% and
above were Pratyush Ramesh
(92.5%), son of Ms. Prema Ramesh
and Harikrishnan (90.83%), son of
Mr. P. Narayanan. They received
cash award of Rs 1000/- each,
a meritorious certificate and a
trophy.
Children scoring more than 80%
or passing with grade 'A' for
their performance in I to V standard
received certificates of merit,
trophies and gifts. The children in
this category were Amrutha SNair,
daughter of Ms. Usha S. Nair with
'A' Grade, Anushka Joyal, daughter
of Mr. Rakesh Joyal (89.75%),
Aakash Rawat, son of Mr. Mohan
Singh (89.2%) and Nishtha Neogi,
daughter of Dr. Sharmila Ghosh
Neogi (85.5%).
Master V Satyanarayanan, son of
Mr. K. Venkatachalam was awarded
for his outstanding performance in
IX standard (94.19%) with a cash
award of Rs 2,000, a meritorious
certificate and a trophy. Master
Abhishek Sekharan for his per-
formance in VIIIstandard (89.5%),
son of Mr. P. J. Sekharan and
Urvashi Paul, daughter of Mr. P. K.
Paul for her performance in VI
standard (81.6%) received certificates
of merit, trophies and gifts.
The myth of overpopulation is destructive because it prevents constructive
thinking and action on reproductive issues. Instead of clarifying our
understanding of these issues, it obfuscates our vision and limits our ability to
see the real problems and find workable solutions. Worst of all, it breeds racism
and turns women's bodies in to a political battlefield. It is a philosophy based
on fear, not on understanding.
- Betsy Hartmann, Reproductive Rights and Wrongs:
The Global Politics of Population Control
Dr. Vikram Gupta worked
with PFI as Regional
Coordinator, Rajasthan in
May 2008. He has joined in
Sir Ratan Tata Trust, Mumbai
as Senior Programme
Associate (Health).
Editorial Guidance
Mr A.R. Nanda
Ms Sona Sharma
Editor
Ms Chandni Malik
Editorial Assistance
Ms Jolly Jose
Editorial Committee
Ms Usha Rai
Dr Almas Ali
Dr Kumudha Aruldas
Dr Lalitendu Jagatdeb
Dr Sharmila G. Neogi
m
Published by
Population Foundation of India
B-28, Qutab Institutional Area
New Delhi-110016, India
Tel: 91-11-42899770,42899771
Fax: 91-11-42899795
e-mail: popfound@sify.com
website: www.popfound.org