Popfocus 2006 April June English :: PFI Publication :: KNOWLEDGE MANAGEMENT CENTRE PORTAL, POPULATION FOUNDATION OF INDIA

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Popfocus 2006 April June English

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Popfocus 2006 April June English

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TIEPIPUllTll1 FIUIOITlII IF 11011 IEWSlETJEI

The Population Foundation of India's

State level Conference in ChhaDisgarh

The Population Foundation of

India, as part of its advocacy

initiatives, has, since 1994, organised

state level conferences in Rajasthan,

Uttar Pradesh, Madhya Pradesh,

Uttaranchal, Maharashtra, Bihar,

Jharkhand and Orissa. The basic

objective of holding such conferences

has been to involvethe people of each

state in the decision making process

and help development of sustainable

policies and programmes on

population. One of the features of the

state advocacy conferences is a

publication and the release of a wall

chart and district profile of the specific

state. On April 28 - 29,2006, a two

day state level conference on

"Population Stabilisation, Health

and Social Development Issues in

Chhattisgarh" was organised at

Raipur, Chhattisgarh.

The

conference, which was held at the

Hotel Babylon, focused on

population, health and social

development issues in Chhattisgarh.

The Chief Minister of Chhattisgarh,

Dr. Raman Singh, inaugurated the

conference. The Minister of State for

Health and Family Welfare,

Dr. Krishnamurty Bandhi, the Chief

Secretary of Chhattisgarh, Mr. R.P.

Bagai, Health Secretary, Mr. B.L.

Agarwal, PFI Governing Board

members Mr. B.G. Verghese and Ms.

Nina Puri, Member, Advisory

Council, PFI, Ms. Rami Chhabra,

representatives from CARE and

UNICEF, PHs Executive Director,

Mr. AR. Nanda, experts and senior

The Chief Minister of Chhattisgarh (3m from right) releasing the Handbook on

Chhattisgarh Population, Health & Development

officials from the Department of

Health and Family Welfare,

Government of Chhattisgarh and

The Population Foundation of India's

State Level Conference in Chhattisgarh

Scaling-up Pilot Projects in Reproductive

Health and Adolescent Health in India - 4

The Indian Medical Association supports

campaign against sex selection in

Andhra Pradesh - 4

Healthcare in Uttar Pradesh - 5

Crackdown on Female Foeticide -

The Nawanshahr Model - 6

Members of the Legislative Assembly

in Maharashtra are sensitized - 7

Enhancing Reproductive Health Status

in Uttar Pradesh - 7

Community Radio Programmes Evaluated - 8

Punjab, Haryana & Himachal Brainstorm

in Barogh - 8

National Level Advocacy Campaign on

Sex Selection and Pre-Birth Elimination of

Females - The end and a new beginning ... - 9

The Activities of the Global Fund Round 4

Project on Hiv/ Aids - "Access to Cart"

& Treatment" - An Update - 10

Breaking New Ground ... - 10

A Judicial Symposium at Bhopal - 11

Advocacy with Senior Bureaucrats - 11

From the Executive Director's Diary... - 12

Forthcoming Events - 12

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The Gover~~en~ of India's new initiative titled "National Rural

Health MISSIon (NRHM) focuses on enhancing the access of

the rural population to safe, rational, effective, affordable and quality

health services in the eight EAG states, the eight north eastern states

of the country, Himachal Pradesh and Jammu & Kashmir. It would

then be extended to cover all parts of India, through the public

health system. The guiding principles as laid down in the

Implementation Framework of the mission document of the NRHM

emphasize that it would promote equity, access, efficiency, quality

and accountability, decentralize and involve local bodies, recognize

the value of our traditional knowledge base, promote innovations,

methods and process development and enhance people oriented

and a community based approach. The basic change that the NRHM

wishes to bring about in the monitoring framework is to involve

local communities in planning and implementing programmes with

a framework that allows them to assess progress against certain

benchmarks.

Community monitoring should ideally (a) provide regular and

systematic information about the needs of the community to facilitate

proper planning; (b)provide feedback as per locallydeveloped criteria

and basic indicators. This would comprise feedback on the functioning

of the different levels of the public health system - the gaps and

deficiencies; (c) allow the community and community based

organizations to become equal partners in the planning process.

In other words the community should assume an active role in the

context of the public health system; (d)use the community to validate

data collected by the Aanganwadi worker, the Auxiliary Nurse Midwife

and other functionaries of the public health system.

The Population Foundation of India is the Secretariat for the Advisory

Group on Community Action of the NRHM. The third meeting of

the Group was held on June 27, 2006. As community monitoring

should be the core of the NRHM, the main agenda of the meeting

was to deliberate on strategic frameworks for facilitating community

monitoring in NRHM. Views on community monitoring were shared

at the meeting and various suggestions were made. There is an

urgent need to involve the civil society in community monitoring.

An NGO Forum on NRHM could be constituted involving people's

organizations and existing networks. NGOs could play not only an

advisory role but also a participatory role in the NRHM. There is

also a need to define the role of a creative civilsociety in the process

of ensuring that the public health policies and programmes are able

to meet their stated objectives.

Community planning, implementation and monitoring should

essentially be operational at the level of the community and the

first contact point - the villages and the primary health centres.

The work at the district level could form part of the district plan

which could include specialist based clinical care offered through

different institutions. The overall aim of this endeavour would be to

significantly increase the effective utilisation of the services rendered

by primary health centres through sustained convergence of the

community and service providers and qualitative improvement in

the health services on a regular basis.

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many other distinguished persons were

present at the conference.

Mr. B.L. Agarwal, Secretary Health and

Family Welfare, Government of

Chhattisgarh, welcomed the participants

and emphasized the government's

commitment to health. He was appreciative

of the role of the PH in providing a platform

to the Government, non government and

international organizations, for sharing their

experiences from which the state would

benefit in terms of stabiliZing population,

improving health and achieving overall

social development. He announced that

during the conference the draft of the

"Integrated State Health and Population

Policy" would be circulated for debate and

discussion. He urged the participants to take

the opportunity to help the government in

formulating policy and strategic and

programmatic guidelines for Chhattisgarh.

Mr. AR Nanda, Executive Director, PH,

welcomed the participants on behalf of the

Foundation. Expressing his gratitude to all

the participants for taking time out to be at

the conference, he said that this would help

the state to prepare a plan of action for

Chhattisgarh which would be consistent

with their Vision 2020. He encouraged the

participants to actively participate, share

their views and provide their valuable inputs.

Ms. Lata Menon, State Representative,

UNICEF, spoke about the UNICEF's

commitment to the cause of maternal and

child health in terms of reducing Infant

Mortality Rate (IMR)and Maternal Mortality

Ratio (MMR). Stating that India is one of

the countries in the world with the highest

IMR (to which the percentage of neonatal

deaths is a major contributor), she said that

the IMR could be reduced by working in

partnership with all the stakeholders. She

reiterated that the role of "Mitanins"

(Community Health Volunteers) in reducing

neonatal mortality is crucial.

The Chief Secretary, Mr. RP. Bagai, while

addressing the participants, appreciated the

PH s initiatives in the state and said that

the Government of Chhattisgarh would

extend all possible help to the Foundation

in its endeavours. He said that health is a

priority for the Government of Chhattisgarh

and that funds would not be an impediment

to improving health as the budgetary

allocation for the same had been increased

by 39 per cent. He urged non-governmental

organizations to come forward and help the

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PopJOCUs

state in building capacity at all levels

to achieve the goal of universalaccess

to basic health care. He added that

in view of the expertise of the PH,

the government had requested the

Foundation to work with the

Directorate of Health and the State

Health Resource Centre(SHRC), to

formulate an integrated health and

population policy. He thanked the

PH for preparing the draft policy of

Chhattisgarh. He stressed the state's

commitment to decentralization and

said that district level and panchayat

level planning would be initiated

under the Swasthya Panchayat Yojna.

Mr. B.G. Verghese, Member of the

Governing Board of the PFI

mentioned

that although

Chhattisgarh had relatively poor

health indicators in the country with

high levels of mortality, morbidity

and malnutrition, the fertilitylevel in

the state is relatively better than

some other states in the country.

He expressed the need for a

comprehensive reproductive health

care policy and stated that the state

has identifiedthe matters of concern,

accepted the challenges and has

taken a number of administrative and

policy initiatives towards human

resource development.

Dr. Krishnamurthy Bandhi, Minister

for Health and Medical Education,

Government of Chhattisgarh,

asserted that changes are required

to be made in the health sector

for population stabilization.

He expressed concern for the decline

in the Child Sex Ratio in the age

group of 0-6 years. He further added

that the Government of Chhattisgarh

is trying to involvethe private sector

in the training of health workers.

The Minister expressed appreciation

of the efforts made by the Population

Foundation of India and thanked the

PH for helping the state government

in drafting the first integrated

health and population policy of

Chhattisgarh.

In his inaugural address, the Chief

Minister said that education, public

health and population stabilization

play a crucial role in the socio-

economic development of a state or

nation. He said that these subjects

The Chief Minister of Chhattisgarh releasing the Wall Chart on Chhattisgarh

Population, Health & Development

are inter-related and complementary

to one another. The Chief Minister

stated that for strengthening health

facilities,the health budget of the state

has been raised by 40 per cent. Two

hundred new primary health centres

are being set up and the Government

of Chhattisgarh has been laying

emphasis on infrastructure develop-

ment for improving health facilities

in the state. He spoke about the

scheme of "Jeevan Deep Hospital

Sudhar Yojana" and informed the

participants that this scheme would

ensure public participation at the

block, tehsil, district and state level

hospitals. He added that "Jeevan

Deep Committees" would have the

powers to construct hospitals, recruit

doctors and hire specialistsfor special

assignments.

The Chief Minister released the

PH's publication titled "Chhattisgarh

- Population, Health and Develop-

ment". The publication provides an

overview on population, health and

development as well as the district

profiles of Chhattisgarh. It is

envisaged that this publication would

be useful to policy makers, planners,

programme managers and non

governmental organizations in their

endeavours to improve social

conditions in the state. A wall chart

on the state's profile was also

released. Dr. Singh lauded the efforts

of the PH in bringing out such useful

documents.

The inaugural session was chaired

by Mr. B.G. Verghese, Member

Governing Board, PH. This was

followed by three sessions:

Population, Health and Social

Development: Issuesand Challenges,

chaired by Ms. Nina Puri, Member,

Governing Board, PH, Health Sector

Reforms: Towards Effective Health

Management, chaired by Mr. Alok

Shukla, Secretary, Education,

Government of Chhattisgarh and

Public-Private Partnership, chaired

by Ms. Rami Chhabra, Member,

Advisory Council, PH. The

presentations made on the first day

of the conference were on "An

Overview of Population, Health and

Social Development in Chhattisgarh

by Dr. Almas AIi,Senior Advisor,PH,

"Socio-cultural Determinants of

Health in Chhattisgarh" by Mr.Basant

Kar, State Representative, CARE

India, "New Government Initiatives

on Health" by Dr. D. K. Sen, Director,

Health and Family Welfare,

Government of Chhattisgarh,

"Effective Health Management:

Unfinished Reform Agenda" by

Mr. J.P. Mishra of the European

Commission, "Reducing Neonatal

Mortality through Home Based

Neonatal Care: the Gadchiroli

Experience" by Dr. Pradeep

Paranjape of SEARCH; "Demand

and Supply of Family Welfare

Services" by Dr. T. Sundaraman,

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Scaling-up Pilot Projects in Reproductive Health and

Adolescent Health in India

The project on identifying and

facilitating scaling up of pilot

initiatives in reproductive health and

adolescent health was started in

March 2006. This project is being

supported by John D and Catherine

T MacArthur Foundation and

implemented as a partnership

between the Population Foundation

of India (PH) and Management

Systems International (MSn, a United

States based management

consultancy firm. The MSI brings to

the partnership its technical know-

how in scaling up projects in the

developing world. As part of the two

year plan, the PH will be developed

as a centre of excellence for

facilitating scaling up pilot initiatives

in India. The PH will undergo a

learning phase as observer to the

scaling up process, where the MSI

will facilitate scaling up of a few

selected models like those of home

based neonatal care implemented by

SEARCH, improving reproductive

health of married adolescent girls

implemented by IHMP, iron

fortification in wheat flour by Seva

Mandir, community based health

insurance by SEWA and emergency

obstetric care training by the

Federation of Obstetricians and

Gynaecologists Societies of India

(FOGSI). During the scaling up of

such models, the PH will lend its

network linkages and advocacy

capacities to the scaling up process

and thus become a learning partner.

The project and programme staff of

the PH underwent a one-day

Dr. Rajni Ved (left) and Dr. Richard Kohl, from Management Systems

International, at a workshop at the headquarters of the Federation of

Obstetricians and Gynaecologists Society of India (FOGSI)

orientation programme on "Scaling

Up Framework" at the end of March

2006. This orientation exercise,

conducted by the MSI, lays the

foundation in the PH for emerging

as a centre in India for scaling up Pilot

Projects.

Following the one-day orientation,

the MSI conducted a two-day in-depth

training for the project team and the

staff of PH on tools that the MSI

adopts for scaling up. In addition, the

MSI and the PH jointly went to

Gadchiroli district of Maharashtra,

where Dr. Abhay Bang and his NGO

"SEARCH" implements the home-

based neonatal care model. A three

-day visioning exercise was conducted

for his team, during which a broad

plan for scaling up was devised.

Similar exercises were conducted by

the MSI and the PFI for Dr. Ashok

Dayalchand and his team at IHMP,

Pachod in Aurangabad district for

their model for married adolescent

girls and for FOGSI in Mumbai for

scaling up their emergency obstetrics

care training in 15 states.

One of the key tasks for scaling up

is"legitimizationa"nd "coalitionbuilding".

In order to facilitatethe process, the PFI

took initial steps to establish a Multi

Stakeholder Forum, consisting of

organizationsand individualsinterestedin

facilitating the scaling up of successful

pilots in the country. A pre-formation

meeting ofexperts was heldinMay2006

to establisha framework of guidelinesfor

functioning of the Multi Stakeholder

Forum.

De Indian Medical AssociaUon suppons campaign

against sex selecUon in Andhra Pradesh

Members of the Indian Medical

Association (IMA), Hyderabad

City were invited to participate at an

advocacy workshop on April 22,

2006 on sex selection and pre-birth

elimination of females and the rights

of the girl child. A similar workshop

had been held earlier in February

2005. The follow up workshop in

April, to sensitize the members of the

medical fraternity in Andhra Pradesh,

had participation comprising over

130 doctors, and radiologists. Various

issues related to the problem of

declining Child Sex Ratio (CSR) were

discussed including laws such as the

PC & PNDT Act 1994, which is

meant to check the practice of sex

selective abortion. Presentations on

the present scenario of the CSR in

Andhra Pradesh, the role of the

medical fraternity in improving the

CSR and the PNDT Act were

made by the PFI and the members

of the IMA. The participants

were supportive of the campaign

and pledged to stay away from any

form of sex selective abortion

practices.

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Healtheare in

unar Pradesh

An Intensive Family Welfare

Project in the Gunnour Block of

Badaun District of Uttar Pradesh (UP)

is being implemented by the Tata

Chemicals Society for Rural

Development (TCSRD) with support

from the Population Foundation of

India. The five year project has an

outreach of around 92 villages. Out

of these, 48 villages were included in

the first phase of the project,

beginning in April 2002. At present

the project, which is in its second

phase of implementation, is being

carried out in 46 villages since April

2004. Reproductive health services

are being delivered by trained

volunteers through a mobile clinic.

The steps taken to sustain the

programme include issuing identity

cards to the volunteers who are now

called" Swaasthya Mitras" ,providing

them with a small supply of

contraceptives and basic medicines to

encourage them to function as depot

holders and also involving the

volunteers in the project area during

the first phase to keep their interest

alive. It has been observed that the

acceptance of certain contraceptive

methods, such as Copper T (CuT)and

spacing methods such as pills and

condoms, has increased.

The Intensive Family Welfare Project

aims at providing comprehensive

healthcare to the rural population in

Gunnour block, in order to work

towards the goals set by the UP

Population Policy. These goals

include reducing the Total Fertility

Rate to 2.7% per woman, reducing

the Maternal Mortality Ratio by 50%-

from 707 to 394 per 100,000 live

births, reducing the Infant Mortality

Rate from 85 per 1000 live births to

73 per 1000 live births, The

programme also aims at ensuring that

even after the completion of the

project, the villages are self sufficient,

aware and continue to follow the

direction for sustaining the

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achievements and making sure that

the villagers of the target area are

aware about the services provided by

the Government and that they utilise

these services and also demand for

these if necessary.

The methodology involved in the

implementation of the project is the

use of a mobile clinic which delivers

reproductive health services in a

phased manner together with

Behaviour Change Communication

(BCC) activities and capacity building

at the grass roots level.

Director, State Health Resource

Centre, Government of Chhattisgarh

and "Reducing Maternal Mortality

through Safe Abortion Practices"

by Ms. Medha Gandhi from

New Delhi.

On the second day there were four

sessions: "IEC/BCC Strategy in the

context of Family Welfare" which was

chaired by Mr. B.G. Verghese,

Member, Governing Board, PFI,

"Women's Empowerment and

Reproductive Rights", chaired by

Ms. Rami Chhabra, Member Advisory

Council, PH, "Integrated Health and

Population Policy", chaired by Mr.

B.K.S. Ray, Additional Chief

Secretary,

Government

Chhattisgarh and the Valedictory

Session. The recommendations

drawn up during the conference were

presented by Mr. A.R. Nanda at the

valedictory session. The presentations

made on the second day were on "

Information and Communication

Technology (ICT)as a component for

Effective Behavioural Change

Communi-cation" by Dr. B. Shadrach

from IDRC, New Delhi, "Community

Radio: A Tool for Social Mobilization"

by Mr. Babu Thomas, Secretary,

Bastar True Light Samiti, Jagdalpur,

"Innovative Communi-cation Strategy

for Effective Implementation of

Family Welfare Programmes in EAG

States" by K.L. Rao Programme

Associate, PFI, "Population,

Development and Gender Issues" by

Ms. Nirmala Buch, Chairperson,

Centre for Women's Development

Studies, "Women's Empowerment:

Critical to Population Stabilization" by

Dr. Elina Sen from Raipur and

"Women's Empowerment and

Reproductive Rights" by Ms. Vidya

Das, Agragamee, Orissa. The last

session before the Valedictory Session

was on "Integrated Health and

Population Policy" in which a

presentation on "Integrated Health

and Population Policy for

Chhattisgarh" was made by Mr. T.

Sundaraman, Director, State Health

Resource Centre" Government of

Chhattisgarh.

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Crackdown 00 Female Foedcide - The Nawaoshahr Model

Nawanshahr district in Punjab has

a sex ratio of 808 girls to 1000

boys, as per the 2001 Census.

Although this district does not figure

in the 10 districts of the country with

the lowest child sex ratio, in the 0-6

age group, Punjab is nevertheless

home to 7 of the 10 districts.

Mr. Krishan Kumar, District Collector,

Nawanshahr , took it upon himself

to initiate a rigorous drive to redeem

the child sex ratio of his district and

establish a model which could be

emulated by those districts where the

child sex ratio has plummeted to an

all time low - a deplorable 780 in the

year 2001. Using a "carrot and stick

policy", Mr. Kumar has taken on the

stupendous task of monitoring all

pregnancies in the 467 villages in the

5 blocks of Nawanshahr district. He

has mobilised, for this purpose,

several NGOs, the Sarpanches, the

Aanganwadi workers of the districts

and the student community. In fact,

one of the first things that the

Collector did on joining was to bring

together 30 NGOs of the district

under a common banner called the

"Upkaar Coordination Society".

Mr. Kumar is himself the chief patron

of this Society. A software has been

specially developed to maintain the

records. A complete village wise

record is available of population,

children in the 0-6 age group, the

number of male children, the number

of female children, sex ratio, the

names of pregnant women, their

contact telephone numbers and their

expected dates of deliveries.

The District Collector regularly meets

a number of students every day and

talks to them about the declining child

sex ratio and persuades them to keep

a watchful eye on the pregnancies in

the village. To help them to carry out

this work, 5 children in each village

have been identified to represent the

office of the Collector. They have

been given identity cards for the

purpose. They are paid a sum of

Rs.100 for every pregnancy reported.

Each officer of the district, irrespective

of the department in which he works,

has been allocated the responsibility

of monitoring sex selection and

healthcare in five villages. By involving

the people in the drive against sex

selection and by punishing offenders

and rewarding those who make

efforts to rectify the adverse child sex

ratio, it has been possible to actually

bring about some improvement in the

situation. The collective efforts of the

District Collector and his people have

created a model which has come to

be known as the "Nawanshahr

Model".

The Voluntary Health Association of

Punjab (VHAP), the Voluntary Health

Association of India (VHAI), the

Population Foundation of India (PH)

and the state health department

jointly organized a one- day workshop

at Nawanshshr, to study the

Nawanshahr Model in detail. The

VHAP President, Mr. Manmohan

Sharma stated that he would take the

model to other parts of the state.

Dr. Harinder Rana, Director, Health

and Family Welfare, Punjab, said that

the model would be implemented in

other districts of the state soon. She

informed the participants that as

many as 81 cases have been

registered under the PNDT Act so far,

while the registration of 164 scanning

centres has been suspended. The

District Collector, Mr. Krishan Kumar

mentioned in his presentation that in

a village called Kothran, the child sex

ratio has risen to 44 girls per 33 boys

in 2005, as against 31 girls per 50

boys in 2004. He added that' three

girls were born in the village this

month against one baby boy'.

DLAlmas Ali, Senior Advisor,

Population Foundation of India

shared the PHs advocacy initiatives

on containing sex selection and pre-

birth elimination of females in other

states. The state Health Director

presented a cheque of Rs.3,00,000

to the District Collector for

Jullahmajra village that has shown an

improved child sex ratio of 1123

against 1000 boys. A commendable

achievement indeed!

Congratulations ...

Mr. Jata Shankar, who heads the Manav Seva Sansthan, and is also an anti-trafficking activist, was recently awarded a

certificate of appreciation by the Santa Fe City Council. The courageous act which won him the appreciation was the

rescue of a young woman from the clutches of a few anti-social elements who were trying to assault her. Mr.Shankar's

article titled "Good Samaritans" has been published in SPAN, a magazine sponsored by the embassy of the United States

of America.

Karuna Trust and Janani, the partner organizations of the PH at Karnataka and Bihar respectively, have made it to the 12

finalistsof the "How to Improve Health for All"competition being run by Ashoka, Arlington, USA. Ashoka is an international

network of Fellows. Ashoka's mission is to shape a citizen sector that is entrepreneurial, productive and globallyintegrated,

and to develop the profession of social entrepreneurship around the world. Ashoka identifies and invests in leading social

entrepreneurs - extraordinary individualswith unprecedented ideas for change in their communities - supporting them,

their ideas and institutions through all phases of their careers. Ashoka's competition, "How to improve Health for All,"

aims to find innovative health solutions that includelow-incomeand marginalizedpopulations, ranging from health education

and prevention to health financing, healthcare delivery or pharmaceutical development. The title of the entry sent in by the

Karuna Trust is "Innovations in primary health care through public-private partnership". The entry sent in by Janani is

titled "Mobilisingthe private sector resources to address the reproductive health needs of low income people, primarily in

the Indian states of Bihar and Jharkhand".

We wish them best of luck!

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POpJOCUS

Members of the legislative Issemblv in Maharashtra are sensitized

Members of the Legislative

Assembly play an important

role in India's development process.

Regular interaction with people of

their constituencies and awareness of

the socio-cultural ethos empowers

them to be effectiveagents of change.

Their role in development

programmes related to social issues

is of great importance. The

Population Foundation of India, with

the support of Plan International,

India has been conducting advocacy

workshops on sex selection and pre-

birth elimination of females for the

corporate sector, MLAs and other

segments of the population.

The MLAs of Maharashtra were

invited to participate at an advocacy

workshop at Mumbai on April 18,

2006. Around 66 MLAsparticipated

at the workshop. Some of the

important dignitaries who attended

the workshop and voiced their

concern on the issue were Chairman

of the Legislative Council, Deputy

Chief Minister of the state and the

Minister for Health and Family

Welfare. There was active

participation from all the MLAs,

despite the constraint of time. The

interactive workshop ended with a

MLAs of Maharashtra

participating at the

workshop at Mumbai

significant announcement from the

Chairman of the Legislative Council

that in the next session, one whole

day would be dedicated to the issue

of the girl child in the context of the

declining child sex ratio in the state.

Deputy Chief Minister,

Maharashtra Mr. R.R. Patil

addressing the participants

This announcement was supported by

the Deputy Chief Minister. There

were a sizeable number of lady MLAs

who evinced keen interest in

organizing awareness workshops in

their constituencies.

Enhancing Reproductive Heahh Status in Uttar Pradesh

Manav Seva Sansthan (SEVA)is a

partner organization of the

Population Foundation of India in

Gorakhpur, Uttar Pradesh. It had

responded effectively in the recent

past to an outbreak of Japanese

Encephalitis in three blocks of

Gorakhpur District, by generating

awareness in the community on the

causes and prevention of the disease.

At present, SEVA is implementing a

programme on enhancing the health

status of women, children and

adolescents by adapting the RCH Ufe

Cycle Approach in 53 out of 148

villages of Jungle Kaudia block of

Gorakhpur district of Uttar Pradesh.

The area covered by the programme

involvesa population of 51,180 over

a span of three years from October

2004 to September 2007. The

programme has as its objectives -

sensitizing, training and building

capacity of the project level

stakeholders (including stakeholders

in Government) at the block and

districtlevelsfor improvingthe quality

of Reproductive and Child Health(

RCH) services and ensuring its

sustainability; raising awareness and

sensitizing the target community on

RCH issues, health and treatment

seeking behaviour through intensive

IEC/BCC activities and delivering

quality RCH services adapting a life

cycleapproach. The programme thus

focuses on awareness, capacity

building of village stakeholders and

delivery of quality services. The

establishmentof a Health Information

cum Service Centre (HISC)managed

by a Community Health Educator

(CHE), trained and technically

supported by SEVA in collaboration

with volunteers (women from Self

Help Groups) and the Panchayats, is

a unique feature of the programme.

Fifty three villagers are grouped into

13 clusters. One HISC per cluster has

been established. In all, 13 HISCs

were established to provide a range

of reproductive health services.

A doctor visitseach HISC once every

week.

While 12 of the HISCs are based in

the Panchayat Bhawans, one is based

in the house of the Panchayat

Pradhan. Apart from the paid

personnel, recruited for the project,

a number of Self Help Groups and

adolescent groups were formed in the

villages to support the programme.

1.8 Page 8

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Community Radio Prourammes Evaluated

The Population Foundation of

India, in collaboration with

Agragamee, a local non-govern-

mental organization in Orissa had

initiated a community radio

programme titled "Ujala", in the

backward tribal districts of Orissa.

The objective of the programme was

to empower the community and the

members of the Panchayati Raj on

the issues of population, health

and social development through

community radio in areas where the

tribal Desia dialect is spoken. The

Foundation ran another community

radio programme titled "Ujhar" in

Chhattisgarh in collaboration with an

organization called Bastar True Light

Samiti. The programme was aired

from AIR, Jagdalpur and was made

in the Halbi dialect. Both the

programmes were very well received

by listeners and were re-broadcast on

popular demand.

With the help of an independent

research organization - "Health and

Development Initiative", the PFI

carried out an evaluation study of

both the community radio

programmes. The studies revealed

that the listeners appreciated the

programmes and found them useful

as the topics chosen were relevant

to the problems and concerns in their

day to day lives; they were interested

in a re-run of the programmes; the

organizations which ran the

programmes for the PH, found that

listeners participated in meetings of

the Panchayats and now demanded

better services and regular visits by

the local Auxiliary Nurse Midwife

(ANM) and the organizations have

also found that there is more

informed debate amongst the people

on social and health issues. It has

been found that the Listener's Club

has become a forum for discussion

on health issues.

The evaluation studies have

recommended that the programmes

should be repeated to increase

Ujala evaluation study: a focus group

discussion in progress

awareness and affect changes in

habits and practices; recorded

cassettes should be distributed to

enable more people to listen to the

programmes; regular meetings should

be organized in the villages to discuss

the community radio programmes

and motivate people to tune in to the

programmes and to have another

repeat broadcast of the programme.

A proposal for a new phase of the

programmes is in the pipeline.

PuRiab, Harvana & Himachal Brainstom in Barogh

Declining Child Sex Ratio is a

crucial social and demographic

problem faced by India today. In the

last few decades various organizations

have been responding to the issue in

different ways. The formulation of the

PC &PNDT Act has been a milestone

in the efforts towards addressing the

issue of declining Child Sex Ratio.

The Population Foundation of India

has been involved in advocacy efforts

against declining Child Sex Ratio for

the last few years. It has been working

on a national level advocacy

campaign on the issue since 2003.

During the campaign advocacy

workshops with state legislators,

corporate leaders, school teachers,

medical professionals, students and

the media have been held in different

states.

Encouraged by the response received

from the stakeholders, the PFI

launched an advocacy campaign on

"Missing Girls", in association with

the Ministry of Health and Family

Welfare, Government of India, and

the UNFPA, in Haryana and Punjab,

in 2004. The objective of the

campaign was to convert "advocacy

into action". As part of the campaign,

various advocacy initiatives on the

issue of Missing Girls were carried out

at the grassroots level, in which

government officials, NGOs, mahila

mandals and the youth were involved.

A similar campaign in two districts of

Himachal Pradesh has also been

planned for this year. The state

governments of Punjab, Haryana and

Himachal Pradesh have taken several

steps to deal with the issue of

declining Child Sex Ratio.

To bring together all the partners,

government officials and NGOs

working on the issue of declining

Child Sex Ratio in all the three states,

a one day workshop was organized

on June 3, 2006 at Barogh in

Himachal Pradesh. The PFI in

association with the Voluntary Health

Association of Punjab and SUTRA

organized the workshop, the objective

Consultation workshop at Barogh

of which was to share the experiences

of various partners and to draw up a

future strategy involving the state

governments, NGOs working in the

field and the Panchayati Raj

institutions as the Gram Panchayat

is the basic unit of governance at the

village level.

Various factors responsible for the

disappearing girl child were discussed

at the workshop. There was ample

and active participation from all the

three states. There were presenta-

Contd. on page 9

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PopJOcus

lationallevel AdVocacl Campaign on Sex Selection and

Pre-Birth Elimination 01Females - The end and a new beginning ...

The Population Foundation of

India with the support of Plan

International, India had launched a

national advocacy campaign against

pre-birth sex selection and

eliminationof females in eleven states

of the country - Rajasthan, Orissa,

Haryana, Punjab, Himachal Pradesh,

Uttar Pradesh, Uttaranchal, Gujarat,

Maharashtra, Delhi and Andhra

Pradesh. It has been by far the largest

advocacy campaign, reaching the

widest and most varied audience in

the country on the issue of sex

selection and pre birth elimination of

females. The campaign involvedlocal

partners from the states - NGOs,

teachers, the media - designing state

specific advocacy materials and

mobilising the stakeholders in each

of the eleven states. Advocacy

workshops were conducted with

elected representatives like Members

of LegislativeAssemblies,representa-

tives of the corporate and industry

sector, doctors, teachers, NGOs,

students and the media. These

workshops oriented the stakeholders

on the issues of sex selection and pre

birth elimination of females and

declining child sex ratio, stressed the

importance of their involvement in

curbing it and, provided them with

state- specific data which proved to

be an eye opener for many. The

workshops were interactive and

brought forth key suggestions and

recommendations on the roles of

these stakeholders in dealing with

declining Child Sex Ratio.

To share experiences of all those

involved in the campaign, a

dissemination workshop was

organised on June 21, 2006 at the

IndiaHabitat Centre, New Delhi.The

workshop brought the curtains down

on the advocacy campaign which had

started in 2003. At the workshop,

the PH's main partners as well as

officials from the central and state

governments participated. Detailed

and informative presentations were

made by representatives from the

Confederation of Indian Industry(Cm,

SUTRA from Himachal Pradesh, the

Voluntary Health Association of

Punjab (VHAP), CHETNA from

Ahmedabad, the Indian Medical

Association (IMA), Hyderabad,

Datamation Foundation, the Centre

for Women's Development Studies

(CWDS),Campaign against Pre-birth

Elimination of Females (CAPF) and

Aravis from Delhi. The presentations

included not only the activities

undertaken by the various

organisations, but also the develop-

ments that have taken place since the

campaign started in 2003.

An audio-visual report of the entire

campaign, prepared by the PH, was

screened at the workshop.

A television spot prepared on the

theme of female foeticide was

released and screened as part of the

programme.

Interactive discussion during the

workshop

brought

forth

recommendations- that the advocacy

activities should be taken to the

grassroots level, involving legislators

and the corporate sector, that the

Government should insist on medical

audit as a pre-requisite for the renewal

of licenses of ultra sound clinics, that

organisations like the CII and the

Punjab, Haryana, Delhi Chamber of

Commerce and Industry (PHDCCI)

should maintain a record of the

ultrasound machines sold by members

of their industry and that campaigns

of this nature should be selfsustaining-

the costs being borne by stakeholders

as part of their regular activities-

rather than funding based events.

An intensive advocacy campaign on

pre-birth sex selection and elimination

of females was carried out in the nine

districts of Delhi in the summer of

2005. Each of the three organizations

- CAPF,ARAVISand the Datamation

Foundation

made detailed

presentations on their respective

activities related to the Delhi

campaign.

Contd. from page 8

tions made on the initiativestaken to

curb declining Child Sex Ratio by the

state governments. The workshop

provided an opportunity to the

concerned authorities to share

experiences, to get to know about

each other's work and initiatives and

formulate a strategy to tackle the

menace, especially in the inter-state

border districts. The workshop also

gave an opportunity to the NGOs of

the regions to interact with

government officials and work out a

plan for collective approach to deal

with the situation.

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PopfOcus

The Activities of the Global Fund Round 4 Project on III/AIDS -

"Access to Care & Treatmenf' - An Update

The last two months were, for the

Global Fund project unit at the

PR, replete with meetings starting

with a one day national consultative

seminar at New Delhi on May 2,

2006. The seminar had the objective

of developing standards and

guidelines including a component

of palliative care, for Care and

Support Centres for People Living

with HIV / AIDS. All the key

stakeholders such as the WorldHealth

Organisation, India, USAID, the

National AIDS Research Institute,

other international organizations and

experts participated at the seminar.

The Country Coordination

Mechanism Meeting (CCM) for the

Global Fund Programme was held on

May 11, 2006 at the Ministry of

Health and Family Welfare, Nirman

Bhawan, New Delhi. Mr. Subrat

Mohanty, Programme Manager,

Global Fund unit and Mr.Vijaykumar,

Grants Manager of the unit

represented the PFI as special

invitees.

An experience sharing meeting was

held on May 15, 2006 at Imphal at

which antiretroviral (ARV)clients and

health care providers interacted.

There were a total of 48 participants

including 25 People Living with

HIV/ AIDS (PLHAs)at the meeting.

Three training workshops were

conducted at Bangalore, Hyderabad

and Imphal on May 8-10, May

15-20 and June 12-16 respectively.

The purpose of the workshops was

to orient the teams of District Level

Networks (DLNs)and the Treatment

Counselling Centres (TCCs) on

Management Information Systems

(MIS) software. Two people from

each of the selected DLNs and staff

from all TCCs in six states

participated at the workshops. State

Programme Associates and

Programme Officers of the Indian

Network of Positive People (INP+)

from these states and the state units

of the PR participated at the training

workshops. A two member task force

comprising Mr.Raju Kulloli,Assistant

State Coordinator, Karnataka and

Mr. Alwin L. Dass, Assistant State

Coordinator, Tamil Nadu, was

constituted to work on the

development of the software.

The 23rd International Candlelight

Memorial Day was celebrated by the

Manipur Network of Positive People

(MNP+)at Imphal, Manipur, on May

16, 2006. Mr. D.K. Korungthang,

Health Minister, Manipur, was the

Chief Guest at the event. The salient

feature of the event was a blood

donation camp at the blood bank

there. Mr. Subrat Mohanty repre-

sented the PH at the function.

A four day review meeting with the

state programme teams of

Maharashtra, Karnataka, TamilNadu,

Andhra Pradesh, Manipur and

Nagaland took place at

Vishakapatnam, from May 22 to

May 26, 2006. The basic objective

of the meeting was to review the

progress of the Global Fund

programme, identify gaps in the first

phase and develop strategies for the

second phase.

Coordination meetings with individual

Core Sub Grantees (CSGs)were held

to discuss the progress in the first

phase of the programme and draw

up a plan of action for the second

phase. A combined meeting with

all the CSGs was organized on

June 24, 2006 at the PR office at

New Delhi.

An external evaluation of the Global

Fund programme has been initiated .

The overall objective of the review is

to offer immediate corrective

measures, if any, for the second year

of the programme in the first phase

of the implementation of the "Access

to Care and Treatment" (ACT)Project

as well as to provide strategic inputs

for the planning and implementation

for the second phase. At the time of

review 60 DLNs, 10 TCCs, one

Positive LivingCentre (PLC)and one

Comprehensive Care and Support

Centre (CCSC) had been established

in six high prevalence states. The

review team visited 7 TCCs, the PLC,

the CCSC and those DLNs which are

in the vicinity of the TCCs.

An action research project has

recently been initiated to reduce

the prevalence of iron deficiency

anaemia among girlsin the age group

of 13-19 years and pregnant and

lactating mothers in Gurgaon district

of Haryana. The project is being

implemented by an NGO called

SUKARYAbased in Gurgaon. The

project area comprises 10 villages

with a population of approximately

30000. The main objectives of the

project include measuring the

Breaking New Ground_

prevalence of anaemia in the target

group, creating awareness on

anaemia and its adverse effects,

methods of prevention and treatment

and assessing the existingknowledge,

attitude and practice regarding the

consumption of food rich in iron.

An innovative project on the

management of essential RCH and

primary healthcare through public-

private partnership is being

implemented by the Karuna Trust,

Karnataka. The project aims to set

up model public Primary Health

Centres which would effectively

deliverthe essential RCH and primary

healthcare services. The project

would be working on 7 primary

health centres from the 6 socio-

demographically backward districts

of Karnataka - Bagalkot, Bidar,

Bijapur, Gulbarga, Raichur and

Bellary. This project is expected to

benefit more than 2 lakhs people in

that region.

2 Pages 11-20

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2.1 Page 11

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PopJOcus

AdVocacv with Senior Bureaucrats

A dvocacy initiatives on population

nand development have been part

of the activities of the projects