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PFI Annual Report 2010-2011 |
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2010-2011
POPULATION FOUNDATION OF INDIA
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ANNUAL REPORT / 2010-2011
| OUR Vision |
Promoting, Fostering, and Inspiring sustainable and balanced
human development with a focus on population stabilisation through
an enabling environment for an ascending quality of life with equity
and justice.
| OUR Mission |
PFI will strive to realise its Vision by promoting and formulating gender
sensitive and rights-based population and development policies,
strategies and programmes.
To this end, it will:
Collaborate with central, state and local government institutions for
effective policy planning, formulation and facilitation of programme
implementation.
Extend technical and financial support to individuals and civil
society institutions and promote innovative approaches.
Undertake and support systems, action, translational and other
forms of operational research.
Create awareness and undertake informed advocacy at community,
regional, national and global levels for socio-cultural and
behavioural change.
Focus on un-served, under-served areas and vulnerable sections of
society and address the challenges of an emerging demographic
transition.
Mobilise financial and human resources from all sources both
national and international.
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ANNUAL REPORT / 2010-2011
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ANNUAL REPORT / 2010-2011
Contents
Governing Body and Advisory Council
6
Governing Board Chairman’s Address
7
From the Executive Director’s Desk
10
Forty Years of PFI – The Journey Forward
14
PFI’s Presence in India
18
A. COMMUNITY-BASED INTERVENTIONS
Partnership with NGOs
20
A Sub-Centre as an Agency for Maternal Well-Being: Rajasthan
21
Developing Model PHCs through Public-Private Partnership: Karnataka
23
Developing a Model Initiative for Quality Family Planning Services: Uttarakhand
25
Reaching the Unreached: The Brahmaputra River Islands, Assam
27
Reducing Reproductive Morbidity among Young Married Women: Maharashtra
29
Improving Access to Quality Family Planning Services for Young Women: Slums of Delhi
31
Increasing Access to Contraceptives and Reducing Anaemia among Adolescent Girls:
Ganjam, Odisha
33
Ensuring Mother and Child Survival: Tribal Areas of Rayagada, Odisha
35
Improving Child Sex Ratio: Haryana, Punjab and Himachal Pradesh
37
Partnership with the Corporate Sector
38
An Integrated Approach to Family Welfare: Rajsamand, Rajasthan
39
Addressing Gaps in Reproductive Health and Family Planning: Sirohi, Rajasthan
41
Promoting Healthy Families: Badaun, Uttar Pradesh
43
Improving the Health of the Ho Tribals: West Singhbhum, Jharkhand
46
Partnership with the Government
48
Regional Resource Centres: Bihar and Chhattisgarh
49
Community-Based Planning and Monitoring Programme: Bihar
51
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Contents
B. SCALING UP IN THE MATERNAL HEALTH AND ADOLESCENT REPRODUCTIVE
AND SEXUAL HEALTH SECTOR IN INDIA
Scaling Up NGO and Public Sector Innovations
C. SYSTEMATIC REVIEW AND RESEARCH STUDIES
Birth Preparedness and Complication Readiness
Training of ASHAs under the National Rural Health Mission in Uttar Pradesh:
Assessing the Needs
Assessing the Impact of Conditional Cash Transfers on Delaying Marriage
D. PARTNERING WITH THE MEDIA
Jeene Ki Aasha: A Health Campaign on Television
E. EVENTS
Commemorating 40 Years of PFI
World Population Day 2010
National Conference – Scaling Up: Lessons Learnt and Way Forward
F. HIV/AIDS PROGRAMME
PACT for Better Care and Treatment
G. HEALTH OF THE URBAN POOR PROGRAMME
Developing Affordable Quality Health Care
Financial Highlights
Publications During the Year
Our Team
State and Regional Team Offices
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ANNUAL REPORT / 2010-2011
Governing Board Advisory Council
Mr. Hari Shankar Singhania, who succeeded
Dr. Bharat Ram as Board Chairman in
September 2007, heads the Governing
Board. The Board, with the advice of an
Advisory Council, determines the policies
and programme strategies of PFI and sets
priorities.
The distinguished members of the
Governing Board as on September 30, 2011
are:
Chairman
Mr. Hari Shankar Singhania
Members
Dr. Vinay Bharat-Ram
Mr. K. L. Chugh
Dr. Abid Hussain
Mr. R. V. Kanoria
Mr. Kiran Karnik
Mr. J. C. Pant
Dr. Nina Puri
Prof. Ranjit Roy Chaudhury
Ms. Justice Leila Seth
Mr. Ratan N. Tata
Mr. B. G. Verghese
Dr. M. S. Swaminathan (permanent invitee)
The Secretary, Ministry of Health and
Family Welfare, GoI (ex-officio)
Ms. Poonam Muttreja (ex-officio)
The Advisory Council, consisting of experts
in related fields, such as Sociology,
Demography, Communications, Health
Services, the Environment, Education,
Management and Women's Development
contributes to the formulation of the
Foundation's policies and programmes.
The Advisory Council was reconstituted in
September 2011.
The members of the Advisory Council as
on September 30, 2011 are:
Chairman
Dr. M. S. Swaminathan
Members
Ms. Srilatha Batliwala
Dr. M. K. Bhan
Ms. Mirai Chatterjee
Mr. Ajai Chowdhry
Mr. Keshav Desiraju
Mr. Yashodhan Ghorpade
Mr. Sanjoy Hazarika
Ms. Aruna Kashyap
Mr. Anand Mahindra
Dr. Suneeta Mittal
Dr. Saroj Pachauri
Ms. Mrinal Pandey
Ms. Geeta Regar
Dr. Gita Sen
Ms. Anandita Sharma
Dr. Leela Visaria
Ms. Poonam Muttreja
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ANNUAL REPORT / 2010-2011
Governing Board Chairman’s Address
It is a pleasure and a privilege to be witness to the 41st Annual General Body
meeting of the Population Foundation of India (PFI). I have had the opportunity to
share and contribute to PFI's vision and mission for the last 25 years as a member of
the Governing Board and as Chairman since 2007.
I would begin with paying our respects to our friend and colleague, the Vice -
Chairman of PFI's Governing Board, Shri B. G. Deshmukh, whom we lost on the 7th
of August, 2011.
Bhalchandra G. Deshmukh, who joined the Indian Administrative Service in 1951, had
the rare distinction of holding the post of the Cabinet Secretary in the Government
of India from September 1986 to March 1989 and of the Principal Secretary to three
former Prime Ministers of India, Rajiv Gandhi, V. P. Singh and Chandrashekar, from
March 1989 to December 1990. PFI had the privilege of his wise counsel and
administrative acumen in the Governing Board for 15 years, and as the Vice-
Chairman since 2007.
It gives me great pleasure to inform you that the year 2010 saw PFI completing 40
years of its founding. We reiterated our commitment to population and health issues
through a series of regional conferences and other events that brought to the
spotlight, core issues, barriers and success stories in population, health and social
development from different regions. Three regional conferences covering the
eastern, western and north-central regions, have been successfully organised. The
conferences have brought out region-specific priorities and issues and
recommended strategies that will help improve population, health and social
development parameters in these regions.
PFI has sought to strengthen non-government organisations, self-help groups,
Panchayati Raj Institutions and the organised sector on population issues with the
goal of empowering the community as a whole. Advocacy and communication of
population issues has been central to PFI's work.
The Advisory Group on Community Action (AGCA), a group of civil society experts
constituted by the Ministry of Health and Family Welfare (MoHFW), is mandated to
provide guidance on community action under the National Rural Health Mission
(NRHM) with PFI as its Secretariat. PFI played a pivotal role as the National
Secretariat in the first phase of Community Based Monitoring (CBM) of health
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ANNUAL REPORT / 2010-2011
Governing Board Chairman’s Address
services that was initiated through the AGCA in nine states during 2007 to 2009. PFI
has now been appointed as the State Nodal-cum-Technical Agency for the roll out of
Community Based Planning and Monitoring (CBPM) in Bihar.
PFI reinforces its commitment to focus on the un-served and under-served areas and
the vulnerable sections of the society through the Health of the Urban Poor (HUP)
programme, a partnership with USAID India. The HUP programme provides need-
based technical assistance to Central, State and Local government institutions for the
implementation of the proposed National Urban Health Mission (NUHM).
PFI is the first civil society organisation in India to be a Principal Recipient of grants
from the Global Fund to fight AIDS, Tuberculosis and Malaria to implement the Round
4: 'Access to Care and Treatment' (ACT) and Round 6: 'Promoting Access to Care and
Treatment' (PACT) programme for people living with HIV/AIDS. PFI has successfully
managed the programme over the past several years leading a consortium of
selected sub-recipients. Issues of national and state-level significance have been
identified and actively taken up with relevant stakeholders such as parliamentarians,
state legislators, the corporate sector, the media and civil society organisations. PFI
has also been actively promoting greater involvement of the private sector towards
India's aim for population stabilisation. It is my strong belief that the existing scenario
provides a challenge as well as an opportunity for PFI to play a key role in achieving
the national agenda with full commitment and renewed enthusiasm.
Acknowledgements
PFI is grateful to the members of the Governing Board, Advisory Council, expert
groups, social workers, health professionals, NGOs and corporate partners who have
readily responded to our call for advice and assistance in the true spirit of service for
a cause of national importance.
We are grateful to the various government departments, particularly the Ministry of
Health and Family Welfare, Ministry of Information and Broadcasting, Prasar Bharati,
National AIDS Control Organisation (NACO), the office of the Registrar General of
India and the Planning Commission for their sustained interest and co-operation in
furthering the aims of PFI. We are also grateful to the media – both print and
electronic who – in recent times, have displayed enhanced sensitivity to population,
development and gender issues, and helped build public opinion in favour of
determined action.
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ANNUAL REPORT / 2010-2011
Governing Board Chairman’s Address
I wish to thank partner donor organisations, particularly The Global Fund, The David
and Lucile Packard Foundation, UNDP, The John D. and Catherine T. MacArthur
Foundation, USAID and Sir Dorabji Tata Trust.
I take this opportunity to express the Governing Board's and my own appreciation of
the contribution by Mr. A. R. Nanda, Executive Director of Population Foundation of
India during his tenure at PFI from 2003 - 2010. I also extend a warm welcome to
Ms. Poonam Muttreja, who took charge as the Executive Director, PFI in September
2010. Ms. Muttreja brings with her over 30 years of rich experience in the socio-
development sector. We are certain that the organisation will scale new heights
under her able guidance.
I also greatly appreciate the staff of PFI, who continue to discharge their duties with
enthusiasm and efficiency. I look forward to new initiatives towards achieving the
vision of PFI.
Hari Shankar Singhania
CHAIRMAN
Governing Board of PFI
October 2011
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ANNUAL REPORT / 2010-2011
From the Executive Director’s Desk
I feel very privileged to have joined PFI as
it turns 40.
PFI addresses critical issues of population,
health and sustainable development to
enhance the quality of life by improving
access to quality services, strengthening
advocacy and building capacities at the
national, state, and districts levels. Women's
empowerment, gender equity and equality,
quality of care, expanded contraceptive
choices, and the enabling of young people
to make informed choices are PFI's thrust
areas.
PFI has brought
together and created
a common platform
for a large and
diverse civil society
group to debate,
deliberate and
consult on
population, health
and development
issues.
PFI is both a grant making agency as well as a recipient of grants from external
partners. In the four decades of its existence, PFI has received funding from national
and state governments; international agencies including UNFPA, the Ford
Foundation, the David and Lucile Packard Foundation, the John D. and Catherine T.
MacArthur Foundation, Global Fund, USAID and more recently, the Bill & Melinda
Gates Foundation. PFI has, over the years, provided technical and financial support
to more than 350 NGOs. It has actively engaged with different stakeholders and
positioned itself as a convener. PFI has brought together and created a common
platform for a large and diverse civil society group to debate, deliberate and consult
on population, health and development issues. It has supported pilot initiatives and
innovations to improve access and delivery of family planning services, strengthen
local health networks, and train health workers.
According to the Census of India 2011, India's population stands at 1.21 billion. The
country's total fertility rate in 2006 was 2.7. India's growing population continues to
be a major cause for concern among policymakers and civil society. However, there
is considerable misunderstanding about the nature of the 'population problem' and
what needs to be done to achieve rapid population stabilisation. Clearly, incentives
and disincentives for sterilisation are neither sustainable nor are they a solution.
There is need for a better understanding on the three drivers of population growth:
population momentum, wanted fertility and unwanted fertility/unmet need and their
impact on population stabilisation.
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ANNUAL REPORT / 2010-2011
From the Executive Director’s Desk
Population momentum refers to the tendency for population growth to continue
adding large numbers even when couples have fewer children, because of a
relatively high concentration of people in the childbearing years. It accounts for
approximately 70 per cent of the projected population increase.
Unmet need is the disconnect between a woman's desired fertility and her access to
family planning services. It is expected to contribute to approximately 20 per cent of
the projected population growth.
High desired fertility is caused by several factors, including parents giving birth to
more children than they actually want to compensate for high rates of infant
mortality, the low status of women, the limited voice that women have in family and
fertility decisions as well as a strong preference for sons. Desired fertility accounts
for around 10 per cent of the projected population growth. The mounting pressures
of modern society to have a small family combined with a strong preference for
sons often leads to pre-natal sex selection.
Against this backdrop, PFI's long-term goal is to reposition family planning within a
women's empowerment and human rights framework as part of the country's
maternal and child health policies and programmes. This can be achieved only when
the three drivers of population growth (population momentum, unmet need, and
high desired fertility) are addressed effectively and we reach out to young people,
particularly women.
Population momentum can be slowed down mainly by delaying age at marriage and
childbearing in women. Unmet need can be addressed by improving the quality of
family planning services and increasing access to contraceptives. Both high desired
fertility and population momentum can be addressed by interventions that stimulate
a demand for contraception, such as those that promote social norms around small
families, delayed age at marriage, and delayed childbirth.
PFI's five-year strategic plan
A change in leadership presents an opportunity to step back, revisit and revise the
organisation's strategy and activities; to move closer to the Vision and Mission. To
do so, PFI consulted partner organisations and experts to develop a five-year
strategic plan for repositioning family planning.
PFI's long-term goal
is to reposition
family planning
within a women's
empowerment and
human rights
framework as part of
the country's
maternal and child
health policies and
programmes.
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ANNUAL REPORT / 2010-2011
From the Executive Director’s Desk
While, in principle, family planning should not be treated as a vertical programme, in
practice it continues to be so with very little attention paid to quality of care. PFI's
five-year strategic plan takes into account the above realities and requirements. Built
around multiple pathways of social transformation, PFI's Theory of Change is based
on the premise that repositioning family planning within a human rights framework
can be realised by undertaking effective advocacy with different stakeholders,
improved technical support, continuous monitoring of outputs, and tracking and
reporting on outcomes.
Health programme
managers should
adopt a rights-based
approach to plan and
implement family
planning activities
and reproductive
health interventions
in an integrated
manner.
In this context, repositioning family planning at the national level requires
policymakers, donors, scientists and business leaders to create or support budget
line items dedicated to family planning, enact supportive laws and policies in a
gender sensitive and rights-based framework, participate in multi-sectoral
partnerships, and publicly demonstrate their support for family planning. It also
means that health programme managers should adopt a rights-based approach to
plan and implement family planning activities and reproductive health interventions
in an integrated manner. At the local level, it means that community leaders educate
and mobilise constituents, providers offer reproductive health and family planning
counselling and quality services with skill, enthusiasm and consistency, and informed
clients act effectively on their desire to delay, space or limit childbearing.
PFI's strategic plan concentrates on five key focus areas:
(I) delaying age at marriage
(ii) delaying age at first pregnancy
(iii) promoting spacing between births
(iv) improving the quality of care of family planning and reproductive health
programmes
(v) prevention of sex selection.
We recognise that PFI has to be equipped with strong systems and processes to
overcome challenges, make the most of opportunities and effectively implement the
strategic plan in order to keep pace with the growing challenges and opportunities
in the area of population stabilisation and health. Therefore, we initiated an
organisation transformation exercise with the help of an external agency in late
2010. As part of the exercise, we have undertaken an assessment of human resource
capabilities, developed a revised organisational structure, and revised management
processes and key policies. Capacity strengthening programmes for PFI staff on
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ANNUAL REPORT / 2010-2011
From the Executive Director’s Desk
scaling-up management, advocacy strategy development and new media are part of
the plan going forward.
We, at PFI, are committed to working on ensuring a rights-based, gender sensitive
and people friendly approach to family planning. We value the support of all our
partners as we embark on the road to positive change with renewed vigour. We
invite you to join us in our endeavour to contribute to enhancing the lives of those
excluded from India’s economic growth.
Poonam Muttreja
EXECUTIVE DIRECTOR
Population Foundation of India
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ANNUAL REPORT / 2010-2011
The Birth of the
Family Planning Foundation
October 12, 1970
Family Planning Foundation
is registered as a Society
40 years of pfi....
The Beginning...
A group of enlightened, socially committed
and philanthropic industrialists,
led by the late Mr. J. R. D Tata and
Dr. Bharat Ram get together
to found an organisation to assist:
‘All non-official efforts in the country willing and anxious to play their part,
however small, in the great national task of controlling the growth of our population
’ and helping millions of our people to plan the size of their families.
The 1970s
Defining Events
1971 – MTP Act
1976 – The first National Population Policy
1978 – Child Marriage (Restraint) Act (Male – 21 yrs; Female – 18 yrs)
A period when policymakers believed that the high rate of population growth was the
greatest obstacle to economic development
Coercion brought the FP programme to a ‘stand still’ and a ‘state of paralysis’
FPF’s Response
Integrated health care
Biomedical research – reproductive physiology & contraceptive technology
Population education
Pregnancy counselling
Contraceptive practices
Demography studies
1970-79: 120 projects funded worth Rs 1.22 crores
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ANNUAL REPORT / 2010-2011
the journey forward
1981 Census Shook the Nation out of a Stupor
Annual growth rate > 1960s
The long-term goal of lowering fertility to the
replacement level by 1996 seems unrealistic
The population of one billion by 2001 appears
‘inescapable’
The Effect
Revival of political support for FP programmes
Need for better contraceptives
Need for educational campaigns aimed at both
couples and young people in the age group 10 to 18
years
The 1980s
Evaluation Committee – Independent 3-member team constituted for a performance audit of FPF’s activities in the 1970s
Recommendations:
Wider base, more visibility and more effectual policy advocacy, replicating social action programmes
Broadening Focus
Focus was expanded to promote, through action research, family planning as a necessary and integral part of maternal and child care
...including those aspects of development that influence fertility behaviour
FPF’s Activities:
Corporate sector partnerships – to provide FP counselling and services in factories and plants
Moulding public opinion – working with village panchayats, zilla parishads, state legislatures, parliamentarians
Mass communication – documentary and video films for AIR and DD, pamphlets, seminars and workshops
Bio-medical research – anti-pregnancy vaccines, pregnancy testing kit
Research and Diagnostic studies on population
Study on incentives vs. disincentives – disseminated widely and covered in print media as well as DD
The Seventh (1985-89) and the Eighth (1992-97) Five Year Plans – actively involved in their formulation
Land acquired in Delhi. PFI gets its own building
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ANNUAL REPORT / 2010-2011
Defining Events in the 1990s
Global
1994 – International Conference on Population and
Development (ICPD) in Cairo
1995 – World Conference on Women in Beijing
National
1997 – RCH Programme
NFHS I & II
Draft National Population Policy
40 years of pfi....
Name Changed
Family Planning Foundation to Population Foundation of India
The 1990s
PFI’s Response
Commitment to follow the concept of RH through the life cycle approach as against the
earlier limited objective of reduction of population growth rates
Moving away from a mere demographic goal of reducing population growth rate and
concentrating on the improvement of the quality of life
Sustainable human and social development
Activities in the 1990s
Lecture Series, Awards
Advocacy to mould community attitude in favour of FP as part of development programmes
Inducing political commitment towards promoting RH/FP
Involvement of the corporate sector in promoting RH programmes
Identifying adolescents and young people as an important group with special needs and concerns
Focus on women’s empowerment
Empowerment of PRIs
Promoting male involvement in FP
Promotion of RH/FP in urban slums
Setting up of the Training and Resource Development Centre (TRDC) at national and state levels –
with financial support from MoHFW – for capacity building of NGOs working on RH issues
1995 – JRD Tata Memorial Oration –
lecture series
1997 – JRD Tata Awards for Population and
RH programmes instituted
PFI moves into its new building
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ANNUAL REPORT / 2010-2011
the journey forward
Defining Events in the New Millennium
Population Commission
set up
Freeze on the number
of Lok Sabha seats and
state assemblies
Defining Events in the New Millennium
National Population
Policy
RCH II Programme
NRHM
The 2000s
PFI’s Continued Focus
Policy Advocacy
Partnerships
Capacity Building
Service Delivery
Research and Documentation
Quality of Care
To promote and formulate gender sensitive rights-based population
development policies, strategies and programmes
Second Decade of the 21st Century
Network and Alliances
Global Recognition
Advisory Group on Community Action (AGCA) for community-based
monitoring of health services under NRHM (PFI as Secretariat)
National Youth Alliance
White Ribbon Alliance for Safe Motherhood
Prime Recipients
Global Fund – HIV/AIDS – Access to Care and Treatment
USAID – Health of the Urban Poor
Partnerships
David and Lucile Packard Foundation Bill and Melinda Gates
John D. and Catherine T.
Foundation
MacArthur Foundation
International Centre
Government of India
for Research on
Government of Bihar
Women
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ANNUAL REPORT / 2010-2011
pfi’s presence in india
Himachal
Pradesh
Punjab
Uttrakhand
Haryana
Delhi
PFI currently has:
– 11 projects supported by core funds in 12 states
– Donor-funded projects in 17 states
– 13 state offices
– Head office in Delhi
Rajasthan
Uttar
Pradesh
Bihar
Gujarat
Madhya
Pradesh
Maharashtra
Jharkhand
Chhattisgarh
Odisha
W Bengal
Assam
Nagaland
Manipur
Andhra
Pradesh
Karnataka
Tamil
Nadu
Core Funded Projects
Donor Funded Projects
State Offices
Head Office
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ANNUAL REPORT / 2010-2011
A
|Community-Based Interventions|
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ANNUAL REPORT / 2010-2011
Partnership with NGOs
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ANNUAL REPORT / 2010-2011
A Sub-Centre as an Agency for Maternal Well-Being: Rajasthan
Skilled birth attendance (SBA) has
been accepted as a key action strategy
towards reducing maternal mortality.
Action Research and Training for Health
(ARTH), Udaipur, Rajasthan, has evolved
a 'nurse-midwife managed health
centre' model which delivers quality
maternal and child health care services.
This includes round-the-clock (24x7)
delivery services. The maternal health
services are combined with basic
laboratory services, contraceptive
counselling and active and assisted
referral in emergency conditions. PFI
partnered with ARTH for a four-year
project (October 2004 to March 2008)
to demonstrate that a 'nurse-midwife
managed health centre' could be
operationalised successfully by civil
society organisations.
Three health centres were set up at
Ranoli, Tonk district; Luna, Jhunjhunu
district; and Srinagar, Ajmer district in
partnership with local NGOs. The
project demonstrated successful
operationalisation of the model. In the
second phase, titled SAMWEDNA,
which started in April 2008, ARTH
worked with two partner NGOs, Shikshit
Rojgar Kendra Prabandhak Samiti,
Jhunjhunu, and Shiv Shiksha Samiti,
Tonk, to establish the health sub-
centres managed by civil society
organisations. Each sub-centre caters to
a population of 5,000, the core area for
sub-centre services as per Indian Public
Health Standards. Maternal and child
health services are provided to a larger
15,000 population.
Two nurse-midwife managed health
sub-centres were set up under the
project. Round-the-clock obstetric and
child care services and basic laboratory
services were provided at these centres
and through outreach clinics. Nurse-
midwives and the NGOs were trained to
run and manage these centres and
advocate with the government to scale-
up the model. ARTH continued to
function as the technical support
resource for the project. Documentation
of the model and advocacy for
repositioning of sub-centres in primary
health care through a public-private
partnership was an important
component. The two-year period for the
second phase of the project was given a
no-cost extension for nine months till
December 2010.
Key activities during 2010-2011
The nurse-midwives had already been
trained to provide skilled attendance at
birth with quality of care. Capacities of
the NGO partners had also been built to
manage the health centres. During the
last year of implementation, most of the
skill building was done during quarterly
monitoring visits by ARTH, based on
PFI partnered with ARTH
for a four-year project
to demonstrate that a
'nurse-midwife managed
health centre' could be
operationalised
successfully by civil
society organisations.
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ANNUAL REPORT / 2010-2011
A Sub-Centre as an Agency for Maternal Well-Being: Rajasthan
sessions was on reproductive tract
infections (RTIs) and sexually
transmitted infections (STIs), anaemia,
domestic violence, HIV/AIDS and
seasonal diseases like eye flu and
malaria.
the needs of the workers. Nurse-
midwives and village level workers
(VLWs) were given on-the-job training
on using aids (like handbooks and
guides on contraceptives and postnatal
care) while the NGO representatives
were oriented on better maintenance of
project and financial records. In addition
to reviewing the centres, the skills and
capacities of village health workers
(VHWs), one in each village, were also
reviewed and they were given on-the-
job training on counselling.
Behaviour change communication
activities continued throughout the
year. Meetings with pregnant women,
lactating mothers and mothers-in-law
were held on maternal health and the
importance of family planning. Fifty
sessions were held by both the
implementing NGOs with school-going
and non-school going adolescents (105
boys and 720 girls). The focus of these
During the year, the two health centres
conducted 392 deliveries. Thirteen
women had complications during
delivery, out of which nine were
managed by the nurse-midwife and the
remaining were referred. Nurse-
midwives also provided postnatal care
services within three days of delivery to
821 women. A total of 1,911 condoms
and 688 oral contraceptive pills were
distributed, 105 IUDs inserted and nine
women referred for sterilisation. Ten
Depot Medroxy Progesterone (DMPA)
were given and one E-pill user was also
reported. In addition, the VHWs
provided pregnancy testing services in
the village. The health centres
continued to provide the services of
doctors and specialists through weekly
clinics on Sundays. The processes and
learnings from the project have also
been documented.
Though the project ended in December
2010, two health centres set up under
the project continue to provide services
at villages Dhanuri in Jhunjhunu district
and at Ranoli in Tonk district. Both the
centres have been accredited under the
Janani Suraksha Yojana (JSY) by the
Government of Rajasthan and all the
women delivering at these health
centres are entitled to the JSY benefits.
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ANNUAL REPORT / 2010-2011
Developing Model PHCs through Public-Private Partnership: Karnataka
Karuna Trust, a Bangalore-based NGO,
has successfully taken over and
managed government primary health
centres (PHCs) in many states since
1996. The centres provide a successful
model of public-private partnership with
the government providing support for
salaries and logistics, and Karuna Trust
responsible for their day-to-day
management.
drugs. Laboratory facilities were
upgraded and drug inventory improved,
by introducing a BIN Card system.
Information management and
communication systems were improved
through ISRO-supported, satellite-
based communication and training
facilities for the PHC staff, and the
display of a citizen's charter at the
centre.
PFI has been partnering with Karuna
Trust to add value to key processes in
seven PHCs (one each in Bagalkot,
Raichur, Bidar, Gulbarga, Bijapur and two
in Bellary districts) and their 39 sub-
centres, covering a population of two
lakhs in these six districts of northern
Karnataka, which are socio-economically
backward and difficult to access. The
project was initiated for a period of five
years from May 2006 to April 2011 and
was given a no-cost extension of five
months till September 2011.
The project seeks to demonstrate model
PHCs, which effectively deliver essential
reproductive and child health (RCH) and
primary health care services, with value-
added inputs for capacity building and
improved systems, through public-
private partnership.
To achieve this, systems and structures
were strengthened to improve the
quality of RCH services being delivered
24x7 at the seven PHCs and their sub-
centres. This included capacity building
of staff on issues related to gender,
women's health, reproductive health and
family planning. It also included waste
management, health management
information systems and rational use of
In addition, family planning services,
counselling, supply of oral
contraceptive pills and condoms,
insertion of IUDs and sterilisation
services were made available.
Governance was improved by increasing
community participation and
strengthening the Rogi Kalyan Samitis
(locally called Arogya Raksha Samitis)
at the PHC level, and Village Health and
Sanitation Committees (VHSCs) at the
village level.
Key activities during 2010-2011
Training on emergency medical services
was conducted for the staff. Seven PHC
Medical Officers (MOs) participated in
the programme, leading to improved
handling of emergency cases. Capacity
building sessions for 150 VHSC
members to support community health
activities were conducted.
The project seeks to demonstrate model PHCs, which effectively
deliver essential reproductive and child health, and primary health
care services, through public-private partnership.
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ANNUAL REPORT / 2010-2011
Developing Model PHCs through Public-Private Partnership: Karnataka
Capacity building programmes have
been conducted for ASHAs and
Anganwadi Workers (AWWs). The
training reinforced their knowledge on
various health issues. Village Health and
Nutrition Day (VHND) was utilised as an
opportunity to increase mass awareness
and sensitisation on RCH issues.
In August 2010, a gram sabha was
organised at the V. K. Salgar PHC to
select new Arogya Raksha Samiti
members. The Director, National Rural
Health Mission (NRHM), Karnataka,
As a result of the training done on gender issues, the staff of the
seven PHCs started ensuring privacy while examining women and this
led to an increase in the number of women accessing PHC services.
along with other government officials,
visited the project PHCs and
appreciated their management skills
and cleanliness.
As a result of the training done on
gender issues, the staff of the seven
PHCs started ensuring privacy while
examining women and this led to an
increase in the number of women
accessing PHC services. The training of
the laboratory staff and the supply of
equipment led to an increase in the
number of people accessing laboratory
services. The BIN Card system has
helped the PHCs manage drug
inventory better. The improvement in
the capacities of ASHAs and AWWs
contributed towards better community
mobilisation, and has generated a
demand for quality health services in
the area.
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ANNUAL REPORT / 2010-2011
Developing a Model Initiative for Quality Family Planning Services:
Uttarakhand
Quality of care in reproductive health
services and access to a basket of
contraceptive choices are key issues
which need to be addressed for
effective implementation of family
planning programmes in India. The
Himalayan Institute Hospital Trust
(HIHT), Dehradun, with a grant from PFI
has been developing and implementing
an innovative model of quality family
planning services in Uttarakhand, which
includes strengthening the skills and
capacities of government frontline
workers, on the issues of family
planning and quality of care.
The project covers a population of
2,00,000 and seeks to identify the
unmet need for family planning among
eligible couples and increase their
awareness on modern contraceptives so
that they can make informed choices.
It endeavours to complement the
government health programmes by
reinforcing the skills of service providers
(ANMs/nurses, medical officers, ASHAs)
to provide a basket of safe and effective
contraceptive choices. The initiative will
be documented for replication and
scale up.
The key strategies include delivery of
quality family planning services through
HIHT's hospital in Dehradun and two
extension clinics – the Rural Health
Training Centre and the Urban Health
Training Centre in Doiwala block and
Chandreshwar Nagar slums,
respectively. The basket of choices in
these clinics has been expanded to
include injectables DMPA (Depot
Medroxy Progesterone Acetate) and
female condoms. In addition, HIHT is
collaborating with the Government of
Uttarakhand to organise camps at the
Community Health Centre (CHC) and
Primary Health Centres (PHCs) where
service delivery has been strengthened
by including counselling services and
visits by a lady doctor. A Technical
Resource Cell (TRC) has been
established at HIHT and has experts
from community medicine, obstetrics
and gynaecology, surgery and nursing
as members. TRC monitors the quality
of family planning services provided
under the project. It also reviews and
guides the development of tools,
materials and training sessions.
Key Findings of the Rapid Assessment Survey (2010)
The required infrastructure for delivering quality family
planning services is available with HIHT.
The process of counselling was found to be client-
centred and there were efforts to maintain the privacy
and confidentiality of the clients. More emphasis is
needed on follow up.
There were myths about IUDs, which hampered its
acceptance. There was also a ‘provider bias’ towards
the terminal methods.
A full-time counsellor was needed at the facilities.
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ANNUAL REPORT / 2010-2011
Developing a Model Initiative for Quality Family Planning Services:
Uttarakhand
from an external agency. ASHAs were
trained to use it to collect data and
send in their reports. The software is
easy to use and provides accurate
information on the family planning
status at the individual, village, sub-
centre, PHC and CHC level. It also
provides information on the number of
users, switchover cases and
requirement of contraceptives in a
particular village for the month.
114 family planning
camps were organised
at the PHCs, CHC and the
Rural Health Training
Centres. There were
619 new condom users
and 190 oral
contraceptive pill users.
In addition, 59 women
accepted IUD and 44
women were provided
with injectable
contraceptives.
Thirteen vasectomies
and 150 tubectomies
were also conducted.
Key activities during 2010-2011
PFI undertook a rapid assessment
survey to assess the quality of family
planning services being provided in the
project area. Exit interviews,
observation of the facility infrastructure,
process observation and interviews with
providers were used for the study. The
findings and the recommendations are
being utilised to improve the quality of
family planning services further under
the project.
Training programmes were held for the
project staff and frontline workers on
effective communication strategies and
the use of Standard Days Method
(SDM) and Lactation Amenorrhea
Method.
Developing an effective Management
Information System (MIS) to track
contraceptive use by eligible couples
was a major challenge. As most of the
ASHAs were literate and owned mobile
phones, a mobile-based family planning
software was developed with support
As a follow up of the findings of the
rapid assessment survey, a video film
Vishwaas ke Saath was developed by
HIHT to tackle myths related to the
intrauterine device (IUD). The film has
received a good response from the
community and has been instrumental
in motivating clients for IUD insertions.
The BCC initiatives under the project
include interpersonal communication,
group meetings, audio-visual shows,
quiz competitions, games and the
observation of important days.
A total of 114 family planning camps
were organised at the PHCs, CHC and
the Rural Health Training Centres. There
were 619 new condom users and 190
oral contraceptive pill users. In addition,
59 women accepted IUD and 44 women
were provided with injectable
contraceptives. Thirteen vasectomies
and 150 tubectomies were also
conducted. The efforts that the project
has put in for strengthening the
capacities and skills of government
frontline workers is yielding results in
terms of increased acceptance of
modern methods of contraception in
the community.
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ANNUAL REPORT / 2010-2011
Reaching the Unreached: the Brahmaputra River Islands, Assam
The Centre for North East Studies and
Policy Research (C-NES) has been
implementing preventive and promotive
health campaigns through specially-
designed boat clinics since May 2005 in
the islands, locally known as chars or
saporis, formed by the Brahmaputra
River. The success of the boat clinics
that brought immunisation, antenatal
and postnatal care services to the
islands, resulted in the initiative being
scaled up. A Memorandum of
Understanding (MoU) was signed
between C-NES and the National Rural
Health Mission (NRHM) in February
2008 to launch the boat clinics in five
districts of Assam for a period of three
years. The programme was scaled up to
five more districts in March 2009 and
now reaches over 1,20,000 people.
C-NES is currently operating ten boats
that cover approximately 400 islands in
10 districts in collaboration with NRHM,
the District Administration, the Health
Department and UNICEF.
also been planned to record the
processes and lessons learned under
the project. In addition, PFI is also
aiding C-NES to develop films/spots on
RCH and family planning to improve
acceptance of family planning methods
within the community.
Key activities during 2010-2011
The project continued to build
capacities of ASHAs, ANMs and AWWs
to improve their counselling skills on
family planning. A group of 52 AWWs
and ASHAs were trained on inter-
personal communication (IPC), family
planning and counselling. The
challenges faced in improving the
acceptance of family planning were also
discussed. Myths and misconceptions
were identified as a major barrier for
accessing the services. C-NES will
While regular health service provisions
continue, there was a felt need to raise
awareness on reproductive health and
rights with a focus on providing quality
family planning (FP) services. PFI has
collaborated with C-NES to provide this
critical input to 117 villages/islands in the
five focus districts of Dibrugarh,
Tinsukia, Dhemaji, Sonitpur and North
Lakhimpur, covering a population of over
one lakh. The project works at building
sustainable local capacities by improving
the counselling skills of Family Planning
Counsellors (FPCs) and ASHAs and
increasing the access of eligible couples
to modern contraceptive methods.
A strong element of documentation has
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ANNUAL REPORT / 2010-2011
Reaching the Unreached: the Brahmaputra River Islands, Assam
address many of these issues in the films and spots it
plans to develop for the community. C-NES has also
developed a handbook for ASHAs and FP Counsellors,
which uses BCC for family planning.
District FP counsellors for Sonitpur and Lakhimpur
districts were recruited. They, along with the FP
counsellors from the other three districts, were
trained on modern FP methods and FP counselling in
February 2011.
The following month, the FP counsellors organised a
mass awareness programme through the boat clinics
to sensitise the villagers on the importance and
advantages of modern methods of contraception. In
addition to the use of posters and flip charts, street
plays were conducted in collaboration with the
District Health Society.
Some medical officers and ANMs have been trained in
IUD insertion and will begin providing this service in
the boat clinics. A total of 187 female sterilisations and
four No Scalpel Vasectomies (NSVs) were done during
the year in collaboration with the government.
The project has built a good rapport with the
government. However, retaining the staff in these
remote areas after they are trained, is proving to be a
challenge.
The FP counsellors organised a mass awareness
programme through the boat clinics to sensitise the
villagers on the importance and advantages of modern
methods of contraception. In addition to the use of
posters and flip charts, street plays were conducted in
collaboration with the District Health Society.
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ANNUAL REPORT / 2010-2011
Reducing Reproductive Morbidity among Young Married Women:
Maharashtra
In Maharashtra, young married women
in the 15–19 year age group contribute to
26 per cent of total live births,
suggesting that most women get
married quite early. Low age at marriage
and non-use of contraception by young
married adolescents are two critical
factors which need to be addressed for
improved health status in the region. PFI
and the Institute of Health Management,
Pachod (IHMP) joined hands to
implement a three-year integrated,
multi-site action research project in
Maharashtra, aimed at demonstrating
the implementation of a specific
intervention to improve adolescent
reproductive and sexual health (ARSH)
services for married adolescents girls in
five very backward districts.
receiving three antenatal visits and
institutional deliveries by 20 per cent.
In addition, the project also sought to
improve treatment seeking behaviour for
reproductive tract infections/sexually
transmitted infections (RTIs/STIs) and
postnatal and post abortion
complications by 20 per cent from the
baseline.
The project identified and tracked a
cohort of married adolescent girls. They
were provided primary level healthcare,
nutrition education, detection and
treatment of anaemia, antenatal care
and advice regarding child birth, easy
and confidential access to family
planning and medical termination of
The programme titled Safe Adolescent
Transition and Health Initiative (SATHI),
covered a population of one lakh. Sir
Dorabji Tata Trust (SDTT) provided
financial support to the project. The
project period was from January 2008
to December 2010 with a no-cost
extension for six months. It was
completed in June 2011. The initiative
was undertaken in Nanded, Beed,
Amravati, Buldana and Dhule districts
through five implementing field partners.
Low age at marriage and non-use of contraception by young married
adolescents are two critical factors which need to be addressed for
improved health status in the region.
The programme addressed young
married women with the key objectives
of delaying median age at first
conception by one year, increasing
contraceptive use by 10 per cent as
compared to the baseline, reducing
prevalence of anaemia among young
married women by 20 per cent, and
increasing the proportion of women
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ANNUAL REPORT / 2010-2011
Reducing Reproductive Morbidity among Young Married Women:
Maharashtra
pregnancy (MTP) services and treatment
of RTIs/STIs. The programme also
focused on behaviour change
communication, community based
surveillance and referral for
complications.
The project aimed to strengthen the
capacities of five field implementing
partner agencies to carry out action
research, monitor and evaluate the
project and undertake policy advocacy.
PFI's role in the project involved
handling sub-grants and providing
technical inputs on programmatic
interventions, research and advocacy.
IHMP set up a Management Information
System (MIS) for research and services,
and provided capacity building,
technical and onsite monitoring support
to the five implementing partners.
Key activities during 2010-2011
Group meetings with married adolescent
girls and their spouses, need-based
counselling sessions on reproductive
health issues by community organisers
continued. All five partners organised
workshops with couples, youth and
mothers-in-law. SATHI Kendras were set
up for married adolescent girls and their
The findings showed an improving trend for age at marriage, delay
in first conception, use of contraceptives, and utilisation of antenatal
care services. The report also reflected increased treatment-
seeking behaviour for post-abortion, postnatal and neonatal
complications and RTIs/STIs. However, there was little reduction in
the prevalence of RTIs/STIs.
spouses, where they could access
reading materials on reproductive
health. IHMP conducted a quantitative
evaluation of the intervention during
April–August, 2010. The findings
showed an improving trend for age at
marriage, delay in first conception, use
of contraceptives, and utilisation of
antenatal care services. The report also
reflected increased treatment-seeking
behaviour for post-abortion, postnatal
and neonatal complications and
RTIs/STIs. However, there was little
reduction in the prevalence of
RTIs/STIs. The field staff was asked to
disseminate messages on the
importance of treating RTIs/STIs.
A gynaecologist was available at the
clinics for treatment of RTIs/STIs.
A quarterly review meeting was held at
IHMP, Pune, in August 2010.
Activities completed during the no cost
extension phase included a detailed
process documentation of the project, a
qualitative external evaluation and
policy advocacy for scale up within the
government to ensure sustainability of
the project interventions.
During the year, 2,448 married
adolescent girls registered with the
project were monitored for anaemia,
pregnancy, abortions, post-abortion
complications, FP needs and RTIs/STIs.
The project ANMs provided antenatal
care to pregnant women in each project
village. The initiative has contributed
towards improving availability of quality
services to married adolescents, living
in remote rural areas of Maharashtra.
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ANNUAL REPORT / 2010-2011
Improving Access to Quality Family Planning Services for Young Women:
Slums of Delhi
S mile Foundation implemented a
project titled, Swabhiman, in the slums
of Delhi with funding and technical
support from PFI, from May 2007 to
September 2010. The programme aimed
at building awareness on RCH and
providing services through mobile
clinics. In addition, the project provided
adolescent girls in the age group of 10-
19 years, from the lower socio-economic
strata of society, in peri-urban areas,
with life-skills education and
information on reproductive health
issues.
The Swabhiman project was successful
in changing the health-seeking
behaviour of the communities through
effective BCC interventions and issue-
based advocacy. The endline evaluation
of the project showed a marked
improvement on indicators related to
maternal and child health when
compared to the baseline. This included
registration of pregnancy within the
first trimester from 58.8 per cent to 76.8
per cent, and an increase in institutional
delivery from 37 per cent to 59 per
cent; the use of dai delivery kits in
home delivery cases and breastfeeding
immediately after birth increased two-
fold; awareness of the legal age at
marriage increased from 41 per cent to
81 per cent. In addition, Swabhiman
health centres set up at the community
level helped in facilitating access to
information, counselling and health care
services by adolescent girls.
However, there was little improvement
in the contraceptive prevalence rate
(CPR) which increased from 51.1 per
cent to 51.7 per cent in women aged 15-
49 years. A further analysis showed that
CPR among women (15-24 years) was
even less at 45.9 per cent at the end of
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ANNUAL REPORT / 2010-2011
Improving Access to Quality Family Planning Services for Young Women:
Slums of Delhi
During the first phase, a
cadre of 30 Swabhiman
Health Volunteers, who
are adolescent girls in
the age group of 13-19
years, and six
Community Health
Educators, who are
women aged between
15-49 years, were
trained on issues of
reproductive health,
empowerment of women
and life skills.
the first phase of intervention. During
the three years of implementation, the
unmet need for family planning among
eligible women had increased from 30.2
per cent to 54.2 per cent, showing that
though the demand for family planning
services had increased, couples were
not accessing the services.
Hence, the second phase, Improving
access to quality family planning
services for young women was launched
in January 2011 for 18 months. It aims at
improving access to family planning
services through effective BCC, quality
service provisions and empowerment of
women with emphasis on young people.
The project is being implemented in
partnership with three partner NGOs –
Health and Care Society, Sehyogita
Samaj Vikas Sansthan and ADHAAR
Society, with Smile Foundation as the
nodal agency. It covers a population of
one lakh in eight urban slums of Delhi.
The key strategies include creating
awareness among women aged 15-24
years and their mothers-in-law and
husbands, on the consequences of early
marriage, early first conception, and the
lack of spacing between children,
thereby increasing the demand for
quality family planning services. This is
coupled with providing increased
access to temporary methods of
contraception with quality counselling
services. Social marketing and referrals
for terminal methods are the other
components of the project. As men are
active in the decision-making process,
the current phase actively seeks to
involve them.
Key activities during 2010-2011
A detailed work-plan was developed.
During the first phase, a cadre of 30
Swabhiman Health Volunteers, who are
adolescent girls in the age group of 13-
19 years, and six Community Health
Educators (CHEs), who are women
aged between 15-49 years, were trained
on issues of reproductive health,
empowerment of women, and life-skills.
In the current phase, their knowledge
on family planning and counselling is
being strengthened. CHEs have been
oriented on modern methods of
contraception and they have held group
meetings in the community on the
issue.
Communication materials on family
planning in the form of posters,
pamphlets and booklets, were procured
from various sources. Smile Foundation
collaborated with Parivar Seva Sanstha
(PSS) for supplies of pills and condoms
for social marketing. Street plays were
also performed in the community. Smile
Foundation linked up with Radio Fever
104 and observed International
Women's Day on March 8, 2011 at three
prime public places: Delhi Haat, Ansal
Plaza and Shipra Mall. Street plays were
performed by Mahak theatre group,
along with community educators, on
the safety of girls. Radio Fever 104
talked about the initiatives under the
Swabhiman programme, by PFI and
Smile Foundation.
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ANNUAL REPORT / 2010-2011
Increasing Access to Contraceptives and Reducing Anaemia Among
Adolescent Girls: Ganjam, Odisha
Iron Deficiency Anaemia (IDA) is a
leading cause of anaemia affecting over
half a billion people worldwide. Every
second pregnant woman and four out
of ten pre-school children are anaemic
(WHO, 2005). An assessment of IDA
among adolescent girls by the Regional
Medical Research Centre of ICMR in
2005 in three districts of Odisha
showed that 96.5 per cent of them were
anaemic, awareness about anaemia was
very low, ranging from 7.4 per cent to
25.2 per cent. One of the most common
causes of IDA was hookworm
infestation.
Multi Applied System (MAS)
implemented the Health Education
Programme for Adolescents (HePA)
from May 2008 to April 2011. PFI
provided financial and technical
support. The programme was given a
no-cost extension for two months till
June 2011. The intervention addressed a
population of 25,000 in 25 villages of
Ganjam block. The primary beneficiaries
were around 2,500 adolescent girls
aged between 12-19 years. The project
aimed at reducing the prevalence of
anaemia through control of hookworm
infestation and need-based behaviour
change communication. The
intervention also endeavoured to
empower the girls with knowledge on
adolescent reproductive and sexual
health (ARSH) issues and increase their
access to contraceptives with a larger
objective of reducing maternal and
infant mortality in the state.
A cadre of 109 community health
motivators (CHMs) and field
coordinators carried out the behaviour
change communication activities at the
community level. Periodic blood testing
for haemoglobin level and stool testing
for hookworm infestation was done,
and prophylactic doses of Iron Folic
Acid (IFA) and de-worming tablets
provided for girls.
Key activities during 2010-2011
Keeping in view the need to reinforce
knowledge on anaemia and hookworm
infestation, a two-day refresher training
was done for 72 CHMs in April 2010.
In addition, CHMs were given on-the-job
The intervention endeavoured to empower the girls with knowledge
on adolescent reproductive and sexual health (ARSH) issues and
increase their access to contraceptives with a larger objective of
reducing maternal and infant mortality in the state.
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ANNUAL REPORT / 2010-2011
Increasing Access to Contraceptives and Reducing Anaemia Among
Adolescent Girls: Ganjam, Odisha
mentoring support. CHMs regularly met
with adolescent girls in the community.
Girls who were unable to attend the
meetings, were contacted individually
and messages related to anaemia,
ARSH and family planning were
reinforced. Adolescent girls were
engaged in question-answer sessions,
role plays and games and this helped to
involve them in the project activities.
CHMs were trained to facilitate the
exercises. Materials for these activities
were procured from PFI, UNICEF and
CHETNA.
Communication materials such as flip
charts on waterborne diseases, life
cycle of hookworm and roundworm
were developed by the project. A book
containing 50 frequently asked
questions related to aneamia and
adolescent health issues, a leaflet and a
guide book on the role of CHMs helped
the motivators to disseminate correct
messages in the community. The project
also brought out two editions of a six-
monthly newsletter titled, Swasthya
Barta, which was distributed among
government officials, other
organisations and literate community
members. The project team
participated in the monthly meeting of
There has been a positive behaviour change among the target group
in the intervention area towards consumption of iron-rich food and
improvement in practices related to hygiene and sanitation... As an
outcome, haemoglobin testing for girls is being included in day and
residential schools in the entire district.
anganwadi and health workers to
discuss field-level issues related to the
supply and distribution of IFA. As part
of PFI's 40th year celebrations, HePA
organised slogan and poster
competitions in six villages, which
generated a lot of interest among
adolescents.
Health camps were organised every
quarter at the PHCs, and the field level
staff of HePA project helped in
community mobilisation. About 2,500
adolescent girls were issued health
cards under the project which included
details of their haemoglobin status and
general health parameters. These were
updated regularly by the project
workers. The third round of testing has
shown improvement in haemoglobin
levels among the adolescent girls.
MAS conducted a rapid in-house impact
assessment among adolescents in a few
villages and the results also showed
improvement in haemoglobin levels
among adolescent girls. There has been
a positive behaviour change among the
target group in the intervention area
towards consumption of iron-rich food
and improvement in practices related to
hygiene and sanitation. These results
were used as an advocacy tool by the
organisation to convince the district
administration for replication of the
strategy in other blocks of Ganjam
district. As an outcome, haemoglobin
testing for girls is being included in day
and residential schools in the entire
district. An endline assessment has
been commissioned by PFI.
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ANNUAL REPORT / 2010-2011
Ensuring Mother and Child Survival:
Tribal Areas of Rayagada, Odisha
The Odisha Voluntary Health
Association (OVHA) is one of the oldest
state-level federations of health NGOs in
Odisha. OVHA, with financial and
technical support from PFI, implemented
an intervention aimed at addressing the
three critical delays responsible for
maternal and neonatal deaths —
decision-making, transportation and
getting services at the health centres
among the underserved tribal
population of Bissamcuttack and
Muniguda blocks of Rayagada district.
The project, implemented from
September 2006 to August 2009, was
granted a no-cost extension till June
2010. It covered a population of 30,000
living in 60 tribal villages.
The primary objectives of the project
were ensuring essential antenatal,
intranatal and postnatal care;
establishing effective links for referral
of high-risk pregnancies and obstetrical
emergencies with the involvement of
the community. The project also
endeavoured to promote acceptance
of modern family planning methods.
The key strategies included tracking
pregnant women for antenatal care,
referral and safe delivery and
community mobilisation around the
issue of safe motherhood. A cadre of
60 community health volunteers (CHVs)
(one from each village) was identified
and trained on government schemes,
reproductive child health (RCH) issues
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ANNUAL REPORT / 2010-2011
Ensuring Mother and Child Survival:
Tribal Areas of Rayagada, Odisha
The project also trained
Traditional Birth
Attendants (TBAs) as
several deliveries were
taking place at home. In
order to strengthen the
referral system, an
ambulance-cum-referral
vehicle was organized
and used for
transporting pregnant
women to the hospital.
and in using community needs
assessment (CNA) formats for the
collection of household data. The
project also trained Traditional Birth
Attendants (TBAs) as several deliveries
were taking place at home. In order to
strengthen the referral system, an
ambulance-cum-referral vehicle was
organised and used for transporting
pregnant women to the hospital. Need-
based behavior change communication
material was also developed/ collected
by the organisation and meetings were
organised with community stakeholders
— pregnant and lactating women,
auxiliary nurse midwives, accredited
social health activists, and Panchayati
Raj Institution members.
In the last quarter of the project (April
to June 2010), an endline evaluation
was commissioned by PFI to ascertain
the project's impact and effectiveness.
A combination of both quantitative and
qualitative research techniques were
used on a sample of 504 currently
married women in the age group of
15-49 years spread across 18 project
villages for the endline evaluation.
Key findings of the endline showed a
sustainable increase in antenatal and
intranatal care services. Institutional
delivery increased from 13 per cent to
63 per cent and exclusive breastfeeding
rose from 69 per cent to 95 per cent.
Some promising practices that were
identified:
Changing community perception
through community care management:
Under the project need-based training
was imparted to TBAs. This strategy
profoundly impacted newborn care
practices in project villages, especially
among the Dongria Kondh, a major sect
of the Kondh tribe, settled in some
project villages. The project also helped
in changing the perception of the
community that modern health
practices are expensive and institutional
deliveries are needed only in
emergency situations.
Referral transport providing a one-stop
service support: Delay in reaching a
health facility was a major factor
hindering the availability of timely
obstetric care. The mobile vehicle
engaged by the project for transporting
pregnant women to the government
health facilities ensured timely medical
attention to those in a critical condition.
The TBAs trained under the project
continue to be available in the
community and are supported by the
CHWs and sensitised community
members to help pregnant women in
accessing safe delivery services.
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ANNUAL REPORT / 2010-2011
Improving Child Sex Ratio: Haryana, Punjab and Himachal Pradesh
The Voluntary Health Association of
Punjab (VHAP) and Social Uplift
Through Rural Action (SUTRA) of
Himachal Pradesh have been partnering
with PFI in advocacy efforts on the issue
of adverse sex ratio since 2003. In 2004,
VHAP and SUTRA, in collaboration with
PFI, initiated a project to move from
advocacy to action on the issue of the
missing girls in the districts of Fatehgarh
Sahib and Patiala in Punjab; Ambala and
Kurukshetra in Haryana; 55 gram
panchayats of Dharampur and Nalagarh
blocks of Solan district and the Nahan
block of Sirmour district in Himachal
Pradesh.
The project, supported by the Ministry of
Health and Family Welfare (MoHFW) as
part of the UNFPA Country Programme
6, was implemented in one-year phases
over four years. An external assessment
of the project revealed the need for
continuing efforts in the region. PFI
decided to further support the
collaborative effort. The current project
(March 2009 – February 2012) covers 55
gram panchayats in Solan and Sirmour
districts in Himachal Pradesh, 40 villages
in Fatehgarh Sahib and Patiala (Punjab),
and the districts of Ambala and
Kurukshetra.
The project continues to raise awareness
among communities for safe abortions
and against pre-natal sex-selection.
To achieve this, the capacities of
panchayats to monitor the sex ratio at
birth and their involvement in the
campaign against sex selection is being
strengthened. State and district level
government health officials, and
grassroots workers are being sensitised
on the issue. Support and strength is
provided to women through community
support groups to help them take
independent decisions against sex
selection and in favour of safe abortion.
The project also includes advocacy with
the departments of health and women
and child development, for their
support to activities related to reducing
sex selection and sensitising para-
medical staff like ANMs and ASHAs on
their roles and responsibilities towards
this issue.
Key activities during 2010-2011
The 233 Kanya Bachao Samitis in 55
gram panchayats and the 58 Mahila
Gram Sabhas in Dharampur and Nahan
blocks of Himachal Pradesh, which were
set up earlier, have been holding regular
meetings. Four youth melas, two each
in Dharampur and Solan, were
organised on the issue of declining child
sex ratio and its implications.
In Punjab and Haryana, social mobilisers
and key stakeholders such as panchayat
leaders, the Sakshar Mahila Samuh
(SMS), youth clubs and the para-
medical staff working at grassroots
were identified and are being sensitised.
Adolescent groups have also been
formed in the project villages and
meetings held to orient them on the
issue of adverse sex ratio and its
implications. Two clusters of five
villages each in Patiala and Fatehgarh
Sahib districts of Punjab have been
formed and meetings organised with
women to discuss the issues.
The project continues to
raise awareness among
communities for safe
abortions and against
sex-selective abortions.
To achieve this, the
capacities of panchayats
to monitor the sex ratio
at birth and their
involvement in the
campaign against sex
selection is being
strengthened.
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ANNUAL REPORT / 2010-2011
Partnership with the Corporate Sector
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ANNUAL REPORT / 2010-2011
An Integrated Approach to Family Welfare: Rajsamand, Rajasthan
The JK Tyre plant is situated in
Rajsamand, one of the most backward
districts of Rajasthan. The area also has
poor socio-demographic and
reproductive health (RH) indicators. PFI
and JK Tyres decided to collaborate in
enhancing the quality of life of women
and children in the area by bringing
about improvements in their overall
health and RH status through an
integrated approach of awareness
generation, service provision and need-
based socio-economic development
activities. The five-year project, called
Parivartan, was launched in 32 villages
in 2004. After completion of three
years, 28 new villages were added,
taking the total coverage to 60 villages.
The project serves a population of
40,800 spread across 60 villages of
Rajsamand block. The project has been
granted a second no-cost extension
from January 2011 to July 2012.
The 2004 baseline survey showed that
only 17 per cent of pregnant women
received at least three antenatal
checkups; 70 per cent deliveries took
place at home and only 21 per cent
couples were using modern
contraceptives. The project focused on
capacity building of village level
motivators on RCH issues, awareness
generation among community level
stakeholders – village health and
sanitation committees (VHSCs) through
BCC programmes, provision of quality
RCH services though a mobile clinic and
facilitation of socio-economic
development activities at the village
level by creating community assets for
overall sustainable development. The
project also collaborates with the
Integrated Child Development Scheme
(ICDS) on improving health
infrastructure at Anganwadi centres to
enable delivery of RCH services in an
environment of privacy.
Key activities during 2010-2011
Village Level Motivators (VLM), one in
each village, were provided mentoring
support by the project ANM and
supervisors on a regular basis. They
have been oriented on issues of RCH,
quality of care, VHSC formation and
other relevant topics. The capacity
building programmes helped the VLMs
improve their knowledge and
counselling skills on RCH issues.
A professional cultural group, Bhartiya
Lok Kala Mandal from Udaipur, was
engaged to perform nukkad natak on
issues related to maternal and child
health and family planning. Adolescent
camps were also organised to increase
awareness on issues of health and
physical and mental changes among
adolescents.
VHSCs have been formed in all villages,
and the members oriented on how to
The 2004 baseline
survey showed that only
17 per cent of pregnant
women received at least
three antenatal
checkups; 70 per cent
deliveries took place at
home and only 21 per
cent couples were using
modern contraceptives.
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ANNUAL REPORT / 2010-2011
An Integrated Approach to Family Welfare: Rajsamand, Rajasthan
use untied funds for health activities.
Under the ambit of socio-economic
development activities, the project has
collaborated with the district
administration and panchayats to
facilitate construction of low-cost toilets
for below poverty line (BPL) families in
six project villages.
The mobile clinic continued to cater to
the RH needs in the areas where
government health services are poor.
The mobile health team conducted 403
health camps with support of
government ANMs, who provide
immunisation services during these
camps, reaching over 4,600
beneficiaries. Forty per cent of the
beneficiaries in the camps were women
between 15-49 years. A total of 150
antenatal check-ups, and 315 postnatal
check-ups were done. Six men and 73
women underwent vasectomy and
tubectomy operations respectively.
The project has established a good
rapport with the health department,
which is now extending support to the
project by providing iron folic acid
tablets (IFA), oral rehydration solution
(ORS) and contraceptives. Twenty eight
of the project VLMs have been selected
as ASHAs.
The project has made VHSC members
sensitive and aware about community
health issues. The VHSCs are now being
equipped to advocate with the
government for improved service
delivery for women and children.
40 | POPULATION FOUNDATION OF INDIA
The mobile health team
conducted 403 health
camps with support of
government ANMs, who
provide immunisation
services during these
camps, reaching over
4,600 beneficiaries.
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ANNUAL REPORT / 2010-2011
Addressing Gaps in Reproductive Health and Family Planning:
Sirohi, Rajasthan
JK Lakshmi Cement Ltd., with financial
and technical support from PFI, had
implemented a four-year project (July
2004-2008) called Naya Savera in 10
villages of Pindwara tehsil of Sirohi
district, Rajasthan, covering a population
of 30,000. The endline evaluation of the
pilot phase showed a considerable
improvement in key reproductive child
health (RCH) indicators like antenatal
care, safe delivery, institutional delivery
and child immunisation. There were
some improvements in the number of
women accepting oral contraceptive
pills and sterilisation. However, due to
cultural barriers and lack of availability
of good family planning services, the
acceptance of modern contraceptive
methods remained low in the area.
It was, therefore, felt that a structured
programme that repositions family
planning by offering a basket of choices
with 'quality of care' was required.
It was decided that the programme
should cover more villages and reach a
larger population.
documenting the lessons learnt and
good practices for replication and
scaling up.
Communities are being empowered
through activation of village health and
sanitation committees (VHSCs) by
providing information on reproductive
and sexual health, and promoting
informed choices among eligible
couples. In addition, availability and
accessibility to quality RCH and family
planning services is being promoted
through direct service delivery by a
mobile van, social marketing of
contraceptives and coordination and
liaison with the government health
service providers.
The current phase, titled Naya Savera II,
was initiated in August 2008 for a
period of four years and serves a
population of 50,000 spread across 15
revenue villages of Sirohi district. The
project builds on the achievements of
the first phase by improving access to
quality RCH and family planning services
through behaviour change
communication (BCC).
The project also aims at imparting
knowledge to unmarried adolescents on
adolescent reproductive and sexual
health (ARSH) issues as well as
Communities are being empowered through activation of village health
and sanitation committees (VHSCs) by providing information on
reproductive and sexual health, and promoting informed choices
among eligible couples.
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ANNUAL REPORT / 2010-2011
Addressing Gaps in Reproductive Health and Family Planning:
Sirohi, Rajasthan
Village Level Motivators (VLMs). The
training and mentoring support provided
by the project has helped them function
more effectively. Almost all the project
VLMs have now been enrolled as ASHAs
or AWWs.
To promote positive health-seeking
behaviour, meetings have been held with
women's groups, adolescents and VHSC
members. Health melas and rallies were
organised and inter-personal
communication used to counsel eligible
women on reproductive health and
family planning issues. Video shows
were organised in each project village to
sensitise the community on RH/FP
issues. A team of professional artistes
was engaged to conduct cultural shows
in the local dialect.
Key activities during 2010-2011
Forty three VHSC representatives
attended a two-day workshop on the
structure and key functions of the VHSC
and the use of untied funds. They were
also sensitised to women and child
health issues. Three capacity building
programmes were conducted for the 38
A total of 421 health camps were
organised by the Naya Savera medical
team in underserved areas of the
project. Over 5,700 persons benefitted.
The mobile clinic team conducted 757
antenatal checkups and provided
postnatal care to 805 women. A total of
460 couples were motivated to accept
modern contraceptives (365 went in for
spacing methods and 95 for terminal
methods). Eight mass immunisation
camps were organised in tribal villages
covering all children and pregnant
women. Government functionaries
actively participated in this activity.
The project has succeeded in setting up
depots for contraceptives in the villages
and established linkages with
government health providers for the
supply of medicines and contraceptives.
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ANNUAL REPORT / 2010-2011
Promoting Healthy Families: Badaun, Uttar Pradesh
The Tata Chemical Society for Rural
Development (TCSRD) is the social
wing of Tata Chemicals Limited (TCL)
established in 1980. TCSRD has been
working at bringing an improvement in
the quality of life of communities living
around TCL plants. TCSRD implemented
an intervention in Badaun district, Uttar
Pradesh, with technical and financial
support from PFI for improving the
health status of the community. The
project was carried out in two phases.
The first phase (October 2003 - March
2007) focused on promoting
reproductive health and family planning
in 90 villages of Gunnour block. The
endline evaluation of this project
brought to the fore several successes
and achievements. The contraceptive
prevalence rate had increased from 9.1
per cent at the beginning of the project
to 23.7 per cent by the end, although it
was still much below the national
average. The second phase of the
project titled Swasth Aangan –
Promoting Healthy Families was
implemented from November 2007 to
October 2010 and granted a no-cost
extension till February 2011. The project
covered 40 villages and 15 distant
hamlets in Gunnour block, catering to a
population of 75,000.
Swasth Aangan focussed on improving
the health seeking behaviour of eligible
couples through an integrated
behaviour change communication
(BCC) package and increasing the
involvement of different stakeholders
like village health and sanitation
committees (VHSCs) and community-
based organisations (CBOs). The
project also aimed at improving the
access of modern contraceptives by
eligible couples. The documentation of
lessons from the project to enable
replication and scaling up was another
important component.
The project built the capacities of CBOs
and strengthened VHSCs through a
cadre of trained Village Level Motivators
(one VLM per thousand population)
and ran a mobile clinic to provide
reproductive health services. The 40
project villages were divided into 10
clusters, and each cluster was
supervised by a coordinator.
The contraceptive prevalence rate had
increased from 9.1 per cent at the
beginning of the project to 23.7 per cent
by the end, although it was still much
below the national average.
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ANNUAL REPORT / 2010-2011
Promoting Healthy Families: Badaun, Uttar Pradesh
Key activities during 2010-2011
As this was the last year of
implementation, the focus was on
strengthening the VHSCs by training its
members to carry out health planning
for the village, maintain records and
registers and monitor activities at the
village level. Some VHSCs took up the
issue of non-attendance of government
ANMs and ensured that an ANM was
designated for their village.
The grassroots-level workers continued
to reiterate key messages to address
myths and misconceptions related to
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ANNUAL REPORT / 2010-2011
Promoting Healthy Families: Badaun, Uttar Pradesh
family planning. Rallies and quiz
competitions were organised on issues
of health, sanitation and education in
five government schools. A week-long
campaign was organised in September
2010 to create awareness on
breastfeeding. Puppet shows, pamphlet
distribution and door-to-door visits by
VLMs continued. Special days such as
the World Health Day were also
observed. These activities helped in
sensitising the community on issues
related to the health of women and
children. A process documentation of
the project activities, achievements and
lessons learnt, has been commissioned.
The document is expected to provide
lessons on engaging with the
community to increase access to
contraception in remote underserved
areas.
continued its positive trend. The
villagers are opting for condoms and
oral contraceptive pills. IUDs are slowly
getting accepted as a spacing method.
Making contraceptives available at the
village level has also been one of the
achievements of this project. The
Parivar Kalyan Kendras established in
the villages will continue to function as
contraceptive depots for the
community beyond the life of the
project.
A number of village level motivators
trained under the project have been
selected as ASHAs.
A mobile health van continued to
provide reproductive health services in
the project villages. It focussed on
maternal and child health care and
family planning services. There was
regular communication/coordination
between the project and the
government Primary Health Centres
(PHCs) and the Community Health
Centres (CHCs) in the area. In addition,
the ANMs in the area provide
immunisation services on days when
the mobile van clinics are organised.
The sub-centres and the anganwadi
centres in many villages are used as
venues for the mobile clinic camps.
In addition, TCSRD started a community
clinic at the TCL plant premises, which
provides general health services. A
gynaecologist is also available. The
uptake of family planning methods
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ANNUAL REPORT / 2010-2011
Improving the Health of the Ho Tribals:
West Singhbhum, Jharkhand
Noamundi block in the West Sighbhum
region of Jharkhand has a substantial
population of Ho tribals. The area has
low socio-economic development and
poor access to health services. PFI, in
partnership with Krishi Gram Vikas
Kendra (KGVK), the CSR unit of Usha
Martin Ltd, has been addressing the
reproductive health and family planning
needs of the people in this region. The
five-year long intervention (May 2007-
April 2012) will reach 30,000 persons
spread across 34 villages. The project
area is served by a PHC at Bada Jamda
and 13 sub-centres, most of which are
not functioning.
The project seeks to improve the
reproductive health status and
acceptance of family planning methods
among the underserved tribal
populations. For this, the government
health providers are being trained for
improved service delivery and to
provide support to the Saahiyas
(ASHAs in NRHM parlance).
Community-based planning will be
strengthened and health services
monitored through village health and
sanitation committees (VHSCs).
Reproductive health and referral
services and access to modern
PFI, in partnership with Krishi Gram Vikas Kendra (KGVK), the CSR
unit of Usha Martin Ltd, is addressing the reproductive health and
family planning needs of the people in this region. The five-year long
intervention (May 2007-April 2012) will reach 30,000 persons
spread across 34 villages.
contraceptives is being promoted by
providing a basket of choices through
social marketing. Behaviour change
communication (BCC) activities are
being carried out to build awareness
among adolescents on reproductive
health issues.
Key activities during 2010-2011
The project team was sensitised on
adolescent health issues, HIV/AIDS and
to the concept of a basket of choices
for contraception and underwent
training on leadership development and
team building. Refresher training was
held for Saahiyas and VHSC members.
As malnutrition is rampant in the area,
Saahiyas were taken on an exposure
visit to the Malnutrition Treatment
Centre at Jagannathpur, where they
learnt to identify signs of malnutrition in
the community.
VHSCs have been formed and activated
in all the 34 villages and have facilitated
the selection of a Saahiya for each
village. The VHSCs had earlier
refurbished the sub-centre at Baraiburu
through community participation. VHSC
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Improving the Health of the Ho Tribals:
West Singhbhum, Jharkhand
members have been oriented on issues
of family planning, safe motherhood,
HIV/AIDS, water and sanitation. As an
outcome, almost all VHSCs are seeking
untied funds under NRHM and are
discussing about health service
provision for women and children in
their monthly meetings.
On the occasion of World Population
Day, KGVK joined the State Health
Department in observing the third week
of July 2010 as the Pariwar Swasthya
Mela Saptah (Family Health Fair Week).
On this occasion, a prabhat pheri was
organised in coordination with the
Primary Health Centre and school at
Badajamda. A family planning
counselling desk was also placed at
Noamundi Additional Primary Health
Centre to counsel couples. Six nukkad
nataks on family planning were put up
by a professional theatre group.
The mobile health team, comprising a
doctor and an ANM, has been providing
primary health care services and
assisting government health
functionaries in their duties. The team
attended to 7,982 persons in the 173
health camps conducted during the
year. The project provided antenatal
care to pregnant women and motivated
them to plan their families. Dai delivery
kits (DDKs) were supplied through
social marketing. KGVK has purchased
an ambulance for emergency cases.
...almost all VHSCs are
seeking untied funds
under NRHM and are
discussing health
service provision for
women and children in
their monthly meetings.
Meetings and melas were organised in 11
villages to make adolescent girls and
their parents aware of the legal age at
marriage, the importance of a nutritious
diet and seasonal ailments. An
adolescent health week, with quiz and
other competitions, was organised in
August 2010 in the project villages.
Haemoglobin tests were conducted on
124 adolescent girls and a majority of
them were found to be anaemic. The
project is now working with the local
administration to provide a regular
supply of Iron Folic Acid
supplementation to the girls.
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ANNUAL REPORT / 2010-2011
Partnership with the Government
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ANNUAL REPORT / 2010-2011
Regional Resource Centres: Bihar and Chhattisgarh
The Ministry of Health and Family
Welfare (MoHFW), Government of India
(GoI) had initiated the Mother NGO
(MNGO) scheme under the
Reproductive and Child Health (RCH)
programme in 1999. The scheme was
revamped in 2005 and GoI recognised
10 institutions as Regional Resource
Centres (RRCs) to provide technical
assistance and support to the State
NGO Committee, Mother NGOs
(MNGOs), Service NGOs (SNGOs), Field
NGOs (FNGOs) and other stakeholders
across the country.
PFI is the Regional Resource Centre for
the states of Bihar and Chhattisgarh
since February 2005. The RRC Bihar is
supported financially by GoI, and the
RRC Chhattisgarh is funded by PFI.
RRC Bihar and RRC Chhattisgarh are
assisting the MNGO/FNGO network on
reproductive health and related issues
and acting as a catalyst to facilitate
networking between the government
and civil society.
Key activities during 2010-2011
Though the fund release by the state
government and subsequent
implementation of the programme by
the MNGO/FNGO network could not be
rolled out during the year, RRCs in both
the states continued to provide support
and strengthen the capacities of the
network. Advocacy for involvement of
NGOs in Chhattisgarh led to field
NGOs of four districts being involved
in information, education and
communication (IEC) activities, baseline
surveys, distribution of family planning
products and participation in ANC
camps.
RRC Chhattisgarh also organised a two-
day residential training on Village Health
Planning and Community-Based
Monitoring for Mother NGOs and Field
NGOs in March 2011 at Raipur. The
training helped the participants
understand the process of the
development of district and state
Programme Implementation Plans (PIPs).
'Quality of care' has been identified as a
critical issue in delivery of family
planning services. In order to sensitise all
relevant stakeholders in the state, RRC
Bihar organised five regional thematic
workshops on Quality of Care in Family
Planning Services. Participants included
officials from health and other line
departments, NGO representatives and
other stakeholders. These workshops
RRC Bihar and RRC
Chhattisgarh are
assisting the
MNGO/FNGO network on
reproductive health and
related issues and
acting as a catalyst to
facilitate networking
between the
government and civil
society.
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Regional Resource Centres: Bihar and Chhattisgarh
PFI-RRC Chhattisgarh
had drafted the
Integrated Health and
Population Policy of the
state. During the year,
the draft was referred
to the State Planning
Board and will be
presented in the
assembly for approval.
RRC Bihar played a very
important role in the
community based
planning and monitoring
(CBPM) initiatives in
collaboration with the
state government.
culminated into a one-day state level
workshop in March 2011 in Patna. State
health officials, representatives of
Mother NGOs and other stakeholders
participated. A plan of action for
improving the quality of family planning
services in the state was developed.
As financial management has been
identified as an area which needs
strengthening in order to improve the
functioning of the MNGO/FNGO
network, both the RRCs organised
residential training programmes on
financial management for Mother NGOs
and Field NGOs in their states. The
capacity of the accounts personnel was
built on financial administration,
maintenance of books of accounts,
compilation of various financial reports,
financial management of donor-funded
projects and income tax and other legal
liabilities.
The state offices established under RRC
have developed a good liaison with the
respective state governments. PFI-RRC
Chhattisgarh had drafted the Integrated
Health and Population Policy of the
state. During the year, the draft was
referred to the State Planning Board
and will be presented in the assembly
for approval. RRC Bihar played a very
important role in the community based
planning and monitoring (CBPM)
initiatives in collaboration with the state
government. PFI entered into a
Memorandum of Understanding (MoU)
with the Bihar government, to be the
State Nodal-cum-Technical Agency for
providing technical and managerial
support for implementing CBPM in the
state.
PFI-RRC also participated in the Annual
Review Meeting of RRC, organised by
the NGO division in February 2011 in
New Delhi. The meeting convened by
the Joint Secretary, GoI, reviewed the
various challenges being faced by the
RRCs in their respective states.
A committee was constituted for
developing a plan for reviving the
Mother NGO scheme. This committee
has drafted and submitted to GoI the
recommendations on the revised role of
RRCs and Mother NGO/Field NGO
network, under the National Rural
Health Mission (NRHM).
RRCs in both the states continued with
the dissemination of training manuals
and publications. The two state offices
have also developed a good network
with national and international
agencies.
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ANNUAL REPORT / 2010-2011
Community-Based Planning and Monitoring Programme: Bihar
Population Foundation of India has
been in the lead in empowering
communities to plan and monitor health
initiatives under the National Rural
Health Mission (NRHM). PFI functions as
the Secretariat of the Advisory Group
on Community Action (AGCA), a
standing committee constituted by the
Ministry of Health and Family Welfare
(MoHFW), GoI, mandated to spearhead
the community-related initiatives under
NRHM. The group consists of eminent
public health professionals associated
with major NGOs.
NRHM, launched on April 12, 2005, aims
to bring about significant improvements
in the health status of people in rural
areas of the country. It seeks to provide
universal access to equitable, affordable
and quality health care which is
accountable and responsive to the
needs of the people.
The review team reported, “The gains
are impressive, despite the short
implementation time. The most
significant gain from community
monitoring is the active engagement
between the community and the health
department. It is enabling the
community to be in centre-stage and
making them a significant stakeholder
in the management of public health
system. It is empowering too, as the
VHSCs have given a sense of identity
and voice to the community.” The
review team recommended continued
GoI support for institutionalising
community action within NRHM.
To improve the delivery of health care in
the rural areas of Bihar and the health
of its people, the State Health Society,
Bihar (SHSB) has initiated community-
based planning and monitoring (CBPM)
programme for a period of one year
The first phase of community-based
monitoring (CBM) of health services
was initiated through the AGCA with
support from the MoHFW. It was
implemented in the nine states of
Assam, Chhattisgarh, Jharkhand,
Karnataka, Madhya Pradesh,
Maharashtra, Odisha, Rajasthan and
Tamil Nadu from 2007 - 2009. PFI
functioned as the National Secretariat
for this project and was co-supported
by the Centre for Health and Social
Justice (CHSJ), New Delhi.
The first phase of the CBM programme
was reviewed by an external team of
experts, who strongly recommended
that the process be continued and
supported, with some modifications.
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Community-Based Planning and Monitoring Programme: Bihar
(May 2011 – April 2012). This initiative
builds upon the experiences of the first
phase, implemented in nine states. It
aims to make communities aware of
their health-related entitlements within
NRHM, empower them to monitor
health services and enable them to
develop an understanding of the health
issues in their community.
A broad framework for the initiative was
agreed upon in a consultative meeting
of the stakeholders in Bihar organised
by PFI. A State Technical Advisory
Group for Community Action (SAGCA)
was formed for providing advisory
support to the state for implementing
CBPM. A State Technical Assistance
Group (STAG) was also formed for
providing technical assistance to the
process. PFI is a member of the SAGCA
and the STAG.
out of the CBPM in Bihar. The
programme was formally launched by
the Government of Bihar at an event
organised in Patna in February 2011.
The project is being rolled out in five
districts – Bhagalpur, Darbanga,
Nawada, Gaya and Jehanabad. In the
first phase, it will cover 300 villages, 50
panchayats and 10 blocks. In addition to
the CBPM process, there will be an
emphasis on convergence of different
health programmes. Importance will be
given to improving the quality of care
and to organising Village Health
Sanitation and Nutrition Days.
PFI has been appointed as the State
Nodal-cum-Technical Agency for the roll
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ANNUAL REPORT / 2010-2011
B
|Scaling Up in the Maternal Health
and Adolescent Reproductive
and Sexual Health Sector in India|
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ANNUAL REPORT / 2010-2011
Scaling Up NGO and Public Sector Innovations
I n 2006, The John D. and Catherine T. MacArthur Foundation made a grant
to PFI to work on scaling up of pilot initiatives in the area of reproductive
health and adolescent reproductive and sexual health (ARSH) programmes
in the country from April 2006 to December 2008. Management Systems
International (MSI) extended technical support for the project.
MSI developed institutional capacity within PFI for scaling up and provided
technical support and mentoring to the PFI team. PFI and MSI initiated the
process of facilitating scaling up six MacArthur-funded innovative
interventions that focused on reducing maternal mortality and improving
adolescent reproductive and sexual health (ARSH).
The MacArthur Foundation awarded PFI a second grant for the period July
2008 to June 2010. The grant aimed at developing PFI as an apex resource
organisation and a 'Centre of Excellence' for 'Scaling Up Management' (SUM)
in India. During this phase, PFI focused on strengthening its scaling up
efforts with existing NGO partners, extending scaling up support to new
NGOs and creating awareness regarding SUM in the public health sector.
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Scaling Up NGO and Public Sector Innovations
ANNUAL REPORT / 2010-2011
PFI also started internalising scaling up management in its grant
management and grant-making processes.
A national conference on Scaling Up: Lessons Learnt and Way Forward was
organised in April 2010 with the key objective of sharing the experiences
from the health and other social sectors on scaling up within the government
and non-government systems, and developing a vision and strategy for
scaling up social sector programmes in India. A half-day roundtable on
Scaling Up in India: The Way Forward with key members of the government
and civil society was also organised with an aim to develop a scaling up
vision in India.
Driven by the scope and importance of scaling up management, and given
the time consuming processes that need to be followed to develop an
enabling environment for scaling up, the MacArthur Foundation continued its
support to PFI with a third grant for a two-year period (February 2011 to
January 2013). This grant aimed to further strengthen PFI as a Centre of
Excellence for SUM in India and to expand the skills and capacity for scaling
A half-day roundtable on
‘Scaling Up in India: The Way
Forward’ with key members of
the government and civil
society was also organised
with an aim to develop a
scaling up vision in India.
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Scaling Up NGO and Public Sector Innovations
The sessions brought
out the importance of
institutionalising SUM
and PFI's role as a
Centre of Excellence
with respect to scaling-
up management in India.
up management. In the third phase, in addition to NGO initiatives, the project will
support scaling up of public sector innovations.
The programme aims to:
Strengthen capacities and skills on SUM among the larger public health
community and PFI's core staff in specific skill areas such as process
documentation, cost effectiveness analysis, and monitoring and evaluation for
scaling up.
Support scale up of successful NGO models.
Carry out state and national level advocacy for scaling up maternal health and
ARSH models which respond to the specific needs and context of different states
with a special focus on Empowered Action Group (EAG) states – those with poor
health and development indicators.
Key activities during 2010-2011
A two-member team, including a Project Director and a Project Manager, was
appointed at PFI for undertaking scaling up activities under Phase III.
A half-day orientation programme on the scaling up framework was organised in
May 2011. PFI staff from different divisions participated. Dr. Rajani Ved, former Senior
Associate, MSI, who had worked closely with PFI and anchored the scaling up
activities during the first two phases, introduced the concept to the participants and
took them through the lessons learnt in the previous years. Ms. Dipa Nag
Chowdhury, Acting Director, MacArthur Foundation India, and Ms. Poonam Muttreja,
Executive Director, PFI, provided a historical overview and perspective. The sessions
brought out the importance of institutionalising SUM, and PFI's role as a Centre of
Excellence with respect to scaling-up management in India.
Dr. Syeda Hameed, Member, Planning Commission,
whose sectoral responsibilities include health, has
been contacted to discuss the scaling up framework
in the context of the 12th Five Year Plan. Discussions
on organising a workshop in the Planning Commission
have also been initiated with Mr. Arun Maira, Member,
Planning Commission. In addition, a process for
identifying a range of government programmes for
scalability assessment and review is also underway.
Under phase III, PFI will identify two to three
programmes which will then be recommended to the
Government of India for scaling up at the national
level.
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ANNUAL REPORT / 2010-2011
C
|Systematic Review and Research Studies|
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ANNUAL REPORT / 2010-2011
Birth Preparedness and Complication Readiness
The idea of conducting a systematic review of birth preparedness and complication
readiness (BP/CR) interventions came out of a stakeholder consultation organised
by the White Ribbon Alliance for Safe Motherhood India (WRAI), an alliance of
individuals and organisations striving for improving maternal and neonatal health in
the country. Advocacy for BP/CR was identified as a priority. However, as a prelude
to advocating for any action with the government, it was decided to review the
efficacy of community-based BP/CR interventions in improving skilled birth
attendance and thus reducing maternal mortality. Even though there have been
several projects that focused on BP/CR in India, there was no review of the evidence.
As a member of WRAI, PFI proposed to conduct a systematic review to identify key
interventions and conduct a scan of the evidence base available for advocating the
strategy with the Government of India (GoI).
The goal was to provide evidence-based recommendations
to the GoI for programmes that focus on BP/CR, such as the
Janani Suraksha Yojana (JSY), as well as to civil-society
organisations that are involved in implementing such
interventions.
The project ran for seven months (April - November 2010)
with a no-cost extension up to March 2011. PFI worked
closely with Maternal and Child Health Sustainable Technical
Assistance and Research (MCH-STAR), a USAID supported
initiative for overall guidance, technical assistance and
financial support for the activities of the project. The
systematic review was extended to cover other South Asian
countries – Nepal, Bangladesh, Pakistan and Sri Lanka, with
socio-cultural backgrounds similar to India.
Key activities during 2010-2011
Dr. Prathap Tharyan, Professor at Christian Medical College (CMC), Vellore, also the
Director of the South Asian Cochrane Network and Centre and an experienced
trainer on systematic reviews, mentored the PFI core team on the project. Two
members of the PFI core project team also attended a one-week systematic review
workshop conducted by him at CMC, Vellore, in August 2010 to gain an in-depth
understanding of the review processes.
In addition, PFI formed a Technical Advisory Group (TAG) for better understanding
of the methods and techniques of conducting systematic reviews, the complexities
of planning and implementing maternal health programmes, and advocacy with the
government. A TAG meeting was organised in December 2010 to review and provide
feedback on emerging findings from the study.
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ANNUAL REPORT / 2010-2011
Birth Preparedness and Complication Readiness
The project team developed the study protocol and conducted a comprehensive
search for published and unpublished studies and programme reports through
internet databases such as Google Scholar, Cochrane Library, PubMed, Popline and
WHO RH Library. Initially, 3,382 results came up, of which 930 titles were found
relevant to the study. On reviewing the abstracts, 210 relevant abstracts were
identified. Keeping in view the study protocol, all these abstracts were re-reviewed
and 76 studies were finally selected. Simultaneously, a manual search yielded three
additional relevant studies. For all these 79 studies, full text articles were retrieved
and reviewed in accordance with the strict inclusion and exclusion criteria of the
study. Finally, seven studies were included in the systematic review. Data and
information from these seven studies was extracted and analysed to conclude the
study.
The study was extremely useful in building PFI's capacity in
conducting state-of-the-art systematic reviews. It was an
opportunity for PFI to transfer the knowledge to the other
staff members, institutionalise the learning and develop
expertise on this particular research methodology.
The Review Showed
BP/CR interventions at scale have proven to be effective in South Asian countries in
improving knowledge and preparedness for delivery. The interventions could also lead to
significant improvements in the use of skilled birth attendant (SBA), if health service delivery
is also sought to be strengthened along with it.
The most successful components of the BP/CR package are education to improve knowledge
on danger signs, financial preparedness for the delivery/emergency and preparedness for
transport. BP/CR interventions with a strong component of community mobilisation are found
to be more effective.
The interventions along with community mobilisation and supply side strengthening could
lead to improved and timely utilisation of the SBA in South Asian settings. This intervention
could lead to reduction in maternal mortality by addressing all the delays to prevent maternal
deaths in resource-poor settings. This establishes the need for strengthening BP/CR
interventions in public health.
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ANNUAL REPORT / 2010-2011
The Training of ASHAs under the National Rural Health Mission
in Uttar Pradesh: Assessing the Needs
The Government has appointed and trained local women as
Accredited Social Health Activists (ASHAs) in each village under the
National Rural Health Mission. The NRHM designed a 23-day
induction training programme for ASHAs. The programme covers all
community health related issues, which would enable them to be
change agents in their respective villages.
By March 2010, 1,36,000 ASHAs in Uttar Pradesh were trained on
the first four modules of the induction programme. In order to
assess the knowledge gained and retained by the ASHAs and
ascertain existing gaps, the Government of Uttar Pradesh (GoUP)
invited PFI to conduct an assessment of additional training needs of
ASHAs and suggest the content for the periodic trainings. Periodic
trainings are two-day refresher trainings conducted every second
month for ASHAs who have completed their induction training.
The Maternal and Child Health Sustainable Technical Assistance and Research (MCH-
STAR), a USAID-supported initiative, provided PFI with financial and technical
assistance to conduct this assessment. The project spanned four months (June-
October, 2010) with a no-cost extension upto January, 2011.
In order to assess the
knowledge gained and
retained by the ASHAs
and ascertain existing
gaps, the Government of
Uttar Pradesh (GoUP)
invited PFI to conduct an
assessment of additional
training needs of ASHAs
and to suggest the
content for the periodic
trainings.
Key activities during 2010-2011
The data collection tools were developed and shared with MCH-STAR, USAID, TAG,
and GoUP, in late June 2010. The tools were finalised by the end of July 2010 in
consultation with all stakeholders. These were field-tested by PFI along with
researchers from the Centre for Research Evaluation Analysis Training and
Education (CREATE), a research agency selected for field-level data collection.
A three-day training programme for 16 field investigators was organised in Lucknow.
The training was facilitated by the PFI team in partnership with CREATE.
The field-plan for data collection was prepared in consultation with the State
Programme Management Unit (SPMU), NRHM, Uttar Pradesh. Data collection was
initiated in late August and completed by the beginning of September 2010. Data
was collected from 640 respondents (ASHAs, Village Health Workers and
beneficiaries), spread over 10 districts, representing the five administrative regions in
the state. The entire process was supervised by four senior PFI staff members.
Following the collection, the completed schedules were edited, coded, tabulated
and analysed. PFI worked closely with MCH-STAR, TAG members and
representatives from the GoUP during the entire process.
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The Training of ASHAs under the National Rural Health Mission
in Uttar Pradesh: Assessing the Needs
The draft ASHA study report was shared with GoUP and
MCH-STAR. It presented an analysis of the knowledge
and performance of ASHAs on a comprehensive set of
indicators in the areas of maternal health, child health
and population stabilisation. It also investigated the
gaps in their functioning and made key suggestions for
the periodic training in each of the three areas to
improve their effectiveness.
Data was collected from 640 respondents (ASHAs,
Village Health Workers and beneficiaries), spread over
10 districts, representing the five administrative
regions in the state... PFI worked closely with MCH-
STAR, TAG members and representatives from the
GoUP during the entire process.
Key Findings
Study results found gaps in the knowledge and performance of ASHAs in particular areas
concerning maternal health, child health and population stabilisation. Based on these findings
the study made the following suggestions:
Maternal Health
Periodic training of ASHAs should make rigorous and diligent efforts to continuously
enhance ASHA's knowledge on the danger signs of pregnancy.
Maintaining hygiene during delivery should be a major focus area.
ASHAs should be encouraged to continue providing and promoting antenatal care service.
Continuous support should be provided to ASHAs for promoting birth preparedness.
Child Health
Increase ASHAs knowledge on breastfeeding.
Train them on assessment of the condition of a newborn.
ASHAs should be trained to capture the immunisation drop-outs and advise mothers to
complete the immunisation schedule.
Population Stabilisation
Continuously enhance ASHA's communication, motivational and negotiation skills on issues
of family planning.
Equip ASHAs with thorough knowledge on health consequences of unsafe abortion.
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Assessing the Impact of Conditional Cash Transfers on
Delaying Marriage
The Apni Beti Apna Dhan (ABAD) or the Our Daughter, Our Wealth initiative of the
Government of Haryana, which was launched in October 1994, is one of the first
conditional cash transfer (CCT) implemented systematically and consistently by an
Indian state. The International Centre for Research on Women (ICRW) is being
provided funding by USAID to undertake an evaluation of the ABAD programme
over a period of five years. PFI is the primary advocacy partner of ICRW on
stakeholder engagement with regard to government access, research utilisation and
policy.
ICRW has developed a
consortium of partner
organisations to
execute project
activities related to
survey data collection,
qualitative data
collection, outreach and
dissemination. PFI is
collaborating with ICRW
for policy linkage,
outreach and
dissemination.
The study intends to provide reproductive health and development stakeholders
with evidence on how effective the CCT programme has been in delaying marriage
in regions where the proportion of early marriages continues to be high. 'Delaying
age at marriage' is the first of the five key issues that PFI has decided to work on in
fostering sustainable and balanced human development with a focus on population
stabilisation. This study would also contribute towards formulating gender sensitive
and rights-based policies/strategies/programmes in the context of delaying
marriages, specifically in regions where child marriage is prevalent.
In Phase I (October 2010-September 2011), PFI is collaborating with ICRW, in gaining
support and cooperation from key government stakeholders. Together, PFI and
ICRW have undertaken a series of one-on-one meetings with key officials at the
national, state and district levels. ICRW has made a formal presentation to the
Women and Child Development Department on the proposed study. A feasibility
assessment has also been undertaken.
The study seeks to:
Assess if a CCT designed around a long-term incentive of a cash benefit for girls
who delay their marriage is successful in its goal among a significant proportion
of beneficiaries.
Assess how and why the process of programme implementation has led to the
success or failure of CCTs.
Share results, lessons, implications, and evaluation tools with relevant
stakeholders in order to facilitate effective replication and evaluation of CCTs as a
potential solution to early marriage.
ICRW has developed a consortium of partner organisations to execute project
activities related to survey data collection, qualitative data collection, outreach and
dissemination. PFI is collaborating with ICRW for policy linkage, outreach and
dissemination. In Phase II (October 2011-September 2016), a process and impact
evaluation of the ABAD programme will be carried out, along with outreach and
dissemination activities.
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D
|Partnering With the Media|
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Jeene Ki Aasha: A Health Campaign on Television
J eene Ki Aasha is a national media health campaign launched by New Delhi
Television (NDTV) with support from the Bill and Melinda Gates Foundation. The six-
month long campaign, being telecast from May 2011 to October 2011 on all NDTV
news channels, reaches out to a wide cross-section of society. Population
Foundation of India is NDTV's technical advisor cum knowledge partner for this
initiative.
Focusing on maternal, neonatal, child health, and nutrition, this six-month long
campaign endeavours to mobilise the media to create nationwide awareness about
critical health issues. During the campaign, NDTV journalists and correspondents
from across the country, will report on critical issues and path-breaking initiatives
that affect maternal and child health. The television series is accompanied by a web
campaign, including a blog on the NDTV website and also uses new social media
such as Facebook and Twitter.
PFI sees this as an opportunity to advocate for, and actively work towards, the
achievement of Millennium Development Goals (MDGs) to reduce child mortality and
improve maternal health, provide an opportunity to civil society organisations to
showcase promising practices and enable people to voice their opinions on the
policies that affect them.
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Jeene Ki Aasha: A Health Campaign on Television
To kick off the project, PFI met with the
NDTV team to understand the scope
and strategies of the project, the
intended impact of the campaign as
well as their expectations of PFI as a
knowledge partner. The team at PFI
then identified key issues, resource
persons, relevant information and
material including updates, policy
briefs, national and international
publications, demographic data and
factoids to support NDTV in their
preparatory work for the campaign.
PFI is connecting NDTV with opinion
leaders and experts from the
government, and senior representatives
of international, national, and state level
NGOs. An orientation meeting has been
organised at and by PFI. PFI maintains a
'hot-line' for producers at NDTV, so they
are provided with timely and accurate
information throughout the duration of
the campaign.
During the campaign, NDTV journalists and correspondents from across the country,
will report on critical issues and path-breaking initiatives that affect maternal and
child health. The television series is accompanied by a web campaign, including a blog
on the NDTV website and also uses new social media such as Facebook and Twitter.
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Jeene Ki Aasha: A Health Campaign on Television
In addition to news stories, special programmes and panel discussions covering
critical health issues and path-breaking initiatives in related thematic areas, will be
telecast. NDTV will also be broadcasting factoids and information tickers on all its
channels. These factoids will be provided by PFI and will form the information base
of the campaign.
For PFI, this is an opportunity to bring together its large network of partners and
help NDTV make a concerted effort at raising public knowledge and awareness on
health issues through a mass communication campaign.
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E
|Events|
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ANNUAL REPORT / 2010-2011
Commemorating 40 Years of PFI
A series of events and activities were organised during the year across 11 states to
commemorate PFI's 40 years of existence. The activities undertaken were:
Regional Conferences: Three regional conferences covering the eastern, western
and north-central regions have been successfully organised. The first was held in
Bhubaneswar in February 2010, the second in Pune in May 2010 and the third in
Lucknow in August 2010.
The conferences sought to bring out region-specific priorities and issues and
recommend strategies that would help improve the status of population, health and
social development in the regions. These conferences were an endeavour to bring
key stakeholders: government representatives, members of civil society, social
scientists, scholars, national/international institutions and NGOs on one platform for
discussions. The objective was to attain a clear perspective of the demographic and
health transition process in the eastern, western and northern states, recapitulate
initiatives taken by the state governments on population and health issues, and draw
up recommendations with policy and programmatic implications at the state,
regional and national levels.
A wall chart providing a graphic display of key health and population issues,
a publication containing important demographic and health indicators of every
district in the three regions, were printed and released at the conferences.
The conferences received wide coverage from the local and national media.
Recommendations emerging from the conferences have been documented for wider
dissemination.
PFI Films: A 26-minute documentary,
40 Years of Caring Commitment, and
an abridged 12-minute film, Power to
the People, documenting PFI's work
and achievement over the years, was
produced and disseminated at the
regional conferences.
NGO Activities: PFI, in partnership with
NGOs, organised poster, slogan and skit
competitions for adolescents/youth
residing in slums in 44 districts of 11
states. The states were Odisha, West
Bengal, Bihar, Jharkhand, Maharashtra,
Gujarat, Rajasthan, Chhattisgarh,
Madhya Pradesh, Uttarakhand and Uttar
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Commemorating 40 Years of PFI
Pradesh. For each state, three winners
were selected at the district level, and
from among them, two were selected at
the state level. All participants received
cash prizes, mementos and certificates.
The themes for the competitions were:
Role of youth in population stabilisation
and development, Reproductive and
child health, Rights of women,
Involvement of the male partner,
Women's health and development, and
Gender equity.
The Kalyani–II programme telecast on
Doordarshan regional channels from
May 1, 2010 included two awards
sponsored by PFI: The Most Aware
Mother of the Month and The Best
Kalyani Club of the Month. Quiz
questions for The Most Aware Mother of
the Month were included in all episodes
of the Kalyani-II programme telecast
each month in Assam, Bihar,
Chhattisgarh, Jharkhand, Madhya
Pradesh, Odisha, Rajasthan, Uttar
Pradesh and Uttarakhand. The Best
Kalyani Club of the Month was selected
by a committee comprising PFI and
Doordarshan Regional Kendra
representatives. The selection was based
on the activities carried out by Kalyani
clubs to promote reproductive health in
their communities. A colour TV set,
along with a certificate and memento
were awarded to the best Kalyani Club
of the month at a special function
organised by Doordarshan every quarter
in each of the nine states.
This initiative, in collaboration with
Doordarshan, aimed at reaching the
73,000 Kalyani members of the 3,000
registered Kalyani clubs.
PFI, in partnership with NGOs, organised poster, slogan and skit
competitions for adolescents/youth residing in slums in 44 districts of
11 states. The themes for the competitions were: Role of youth in
population stabilisation and development, Reproductive and child
health, Rights of women, Involvement of the male partner, Women's
health and development, and Gender equity.
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World Population Day 2010
There has been an
increase in overall
contraceptive usage in
India, from 41 per cent
in 1992-93 to 56 per
cent in 2005-06. There
has been a similar
increase in rural India
from 37 per cent to
53 per cent. The total
fertility rate has also
declined from 3.4 in
1992-93 to 2.7 in
2005-06.
At a round table conference on Empowering Approach to Population Stabilisation
organised by PFI in July, 2010 on the occasion of World Population Day, health and
population experts debated the issue – How do you reposition family planning within
a non-coercive, rights-based and gender sensitive framework that is pro-people, pro-
poor, pro-women and pro-youth?
The programme, held in New Delhi, included two presentations by eminent civil
society experts. Dr. Abhijit Das, Director, Centre for Health and Social Justice
(CHSJ), New Delhi, made a presentation on Family Planning and Contraceptive Use
in India: New Priorities, New Approaches. Dr. Sundari Ravindran, Honorary Professor,
Achutha Menon Centre for Health Science Studies, Sree Chittira Tirunal Institute for
Medical Sciences and Technology, Thiruvananthapuram, spoke on Fertility Decline
and Women's Reproductive Health in Tamil Nadu.
The first presentation reiterated the importance of involving men in the family
planning programme by addressing their needs and anxieties, appointing male
leaders/ambassadors in the community and within the health system and engaging
male volunteers alongside ASHAs to work with men. Longitudinal and cross
sectional studies to understand the risks of tubectomy performed under various
circumstances were also suggested.
There has been an increase in overall contraceptive usage in India, from 41 per cent
in 1992-93 to 56 per cent in 2005-06. There has been a similar increase in rural India
from 37 per cent to 53 per cent. The total fertility rate (TFR) has also declined from
3.4 in 1992-93 to 2.7 in 2005-06. The total wanted fertility rate for the country is 1.9,
which indicates an overall desire for smaller families. The unmet needs continue to
remain high, with an overall unmet need of 13 per cent. In Uttar Pradesh, Bihar and
Jharkhand, it is over 20 per cent. Contraceptive use is the highest in Himachal
Pradesh (73 per cent) and West Bengal (71 per cent). Female sterilisation accounts
for about 66 per cent of contraceptive methods used. The need to strengthen the
service delivery system and to ensure that women's choices and needs are
incorporated in the planning process was emphasised.
The presentation on Fertility Decline and Women's Reproductive Health in Tamil
Nadu drew attention to the fact that while the state has been in the limelight for
being a good performer in achieving family planning targets, the methods adopted
for achieving these targets did not always ensure family planning and reproductive
rights. According to available statistics, low fertility, which may have been achieved
through induced abortion, was accompanied by poor use of spacing methods and
low level of male responsibility for fertility control. In spite of 98 per cent of
deliveries taking place in hospitals, medical termination of pregnancy in the public
sector is declining and the availability of sexual and reproductive health (SRH)
services is still limited. Although, there is little variation in TFR by socio-economic
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World Population Day 2010
characteristics or place of residence, inequalities may be substantial in other
indicators. Thus, there is a need for more systematic evidence on reproductive
health and health inequalities.
The importance of fertility reduction in contributing to women's empowerment and
development requires emphasis. However, it needs to be associated with specific
investments for improving women's health including SRH and rights and poverty
reduction.
Two films, produced by PFI to commemorate the fortieth year of the organisation,
were screened at this conference. The first film, Haule Haule, was developed for the
Ministry of Health and Family Welfare with support from the MacArthur Foundation.
It has been produced and directed by the renowned theatre director and Bollywood
film maker Mr. Feroz Abbas Khan. The film entwines key messages on increasing age
at marriage, the importance of delaying first pregnancy, spacing between two
children, women's empowerment, male involvement, better health facilities, quality
of care and reproductive rights. An entertaining drama format has been used in the
film to reach out and appeal to different audience segments in the community. The
key message of the second film, Jan Aur Sankhya is that population stabilisation is
not merely about numbers but has to be looked at in the wider context of social
development.
According to available
statistics, low fertility,
which may have been
achieved through
induced abortion, was
accompanied by poor
use of spacing methods
and low level of male
responsibility for
fertility control.
Senior government officials, members of civil society organisations, the Family
Planning Coalition, the Coalition on Rights Based Programming for Contraception,
and representatives from the donor community and international agencies actively
participated in the conference.
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National Conference
Scaling Up: Lessons Learnt and Way Forward
Over the past few years, PFI, supported by the MacArthur Foundation and with
technical support from Management Systems International (MSI), has been
facilitating the scaling up of NGO-led innovations in the area of reproductive and
child health (RCH) in India. These scaling up initiatives have been guided and based
on the application of a scaling up management framework developed by MSI on the
understanding that there are many promising, or even proven, small-scale
innovations which can have substantial impact on health outcomes, if these are
scaled up systematically.
To enable a sharing of scaling up experiences, a National Conference on Scaling Up:
Lessons Learnt and Way Forward, was organised on April 19, 2010, at the India
Habitat Centre, New Delhi. Organised with support from the Planning Commission,
and in collaboration with the MacArthur Foundation and MSI, the conference
brought together practitioners, administrators and academicians from the national
and international arenas. The conference drew on national and global experiences of
scaling up and explored the reasons behind the limited success in scaling up of
many pilot projects. It aimed at developing a vision and strategy for scaling up
social sector programmes in India.
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National Conference
Scaling Up: Lessons Learnt and Way Forward
The inaugural session highlighted the concept of scaling up and built a common
understanding on the scaling up management framework which had been used to
scale up reproductive health pilots in India. Ms. Poonam Muttreja, former Country
Director, MacArthur Foundation, shared the Foundation's experiences and
challenges of funding innovations/pilots with a potential to be scaled up. Mr. A. R.
Nanda, former Executive Director, PFI, Dr. Richard Kohl and Dr. Rajani Ved,
representing MSI, spoke on the scaling up framework and shared experiences of
facilitating scaling up as an intermediary resource organisation and the lessons
learnt thereof. Giving the inaugural address Mr. Arun Maira, Member, Planning
Commission, Government of India, emphasised the need to devise solutions which
were effective at the global and local levels at the same time.
The first session focused on Scaling Up through Government Systems and was
chaired by Mr. Maira. The panelists for this session were: Ms. Sudha Pillai, Secretary,
Planning Commission; Mr. Larry Cooley, President, MSI, and Dr. A. K. Shiva Kumar,
Development Economist. The session highlighted the importance of having
developmental milestones inbuilt in pilot programmes, which would in turn help in
their scaling up and to put marginalised groups at the centre of such initiatives.
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National Conference
Scaling Up: Lessons Learnt and Way Forward
It was acknowledged that the challenge is in scaling up multi-
sectoral initiatives within a very complex environment where
multiple organisations/actors and multiple issues are involved.
The second session showcased Selected Experiences of Scaling Up
from the country. The chairperson for the session was Dr. Syeda
Hameed, Member, Planning Commission and the panelists included
Dr. Abhay Bang, SEARCH; Dr. H. Sudarshan, Karuna Trust; Ms. Mirai
Chatterjee, Vimo-SEWA; and Mr. K. S. Murthy, Bhavishya Alliance.
The session discussed the evidence based approach adopted by the
home-based newborn care model of SEARCH that helped counter
a number of challenges while scaling up in India and other countries.
The public-private-partnership model in primary health care
management by Karuna Trust, Bangalore, and the community-based
micro insurance model by Vimo-SEWA, Gujarat, were also discussed. These path-
breaking initiatives provided a useful insight into the scaling up process in India.
The third session was on the Role of Monitoring, Evaluation and Evidence Building in
Scaling Up. The chairperson for the session was Dr. Narendra Jadhav, Member,
Planning Commission and the panelists included: Dr. Prathap Tharyan, Director,
South Asia Cochrane Centre and Network; Dr. Richard Cash, Harvard School of
Public Health; and Dr. T. Sundararaman, Executive Director, National Health Systems
Resource Centre (NHSRC). 'Don't just do it, do it right' was the key message that
emerged from the session, emphasising the need to gain clarity before scaling up.
The discussion was concluded by accentuating the importance of evidence building,
evaluation, adaptation and advocacy in scaling up.
In the concluding session, Ms. Poonam Muttreja and Dr. Richard Kohl summarised
the discussions and said that one of the biggest challenges that emerged during the
deliberations was that many NGO pilots were not designed using the scaling up
framework as a basis. Many of them lacked quantitative evidence of impact. An in-
depth understanding of the issues such as fund management, cost effectiveness and
accountability are prerequisites for the scaling up process to be sustainable.
Asserting that the challenge today was 'building commitment towards the adoption
of a pro-active approach to scaling up', the conference concluded with the hope
that further dialogue with the Planning Commission would bring forth some strong
recommendations in this direction.
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F
|HIV/AIDS Programme|
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PACT for Better Care and Treatment
The Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) provides funding
to India to focus on the provision of antiretroviral treatment (ART) and to enhance
access to care and support services for people living with HIV/AIDS. The National
AIDS Control Organisation (NACO) provides ART through the State AIDS Control
Society (SACS) in each state and NGO/private sector makes available care and
support services to People Living with HIV/AIDS (PLHIV).
PFI is the first civil society organisation to be a Principal Recipient of the Global
Fund grants in India. A PFI-led consortium of partners successfully implemented
Round 4 of Access to Care and Treatment (ACT) from April 2005 to March 2010 and
Round 6: Promoting Access to Care and Treatment (PACT) programme from June
2007 to March 2010. Both these programmes complemented the National AIDS
Control Programme (NACP).
Based on accelerated performance of these programmes, PFI was invited to apply
for the Rolling Continuation Channel (RCC), a funding mechanism of the Global
Fund, through which good performing programmes receive funding for an
additional six years. PFI and NACO received funding from the Global Fund under
RCC and consolidated both Round 4 and Round 6 initiatives. The six-year
programme (April 2010 to March 2016) is being implemented in two phases of three
years each. Implementation of the first phase of the RCC, Promoting Access to Care
and Treatment started in April 2010. PACT aims to improve survival and quality of
life of PLHIV and reduce HIV transmission. It is being implemented in 15 states of
India through the partners – Indian Network for People Living with HIV/AIDS (INP+),
Hindustan Latex Family Planning Promotion Trust (HLFPPT), Confederation of Indian
Industries (CII), Enable Health Society (EHS), and Catholic Bishops' Conference of
India (CBCI).
PFI is the first civil society organisation
to be a Principal Recipient of the Global
Fund grants in India. A PFI-led consortium
of partners successfully implemented
Round 4 of Access to Care and Treatment
(ACT) from April 2005 to March 2010
and Round 6: Promoting Access to Care
and Treatment (PACT) programme from
June 2007 to March 2010.
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PACT for Better Care and Treatment
The RCC PACT programme is in complete alignment
with the Millennium Development Goals (MDGs) of the
United Nations on HIV/AIDS. The MDG on HIV/AIDS –
to halt and begin to reverse the spread of the epidemic
by 2015 – requires far greater access to HIV prevention
services and AIDS treatment, care and support. In line
with universal access to treatment for HIV/AIDS, this
programme envisages the scale up of comprehensive
and integrated AIDS response, including prevention,
treatment, care and support across the entire country.
PACT is designed with an understanding that all people
should have access to information and services that are
equitable, affordable, comprehensive and sustainable.
NACP III shall provide the national leadership required to establish policies that
support the momentum of treatment scale-up by increasing the number of people
who choose to know their HIV status, reducing HIV stigma, building human capacity
to sustain treatment through training and by better use of current human resources,
improving supply management and integrating HIV care with other health services.
Support nets
The RCC PACT programme focuses on positive prevention which is key to improving
survival and reducing morbidity and mortality of PLHIV. Positive prevention
intervention is both behavioural and biomedical. It stresses on abstinence or using a
condom during every sexual encounter so as to reduce the viral load. Positive
prevention also aims at preventing unintended pregnancies among HIV positive
women who do not want children, safe timing of pregnancy, prevention of parents
to child transmission (PPTCT), care for HIV positive children and support for
orphans. Through this programme, institutional delivery is promoted for HIV positive
women. They are linked to the PPTCT programme under the government by district
level networks (DLNs) and community care centres (CCCs). The programme also
encourages women to become peer educators and form support nets. Women
support nets or self-help groups (SHGs) are motivated to initiate micro credit
programmes and become self sustaining.
Positive prevention also
aims at preventing
unintended pregnancies
among HIV positive
women who do not want
children, safe timing of
pregnancy, prevention
of parents to child
transmission (PPTCT),
care for HIV positive
children and support for
orphans.
The programme aims to address the gender dimension of treatment and adherence.
It enables men to become supportive partners and contribute effectively in care,
treatment and support, while taking an active role in reducing transmission. It also
plans to provide training on sexual and reproductive health (SRH) issues of people
living with HIV so as to equip them with skills to motivate others living with HIV to
address their SRH issues and access services. The RCC PACT programme aligns with
PFI's vision and mission by promoting positive prevention as an intervention to
avoid unintended pregnancies and reducing HIV re-infection and further
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PACT for Better Care and Treatment
The programme aims to
address the gender
dimension of treatment
and adherence. It
enables men to become
supportive partners and
contribute effectively in
care, treatment and
support, while taking an
active role in reducing
transmission.
transmission. It also promotes institutional delivery and aims to increase the quality
of life of PLHIV and people associated with them.
Care and support services are provided to PLHIV through DLNs and CCCs in 15
states of India – the six high prevalence states of Andhra Pradesh, Maharashtra,
Tamil Nadu, Karnataka, Manipur, Nagaland and the nine highly vulnerable states of
Uttar Pradesh, Madhya Pradesh, Rajasthan, Odisha, West Bengal, Chhattisgarh, Bihar,
Gujarat and Jharkhand. DLNs and CCCs provide care and support services to PLHIV
including treatment literacy, enhanced access to services, improved drug adherence,
tracking and retrieving missed and lost to follow-up on ART, referring and linking
them to various social security schemes.
The programme aims to:
Scale-up access to Antiretroviral Treatment, prophylaxis and treatment of
opportunistic infections to a minimum of 75% of PLHIV detected.
Strengthen care and support services to improve drug adherence to over 95%.
Build capacities and strengthen the public health system for mainstreaming and
long term sustainability of services.
Develop and strengthen the information system for quality control, monitoring and
evaluation of services.
Key activities during 2010-2011
The involvement of PLHIV networks and the services offered under the ACT and
PACT programmes implemented by PFI have made a difference to the lives of PLHIV
by providing them psycho-social support, treatment access, improved health,
reduced opportunistic infections and the courage to get on with their lives
productively. The DLNs established in both programmes were primarily focused at
the district level. Their operations have now been decentralised through a voluntary
peer outreach strategy. PFI has entered into direct agreements with over 200 DLNs.
Support net groups of PLHIV have been established at the sub-district levels. In
selected taluks/blocks, DLN staff identified potential and motivated PLHIV who are
willing to voluntarily support the outreach activities. These support net groups
provide psycho-social support to PLHIV at the community and household levels and
link them to care and support services as per their requirements. Efforts are made to
encourage the participation of women as peer educators. As of March 2011, 1,091
support nets were formed at the sub-district level in nine states. These support nets
contacted 24,201 PLHIV at the household level and motivated 7,221 of them to
undergo initial assessment for ART eligibility centres. A total of 737 individuals have
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PACT for Better Care and Treatment
been trained in peer education by Enable Health Society.
The support net groups also link the voluntary members
to various social security schemes and help them establish
and run micro-credit programmes for the sustainability of
PLHIV groups and individuals.
HIV infected and affected children less than 15 years of age
are provided formal school education support. A total of
6,124 children had been provided one time school support
through the DLNs till March 2011 against a target of 6,900.
As part of the scheme, school books, bags, stationery and
uniforms were provided to the children.
Sensitisation and coordination meetings were organised at
the district and sub-district/block levels by the DLNs to share
and discuss access to health and social security schemes and
improving linkages and referrals. The participants include key
functionaries from integrated counselling and testing
centres (ICTC), PPTCT, Integrated Child Development
Scheme (ICDS), lead NGOs working in the field of health and
social welfare, and Panchayat Raj Institution members.
Counselling for ART
Community care centres (CCCs) provide outpatient and
inpatient treatment, care and intensive counselling for those
patients on ART, including the monitoring of initial side effects. These services have
been found to be critical for the successful initiation of ART. In addition, CCCs also
follow-up with those ART patients who don't return for their subsequent visits. As
pre-ART work takes two to four days on an average, the CCCs help the PLHIV and
their companions from incurring high out-of-pocket expenditure on lodging and
food. A total of 31,169 PLHIV were provided care and support services through 78
CCCs set up across the nine highly vulnerable northern states of India.
PFI conducted the evaluation of the Round 4 and Round 6 programmes
implemented from April 2005 to March 2010. The evaluation design and tools were
developed under the guidance of the Technical Resource Group (TRC) set up by PFI
for its operations research and programme evaluation activities. The evaluation acts
as a baseline for the RCC programme.
Data collection has been completed in 45 districts covering a sample of 7,941
PLHIV. The study is expected to provide information on certain key indicators
among PLHIV such as contraceptive prevalence rate, fertility rate, condom
usage, hospitalisation rate, ART adherence rate and disclosure status.
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PACT for Better Care and Treatment
A management information system (MIS) has been developed to capture the
activities implemented at the service delivery points. The MIS for CCCs was
developed in coordination with NACO and the Karnataka Health Promotion Trust
(KHPT) while the DLN component has been developed by PFI. The programme
management unit of PFI provided MIS training on the DLN component for state and
regional teams in January 2011. In February 2011, these trainers trained the staff of
211 DLNs in their respective states. Training of trainers on CCC MIS was also
conducted for the state and regional teams of PFI, HLFPPT and CBCI in March 2011.
The story of a Peer Educator
Penary is a 37-year-old hardworking woman from a remote village called Chakpikarong in Sugnu,
Manipur. Her husband is a daily wage earner. Both of them are HIV positive and are on ART since
2007. They have a daughter and a son.
After their neighbours found out their HIV positive status, they stigmatised and discriminated against
them and their children At that point, Penary decided to stop taking her medicines as she had lost
the desire to live. She joined a faith-based religious healing centre far from her village. She lived there
for about seven months.
In 2008, the staff of Sugnu DLN contacted her and urged her to participate in its activities. With the
psychological support provided by the DLN staff, she restarted her treatment and started gaining
confidence. Now she discloses her status openly and is able to share her experiences in meetings and
forums.
Penary became the leader of Ibumpe support net formed under the RCC PACT programme. This
group consists of 12 women, of whom 11 are on ART. These women are from different villages and
come together twice a month at a particular village for the meetings. The group members cultivate
peas on land owned by one of the members. These women have also helped identify people who are
infected but have not declared their positive status. The group is helping people like them to come
out and live with dignity.
Penary also attended the master peer educator training in February 2011 and she now plans to train
the support net members of Sugnu DLN on HIV/AIDS. She has become an active peer educator of the
DLN and has advocated HIV/AIDS issues with village chiefs and church leaders.
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|Health of the Urban Poor Programme|
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Developing Affordable Quality Health Care
The quality of lives of
the urban poor can be
made better if the
underlying health
determinants (water,
sanitation, nutrition and
hygiene) are improved.
Hence, the project
emphasises institutional
convergence of various
schemes and
programmes...
As per the 2011 Census, 377.1 million people reside in urban areas of the country, of
whom around one-fourth live in slum and slum-like conditions. The urban poor are
vulnerable to health risks as a consequence of living in a degraded environment,
with inadequate and limited access to quality health care, irregular employment and
widespread illiteracy.
With the declining status of urban health, and the emerging need to increase efforts
to strengthen primary health initiatives in urban areas, PFI entered into a partnership
with USAID India in October 2009 to start a comprehensive urban health project –
Health of the Urban Poor (HUP). HUP is supported through a bilateral grant
approved by the Department of Economic Affairs, Government of India (GoI), and
Ministry of Health and Family Welfare. It is being implemented by a PFI-led
consortium, which includes Plan-India, IIHMR-Jaipur, Bhoruka Charitable Trust, Care-
India, CEDPA, Micro Insurance Academy and the International Institute for
Population Sciences (IIPS), Mumbai, as partners.
Through HUP, PFI reinforces its commitment to focus on the un-served and under-
served areas and the vulnerable sections of society. The programme envisages the
development of a responsive, functional and sustainable urban health system that
provides need-based, affordable and accessible quality healthcare and improved
sanitation and hygiene for the urban poor in eight states – Bihar, Chhattisgarh,
Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh, and
five cities – Agra, Bhubaneswar, Delhi, Jaipur and Pune.
The programme will:
Provide quality technical assistance to the GoI, states and cities for effective
implementation of the proposed National Urban Health Mission (NUHM).
Expand partnerships in urban health, including engaging the commercial sector
in public-private partnership (PPP) activities.
Promote the convergence of different GoI urban health and development efforts.
Strengthen evidence-based, city-level demonstration and learning efforts to
improve programme learnings.
HUP will help in influencing governance at various levels. For example, through three
city demonstration and learning models, it will help the city governments (local self
governance institutions and other line departments) to improve evidence-based
planning, supportive supervision, emphasise on process and outcome monitoring,
and engage the community in planning, monitoring and management of resources.
HUP will transfer these skills to the government bodies and local civil society
organisations by way of technical assistance and capacity building.
The quality of lives of the urban poor can be made better if the underlying health
determinants (water, sanitation, nutrition and hygiene) are improved. Hence, the
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Developing Affordable Quality Health Care
project emphasises institutional convergence of various
schemes and programmes implemented by the Ministry
of Urban Development (MoUD), Ministry of Housing and
Urban Poverty Alleviation (MoHUPA) and Ministry of
Health and Family Welfare (MoHFW) such as the
Jawaharlal Nehru National Urban Renewal Mission,
Swarn Jayanti Shahri Rojgar Yojana, Rajiv Awas Yojana,
the Integrated Child Development Scheme (ICDS) and
the proposed NUHM.
PFI has taken the overall responsibility for coordination
among all the agencies in the consortium to ensure
quality of deliverables. PFI is also responsible for
meeting contractual and technical obligations, project
monitoring and reporting, and overall management of
the cooperative agreement. It is also managing the
Bhubaneswar, Delhi and Agra sites.
Key activities during 2010-2011
National consultation on NUHM organised in collaboration with MoHFW, MoUD,
MoHUPA and state governments in July 2010. The consultation provided a wider
perspective on implementation approaches of the proposed NUHM.
• Consultation organised at MoHFW to discuss the strategy of communitisation
under the proposed NUHM in November 2010.
• HUP team has been a part of various small group consultations organised under
the chairmanship of Joint Secretary (Policy) to finalise the contours of NUHM
implementation framework and has contributed to preparing the NUHM budget.
• Reviewed the urban RCH component of programme implementation plans for all
35 states and UTs.
• State teams (Odisha, Jharkhand and Madhya Pradesh) provided technical
assistance to prepare state PIPs (2011-2012).
• Participated in the fourth common review mission of the MoHFW in Odisha,
Maharashtra and Chandigarh.
• Three thematic studies are being conducted as per MoHFW suggestion:
s the disease burden in urban areas.
s promising PPP practices on urban health.
s review of existing behaviour change communication materials on
maternal and child health to determine their relevance in urban areas.
• Baseline survey and facility assessment process has been initiated by IIPS in the
three demonstration cities – Bhubaneswar, Jaipur and Pune.
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financial highlights
INCOME
Particulars
2009-10
Rs.
(in lakhs)
Interest/Dividend/Gains on Investments/Misc. Receipts 244.11
Rent for Premises
531.37
Grants in aid – International Agencies
4629.16
Grants in aid – National Agencies
132.87
Total
5537.51
2010-11
Rs.
(in lakhs)
160.52
543.82
3610.52
124.93
4439.79
EXPENDITURE
Particulars
Programme Grants – Own Funds
Project Implementation Expenses
Management & Admin. Expenses
Grants in aid – International Agencies
Grants in aid – National Agencies
Total
2009-10
Rs.
(in lakhs)
207.26
81.17
83.11
4629.16
132.87
5133.57
2010-11
Rs.
(in lakhs)
288.23
148.28
211.71
3610.52
124.93
4383.67
ASSETS
Particulars
Fixed Assets
Investments
Dividend/Interest Receivable on Investments
Cash & Bank Balances
Sundry Deposits
Advances (Unsecured but considered good)
Total
2009-10
Rs.
(in lakhs)
108.91
2496.66
58.44
858.57
1.34
21.20
3545.12
2010-11
Rs.
(in lakhs)
116.44
2645.69
24.28
1879.19
1.46
18.84
4685.90
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ANNUAL REPORT / 2010-2011
financial highlights
LIABILITIES
Particulars
Corpus Fund
Society Fund
Project Grants – International Agencies
Project Grants – National Agencies
Current Liabilities & Provisions :
– Current Liabilities
– Provisions
Total
2009-10
Rs.
(in lakhs)
500.00
2227.35
693.90
65.72
3.25
54.90 58.15
3545.12
2010-11
Rs.
(in lakhs)
500.00
2283.48
1485.45
69.36
293.41
54.20 347.61
4685.90
DOMAIN-WISE EXPENDITURE FOR PROJECTS/PROGRAMMES
(Rs. in lakhs)
Sr.
Projects/Programmes
No.
2009-2010
Rs.
%
2010-2011
Rs.
%
1
Policy Research & Studies
65.70
1.32
32.00
0.80
2
Advocacy & Communication
108.06
2.17
29.40
0.73
3
Reproductive & Family Planning Projects
299.05
6.02
389.20
9.67
4
Scaling-up
44.85
0.90
84.62
2.10
5
Health of the Urban Poor
49.34
1.00
454.39
11.29
6
HIV/AIDS
4402.28
88.59
3034.06
75.41
Total
4969.28 100.00
4023.67 100.00
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ANNUAL REPORT / 2010-2011
PUBLICATIONS during the year
National Conference on Scaling Up in India: Lessons Learnt and the Way Forward
The publication is a documentation of the National Conference on Scaling Up in
India: Lessons Learnt and Way Forward organised on April 19, 2010 at India Habitat
Centre, New Delhi with support from the Planning Commission and in collaboration
with Management Systems International (MSI) and the MacArthur Foundation. The
objectives of the conference were to share experiences from health and other social
sectors on scaling up within government and non-government systems and develop
a vision and strategy for scaling up social sector programmes in India.
Population, Health and Social Development: Western and North-Central Regions
PFI organised three regional conferences covering the eastern, western and north-
central regions, to commemorate its fortieth year. The conferences aimed to get a
clear perspective on the demographic transition process of the regions in order to
draw attention to the reproductive health issues, effective strategies to address
them and to recapitulate initiatives by the state governments and civil society.
Documents on population, health and social development, along with wall charts
providing a graphic display of key health and population issues, were prepared for
each conference. The documents depict state and district profiles with data on
population, health and selected social development issues of the regions.
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ANNUAL REPORT / 2010-2011
Publications during the year
Fundamentals of Accounting: A Manual for NGOs
The manual provides information on basics of accounting, provisions in the Income
Tax Act and the Foreign Contribution and Regulation Act (FCRA). The first edition
of the manual was printed in 2007. The second edition has been printed based on a
demand from the NGO sector, especially from the states of Bihar and Chhattisgarh.
The manual enables NGOs to learn and incorporate financial management systems
for effective programme implementation.
Consultation Workshop on National Urban Health Mission
The publication documents a day-long consultation workshop on National Urban
Health Mission (NUHM) organised jointly by the ministries of Housing and Urban
Poverty Alleviation (HUPA) and Health and Family Welfare (H&FW) in July 2010 in
New Delhi. Key recommendations from the workshop are included.
Factsheets for Urban Poor
A series of eight factsheets on the urban
poor in India and the states of Maharashtra,
Madhya Pradesh, Rajasthan, Uttar Pradesh,
Bihar, Jharkhand and Delhi, were prepared
with support from USAID. Each factsheet
depicts information on marriage and
fertility, maternal health, child health and
survival, family planning, environmental
conditions, infectious diseases, access to
health care, education, religion, caste/tribe
and more. The factsheets are a compilation
of data from the NFHS-2 and NFHS-3.
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ANNUAL REPORT / 2010-2011
OUR team
DELHI OFFICE
Ms. Poonam Muttreja
Dr. Arundhati Mishra
Ms. Bharti Prasad
Dr. Phanindra Babu
Dr. Sainath Banerjee
Dr. Subrato K. Mondal
Dr. K. K. Upadhyay
Dr. Rashmi Pachauri
Dr. Sharmila Ghosh Neogi
Ms. Sona Sharma
Ms. Shipra Saxena
Mr Surendra Singh
Mr. C. S. N. Murthy
Md. Raza Ahmed
Ms. Aparna G.
Mr. Nihar Ranjan Mishra
Ms. Sindhu Nambiath
Mr. Sunil Kumar
Mr. Milan Rana
Mr. Bijit Roy
Ms. Parul Sharma
Ms. Jayati Sethi
Ms. Monica Sahni
Mr. Shahid Ansari
Dr. Swati Mahajan
Dr. Lalitendu Jagatdeb
Ms. Varsha Sharma
Ms. Rajani Gupta
Ms. Manju Sharma
Ms. Richi Dhillon
Mr. Amit Kumar
Mr. Sunil Kumar Singh
Ms. Tripti Chandra
Mr. Neeeraj Mishra
Executive Director
Additional Director
Director (Finance and Administration)
Project Director (Global Fund HIV/AIDS programme)
Chief of Party (Health of the Urban Poor programme)
Director – Knowledge Management and
Research (HUP)
Senior PPP Specialist (HUP)
Senior Advisor (Scaling Up)
Joint Director (Programme Development)
Joint Director (Advocacy and Communication)
Water Supply and Sanitation Specialist (HUP)
HR Manager
Manager (Finance)
Senior Programme Manager (GF)
Senior SIE Manager (GF)
Programme Manager (Monitoring & Evaluation)
Programme Manager (Scaling Up)
Grants Manager (GF)
Admin. and Finance Manager (GF)
Programme Officer (Community Action)
Programme Associate (PD)
Programme Associate
Manager Finance and Administration (HUP)
Grants Manager (HUP)
Demonstration Officer (HUP)
MIS Manager (HUP)
Communication and Advocacy Manager (HUP)
Finance Officer (HUP)
Procurement Officer (HUP)
HR & Admin. Executive (HUP)
Grants Officer (GF)
Admin. and Procurement Officer (GF)
Senior Programme Associate (GF)
Senior SIE Associate (GF)
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ANNUAL REPORT / 2010-2011
our team
DELHI OFFICE
Mr. Shariq Jamal
Mr. Javed Hasan
Ms. Debamitra Bhattacharya
Mr. Pradeep Sangwan
Mr. Sanjeev Ranjan
Ms. Leelamma Mathew
Ms. Chhaya Devi Gupta
Ms. Mithilesh Yadav
Ms. Veena Gopal
Ms. Prema Ramesh
Ms. Jolamma Jose
Ms. Usha S. Nair
Mr. Rakesh C. Joyal
Mr. Shailender S. Negi
Mr. P. K. Paul
Mr. Joseph George
Mr. K. Venkatachalam
Mr. Vijaya Reddy
Mr. Arogya Das
Mr. Mohan Singh
Mr. P. Narayanan
Mr. Shyam Lal
Mr. Ram Narayan
Mr. Gourav Sindhi
Ms. Kanta
Mr. Nar Bahadur Thapa
Mr. Kamlesh Kumar
Mr. Sanjay Ekka
Mr. Vijender Kumar
Programme Associate (GF)
Programme Associate (GF)
Programme-cum-Documentation Associate (GF)
SIE Associate (GF)
Accounts Officer (GF)
Accounts Officer
Accounts Officer
Accountant (GF)
Personal Secretary to ED
Senior PA cum Programme Assistant
PA cum Programme Assistant
Receptionist cum Telephone Operator
Librarian
System Administrator
General Maintenance Executive
Library Assistant
Assistant Maintenance Up Keep
Driver (ED)
Driver (GF))
Messenger (HUP)
Messenger
Messenger
Messenger (GF)
Messenger (GF)
Pantry Attendant
Messenger (HUP)
Gardner
Helper/Cleaner
Helper/Cleaner
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ANNUAL REPORT / 2010-2011
state AND regional team offices
Dr. K. Venkata Rao
Andhra Pradesh
State Coordinator (GF)
Population Foundation of India
Plot No. 14 – B, Gandhian School Street
Vasavinagar – B, Picket
Secunderabad – 500015
Tel: 040-65999770
pfiapsco@yahoo.com,
pfiapsco@gmail.com
Mr. Matish Kumar
Mr. Pritam Prasun
Mr. Sudhir Kumar
Bihar
State Coordinator
Programme Officer (ASHA Training)
Project Associate (Admin & Finance)
Population Foundation of India
123-A (First Floor), Pataliputra Colony
Patna-13, Tel: 0612-2270634
Mr. Jagannath Kompella
Chhattisgarh
Training Coordinator (RRC)
Population Foundation of India
C-5 and C-6, Sahni Vihar
Raipur-492006, Tel: 0771-4013065
Mr. Vivian S. Correa
Karnataka
State Coordinator (GF)
Population Foundation of India
1657/A, Saurabha Building
3rd Cross, Prakash Nagar
Bangalore-560021, Tel: 080-41279018
karnatakapfi@gmail.com
Ms. Achint Verma
Mr. Tapas Kumar
Ms. Mini Ramachandran
Mr. Anujesh Mathur
Mr. Rambir Singh Sikarwar
Mr. Prabhu Nath Mishra
Mr. Chanchal Sur
Mr. Raghuvir Singh Sood
Madhya Pradesh
Regional Coordinator (GF)
State Coordinator (GF)
Asst. State Coordinator (GF)
Project Director (HUP)
Convergence Advisor (HUP)
Finance & Admin. Officer (HUP)
MIS Officer (HUP)
Support Staff (HUP)
Regional Office:
Population Foundation of India
E – 1/119, Arera Colony
Bhopal - 462016
Tel: 0755-2429787/0755-4008895
pfi.madhyapradesh@gmail.com
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ANNUAL REPORT / 2010-2011
state AND regional team offices
Mrs. Rohini Gorey
Ms. Vijaya P. Kanase
Maharashtra
Regional Coordinator (GF)
State Coordinator (GF)
Population Foundation of India
214, 2nd. Floor, Raiker Chambers
Govandi
Mumbai-400088
Tel: 022-65029710
mahapfi@gmail.com
Ms. Archana Oinam
Mr. Yumnam Sanjoy Singh
Manipur
State Coordinator (GF)
Asst State Coordinator (GF)
Nagaland
Ms. Veswukholu Everista Kapu State Coordinator (GF)
Mr. R. Vitsiatho Nyuwi
Asst State Coordinator (GF)
Population Foundation of India
Saga Road, Thouda Bhabok Leikai
(Near Royal Sound)
P. O. Imphal- 795001, Imphal West
Tel: 0385-2445072
pfimanipur@rediffmail.com
Population Foundation of India
OC-15,2nd. Floor, Naga Shopping Arcade
Near Town Hall, Dimapur – 797112
Tel: 03862 – 234009
popfound_nagaland@yahoo.co.in
Mr. Smarajit Chakraborty
Mr. Sukanta Kumar Mishra
Ms. Biraja Kabi Satpathy
Dr. Hrudananda Mohanty
Mr. Shekh Nausad Akhtar
Mr. Partha Roy
Mr. Basudev Panda
Mr. Ranjit Kumar Nayak
Mr. Dinesh Kumar
Odisha
Project Director (HUP)
PPP Specialists (HUP)
Water Supply and Sanitation
Specialist (HUP)
Convergence Officer (HUP)
MIS Officer (HUP)
City Coordinator (HUP)
Documentation Officer (HUP)
Finance and Admin. Officer (HUP)
Support staff (HUP)
Population Foundation of India
M-76, Madhusudan Nagar, Unit – 4,
Bhubaneswar
Odisha – 751 001
Tel: 0674 - 2392595
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ANNUAL REPORT / 2010-2011
state/regional team/offices
Rajasthan
Mr. Ramesh C. Parmar
Mr. Subhash Kumar Sharma
Regional Coordinator (GF)
Asst. State Coordinator (GF)
Mr. K. Balasubramanian
Mr. D. Alwin Leone Das D
Tamil Nadu
Regional Coordinator (GF)
State Coordinator (GF)
Mr. Salim Khan
Mr. Ashish Kumar Amber
Mr. Surojit Chatterji
Mr. Dipankar Barkakati
Mr. K. P. Singh
Ms. Ratna Khare
Uttar Pradesh
Regional Coordinator (GF)
State Coordinator (GF)
Project Director (HUP)
Water Supply and Sanitation
Specialist (HUP)
Convergence Advisor (HUP)
Documentation and Advocacy
Officer (HUP)
Mr. Rajeev Kumar Singh
Mr. Deepak Ranjan Mishra
West Bengal
Regional Coordinator (GF)
State Coordinator (GF)
Regional Office:
Population Foundation of India
Plot No. 66, Geejgarh Vihar
Hawa Sadak, Jaipur – 302019
Tel: 0141-2210680
pfirajasthan@gmail.com
Population Foundation of India
Old No. 89, New No. 109
South West Boag Road,
T. Nagar
Chennai - 600017
Tel: 044-24329074
pfichennai@gmail.com
Population Foundation of India
(HUP Office), 11, Krishna Colony,
Behind Fatima Hospital
Mahanagar, Lucknow – 226006
Tel: 0522 – 3920490
Regional Office:
A-743, Ground Floor, Indira Nagar
Lucknow-206016
Tel: 0522-2353838
pfiuttarpradesh@gmail.com
Regional Office:
Population Foundation of India
AE–191, Sector 1, Salt Lake
Kolkata-700064
Tel: 033 – 40679066
pfikolkata@gmail.com
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