Focus 2006 January-March English

Focus 2006 January-March English



1 Pages 1-10

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1.1 Page 1

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The Regional Resource Centre - The Recent Activities
The Population Foundation of
India is the Regional Resource
Centre (RRC) of the Government
of India, in Bihar and Chhattisgarh.
The role of the RRCs is to provide
technical support to Mother NGOs
(MNGOs) for the implementation of
RCH initiatives and to enhance the
quality of service delivered by
stakeholders.
On January 23, 2006, the RRC
organized a workshop on the
development of project proposals
for the 12 MNGOs of Bihar, in
Patna, for grant-in aid under the
RCH II programme and the
National Rural Health Mission
(NRHM). The workshop was for
formulating project proposals to be
developed for the unserved/
The Chief Minister of Bihar Shri Nitish Kumar addressing the State Health
officials and NGOs at the GO-NGO workshop.
The Chief Minister of Bihar Shri Nitish Kumar and the Health Minister 0/ Bihar
Shri Chandra Mohan Rai at the inaugural session of the workshop on GO-NGO
partnership.
The Regional Resource Centre -
The Recent Activities - 1
Advocacy Initiatives on Population and
Development - 3
Project Activities of the Regional Training
and Resource Development Centre - 4
A Busy Schedule for the Global Fund
Round 4 Programme on HIV/ AIDS - 5
The Parivar Kalyan Sansthan and the
Tata Steel Family Initiative Foundation - 6
Health Centre in Rajasthan to
the Rescue - 7
Saving Lives in Rajasthan - 8
The Prem Jyoti Community Health and
Development Project, Jharkhand - 9
India to Host the 4th Asia Pacific
Conference on Reproductive and
Sexual Health in 2007 - 10
From the Executive Director's Diary - 12
Forthcoming Events - 12

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Model Interventions in Reproductive Health - Scaling up
The Population Foundation of India strives to promote more effective
formulation and implementation of population and development
policies, strategies and programmes in India. The Foundation funds its
own innovative projects as well as helps projects being implemented by
others by providing training, monitoring and evaluation and advocacy work.
Despite the fact that donors, including the Population Foundation of India,
are providing financial and technical support to NGO implemented projects
and the Government has established an extensive health care delivery
system and specific policies to improve reproductive health outcomes, the
reproductive health indicators in India remain unacceptable with high levels
of maternal and infant mortality. The Government of India has recognized
that unless greater efforts are made, India will neither be able to achieve
its own socio-demographic goals of the National Population Policy, nor
those milestones incorporated in the Millennium Development Goals.
The Government of India(GOI) has created several new programme
frameworks, like the RCH II and the National Rural Health Mission.
As part of these efforts, the GOI is actively trying to integrate programmes
from NGO implemented model interventions into its efforts and strategies
and to use relevant NGOs as implementing organizations in public-private
partnerships. At the same time there are many NGOs which have
successfully piloted innovative model interventions and are keen to see
these adopted by the Government or other NGOs and implemented on a
large scale. There is a demand and supply in terms of successful model
interventions in reproductive health but the convergence is restricted due
to various reasons, such as lack of skills, capacity and resources to (a)
prepare their models for going to scale (b)conduct the necessary advocacy
work to get formal adoption (c) transfer their models and help with
implementation. Most of the NGOs implementing innovative models need
an intermediary to bring together the two parties.
The Population Foundation of India would like to fillthis gap, and play the
role of an intermediary, in taking the NGO model interventions to scale.
It would like to identify and evaluate model interventions which show
potential, help the implementing NGOs to prepare themselves for going
to scale by providing assistance with impact evaluation, documentation,
assessment of cost and cost effectiveness. The PH plans to organize and
facilitate planning workshops to design strategies for getting adoption and
implementation; implement scaling up strategies in partnership with NGOs
including advocacy work and coalition building; work on public relations
and communications to achieve adoption; assist in developing materials
to transfer the model to adopting organizations; help in successful
implementation through training and capacity building and create and
convene a multi-stakeholder forum on how scaling up of pilot reproductive
health projects can be used for greater impact. The PH would endeavour
to have one or more NGO model interventions in reproductive health
implemented on a larger scale by the national and state governments.
The models that the PH has identified as potential candidates for scaling
up have shown significant reductions in maternal and infant mortality,
improvements in the age of the first delivery of married adolescent girls
and child spacing, improved rates of child immunization and increased
use of family planning commodities and services. As these models are
applied on a larger scale, it is hoped that the same outcomes would be
achieved in terms of lives saved, illnesses averted and quality of life
improved.
fbcus
underserved areas in Bihar, where
gaps have been identified by the
District Health Society.
In collaboration
with the
Government of Bihar, the RRC
organized a two day thematic
workshop on the issue of 'Planned
Parenthood'
at Patna, in
December, 2005. Subsequently,
regional thematic workshops were
organized for MNGOs, Field
NGOs (FNGOs), other NGOs and
government functionaries in
Muzaffarpur and Patna on
February 23, 2006 and March 4,
2006, respectively. The workshops
were inaugurated by the respective
Chief Medical Officers of the two
districts. The organization 'Ipas'
participated at the workshops and
disseminated information on safe
abortions and other issues related
to planned parenthood.
The RRC in Chhattisgarh has
developed guidelines for the
preparatory grant-in-aid from the
state government. The guidelines
were ratified during a consultative
meeting with the Government and
8 MNGOs of Chhattisgarh, An
action plan with a time line for the
MNGOs was proposed at the
meeting. Since then, the RRC has
organized four regional workshops
on the prevention of maternal
deaths through institutional delivery
and the paradigm shift to "skilled
birth attendants" as opposed to
"trained birth attendants", in the
state. All the districts of the state
were represented
by their
respective Chief Medical Officers
(CMOs), Block Medical Officers
(BMOs), and functionaries of
the Primary Health Centres.
A workshop for the northern
districts was held on March 1,
2006, at Ambikapur in the Sarguja
district, at Bilaspur in Bilaspur
district on February 27, 2006, for
the north-central districts, at Durg
in Durg district, on February 17,·
2006, for the south- central districts

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Advocacv Initiatives on Population and Development
The advocacy project titled
"Building Supportive Environ-
ment for Young Adults'
Reproductive and Sexual Health",
supported by the Packard
Foundation is a three year project
in Bihar and Jharkhand.
The initiative focuses on advocacy
intervention with stakeholders
through sharing. The aim of the
project is to primarily promote the
participation of young adults at the
community level. It also attempts
to provide inputs to both
governmental
and non-
governmental fora. As part of the
initiatives of this project, block level
workshops were organized in two
selected districts - Gaya and
Vaishali. The basic objective of the
workshops was to share the
primary level information on young
peoples' issues and possible
solutions. A total of 37 block level
workshops were organized in
collaboration with 16 local NGOs.
Participants at these workshops
comprised adolescents, parents,
government officials, primary
health centre (PHC) doctors, health
workers, representatives of the
Integrated Child Development
Services (lCDS), members of the
Hon'ble Speaker of the Bihar Legislative Assembly, Shri Uday Narayan Choudhury,
inaugurating the Block level workshop at Imamganj, Gaya district.
Panchayati Raj Institutions (PRI),
teachers, media persons and elected
representatives.
The Hon'ble
Speaker of the Bihar Vidhan Sabha,
Mr. Uday Narayan Choudhury,
inaugurated the workshop at the
Imamganj Block of Gaya district.
The workshop at Vaishali was
inaugurated by Mr. Chandra Mohan
Rai, Health Minister, Bihar.
Engineer Ajit Kumar, Road
Transport Minister, Bihar presided
over the block level workshop at
Goraul block of Vaishali district.
The workshops provided a good
opportunity for various stake-
holders to share important
information on young peoples'
issues. The participants at all the
workshops drew up a number of
recommendations for improving the
current situation. It is .hoped that
these recommendations would
provide a basis for formulating the
District Plan of Action for young
people. The major findings of the
preliminary study and the
recommendations of participants
are compiled by the PFI YARSH
Team in Bihar.
The workshop on Population, Health & Media at Karim City College,
Jamshedpur, in progress.
The NGOs which helped in orga-
nizing the work-shops were (1)
Mahila Bal Jyoti Kendra, Patna (2)
Pragati Founda-tion, Vaishali (3)
Poor Urban and Rural Women's
Association, Patna (4) Gram Swaraj
Abhiyan San-sthan, Vaishali (5)
Adarsh Mahila Kalyan Kendra,
Gaya (6) OSERD, Patna (7) ARPAN
Gramin Vikas Samiti, Patna
(8)Mahila Vikas Samiti, Nawada (9)
Jan Jagl'an Sansthan, Gaya
II

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Project Activities of the Regional Training and
Resource Development Centre IRTRDC)
- The End line Findings
fbcus
The Population Foundation of
India had set up Regional
Training
and
Resource
Development Centres (RTRDCs)
with various NGOs/institutions in
various states for the purpose of
capacity building of small NGOs,
through a group of master trainers
who would in turn train the
implementing
partner NGO
personnel with the technical
support on planning, goal-setting,
resource mobilization
and
implementation of Reproductive
and Child Health (RCH)
programmes. Thirteen RTRDCs
had been set up in ten states of
India.
In coordination with the Population
Research Centre (PRC) and the
Mohanlal Sukhadia University,
Udaipur, the PFI established one
such centre in Rajasthan, for a
period of four years. The project
has been completed and an
evaluation has since been carried
out. Quite a few interesting facts
came to light as a result of the
evaluation.
At the Training of Trainers
programmes, a total of 30 persons,
have been trained as Master
Trainers. These persons include
social scientists, medial practi-
tioners, PRC research staff and
project staff. The RTRDC has so
far conducted 30, five-day
programmes for NGOs, located in
southern Rajasthan. A total of 709
representatives from 364 NGOs
from nine districts - Udaipur,
Chittorgarh, Rajsamand, Banswara,
Dungarpur, Sirohi, Jaipur, Pali and
Shikhar - were trained on the issues
of Reproductive and Child Health.
Out of the NGOs which participated
at the training programmes, the
maximum number of NGOs were
from Udaipur district while the
lowest number of NGOs were from
Sirohi, Jaipur, Pali and Shikhar ..
More than 80% of the participants,
(two thirds of which were males)
representing NGOs were in the age
group of 25 years and above.
The educational profile of the
participants was that while 66%
of them were graduates, only
24% had post graduate quali-
fications. Both pre-training and post
training assessments were shared
with the participants.
Four hundred NGOs located in
southern Rajasthan are currently
implementing RCH programmes.
However, 1500 NGOs are
interested in implementing the
programmes. Varied activities are
being carried out by the different
NGOs. Educational activities are
being done by most of the NGOs.
Workshops, seminars and camps
on RCH were organized by 13%
of NGOs, training programmes
were conducted by 11 % of the
NGOs in their respective areas of
work, while 27% of them organized
health melas and IEC programmes
on RCH. Most of the NGOs
distributed, free of cost, contra-
ceptives, medicines, Information,
Education & Communication
(IEC) materials, at the health melas.
They also organized free medical
check up camps at schools and
in villages and actively participated
in polio immunization programmes.
Four follow up workshops were
conducted by the PRC, the
implementing agency, at which
240 NGO representatives
participated. The workshops
received good attention of the
media.
To gauge the impact of the training
programmes, six selected NGOs,
were visited and their work
observed .. It was found that the
major activities in which the NGOs
have been involved after the training
are: establishment of Adolescent
Counselling Centres; organization
of health camps/ group meetings,
awareness programmes
on
HIV / AIDS, and on Vitamin A;
development of IEC material;
IEC on RCH/Family Planning/
Community Health Issues; Training
of Trainers for Panchayati Raj
Institutions and executives at the
district level; training on income
generation activities through
small scale industries; training
programmes on midwifery - 'Dais';
formation of women's cooperative
societies and self help groups;
participation at Pulse Polio
programmes and organization of
programmes on service delivery with
regard to RCH and other related
issues.
The evaluation suggests that
training programmes should be
organized from time to time on a
regular basis to motivate NGOs to
remain involved in RCH activities.
To enable them to implement
programmes effectively, it is
important that they are equipped
with the requisite infrastructural
facilities. The two limitations which
surfaced during the endline
evaluation were that the Master
Trainers residing in Udaipur district
were not available for training
programmes in other districts
and that residential training
programmes could not be organized
due to lack of facilities for the
purpose.

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A Busv Schedule for the
Global Fund Round 4 Programme on HIV/AIDS
- Access to Care & Treatment
focus
The year 2006 brought in it's
wake a flurry of activity for the
Global Fund Round 4 Programme
on HIV/AIDS "Access To Care &
Treatment" team. A three day
orientation training programme
on Management Information
Systems (MIS) was conducted at
Manipur on January 16-18, 2006.
Mr. Phanindra Babu, Programme
Manager (MIS), of the Programme
Management Unit at PFI, was the
resource person at the training
programme. Team members from
the district level networks and
Manipur Networks of Positive
People (MNP+), participated at the
programme.
The second coordination meeting
with the National AIDS Control
Organization (NACO) was held at
the Population Foundation of India,
on January 16, 2006. Represen-
tatives from the UNICEF, UNAIDS,
the PH and the Core sub-grantees
of the Global Fund Programme,
participated at the meeting, which
was chaired by Ms Sujatha Rao,
Additional Secretary, Health
Ministry, and Director General of
the NACO.
The Country Coordination
Mechanism (CCM) meeting for the
Global Fund Programme took place
on January 18, 2006 at the Ministry
of Health, Nirman Bhawan.
Mr. P.K. Hota, Secretary Health,
chaired the meeting. Mr.A.R.
Nanda, Executive Director, PFI, was
a special invitee to the meeting.
The State Coordination Committee
meeting with the Tami! Nadu State
AIDS Control Society was held on
January 18, 2006, followed by the
meeting with the Karnataka State
AIDS Control Society on January
28, 2006. The sub-grantees of the
Global Fund were represented at
the meeting.
A two day orientation training
programme on Programme and
Management Information Systems
(MIS) was conducted in Nagaland
on February 6-7, 2006. Ms. Rashmi
Sharma, Programme Associate,
and Ms. Aparna G, M&E Associate
with the Programme Management
Unit at the PFI, were the resource
persons at the training programme.
Participants included team members
from the District Level Networks
and the Nagaland Networks of
Positive People (NNP+).
State level coordination meetings
were held with the State AIDS
Control Societies of Andhra
Pradesh, Manipur, Nagaland and
Maharashtra. A meeting of the
Project Advisory Board took place
on February 13, 2006. A review
meeting of the PH - Global Fund
Project Team was held at Pune on
February 21-24, 2006. The
objective of the meeting was to
review the progress of the project
and identify, in the process, gaps
and possible ways of filling these
gaps at the central and state levels.
The meeting concluded with a
summing up of all the issues related
to the Global Fund project and also
thoughts on the activities for the
second year of the project.
A number of meetings were held in
the month of March as well. On
March 13 and 14, 2006, a two day
coordination meeting with the
Indian Network of Positive People
(lNP+) was held at Chennai.
A meeting with the Engender
Health Society, and the INP+ took
place at the PFI on March 20,
2006.
The PFI office at Nagaland
coordinated a visit of the persons
of the Nagaland State AIDS Control
Society (SACS) to Tamil Nadu. The
visit was termed an 'exposure visit' .
Fourteen members of the Nagaland
SACS visited Namakkal, Tamil
Nadu, along with Mr. Visiatho
Nyuwi, Assistant State Coordinator,
PFI, for an 'exposure visit' to
Treatment Counselling Centres
(TCCs), District Level Networks
(DLNs) and Positive Living Centres
(PLCs). They also visited
Antiretroviral (ART) centres, the
International Training & Education
Centre on HIV and the Government
Hospital at Tambaram.
SYNOVATE made a presentation
of the formative phase of the
Operation Research studies, for the
Technical Resource Team at the
PH, on March 17, 2006. Operation
Research Studies on defining
palliative care and a basket of
services of the Comprehensive Care
and Support Centre and the
documentation of capacity building
institutions are in progress.
A team of two members of the
'Developing Country NGOs
Delegation, Global Fund for AIDS,
TB & Malaria visited the PH, at New
Delhi on March 23, 2006. The
delegation was led by Ms. Rita
Arauz Molina, Board Member of the
Global Fund.
Activities planned for the next few
months include a national
consultative workshop on palliative
care; preparation of the final reports
of the 4 Operation Research
studies; a review meeting of the PH
and the Global Fund team; initiation
of two more Operation Research
studies; an orientation programme
on Management Information
Systems (MIS)for the TCCs and the
DLNs; establishment of 4 TCCs
and strengthening of 22 DLNs;
establishment of 1 PLC to function
from Maharashtra; setting up of two
Certified Education and Training
Centres (CETCs) and one training
base for the north east by the
Engender Health Society; service
quality from two corporate
Antiretroviral (ART) Centres and
initiation of the Phase II planning
process.

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The Parivar Kalvan Sansthan and the Tata Steel Familv
InitiatiVe Foundation - An Endline Survey Brings UP the Success Stories .
The Parivar Kalyan Sansthan
(PKS) of Tata Motors and the
Tata Steel Family Initiative
Foundation (TSFIF) have been
implementing
projects on
Adolescent Reproductive and
Sexual Health (ARSH) issues since
the last two years, in the urban
slums of Jamshedpur, Jharkhand.
Each of the projects caters to a
population of 20000 adolescents
living in the slums. The projects had
as their objectives : providing sex
education through adolescent
reproductive health sessions in
schools and through 'kishore/
kishori groups, providing life skills
to increase their decision making
powers and negotiating skills,
promoting the use of condoms
amongst the youth, creating
awareness on sexually transmitted
diseases (STD) and HIV / AIDS,
promoting gender equality and
gender equity, creating responsibility
of child spacing and childbearing
amongst both males and females and
providing a wide range of
contraceptives, along with all the
requisite information through clinics.
The primary strategy involved a
combination
of adolescent
reproductive health (ARH) sessions
in schools and addressing out of
school adolescents through the
'peer approach'.
This was
complemented by Information,
Education, Communication (IEC)
activities by making services
accessible to the adolescents.
In order to assess the impact of the
projects, an endline survey was
recently carried out. What emerged
from the survey was that the ARSH
projects implemented by the PKS
and the TSFIF have been successful
in that:
• Both the organizations have
been successful in disseminating
information on ARH to
adolescents through ARH
sessions in schools and through
health melas and Nukkad
Nataks. Counselling by the field
workers and dissemination of
information through friends and
relatives have also been found
to be effective;
• The projects have been
successful
in achieving
awareness on gender equality
and in providing information on
the physical changes that take
place in boys and girls at
puberty;
• The reproductive health seeking
behaviour of adolescent girls has
improved;
• The projects had a positive
impact on the attitude of
unmarried males to marriage. It
has been found that 70% of
them would now like to get
married only after getting
employment and attaining
economic stability in life;
• The project has been successful
in generating awareness on the

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fOcus
Heahh Centre in Rajasthan to the Rescue ...
Based at a village called 'Luna',
in the Alsisar block in the
Jhunjhunu district of Rajasthan, a
health centre called 'Aapno
Swasthya Kendra, looks after
maternal and child health services
in 23 villages of the Block. The
centre is run by a non-profit
organization named 'Shikshit
Rojgar Kendra Prabandhak Samiti
(SRKPS) with support from the
Population Foundation of India, as
part of its RCH initiatives in
Rajasthan. This health centre which
has been functioning since May,
2005, is equipped to provide basic
maternal and child health services.
Two trained nurse midwives, Ms.
Suman Khalia and Ms. Vijaylaxmi,
along with other team members,
help in rendering these services.
The centre also takes care of several
critical conditions to ensure safe
deliveries. As they say, the proof
of the pudding is in the eating. In
this case, the proof lies in the fact
that the centre has till the end of
the year 2005, carried out 27 safe
deliveries at the centre and 10
home deliveries as well.
The story of a lady, Mrs. Sulochana,
in the context of the services
provided by the centre, deserves a
special mention. Married and
twenty five years of age, she is
mentally challenged and belongs to
one of the poorest families of the
village of Ladusar. In the first three
months of her first pregnancy,
complications arose in the form of
sudden bleeding. Unfortunately, on
account of her disability, she was
unable to take her family members
into confidence immediately. The
condition worsened and after two
days she was taken to the hospital,
where she went through an
abortion.
A couple of months later, she was
pregnant for a second time. This
time she was administered a
Tetanus Toxoid vaccine. One day,
in the afternoon, she experienced
abdominal pain, and within an hour,
was bleeding. Acting on the advice
of the members of the community,
she was rushed to the Aapno
Swasthya Kendra at Luna. An
examination of the patient by
Ms.Suman Khalia, one of the nurse
midwives at the centre; revealed that
due to premature labour pains the
amniotic membrane had already
ruptured and the time for the
delivery had arrived before the
expected time. Her family members
were informed by the nurse, that
there would not be enough time to
take her to the district hospital at
Jhunjhunu, which was a good 15
kilometres away from the centre.
Preparation for a delivery was made
but was rendered difficult as
Mrs. Sulochana was unable to
follow the instructions of the
midwife nurse, because of her
mental disability. All's well that ends
well, and a premature baby was
safely delivered in the evening. The
baby was blue and had a slow rate
of breathing at the time of birth. The
nurses at the centre consulted
Dr. Sharad and Kirthi Iyengar of
ARTH (Action Research and
Training on Health), Udaipur, on
telephone, and under their
directions, both mother and child
were treated for a return to healthy
normal conditions. Two hours after
the delivery, the baby was breast fed
and a couple of days later they were
discharged from the centre. Both
mother and child are now in fine
fettle, both in health and spirits.
methods of family planning.
Ninety three percent of
adolescents in the project areas
believe in the small family norm
now. The use of condoms as a
method of family planning and
as protection against sexually
transmitted infections (STI) and
reproductive tract infections
(RTI) had be~n adequately
advocated and promoted
amongst the adolescents. The
social marketing of contra-
ceptives has also been done in
an appropriate manner;
• The level of awareness on the
importance of regular routine
check ups during pregnancy and
nutritional diets has also
increased; and
• The awareness generated on the
causes of HIV/ AIDS has had a
positive impact on the
adolescents. The projects have
helped to eradicate from their
minds, the myths and mis-
conceptions'
related to
HIV/AIDS.

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Saving lives in Rajasthan
focus
Aruna Devi (name changed to
maintain confidentiality) is a
young, illiterate dalit woman
residing in the village Banwada in
Piplu block, in the Tonk district of
Rajasthan. Her husband is a manual
labourer living away from the family
in Jaipur to earn a living and
support his family. Aruna Devi is a
mother of three children-two
daughters and one boy.
At the time when she was pregnant
with her fourth child she was
malnourished and very weak. She
had excessive swelling in her hands
and feet. Her condition was
compounded by the burden of
taking care of the other three
children and the absence of her
husband.
She had heard of the field clinics
regularly organized by" Shiv
Shiksha Samiti" where a Nurse
Sister examined the pregnant
women, mothers and children. She
knew that the Nurse Sister, or
'Didi', also paid home visits to those
who had recently delivered babies.
Aruna Devi wanted to get herself
examined. Alas! she did not have
any money. At this juncture her
close friend informed her that
Nurse Didi's services, were free of
cost. Distressed because of her
poor health she finally gathered
courage to visit the field clinic. She
was examined by the nurse-midwife
Durga Meena. Durga
sympathetically questioned her
about all her health problems,
examined her and advised her to
go to the district hospital at Tonk
as she was unwell and needed
further care. Aruna returned home
knowing very well that she could
never afford a visit to the district
hospital at Tonk , 35 kms away
from where she lived.
A few days later, Durga the Nurse
Didi visited Aruna at her residence.
Aruna was surprised and also
overwhelmed and happy that
Durga cared so much for her. On
being asked why she had not gone
to the district hospital, Aruna
confided in the Nurse didi, that she
could not do so as she had no
money. Durga realized that Aruna
was indeed so poor that she could
not even afford to meet the costs
involved in going to the district
hospital at Tonk. Taking cognizance
of the gravity of her condition and
also her inability to pay, Durga
discussed her case with the other
staff at the health centre. They
decided to help Aruna through the
emergency health fund. She was
loaned an amount of Rs 1000 to
cover her expenses on the trip to
the district hospital.
Aruna received care from the district
hospital, which was followed up by
Durga at the field clinic. She had a
normal delivery after completing the
full term of her pregnancy.
However, because of lack of
transport facilities she could not
come to the health centre for
delivery which had to be taken care
of by a local health practitioner.
Today, Aruna is happy with her
newborn child and is returning the
loan in small installments.
Durga was the saviour for another
woman, called Phoola Devi, who
lives in the Bairwa hamlet of village
Churara in Tonk district. In the
Bairwa hamlet of village Churara
(District Tonk), there is no road.
When it rains, it is cut off from the
nearby areas. There are no health
service providers in the village. The
hamlet is sandwiched between two
Primary Health Centres, each
8-10 kms away. Phoola Devi is
illiterate and very poor. Her
husband, Bajrang is a manual
labourer. He works as an agricultural
labourer in the fields of others and
when unable to find a job, goes to
the state capital in search of a job
as a casual labourer.
27 year old Phoola was pregnant.
She had never had any vaccination
or taken any supplement of Iron-
Folic acid. She is no different from
any other woman of her village.
None has seen an ANM or any
other health provider come to
vaccinate the pregnant women.
To deliver at home is the norm.
Thus when the labour pains started
one day in the morning , there was
no concern as she was anyway to
deliver there itself .. However, the
progression of Phoola' s pain was
not normal and her condition began
to deteriorate. She was taken to a
doctor 2.5 kms away. He gave her
some pain enhancing injections and
asked her to go back home, re-
assuring her that everything would
be alright. However, after returning,
there was a further deterioration in
Phoola's condition. Incidentally, the
village health worker of the "Safe
motherhood Programme" imple-
mented by Shiv Shiksha Samiti,
Tonk, with the support of the
Population Foundation of India,
was present. She recommended
that Phoola Devi be taken to the
health centre run under the project
at Piplu. With no other options
available, Phoola was taken to the
centre. Durga Meena at the centre
quickly assessed the condition. She
kept Phoola under constant
observation. She refused to
prescribe any injection unless
needed and after several hours the
baby was delivered. However, the
troubles had just started. The baby
was not breathing. Durga had been
taught newborn resuscitation during
her three month training at Action
Research and Training for Health
(ARTH) , an NGO at Udaipur. She
did not panic, and quickly set about
her task and resuscitated the
newborn. There were cries of joy
all around and the family thanked
Durga profusely for her efforts.

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focus
The Prem Jvoti Community Health and
Development Project, Jharkhand - An Update ...
The Emmanuel Hospital
Association (EHA) implements
the Prem Jyoti Community Health
and Development Project in
Jharkhand, which is supported by
the Population Foundation of India,
for a period of 3 years. The project
caters to a population of the Malto
tribe in the Sahibganj district of
Jharkhand. The Maltos are a tribe
living in the Rajmahal hills of the
Santhal Parganas of Jharkhand.
They generally suffer from poor
health, not only from reproductive
and child health problems but also
from diseases like malaria, kala-azar
and tuberculosis. The Prem Jyoti
Project is primarily an outreach
programme for providing primary
health care to 16000 Malto tribals
living in 11 clusters of 140 villages,
supported by a fifteen bedded
secondary level hospital facility to
deal with emergencies. The basic
objectives of this project are to
improve the overall status of health
of the members of the Malto tribe
in the project area, to empower the
Malto tribe to take better care of
their own health at the village level,
to improve the reproductive and
child health of the community and
to enhance awareness of the
community on the major health
problems affecting women and
children.
Recently, a baseline survey was
conducted, in the area where the
project is being implemented. The
survey was carried out on 589
women in the reproductive age
group. It revealed an agrarian
society comprising nuclear families
and 90% illiteracy amongst the
womenfolk. The other facts which
emerged as a result of the survey
are that
• The age of marriage is 16 years,
and the age at the time of the
first childbirth is 17 years
• Only 5% of the women receive
complete antenatal care, and
97% of them are still delivering
babies at home
• Only 23% of the women are
aware of Disposable Delivery kits
(DDK)
• Only 24% of the children have
complete immunization . A large
number of children suffer from
various ailments - 57% of them
suffer from malaria, 14% from
colds and coughs, 9% from skin
diseases, 7% from diarrhoea
and 4% from pneumonia - thus
showing that malaria tops the
list.
• The knowledge/information
regarding family planning is: 78%
about intrauterine devices (IUD),
64% about pills, 55% about
tubectomy and 31 % about
vasectomy.
• The contraceptive prevalence
rate is very low- only 18.2%
reported that they are using
modern
methods
of
contraception.
• The Total Fertility Rate (TFR) is
6.73%.
• Only 28% of the women are
aware of reproductive tract
infections/sexually transmitted
infections (RTI/STI). One out
of five women report suffering
from any RTI symptom and
18% of them are aware of HIV/
AIDS.
(10) MUSKAN, Jehanabad (11)
LAKSHYA, Patna (12) Avidya
Vimukti Sansthan, Gaya (13)
Samagra Seva Kendra, Gaya (14)
Vaishali Samaj Kalyan Sansthan,
Vaishali (15) Jan Kalyan Samiti
Chakwaja, Vaishali and (16) Aulia
Adhyatmik Anusandhan Kendra.
The orientation of media workers
on the issues of population and
reproductive health is one of the
priority areas of the advocacy
initiatives of the Foundation.
Orientation and skill enhancement
workshops on Population, Health
and Development were organized
at four places in Bihar and
Jharkhand last year. The parti-
cipants were mainly rural reporters,
freelance journalists, stringers and
journalists working with the
mainstream media. Eight of the
participants - 5 from Jharkhand
and 3 from Bihar were selected for
a 5 month media fellowship
programme. The Fellowship is
being supported by the Population
Foundation of India and is
coordinated by Manthan Yuva
Sansthan, Ranchi. The candidates
for the Fellowship were selected
Orientation workshop on Population &
Health at Xaviers College, Ranchi
on the basis of their interest, past
records and consistency in writing
and publishing on development
issues at the local and state levels.
Based on the responses received
from the media workshops, the PFI
and Manthan Yuva Sansthan,
Ranchi organized orientation
programmes with three institutes in
Jharkhand - the Prabhat Khabar
Institute for Media Studies, Ranchi;
St.Xaviers College, Ranchi and
Karim City College, Jamshedpur.
The heads of departments, faculty
members and students of the
institutes were involved in the
organization of the workshops. The
discussions generated a lot of
interest amongst the students, some
of whom expressed their willingness
to work exclusively on social
development subjects.

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fOcus
The Asia Pacific Conference on Reproductive and Sexual Health (APCRSH) is organized every other year
through a consortium of organizations working on the issues of Reproductive and Sexual Health. It is guided
by an International Steering Committee comprising experts and practitioners. The host country further forms a
Local Organizing Committee to facilitate organization of the conference. The conference serves as a forum for
researchers, educators, service providers, NGOs and governments of the Asia Pacific region to collectively review
the emerging trends, share experiences and identify the challenges and opportunities available in the region.
Three such conferences have been organized so far and India would be the host for the fourth one to be organized
towards the end of the year 2007.
The 1st Asia Pacific Conference on Reproductive Health (APCRH) was held in Manila, the Philippines in February
2001 to increase awareness of sexual and reproductive health issues in the region. The Conference provided a
platform for the Asian and Pacific nations to exchange ideas, knowledge and experiences on key reproductive
health issues. The 2nd Asia Pacific Conference on Reproductive and Sexual Health) was held in Bangkok, Thailand,
in October 2003, on the theme "Moving into Action: Realizing Reproductive and Sexual Health and Rights in the
Asia Pacific Region". The 3rd APCRSH Conference was an opportunity to affirm and strategically move forward
to attain the commitments made at the International Conference on Population and Development (ICPD), Cairo
and the related Fourth World Conference on Women in Beijing in 1995. It was based on the theme "Expanded
and Comprehensive Response in Sexual and Reproductive Health and Rights for all Communities."
The APCRSH so far have witnessed immense enthusiasm and active participation from the government
departments, civil society organisations, young people and the academia.
Since 1994 most of the countries in South Asia have moved the ICPD agenda ahead with full commitment. Most
countries in the South Asia region now have national policies on reproductive and child health. The rights based
approach to sexuality is fully respected as is evident from the passing of the Women's Bill in Nepal in 2002, which
legalizes safe abortion as an issue of womens' right. This Bill was passed with a thumping majority in the Nepal
Parliament on 14th March 2002 getting 147 votes out of 148 Members of Parliament in attendance. In Bangladesh
the work on sexual and reproductive health is now showing its impact through repeated increases in contraceptive
prevalence rates. In 1991 the contraceptive prevalence rate was 40 per cent. This figure rose to 58 per cent in
2003 (source: Bangladesh DHS). In Sri Lanka and the Maldives access to sexual and reproductive health services
has improved tremendously over the last decade and the social marketing of contraceptive commodities in
Sri Lanka is a case well documented for its success.
At the same time the South Asia region is full of paradoxes. In spite of the repeated advances mentioned above,
and a strong commitment to the ICPD platform for action by government and civil societies in the region, the
and at Jagdalpur on February 23,
2006 for the southern districts. The
workshops were inaugurated by the
respective pistrict Magistrates.
Dr.Almas Afi, Senior Advisor, PH,
set the tone for the workshop at
Durg, with his presentation on an
overview of the maternal mortality
scenario in Chhattisgarh.
The RRC completed one year in
March, 2006. An annual review
meeting was held at the Population
Foundation of India on March
24-25,2006. The achievements of
the year and the challenges faced
were presented by the RRCs of both
Bihar and Chhattisgarh, along with
the Plan of Action for the coming
year. Dr. P.C. Das, Assistant
Commissioner, NGO Division, and
Dr. Vasanthi Krishnan, Consultant,
from the Government of India
participated at the meeting.
A Government (GO) / NGO
workshop was held at Patna on
March 30, 2006. The Chief
Minister of Bihar, Mr. Nitish Kumar,
the Deputy Chief Minister
Mr. Sushil Modi, the Health Minister
of Bihar, Mr. Chandra Mohan Rai
and the Speaker of the Bihar
Legislative Assembly, Mr. Uday
Narayan Choudhury, participated
at the workshop, and addressed the
participants.

2 Pages 11-20

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2.1 Page 11

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fbcus
tproductive and Sexual Health in 2001
indicators for well being of mothers, children, gender equality, status of women and health still remain critical.
Reproductive and sexual choices within the framework of rights are not understood by most. The region is home
to countries with large populations of marginalized people. All countries have significant numbers of people living
below the poverty line, most face issues of internal strife and insurgency which results in displacing families and
people, migration and refugee like situations. These situations lead to increased vulnerability of women and
children to infection, abuse and sickness.
In addition to these problems, the infrastructure facilities for health in some of the most densely populated
countries are dismal, making access extremely difficult. Most of the sexual health facilities are urban based and
less than 2,000 out of the 24,000 Primary Health Centres in India provide abortion or abortion related
services.
This scenario gets accentuated in its worst form amongst adolescents/youths who represent more than 30 per
cent of the population of the South Asia. Adolescents/youth in South Asia are at risk for HIV/ AIDS. They are
initiating sexual activity increasingly at younger ages without accurate preventive knowledge and inconsistent use
of condoms. Worldwide, adolescents have always been a high-risk group for HIV/ AIDS. However, recent data
suggest that the projected numbers of young people living with HIV/ AIDS will rise steadily over the next two
decades. This is due to the fact that high rates of HIV infection among young people are, for the most part,
occurring in countries with very young population. The confluence of high HIV / AIDS prevalence and
disproportionately young population results in a concentration of new infections among youth.
South Asia is also a region where early child marriages are common, son preference and sex selection are serious
challenges. Prevalence of gender-based violence is high and there are many forms in which women suffer violence.
Honour killings, dowry related deaths; female infanticides are some of the forms of gender based violence which
are still prevalent in this region.
It is in this climate of sexual and reproductive health needs of a substantial and dynamic population that the India
Consortium on Sexual and Reproductive Health and Rights has come forward to move the Sexual and
Reproductive Health and Rights agenda jointly. The members of the consortium are: CEHAT, Mumbai; Centre
for Operations Research and Training, Baroda; CHETNA, Ahmedabad; Child In Need Institute (CINI), New Delhi;
the Family Planning Association of India (FPAI), Mumbai; ,Indian Society for the Study of Reproduction and
Fertility, Mumbai; MAMTA, New Delhi; the Population Foundation of India, New Delhi and The Humsafar Trust,
Mumbai.
The Population Foundation of India has received a grant from the John D and Catherine T MacArthur
Foundation to facilitate the scaling up of successful model interventions addressing maternal mortality
and young people's sexual health and reproductive rights over a period of two years. In this endeavour,
the PFI would be collaborating with the Management Systems International (MSI), a consulting firm
based at Washington DC, which specializes in applying strategic management to international
development. There is a demand and supply relating to successful model interventions, but the
convergence is limited. The PH would be playing the role of an intermediary in taking NGO model
interventions to scale.

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From the Executive Director's Diarv...
Mr.AR.Nanda, Executive Director, PH, was invited by JANANI, to chair a session on 'Innovative Technologies II'
on January 16-17, 2006 at a two day workshop on 'Using Technology to Deliver Health and Reproductive Health to
the Rural Poor'. The workshop was organized at the India Habitat Centre, New Delhi.
• The keynote address was delivered by the Executive Director (ED), PH, at a workshop on 'Health and Social
Development of Women in Orissa: Opportunities and Challenges' on January 19, 2006, at Bhubaneswar. The
workshop was organized by 'Mamata' an organization in Bhubaneswar.
• The Centre for Health and Social Justice invited the ED to chair a session on 'Monitoring Public Health Programmes
- Issues and Experiences' on January 23-24, 2006, at a two day workshop on 'Monitoring Public/Reproductive
Health Policies and Programmes: A Civil Society Initiative' at Hotel Jukaso Inn, New Delhi. The Centre had its first
General Body Meeting on January 25 at the PFI. The ED participated at the meeting as member of the Advisory
Board of the Centre.
• The ED participated at a two day 'Writers Workshop for the Compendium on Population and Development', at the
India International Centre, New Delhi, on February 2-3, 2006.
• The Population Council organized a half day dissemination meeting of the three FRONTIERS (in reproductive health)
studies, on February 8, 2006 at Hotel Ambassador, New Delhi. The ED participated at this meeting.
• The MacArthur Foundation organized a two day workshop on 'Young People's Sexual and Reproductive Health for
the Future', on February 10-11, 2006, at the Pataudi Palace at Haryana. Mr AR.Nanda was invited to chair a session
on 'Advocacy on Young People's Sexual and Reproductive Health and Rights: Issues and Strategies'.
• The Executive Director, PH, is a member of the International Advisory Committee on Population Programme of the
David and Lucile Packard Foundation. The Foundation invited him to participate at a meeting of the Advisory Committee,
on February 23-24, 2006, at Palo Alto, San Francisco, USA
• A National Seminar on Reproductive and Child Health and Population Dynamics took place on March 6-8, 2006
at the India Habitat Centre, New Delhi. Mr.AR.Nanda was invited to chair a session on 'District Level Household
Survey: Reproductive and Child Health' at the seminar, which was organized by the International Institute for Population
Sciences, Mumbai.
Forthcoming Events
Training programmes for NGOs:
• At Malkangiri,Orissa, on April 3, 2006.
• At Nabarangpur, Orissa, on April 10-15, 2006.
• At Malkangiri,Orissa on April 22-24, 2006 (Refresherprogramme).
• At Kashipur,Orissa on May 3-8, 2006.
• At Kashipur,Orissa, on May 19-21 (Refresherprogramme).
• At Koraput, Orissa, during 2nd week of May, 2006.
• At Koraput, Orissa during 2nd week of June (Refresherprogramme)
• At Rayagada, Orissa during 4th week of June
The training programmes would be organized by "Agragamee" - a partner NGO workingas
the Regional Training and Resource Development Centre (RTRDC)for the PH in undivided
Koraput districtin Orissa.
Three 6 day training programmes are scheduled to be held at Lucknow, Uttar Pradesh on
April 10, May 19 and June 19, 2006. The programmes would be organized by the India
LiteracyBoard, Lucknow- the RTRDCfor the PH in Uttar Pradesh.
.
• A State LevelAdvocacyWorkshop on April-28-29,2006, at Raipur,Chhattisgarh.
Editorial Guidance
Mr A.R. Nanda
Editor
Ms A. Banerji
Editorial Committee
Ms Usha Rai
Dr Almas Ali
Dr Lalitendu Jagatdeb
Dr Kumudha Aroldas
Published by
Population Foundation of India
8-28, Qutab Institutional Area, New Delhi-1100 16, India
Tel: 91-11-42899770, 42899771 Fax: 91-11-26852766
e-mail: popfound@sify.com
website: www.popfound.org