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PFI Annual Report 2011-2012 |
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Cover photo:
A Sahiyya, or an Accredited Social Health Activist (ASHA), in Karra block, Khunti district of Jharkhand.
Population Foundation of India recently carried out an evaluation of the national pilot scheme — the Home delivery of
Contraceptives by ASHAs. PFI is also involved in training ASHA master trainers in Bihar.
Photo by Bijit Roy, Programme Coordinator, PFI
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Annual Report
2011-2012
Population Foundation of India
New Delhi
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PFI Governing Board and
Advisory Council
Governing Board
Chairman
Mr Hari Shankar Singhania
Members
Mr B G Verghese
Mr J C Pant
Mr K L Chugh
Mr Kiran Karnik
Ms Justice Leila Seth
Dr Nina Puri
Mr R V Kanoria
Prof Ranjit Roy Chaudhury
Mr Ratan N Tata
Dr Vinay Bharat-Ram
Dr M S Swaminathan (permanent invitee)
Secretary, Ministry of Health and Family Welfare, GOI
(ex-officio)
Ms Poonam Muttreja, Executive Director, PFI (ex-officio)
Advisory Council
Chairman
Dr M S Swaminathan
Members
Mr Ajai Chowdhry
Mr Anand G Mahindra
Ms Anandita Sharma
Ms Aruna Kashyap
Ms Geeta Regar
Dr Gita Sen
Mr Keshav Desiraju
Dr Leela Visaria
Dr M K Bhan
Ms Mirai Chatterjee
Ms Mrinal Pande
Mr Sanjoy Hazarika
Dr Saroj Pachauri
Ms Srilatha Batliwala
Prof Suneeta Mittal
Mr Yashodhan Ghorpade
Representative of the Ministry of Health & Family
Welfare
Ms Poonam Muttreja
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Contents
PFI’s Presence in India
iv
The Governing Board Chairman’s Address
1
From the Executive Director’s Desk
3
The 12th JRD Tata Memorial Oration
Professor Amartya Sen on Women and Other People
5
The 5th JRD Tata Memorial Awards
7
Supporting Innovations: PFI as a Grant Making Agency
9
PFI-Supported Projects
18
Community Action: Empowering Communities to Plan and Monitor
22
Research: The Foundation of our Work
26
Visiting Scholar
27
Advocacy and Communication
28
Training and Capacity Building
33
Strengthening Systems to Bring Better Health to the Urban Poor
38
The Global Fund: Round 4 RCC Promoting Access to Care and Treatment Program
41
Publications
46
Financial Highlights
48
PFI’s Partners
51
PFI’s Offices
52
Our Vision and Our Mission
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The Governing Board
Chairman’s Address
Iwelcome you to the 42nd Annual General
Body Meeting of the Population Foundation of
India (PFI).
I would begin with paying our respects to Dr Abid
Hussain, a member of our Governing Board whom we
lost on June 21, this year. He was a reputed economist
and a highly respected diplomat. He had served as India’s
ambassador to the United States, and as member of the
Planning Commission. He had been associated with PFI
from 2001. We will miss his guidance, encouragement and
support for the causes PFI strives for.
I am happy to inform you that this has been an eventful
year and we have covered much ground.
PFI has been organising periodically the JRD Tata
Memorial Orations. This year we organised the 12th JRD
Memorial Oration, which was accompanied by 5th JRD
Tata Memorial Awards function. While the oration is
all about ideas, the awards are about implementation of
policies and programmes. The awards honour states and
districts that do well in reproductive health and family
welfare programmes.
The oration has been a medium through which PFI
engages with the best minds on the subject of population
and development. The oration is followed by questions
from a specially invited audience, consisting of members
of India’s intelligentsia.
PFI was fortunate this year to have with us noted economist
Prof Amartya Sen who delivered the oration on Women
and Other People. The oration focused on very important
concerns for India – the declining sex ratio and the low
status of women – issues that are even more relevant today
and a prime area of PFI’s work. It received good media
coverage and the video and audio footage were put up on
our website and linked to our Facebook page.
The JRD Tata Memorial awards recognize sustained effort
and progress achieved over a period of time. Despite the
relatively slow performance of reproductive and child
health for the country as a whole, there are districts and
states, which have made significant strides in the field.
The Awards have been instituted with the hope that they
will generate the much-needed impetus among others to
achieve similar standards.
The 5th JRD Tata Memorial Award – a trophy and a
cheque of Rs 15 lakh – were presented to Mizoram in the
high focused states category. Goa got the award – a trophy
and a cheque of Rs 10 lakh for the best state in the non-
high focused states category.
The six-award winning districts were – Varanasi (Uttar
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Pradesh) from the High population category, Jajpur
(Odisha) from the Medium population category and
Thoubal (Manipur) from the Low population category
among high focused states. Ahmadnagar (Maharashtra)
from High population category, Firozpur (Punjab) from
the Medium population category and North Goa (Goa)
from the Low population category from among non-high
focused states. Each award-winning district was presented
with a trophy and a cheque of Rs 2 lakh.
The awardees were chosen by a high level six-member
technical advisory committee led by Dr P M Kulkarni,
Professor, Centre for Study in Regional Development,
Jawaharlal Nehru University.
Major highlights
The Memorial Oration and Awards were the major
highlights of this year’s activities.
PFI has also continued its march in its focus areas of
the Health of the Urban Poor program, the HIV/AIDS
programme and support to other organizations for scaling up
and improving the reproductive health advocacy capacity.
PFI’s Health of the Urban Poor program provides technical
assistance to municipal corporations, local governments
and civil society organizations. Successful strategies from
the implementation areas in eight states and five cities are
being used for policy advocacy and scaling up.
PFI, in technical collaboration with Management Systems
International (MSI), has been identifying and building a
pool of master trainers in scaling up management to help
organizations identify scalable models and plan for the
scaling up.
In this context, we held a workshop jointly with MSI in
February 2012 where 30 NGO leaders and development
workers from different states were taken through the steps
for scaling up.
to increase the reproductive health advocacy capacity,
especially on family planning, among selected groups
active in Delhi, Bihar and Uttar Pradesh. As part
of the initiative, a series of trainings on the Spitfire
SMARTCHART communication tool were conducted
to strengthen the capacity of potential leaders to plan,
develop and manage advocacy activities.
Gearing up for new challenges
PFI is gearing up for new opportunities and challenges.
A rigorous strategic planning exercise has been initiated
with key stakeholders to converge on ideas and strategies
for repositioning family planning. PFI’s role and areas
of primary focus are also being charted and redefined.
Furthermore, PFI has undertaken an organisational
transformation exercise to align itself to the call of the
hour.
In our quest for a healthy India, where each child is
planned and wanted, PFI works with many remarkable
individuals, institutions and organizations. They have
been contributing in many ways and I wish to thank each
one of them: the governments both at the Centre and
the states where we work, NGOs we partner with, social
workers, health professionals, field workers and the media.
I also thank our funders – the Central government and the
state government of Bihar, USAID, John D and Catherine
T MacArthur Foundation, the David and Lucile Packard
Foundation, The Global Fund, International Centre for
Research on Women, and the Advance Family Planning/
Johns Hopkins University Bloomberg School of Public
Health for supporting our efforts to ensure health and well
being to the most vulnerable populations.
The very competent team at PFI headed by Ms Poonam
Muttreja and under the able guidance of the Governing
Board and the Advisory Council have put in hard work
with renewed commitment and a sense of urgency. India
has come a long way, but we still have much to achieve.
PFI and the Advance Family Planning (AFP) program
at the Johns Hopkins University are working together
Hari Shankar Singhania
December 2012
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From the Executive
Director’s Desk
• When Rukmani from Solan in Himachal Pradesh
stands up in a crowd and says she is proud to be the
mother of daughters, we feel elated.
• When Paro in a remote village in Uttar Pradesh
contacts the ASHA and asks for an IUD, we feel our
work has paid off.
• When Shabnam gets up at a jan samvad (public
dialogue) being held in a rural district of Bihar and
demands that the ANM be regular in her visits, we feel
a sense of achievement.
Ordinary women, small actions, but which call for
extraordinary efforts on their part.
Giving them strength, nudging them on, working to make
the world a better place for the Indian women and their
families is what we do in the Population Foundation of India.
healthy lives and share in the fruits of India’s progress and
growth. The visionary that he was, he linked this to their
ability to plan and care for their families. Just two days
earlier, we had marked his 108th birth anniversary.
Forty years is a milestone in an organization’s journey. It is
time to look at the distance covered and plan the journey
ahead. And we were fortunate, that we had another
visionary with us on that day – Prof Amartya Sen who
had turned the spotlight on women and the marginalized
in the development discourse. On that day, he took stock
of a very vital reality of our times – the skewed sex ratio
when he gave the 12th JRD Tata Memorial Oration on
Women and Other People. It is one of the six core areas of
work for PFI in the coming years. Before I elaborate on
that, let us look at PFI’s journey so far.
We marked 40 years of our work with a series of events that
culminated on July 31 this year with the 12th JRD Tata
Memorial Oration by Nobel Laureate Amartya Sen, and the
presentation of the 5th JRD Tata Memorial Awards.
The day was special. For on that day we paid homage
to our Founder Chairman, JRD Tata. He was deeply
concerned about infant and child mortality, health
consequences of early marriage on women, female
education and the miserable conditions in which a large
percentage of Indians lived. He wanted them to lead
In the 1970s, many demographers and policy makers had
regarded the high rate of population growth as the greatest
obstacle to economic development. Coercion had brought
India’s family planning programme to a ‘stand still’. PFI had
then, advocated and promoted, flexible innovative approaches
to family planning that were built on informed choice.
In the 1980s, PFI’s work revolved around building political
commitment, and strengthening its advocacy for family
planning, as a necessary and integral part of maternal and
child care.
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In the 1990s, PFI moved away from a demographic goal
of reducing population growth rates and concentrated on
the improvement and quality of life, sustainable human
and social development. PFI’s work got a big boost from
two defining events during this period – the International
Conference on Population and Development in Cairo, 1994,
and the World Conference on Women in Beijing, 1995.
Wake-up call
As we worked through the decades, a new reality was
being added. With new technology, it was now possible to
determine the sex of the foetus. A society that was known
to neglect its girl child, now had the choice of preventing
her from being born. And it did with a vengeance. Two
decades ago, Prof Amartya Sen’s essay, More Than 100
Million Women Are Missing, was a wake-up call to confront
a frightening reality, which has only got worse over the
years. Therefore, as we work at bringing health to the
Indian woman, and with it the ability to plan her family,
it becomes imperative to change mindsets, and get the
society to value the girl.
For when a woman’s right to be born is snatched away, other
rights automatically get curtailed. The consequences of
warped sex ratios can be far reaching, leading to imbalance
in the nature of things. PFI has integrated preventing sex
selection into its five-year strategy plan. Son preference
is a very inadequate explanation for sex selection. In fact,
it is sadly daughter aversion that leads to this unacceptable
consequence. At PFI, we therefore, consider this a huge
challenge that needs the attention of all those who are
concerned with India’s future. While preventing sex
selection, we have to ensure that facilities for safe abortion
are available and easily accessible to women.
PFI is working to reposition family planning within a
women’s empowerment and human-rights framework. It
will be our endeavour to –
• prevent sex selective abortions
• end child marriage
• ensure that women bear their first child when they are
emotionally and physically prepared
• promote healthy timing and spacing of births
• improve access to better quality reproductive health
services through non-coercive programmes and policies.
PFI is both a grant-making and a grant-receiving
organization. We have reworked our grant-making strategy.
We carry out a detailed pre- and post-grant review of the
projects we fund. Among the new projects we are funding
and collaborating on is a public-private initiative by Karuna
Trust, which is focusing on repositioning family planning
in 14 PHCs in Karnataka, an initiative by the Socio-Legal
Information Centre that will build on the legal framework
around family planning to ensure reproductive health and
rights, another by SUTRA that gets women to collectively
battle discrimination against girls. We are working with the
Foundation for Research in Community Health to drawn
up guidelines for maternal health management that will
ensure an improvement in the quality of care.
Our Health of the Urban Poor program has made
considerable progress in building tools, guidelines and
processes, and is all set to contribute to urban health in
general and the proposed National Urban Health Mission
in a substantial way. Our HIV/AIDS program team amidst
many challenges worked to bring care and treatment to
PLHIV in 19 states.
A systematic review
The Chairman in his speech has covered our work and
achievements during the year. I will discuss a few other
initiatives that we have launched. We brought together
a group of eminent Indians from different walks of life to
work for ending child marriage. And we collaborated with
The Elders, a group of global statesmen led by Desmond
Tutu, who are piloting a global effort to promote equality
for girls. These initiatives have been highlighted on our
website-http://www.populationfoundation.in .
We have initiated a systematic review of evidence from
best practices, policies and programmes on family planning
on our key focus areas so as to inform our advocacy. We
carried out an evaluation of the Government of India’s pilot
scheme on Home delivery of contraceptives by ASHAs with a
view to analyse its potential for scaling up.
We are very encouraged with the outcomes of our
programme on community action, with state governments
ready to scale up and embed it across India. This will bring
‘public’ into public health.
Over the last year, we focused on realizing many of our
objectives. We used every advocacy opportunity – critical
meetings and conferences at the state, national and
international levels, every possible forum, to highlight the
need to reposition family planning as a woman’s rights and
empowerment issue.
I look forward to your continued support. I thank each of you,
who has worked with us to empower young women so that
they can marry as adults, access contraceptives and quality
health care, and plan along with their men when and how
many children to have, steering their families to better health.
Poonam Muttreja
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The 12th JRD
Tata Memorial Oration
Professor Amartya Sen on
Women and Other People
Professor Amartya Sen is well recognised for having
added a strongly moral dimension to the discipline
of economics. What is rather less stated is the
consistency with which he has brought gender into his
economic analysis, causing some to even salute him as a
“feminist economist”.
as he went along. Men and women, he observed, have
both “congruent and conflicting interests” within the
family. Since there are extensive areas of congruence,
families typically arrive at a compromise by seeking the
cooperation of both men and women, and coming up with
some agreed solutions to tackle the areas of conflict.
Both these attributes – the moral dimension and the
gender concern – informed the JRD Tata Memorial
Oration, hosted by the Population Foundation of India
(PFI) that he delivered on July 31, 2012 in Delhi, wherein
he undertook a magisterial survey of women’s place in
contemporary India. Entitled Women and Other People,
it revealed that the Nobel Laureate in his 78th year is
as engaged as ever with making sense of the world –
particularly of the country of his birth and its social and
economic evolution.
Such family arrangements are usually grounded in what
Sen termed as “cooperative conflict”. Some of these
arrangements are particularly unfavourable to women,
and if the cooperation is to such kinds of division it
can yield tremendous gender inequality. The fact that
women conceive and produce children makes them
more dependent on the harmony of the family and less
demanding of their fair share of the family’s joint benefit.
They end up, therefore, getting the worst end of the
bargain.
The position of women in India has long been a source
of disquiet for Sen since he regards gender equity and
equality as fundamental for social development. He began
his talk by stating that he found it hard to accept the
fact that the biological fact of women having to play a
reproductive role in society should deprive them of their
freedom to do other things with their lives.
This led him to interrogate the family and unpack it,
layer by layer, deploying economic models and analogies
Here Sen drew on the analogy of globalisation, which is
often presented as benefitting all countries equally but
which, in fact, has some countries gaining very little and
others gaining very much. What makes the situation of
women perhaps even more complex is the fact that this
conflict is well-hidden in various cultures of family living.
Dwelling on conflicts, rather than on family unity, tends
to be seen as aberrant behaviour. Apart from this, women
themselves are sometimes unable to assess the extent of
their own deprivation.
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Having reviewed the bad “deal” that women get, Sen went
on to analyse how their contribution to family prosperity
in terms of “home work” is consistently undervalued.
To address these inequalities and inequities that blight
women’s lives within the family, Sen underlined the
importance of women’s ability to earn independent
incomes outside the home. This, of course, is linked
crucially to their levels of literacy and education.
Ownership of property can also add to the influence
and power exercised within the family. In fact, for Sen,
all these attributes together add to women’s agency,
independence and a stronger role in decision-making
within the household and beyond.
Women’s enhanced decision-making powers are
particularly significant. As Sen put it, “From the crude
barbarity of physical violence against women, to the
complex instrumentalities of her neglect, the deprivation
of women is not only linked to the lower status of women
but also to the fact that women often lack the power
to influence the behaviour of other members of society
and the operation of social institutions”. But in order
that women can work outside the home, they need both
institutional support, in terms of child care, as indeed
social acceptance of such a course.
Women's well-being impacts national
development
What is important to note here is that gender equality is
not for the well-being of women alone, it has direct impacts
on national development. Sen cited the fact that reduction
of birth rates has often followed enhancement of women’s
status and power that are most constrained by frequent
child bearing. “Any social change that brings voice, not just
to women in general but young women in particular, has a
tremendous impact on fertility decisions,” he said.
Bangladesh is a good example of the close link between
enhanced women’s agency and positive national outcomes
in Sen’s assessment. He devoted a good part of the JRD
Tata Oration in considering how that country had proved
wrong the prophets of doom who had once seen it as a
“basket case”.
Although Bangladesh is still one of the poorest countries
in the world, it has made rapid progress particularly over
the last 20 years, overtaking India in terms of the most
crucial social indicators – including the gender specific
mortality rate – despite having a GDP half that of India’s
and a public expenditure that is a mere 10 per cent.
So what did Bangladesh do right? A significant clue, Sen
said, lay in a sustained policy change in gender relations –
measured in terms of the levels of school participation of
girls and workforce participation of adult women. “It looks
as if we can conclude that Bangladesh would have been a
very different country and far less successful if it was not
for the positive role played by women,” he remarked.
But gender agency, even where it exists, can often be
restrained by a lack of access to information and knowledge
and also by the absence of courage and temerity to think
differently. It is only when women’s agency is marked by
the ability of independent thought that it acquires the
power to end inequities that feed into social practices and
arrangements accepted as part and parcel of an assumed
“natural” order. This is where Sen touched upon the vexed
issue of sex selective abortions in Asia. It is striking that
despite China and South Korea having achieved high
levels of female literacy and economic independence of
women, both countries have been unable to stem the tide
of inequality in the form of sex selective abortions of female
foetuses, although South Korea has made some progress in
its attempts to counter the trend.
Need freedom of thought
India, too, while it has seen a reduction in excess female
mortality, is witnessing the growing tendency of new
technologies being used to abort female foetuses, and
women’s education alone has not been able to address
it. This seems to suggest that combating the trend would
require not just freedom of action, but freedom of thought.
Sen, who was the first academic internationally to examine
the concept of 'missing women', is presently grappling
with the data thrown up by India’s 2011 Census on child
sex ratios. His talk reflected his recent thoughts on the
conundrum. Taking the German ratio of 94.8 girls to
100 boys as the cut off mark, he finds it intriguing that
the 2011 Census repeated a pattern first registered in the
2001 Census, in which the states of the north and west
had a child sex ratio that was substantially lower than
the German cut off, while the states in the east and south
of India had a sex ratio around the German cut off. As
Sen put it, “I was struck by the fact that this difference
within the country is very different from just the classical
distinction between the north and the south.”
This is yet another riddle about 'women and other people'
that continues to intrigue Sen. But he is not discouraged
by questions. He concluded his talk with the words, “We
will never get the right answers, if we don’t ask the right
questions.”
Women's Feature Service
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The 5th JRD Tata
Memorial Awards
Mr Lalrinliana Sailo, Minister for Health and Family Welfare,
Government of Mizoram received the award – a trophy and
Rs 15 lakh on behalf of Mizoram. He is greeted by
Mr Hari Shankar Singhania, PFI Governing Board Chairman.
The JRD Tata Memorial Award has been instituted
in memory of PFI’s Founder Chairman JRD Tata.
The award recognizes the pace of progress by
states and districts on population and reproductive health
programmes.
The Winners
States
Mizoram from among 18 high-focus states (defined
under the National Rural Health Mission as
states with poor health indicators and weak
infrastructure)
Goa from among the non high-focus states
Districts from high-focus states
Varanasi, Uttar Pradesh (large population
category)
Jajpur, Odisha (medium population category)
Thoubal, Manipur (small population category)
Districts from non high-focus states
Ahmadnagar, Maharashtra (large population
category)
Firozpur, Punjab (medium population category)
North Goa, Goa (small population category)
Nobel Laureate and renowned economist Prof
Amartya Sen presented the award to senior
ministers and district collectors from the award-
winning states and districts at the JRD Tata
Memorial Oration and Awards ceremony on July
31,2012 in New Delhi.
Mr Francis D’Souza, Minister for Urban Development,
Government of Goa, receives the award – a trophy and
Rs 10 lakh – on behalf of his state. (Photos: Monica Dawar)
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The way the selection was done
PFI had set up a high-level technical advisory
committee chaired by Prof P M Kulkarni, Centre for
Study in Regional Development, Jawaharlal Nehru
University, New Delhi to select the winners. Other
members included Dr Shireen Jejeebhoy, Senior
Associate, Population Council, New Delhi; Dr Alaka
M. Basu, Professor, Department of Development
Sociology, Cornell University; Dr Arvind Pandey,
Director, National Institute for Medical Statistics,
Indian Council for Medical Research; Mr A.R.
Nanda, Former Executive Director, Population
Foundation of India; and Ms Poonam Muttreja,
Executive Director, Population Foundation of India.
The committee identified a set of 13 indicators to
measure the progress of the districts. Data from two
rounds of District Level Household Surveys, DLHS
2002-04 and DLHS 2007-08, and the Census of 2001
and 2011 was analysed. The combined performance of
the districts was taken into account while selecting the
states for the awards.
The indicators on which the performance of the
districts was judged were:
Access to improved sources of drinking water,
households with toilet facility, women in the 20-24
year age group who were married before 18 years,
women with birth order three and above, current users
of spacing methods of family planning, unmet need
for contraception, full antenatal care, safe delivery,
postnatal care within 48 hours after delivery, full
immunization of children (12 - 23 months), female
literacy rate, ratio of females to males with primary
education and child sex ratio.
Award signifies pace of progress over a period
of time
Speaking on the occasion, the Chairman of PFI
Governing Board, Mr Hari Shankar Singhania, said the
award signified the pace of progress achieved over a period
of time. “It is well known that despite the relatively slow
performance of reproductive and child health for the
country as a whole, there are states, which have made
significant strides in the field, and their achievements
are comparable to the best in advanced societies. This
demonstrates that given the leadership and will, such
successes can be repeated in other regions,” he added.
District Collectors
Mr Sorabh Babu of Varanasi,
Mr Anil Kumar Samal of Jajpur,
Dr Sanjeev Kumar of Ahmadnagar,
Dr S Karuna Raju of Firozpur and
Mr K Radhakumar Singh of Thoubal
were each presented with a
trophy and Rs 2 lakh prize money
for their districts. The prize money
is to be spent on strengthening
the work of NGOs working on
reproductive health and family
planning programmes.
PFI’s Executive Director, Ms Poonam Muttreja, while
welcoming the gathering said: “The need to go well
beyond contraception while addressing the population
question is even more relevant today, given that family
planning is a
matter of women’s
rights and
gender justice.
It is a matter of
treating women
with dignity, of
advancing sexual
and reproductive
health, saving
lives, and
empowering
women and
communities.”
The distinguished gathering. (Photos: Monica Dawar)
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Supporting Innovations:
PFI as a Grant Making
Agency
A rally for community awareness.
(Photos by Karuna Trust)
A model Primary Health Centre at
Hudem, Bellary in Karnataka.
Population Foundation of India has been supporting
small and innovative grassroots initiatives that
provide basic and reproductive health care and
family planning to the unreached and poorly reached
communities. PFI works in the field with local NGOs or
corporate partners in their corporate social responsibility
efforts.
Typically, the projects include a strong component of
community mobilization and are linked to the government
service delivery system. Persons from the local
community get trained in outreach, behaviour change
communication, counseling on basic health, family
planning methods, sanitation, hygiene and nutrition. Such
initiatives usually run from three to five years. The project
performance and results are regularly monitored and
evaluated by PFI. The initiatives provide the opportunity
to develop models that reach out to communities and
orient them to a health-seeking behaviour. They bring
a change on the ground, improving the health and well
being of the people.
The initiatives are a very important aspect of our work,
for they ground our advocacy with experiences and field
reality.
This section is in two parts – In the first we share the
difference that three of our projects have made. Endline
surveys were carried out for these three projects this year.
In the second section, we focus on our new grants and
what they are expected to achieve.
I. Reaching out to the unreached, putting
systems in place
Poorly functioning PHCs turned
into model centres
It was a five-year partnership (2006-2011) between
Karuna Trust and PFI. The project: Total Management
of Essential RCH & Primary Health Care through
Public Private Partnership. Karuna Trust had been
successfully managing government primary health centres
(PHCs) in many states since 1996. PFI partnered with it
to add value to key processes in seven PHCs and their
39 Sub-Centres in six districts of northern Karnataka –
Bagalkot, Bellary, Bidar, Bijapur, Gulbarga and Raichur.
The districts were selected based on poor health and
development indicators such as literacy, sex ratio, unmet
need for family planning, percentage of safe deliveries and
immunisation. All these indicators were below the
state average.
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The selected PHCs catered to a two-lakh population
in economically backward and difficult to access areas.
The Institute of Health Management Research (IHMR)
Bangaluru, conducted an initial assessment and found the
buildings to be in despair, bereft of basic furniture and
medical equipment. The drug and medical supplies were
sporadic and the surroundings unclean.
The PFI partnership helped in strengthening the systems
and services with staff training. The staff was sensitized to
issues of gender, women’s health, reproductive health and
family planning. They were trained on waste management,
health management information systems, emergency
medical services and the rational use of drugs. Laboratory
facilities were upgraded and drug inventory improved with
I mpact
Timely care and trained staff
can save lives
Huligamma, 21, and her husband, Yellappa, work as
coolies. The ANM of the Arsigere Sub-Centre, which
falls under Chandrabanda Primary Health Centre (12
kms from Raichur city), on a routine visit found that
Huligamma had recently moved into the village and
was 34 weeks pregnant. She registered her for the ANC
checkups. The initial examination showed she weighed
46 kg and her hemoglobin was 8gm. IFA tablets were
prescribed and she was advised to take nutritious food.
She was then referred to the PHC for further checkups.
A lab test showed that her Hb level had further fallen to
6 gm. As this was her first pregnancy, and she was a high-
risk case, the ASHA and the ANM visited her regularly.
A few weeks later, one morning when she developed labour
pains, the ANM called for the ambulance and she was
shifted to the PHC within 45 minutes. She was examined
and advised to go to the First Referral Unit. However,
probably due to her financial condition, she refused.
Her labour progressed gradually. The staff nurse who
had undergone a skilled birth attendant training
maintained the partograph, as she was aware of all
risks involved. Huligamma’s blood pressure, pulse
and contractions were monitored and recorded. An
episiotomy had to be done as she was a primigravida. By
night she delivered a baby weighing 3.1 kg. Immediate
care was given to the newborn.
Unfortunately she developed postpartum hemorrhage.
She was then immediately treated with oxytocin.
Simultaneously her abdomen was massaged and digital
compression given to the uterus to stop the bleeding.
The bleeding was brought under control within an hour.
The difficult labour could be managed at the PHC as
the nurse had undergone the skilled birth attendant
training. These trainings as well as refresher courses for
the staff are supported by the government and PFI. The
percentage of safe deliveries has risen.
A functioning health centre
can change lives
Eleven-year old Lakshmi lives with her parents and
five siblings in Kadekolla village in Bellary district of
Karnataka. Her father is a daily wage labourer and the
only bread-winner of the family, which survives on an
annual income of less than Rs 20,000.
Lakshmi, her elder sister and a younger brother were all
born blind. Being poor and uneducated, the family was
unable to provide proper medical attention. All they
could do was visit several temples hoping for a miracle.
The village Lakshmi lives in has a sub-centre,
Bheemasamudra that comes under Hudem PHC. The
PHC was taken over and managed by Karuna Trust and
supported by PFI. A vision centre was established as part
of the primary healthcare services at the centre.
At a screening camp conducted at the PHC, Lakshmi
was examined and referred for diagnosis and treatment
to the medical college in Bellary. She was found to have
congenital cataract. Her left eye was operated upon.
She can now see and her life has changed dramatically.
From a lonely, sad girl, she has turned into a confident,
bubbling child. She now wants to study, play with other
children and do something worthwhile in life. She has
been advised surgery for the other eye too.
Karuna Trust now plans to get her siblings examined too,
and get Lakshmi into school.
Lakshmi got a chance to lead a normal life, only because
her village had a functioning sub centre which provided
basic health care.
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the introduction of the BIN card system. The system helps
record and manage drug inventory effectively.
In addition, family planning services – counseling, supply
of oral contraceptive pills and condoms, insertion of IUDs
and sterilization services were made available. The staff
at the sub centres could diagnose and treat RTIs/STIs.
Cases were referred to the PHCs for further treatment
when necessary. Governance was improved by increasing
community participation and strengthening of the Rogi
Kalyan Samitis at the PHC level, and Village Health and
Sanitation Committees at the village level. Information
management and communication systems were improved
through ISRO-supported, satellite-based communication
and PHC staff training.
The citizen’s charter was
prominently displayed
at each facility.
designed boats with trained health staff and medicines,
and with the support of the National Rural Health
Mission (NRHM).
In 2009, PFI entered into a partnership with C-NES to
introduce and support a family planning component in the
existing programme in five districts of Assam – Dibrugarh,
Tinsukia, Dhemaji, Sonitpur and North Lakhimpur. Five
graduates with experience in community health issues
were hired. They along with the ASHAs were trained
in interpersonal communication, including counseling,
and sensitised on gender and family planning issues. Each
counselor covers one district and works along with the
government-appointed ASHA.
The counselors work at raising
awareness on reproductive health
and family planning issues, encourage
All performance
indicators in the area
covered by the PHCs
– ANC registration,
institutional and
safe deliveries, and
home visits by health
workers, have improved
substantially. The
endline evaluation
The staff of the boat clinic looks for the right
spot to set up the camp for the day.
commissioned by PFI shows–
• Institutional delivery has increased by 67 percent from
the baseline.
• Home deliveries have come down from 77 percent in
Dispensing medicines to the villagers.
baseline to 11 percent in endline.
• Safe deliveries have increased by 49 percent
• Home visits by a health worker during the last 12
eligible couples to adopt family planning methods and
months went up by 11 percent.
ensure that a regular supply of modern contraceptives
• 38 percent more women now report that the medical
methods reaches them under the programme titled –
staff spends enough time with them during home visits. Mobilizing the Unreached. The people are informed
about the advantages and side effects of different
Counselling and care for a vulnerable
contraceptive methods so that they can make an informed
population
choice. They are also provided with follow up services.
The Centre for North East Studies and Policy (C-NES),
Assam has been providing basic health care to the
The boats reach the islands on set dates in a month. The
vulnerable communities living on the islands, or saporis,
project maintains data on each visit which is compiled at the
of the Brahmaputra. Every time the river is in spate, the
end of each month at the C-NES headquarter, and reviewed.
people are displaced and have to move to higher grounds
or other islands. The islands are difficult to reach as there An endline evaluation done in the experimental districts
is poor connectivity and infrastructure.
by an external agency showed:
• The proportion of currently-married women aware of
C-NES started reaching out to sapori people in 2005, with
any family planning method had increased from 50%
a preventive and promotive health campaign in specially
at the baseline to 75%.
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• The proportion of women currently using any family
planning method had increased from 47% at baseline
to 59%.
• Currently-married women receiving follow up services
after accepting certain family planning methods had
jumped from 9% at baseline to 68%.
• 42% women received at least three antenatal care
(ANC) visits as against 10% reported at the baseline.
• Children with full immunization went up from 20% at
baseline to 50%.
a macro health intervention championing the PPP
approach, the focus should be more on quality of
health care.
• The core team at the headquarter needs to be further
strengthened. Public health care professionals, and
professional community care givers, need to be
integrated into the existing project management team
keeping in mind the attrition level.
• Local bodies, panchayati raj institutions (PRIs) need
to be involved.
The boat clinic docks.
The results were encouraging and showed that adding
a Family Planning Counselor to the boat clinic is an
effective strategy. However, to make their presence more
effective, the agency has recommended –
• That the frequency of boat clinic visits to the
saporis needs to increase from once a month to at
least twice a month to ensure sustained and effective
follow up.
• There is a need to scale up the activities of the Boat
Clinic Project. Having been already recognized as
Disembarked and
ready to set up a
health camp.
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I mpact
Winning a battle against superstition
Sunali Doley, 34, lives with her 42-year-old husband,
Ajit, and six children on the island of Adisuti on the
Subanshiri river. The oldest of her children is 14 years
and the youngest is one and a-half years old. The first
thing you notice about Sunali is how frail she is.
When asked why she has a large family, she says her
husband was keen to have many children as they would
grow up and earn. But right now, she is finding it very
difficult to feed and look after them. The family is
dependent on some farming and a household piggery,
which does not get them even one full meal a day.
Sunali’s story finds an echo in the lives of majority of
the women in the village, who are frail and anemic
like her. She knows that frequent childbirth weakens
a woman. She has seen many women in her village die
during pregnancy and childbirth.
Village Adisuti, populated by the Mising tribe, is one
of the most backward villages in Lahkimpur district of
Assam. Access to basic health care and other facilities
like education, communication and infrastructure care
is severely limited. The Lakhimpur boat clinic visits the
village once a month to provide some basic health care,
immunization and family planning services.
The health team has an onerous task. Apart from
battling the elements that make transversing the river
dangerous, they face another difficult battle: to counter
myths and superstitious practices. Sunali tells the
Family Planning Counsellor of one such practice: any
villager who undergoes sterilization is not allowed to
enter the village.
Sunali confides of her desire to adopt a permanent
method, believing it to be an end to her perpetual fear
of getting pregnant again. But she is scared that she will
be forced out of the village. She requests the counselor
to meet her husband separately and discuss the issue.
But Ajit will not allow his wife to undergo sterilization
or use a spacing method.
The health team then decides to call for a village
meeting. The help of the ASHAs, anganwadi workers,
panchayat members and the village head is taken to
organize a mass health awareness camp in the village.
The villagers turn up in large numbers. However, it is
not easy to discuss the issues in front of the village elders.
Most of them oppose the meeting and want the health
team to leave the village. But they are persuaded to listen
and then decide if they want to opt for the methods. The
villagers are told about all the family planning methods –
spacing as well as permanent – that they could avail of.
The camp helps in changing the mind set of some
people. They begin coming forward to adopt modern
methods of family planning.
In February 2012, for the first time women of the village
– Sunali and five others – undergo sterilization.
Empowering communities to combat declining
sex ratio
India has been a society with strong son preference.
Over the past decades, fertility decline combined with a
strong gender bias/son preference has been resulting in
sex selection, and ultimately, a skewed child sex ratio in
favour of boys. Preventing sex selection is one of the six
key areas that PFI focuses on.
Sustainable Action against Declining Sex Ratio at
Birth in the States of Haryana, Himachal Pradesh and
Punjab, a three-year project (March 2009-March 2012
with a one-month no-cost extension) was implemented
by the Voluntary Health Association of Punjab (VHAP)
and Social Uplift Through Rural Action (SUTRA).
The project covered a population of one lakh in 55 gram
panchayats in Solan and Sirmour districts of Himachal
Pradesh, and 40 villages in the districts of Fatehgarh Sahib
and Patiala in Punjab, and Ambala and Kurukshetra in
Haryana. The districts and villages were selected on the
basis of adverse child sex ratio (0-6 years) as per the 2001
Census.
In Himachal Pradesh, SUTRA involved the Panchayati
Raj Institution members through various activities –
discussions at village meetings and in the formation of
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Mahila Gram Sabhas (village women’s meet) and Kanya
Bacho Samitis (save the girl groups). The newly-elected
representatives were sensitized to the issues, and the
involvement of male ward members was actively sought.
The community was sensitised through regular meetings
of the Mahila Gram Sabhas and Kanya Bachao Samitis,
ensuring community action in form of early registration
and follow up of pregnancies, involving youth in the
processes and interactions with the media.
A total of 233 Kanya Bachao Samitis were formed in 55
gram panchayats in Himachal Pradesh. Mahila Gram
Sabhas were convened 182 times. Information on the
PCPNDT Act, and government schemes like the Atal
Swasthya Yojana, Janani Suraksha Yojana, Rashtriya
Swasthya Beema Yojana, Beti Anmol Yojana, Muskan
and others was shared. Eight youth melas, four each in
Dharampur and Nahan, were held to sensitize the youth on
the issue of declining sex ratio and gender discrimination.
In Punjab and Haryana, VHAP adopted a three-phase
approach to reach out to the community. In the first phase
social change agents were identified and their capacity
to address these issues was built. In the second phase,
intervention villages were identified and advocacy meetings
held. In the third phase, the interventions were reviewed
to address the gaps. Activities continued at the village level
and advocacy was undertaken at the state level.
The sensitization programmes, media advocacy, training
and state-level consultations focused on raising awareness
around relevant laws and acts against sex selection. The
social change agents were also from women’s groups such
as Sakshar Mahila Samoohs, Mahila Mandals, Self Help
Groups with whom VHAP conducted periodic group
discussions on sex selection, and on issues like domestic
violence and social security schemes for women.
An endline evaluation undertaken by an external agency
showed:
• An overall improvement in the sex ratio in
the districts of Punjab and Haryana where the
interventions were undertaken, as evident from
the Census 2011. Though the Child Sex Ratio
in Himachal Pradesh declined between 2001 and
2011, it improved in the panchayats where SUTRA
had intervened, evident from the data that the
organization has been collecting on registered births.
• The formation of Mahila Gram Sabhas has engendered
the panchayat system. It prepares women to articulate
their issues and take them to the general village
meeting. While there is no government resolution
formally accepting these bodies, the women have
succeeded in getting some legitimacy and recognition
as they continue to gather together and call the
panchayat pradhan and secretary for their meetings.
The pradhan often cannot refuse as 40 to 60 women
usually collect for a Mahila Gram Sabha meeting.
• The Mahila Gram Sabhas discuss women’s priorities
and pass resolutions on a range of issues: ration
depots, roads, posting of female health workers,
water provision, employment and livelihood for
women, action against domestic violence, gender
discrimination, sex selection and reproductive health
of women. The annual reports contain an impressive
list of resolutions that are passed by the samitis and
taken to the gram sabha and the panchayat. These
issues are then addressed by the panchayat pradhans.
I mpact
Members of women’s groups lead
the change
When a member of a Kalyan Bachao Samiti gave birth
to a second girl child in Kanu Village in Himachal
Pradesh, her husband began harassing her and even
threatened divorce. She was forced to go back to her
parental house. Other members of the samiti and her
family told the husband that if he wished he could
divorce her. But he would have to look after her
daughters and also give the reason in writing that the
divorce was due to the birth of the second girl child.
They explained to him that these days women are as
capable as men, provided they are given equal access to
education. He understood that the birth of a girl child is
no reason for divorce. He took his wife back.
While discussing discrimination against women
at a Kanya Bachao Samiti meeting in Ghadsi, a
member shared her own experience. She told the audience
that she celebrates the birthdays of her three daughters by
giving food to the entire village to convey the message that
times are changing, and girls should be treated as well as boys.
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• The role of the Kanya Bachao Samiti also appears to
have expanded. The samitis have been –
Mediating in marital discords and fights
Sorting out cases of domestic violence by drunken
husbands, ‘eve teasing’ and molestation cases
At Badhauni Ghat, the Kanya Bachao Samiti
was involved in getting a ration depot closer to
the village, as the existing ration store was 10 km
away and commuting was a problem. In other areas
the liquor shops were made to shift as they were a
nuisance to the neighbouring residents.
II. New grants to further work on our six
focus areas
This year, a grant-making strategy was developed to ensure
that new grants focus on our six strategic areas of work
in states and districts with poor demographic and socio-
economic indicators. PFI looks out for innovative projects
that have a potential for scaling up.
Till July 31, 2012, the following new grants had been
made –
1. KHUSHALI: A family planning programme to
bring sustainable improvement in the health and
well being of poor and disadvantaged families in
the urban slum of Madanpur Khader, a
resettlement area of
5 sq km in South Delhi
Project partner: Agragami
India
children, were not using any method of contraception.
NFHS 3 data of Delhi slums indicates that 58.7% of
married adolescent females, including 12% of all 15-19
year old females have begun child bearing; 60% of all
births are at intervals shorter than 36 months, 17% are
less than 18 months apart, and 17% less than 24 months
apart. International and Indian evidence demonstrate
that such patterns of reproduction and fertility increase
maternal and infant mortality. They adversely affect
the health of women, and the nutritional status and
development of children.
The programme empowers adolescents to take safe and
responsible reproductive health decisions as they grow
into adulthood, so that age at marriage is increased and
the first child is delayed. It works at increasing community
acceptance of delaying the first birth till the woman is
21 years of age, and the use of contraception by couples
to delay the first child. The programme will also work at
increasing community acceptance of a minimum interval
of 36 months between two children, and improve access
to, and increase the acceptance of, long-acting and
permanent contraceptive methods.
The project repositions family planning and addresses
three of our six focus areas: delay age at marriage, delay
age at first pregnancy and promote spacing between
births.
The project aims at
demonstrating a cost effective,
comprehensive urban slum
family planning programme
that will reduce fertility,
and bring about sustainable
change in the health and well
being of mothers, children
and families. The intervention
will serve as a model for future
replication at greater scale
through programmes such as
the proposed urban health
mission.
A baseline survey done in a
4,650 population cluster in
June 2011 revealed that 48%
of 15-49 year-old women
who did not want any more
A Village Health and Sanitation Committee meeting in progress. (Photo: Karuna Trust)
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2. Repositioning Family Planning in 14 PHCs in
Karnataka through a Public Private Partnership
Project partner: Karuna Trust
PFI had supported Karuna Trust for strengthening seven
government PHCs in six backward districts of Karnataka
and make them into model centres. The new project
focuses on repositioning family planning in 14 PHCs
(seven earlier and seven new) in Karnataka. The PHCs
have 64 sub centres and reach a population of over 3
lakhs. The project aims to empower men and women to
lead healthy lives by being able to regulate their own
fertility through family planning services at the village
level.
The grant is being used for strengthening systems and
structures to improve the quality of family planning
services delivered through these PHCs and their sub
centres. This includes building the capacity of the staff
on PHC management, counseling on family planning,
sexual and reproductive health, improving supply chain
management of oral contraceptives and providing IUD
insertion and sterilization services at all the PHCs. The
project will work to create a demand for quality family
planning services through innovative IEC and behaviour
change communication programmes. It will also work
towards accreditation for the PHCs from the National
Accreditation Board for Hospitals.
The project works at repositioning family planning and
addresses three of our focus areas: delay age at first
pregnancy, promote spacing between births, and improve
the quality of RCH and primary health care services.
3. Legal Interventions to Address the Health
Needs of Women, Children and Adolescents
Project partner: Socio-Legal Information Centre (SLIC)
The project aims to increase availability, enhance quality
and expand access to reproductive health services for
women, ensuring that every family is planned. This will
be done by increasing the capacity of PFI partners, NGOs,
lawyers, paralegals and judges to use legal instruments and
mechanisms to address reproductive health, especially
family planning needs, and prevent child marriages.
SLIC plans to strengthen the implementation of
government schemes, expand access to health and family
Interventions by SLIC will enhance the quality of health services for women and children.
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planning services, and raise awareness of human rights
through the use of strategic legal interventions, capacity
building programmes and legal literacy materials. It will
make use of the Public Interest Litigation (PIL), a unique
feature of India’s judicial system, that permits any person
to file a petition on behalf of vulnerable and marginalized
members of the society. The orders of the Supreme Court
on identified PIL issues cover the entire country and are
enforceable in all states across India. Similarly, High
Court judgments carry binding force within the respective
state and can be used in other states to obtain similar
judgments.
The project interventions reposition family planning
within a reproductive health and human-rights
framework, addressing all the six focus areas.
4. Ensuring reproductive rights of women in 300
gram panchayats across five districts of Himachal
Pradesh
Project partner: SUTRA (Social Uplift Through Rural
Action)
The project proposes to scale up SUTRA’s previous work
on preventing sex selection in 55 gram panchayats. An
evaluation of the model has shown that mobilization
of women through various village/panchayat level
institutions – Kanya Bachao Samitis (KBS), Mahila Gram
Sabhas (MGS), mahila mandals, and Self Help Groups –
is its strength. In each village SUTRA has been able to
mobilize around 30-40 women as a part of KBS and 80-90
women as a part of MGS.
PFI will support SUTRA to scale up the model to 300 gram
panchayats with the worst child sex ratio in five districts
of Himachal Pradesh – Kangra, Mandi, Sirmaur, Solan and
Una. From each district, two blocks have been selected
based on their adverse sex ratio status, and the strength
of the partner organizations. SUTRA will lead the effort
along with four local partner organizations. As the project
title, Ensuring Reproductive Rights of Women, indicates,
a more comprehensive approach of reproductive rights
and family planning will be adopted in the new project in
addition to the strategies used in the previous phase.
The new project will involve the community through
Mahila Mandals, Ekal Nari Shakti Sangthans and SHGs
to promote change in the health-seeking behaviour
especially with regard to RTI/STIs. It will work towards
increasing women’s access to information on reproductive
and sexual rights to enable them to choose methods for
spacing or limiting family size, and use MGS-KBS to
promote gender equality, and build a people’s movement
against sex selective abortions.
The project addresses two key areas – promoting spacing
methods of contraception and preventing sex selection.
5. Generation of evidence for development of
guidelines to strengthen comprehensive maternity
management system
Project partner: Foundation for Research in Community
Health (FRCH)
One of the prime reasons for limited use of family
planning services, in spite of the huge unmet need and
high awareness, is their poor quality. The quality and
uptake of family planning services can greatly improve
with the introduction of guidelines and the setting of
standards.
The grant supports FRCH to explore perspectives
on guidelines with multiple health providers in
three implementation states; generate evidence for
development, modification/adaptation of guidelines;
demonstrate the value of guideline adaptation in
achieving good outcomes through case studies, both at the
state and the national levels; and select areas for guideline
implementation in these states for the next phase of
the project.
The project fits into PFI’s strategy of improving the
quality of care and service of family planning and
reproductive health programmes.
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PFI-Supported
Projects
Sl.
No.
Project Name
Implementing Partner Project Duration
Geographical
Coverage
1 PARIVARTAN - A Family JK Tyre Limited
Welfare and Population
(A division of JK
Development Project
Industries Limited)
5 years (July 15, 2004
to July 14, 2009). No
cost extension given
till July 2012.
60 villages in
Rajsamand block of
Rajsamand district,
Rajasthan
Approximate
Demographic Reach
40, 000 people
2 Total Management of
Karuna Trust,
Essential Reproductive and Bangalore
Child Health (RCH) and
Primary Health Care (PHC)
through Public-Private
Partnership: A Model and
Innovative Project
3 Repositioning Family
Karuna Trust,
Planning in Primary Health Bangalore
Centres in Karnataka through
Public Private Partnership
5 years (May 2006
till April 2011). No
cost extension till
September 2011.
7 PHCs from 6 districts 2,10, 000 people
of Karnataka
3 years (April 2012 to 14 PHCs from 12
3,13,000 people
March 2015)
districts of Karnataka
4 Improving Reproductive and Krishi Gram Vikas
5 years (May 2007 to
Child Health Status of the Kendra (KGVK) –
April 2012). No-cost
Tribals in Noamundi Block, CSR division of Usha extension given till
West Singhbhum District of Martin Ltd., Ranchi, October 2012.
Jharkhand
Jharkhand
34 villages of
Noamundi block of
West Singhbhum
district, Jharkhand
30,000 people
5 A Model Initiative to Ensure The Himalayan
Quality Family Planning
Institute Hospital
Services in Uttarakhand
Trust (HIHT),
Dehradun,
Uttarakhand
4 years (September 1,
2008 to August 31,
2012)
Doiwala block of
Dehradun district and
slums of Rishikesh
31,000 eligible couples
6 Naya Savera II- Building on
gains and addressing gaps in
Reproductive Health and
Family Planning
J.K. Lakshmi Cement 4 years (August 2008
Ltd. Sirohi, Rajasthan to July 2012)
16 villages in
Pindwara block of
Sirohi district
50,000 people
7 Mobilizing the Unreached: Centre for North East 3 years (September
The islands on the
One lakh people
Using Behaviour Change
Studies and Policy
2009 to August 2012) Brahmaputra river in
Communication and ensuring Research (C-NES)
5 districts of Assam
quality Family Planning
(Dibrugarh, Tinsukia,
services through Boat Clinics
Dhemaji, Sonitpur and
in Assam
North Lakhimpur)
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Goal
Objectives
Improve reproductive and child health
(RCH) status in 60 project villages through
an integrated approach.
1) Raise awareness and knowledge of the community on RCH issues and general health
through IEC and BCC programmes 2) Provide quality RCH services through the mobile
health team 3) Take up socio-economic development activities to enhance the effectiveness
and acceptability of the programme.
Demonstrate models of PHCs, which
effectively deliver essential RCH and
primary health care services through Public
Private Partnership in seven PHCs in
Karnataka.
1) Manage routine functioning of select government PHCs and strengthen them into model
PHCs 2) Maximize utilisation of RCH services at the sub-centres of the select model PHCs
3) Influence and facilitate change for improved health-seeking behaviour in the communities
covered by the model PHCs.
Empower men and women lead healthy,
productive and fulfilling lives, and exercise
the right to regulate their own fertility
through family planning services at the
village level.
1) Delay first pregnancy 2) Increase spacing between births 3) Improve quality of care of
family planning and primary health care services through accreditation and continuous
monitoring and review.
Ensure improvement in Reproductive
and Sexual Health (RSH) status and the
acceptance of family planning methods
among the under served tribal population
of Noamundi block in West Singhbhum
district of Jharkhand.
1) Generate awareness among eligible couples (women in the age group 15-49 years and their
husbands) on use of modern contraceptives for family planning and child spacing 2) Increase
use of modern contraceptives among eligible couples by providing a basket of choices
through social marketing and improving access to both male and female sterilizations 3)
Create community-based mechanisms and linkages for improved health services and referrals
4) Build awareness and capacities of adolescents in contraception and neonatal care.
Develop and implement an innovative
model of ‘quality’ family planning services
in Doiwala block of Dehradun District
and the adjoining slums of Rishikesh
(Chandreshwar Nagar).
1) Identify the unmet need for contraception among the eligible couples (wherein the
women are in the age group 15-49 years) 2) Enhance awareness among eligible couples
about family planning through appropriate communication strategies for behaviour change
3) Reinforce service providers’ (ANMs/Nurses, ASHAs) capacities in counselling and
quality services for family planning including infertility 4) Provide a basket of choice of
safe and effective family planning methods (including NSV, female condoms, injectable
contraceptives, emergency contraception, etc) to eligible couples of the area 5) Document
the process and results of the intervention and share the learning with various stakeholders,
including the Government.
Sustain and improve upon the gains made
in the previous phase and extend the
project activities to six new villages.
1) Increase the acceptability of, and access to family planning methods by promoting
informed choices and behaviour change communication 2) Ensure quality reproductive and
child health services through a mobile clinic and improve linkages with the government 3)
Prepare unmarried adolescents for responsible parenthood by increasing their knowledge on
ARSH issues and imparting life skills 4) Document the learning, processes and good practices
for replication and scale-up.
Ensure improvement in the family
planning/RCH status of vulnerable
population on the islands known as Chars/
Saporis in the Brahmaputra river in Assam.
1) Increase awareness on reproductive health and family planning issues among eligible
couples (women in the age group 15-49 years and their husbands) 2) Enable behaviour
change through a need-based comprehensive communication package 3) Build sustainable
capacities in interpersonal communication including counselling skills, in delivering
quality family planning services and in effective documentation 4) Improve availability of
and accessibility to modern contraceptives for eligible couples including services for IUD
insertion, injectables and establish effective linkages/referrals 5) Document learnings,
processes and best practices for scaling-up.
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Sl.
No.
Project Name
Implementing Partner Project Duration
Geographical
Coverage
Approximate
Demographic Reach
8 Improving Access to Quality SMILE Foundation
Family Planning Services for along with 3 NGO
Young Women in Urban
partners (Aadhar,
Slums of Delhi
Sehyogita, Health &
Care Society)
18 months (January
2011 to June 2012).
No-cost extension
granted till September
2012.
8 urban slums of Delhi
One lakh people
9 KHUSHALI: A family
Agragami India
planning programme to
bring about sustainable
improvement in the health
and well being of poor and
disadvantaged families in
the urban slum of Madanpur
Khader, New Delhi
10 Legal Interventions to
Address the Health Needs
of Women, Children and
Adolescents
Socio-legal
Information Centre
(SLIC)
11 Generation of evidence for
development and use of
guidelines to strengthen
comprehensive maternity
management system
Foundation for
Research in
Community Health,
Pune
3 years (June 2012 to Madanpur Khader
May 2015)
slum, New Delhi
53,000 people
2 years (May 2012 to
April 2014)
Vulnerable and
underprivileged
women, adolescents
and children in the
eight Empowered
Action Group (EAG)
states
18 months (May 2012 Maharashtra, Bihar
to October 2013)
and Assam/ Odisha
12 Health Education Programme Multi Applied Systems 3 years (May 2008 to
for Adolescents (HePA)
(MAS), Bhubaneswar, April 2011). No cost
Odisha
extension till June
2011.
25 villages in Ganjam 25,000 people
block, Ganjam district,
Odisha
13 Sustainable Action Against Social Uplift
3 years ( March
Declining Sex Ratio at Birth Through Rural
2009 to March 2012
in the states of Himachal
Action (SUTRA) for including one month
Pradesh, Haryana and Punjab Himachal Pradesh
no-cost extension)
and Voluntary Health
Association of Punjab
(VHAP) for Haryana
and Punjab
55 gram panchayats
(Solan and Sirmour
districts in HP); 40
villages in Fatehgarh
Sahib, Patiala
(Punjab), Ambala and
Kurukshetra districts
(Haryana)
44,500 people in
Himachal Pradesh;
24,000 people in
Punjab; and 22,000
people in Haryana
14 Ensuring Reproductive Rights Social Uplift through
of Women
Rural Action
(SUTRA)
3 years (May 2012 to
April 2015)
300 gram panchayats
in 5 districts of
Himachal Pradesh:
Kangra, Mandi,
Sirmaur, Solan and
Una
7,09,500 people
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Goal
Objectives
Improve access to family planning services
through effective BCC, quality service
provision and empowerment of women.
1) Facilitate adolescent girls aged 13-19 years as change agents, to bring about improved
health-seeking behaviour in the community on issues of reproductive health and family
planning 2) Promote positive behaviour change among eligible couples (with a focus on
women in the age group of 15-24 years) through IEC/BCC activities (Improve couple
communication; Empower women for decision making on reproductive health/ family
planning; Enable increased demand for and utilisation of reproductive health/ family
planning services) 3) Establish a model with promising practices for scaling-up 4) Increase
access to quality family planning services with an emphasis on young people.
Demonstrate for future replication
at greater scale (covering another
25,000 population), a cost effective,
comprehensive urban slum family planning
programme that will reduce fertility, and
bring about sustainable change in the
health and well being of mothers, children
and families.
1) Empower adolescent girls and boys aged 15-19 years, to take safe and responsible
reproductive health decisions as they grow into adulthood, so that age at marriage is
increased and the first child is delayed 2) Increase community acceptance of delaying the
first birth till the woman is 21 years of age, and the use of contraception by couples to delay
the first child 3) Increase community acceptance of a minimum interval of 36 months
between two children, and the use of contraception to space children 4) Improve access to,
and increase acceptance of, long-acting and permanent contraceptive methods so that small
families are achieved.
Recognize and protect the reproductive
rights of women and adolescents.
1) Increase availability, enhance quality and expand access to reproductive health services
for women, ensuring that every family is a planned family 2) Increase the capacity of PFI
partners, NGOs, lawyers, paralegals and judges to utilise better a rights-based framework
using legal instruments and mechanisms to address reproductive health, especially family
planning needs, and prevent child marriages 3) Increase legal literacy and public awareness
of human rights and entitlements that guarantee access to reproductive health.
Demonstration of a comprehensive
maternity management system with a focus
on development of guidelines.
1) Generate of evidence for development, modification or adaptation of guidelines for
a comprehensive maternity management system 2) Demonstrate the value of guideline
adaptation in achieving good outcomes through case studies, both national and state
3) Explore perspectives of guidelines among multiple health providers in the three
implementation states 4) Select areas for guideline implementation in these states for the
next phase of the project.
Address adolescent girls aged between
12–19 years; reduce prevalence of Iron
Deficiency Anemia (IDA) through control
of hookworm infestation; and empower
them with knowledge on ARSH/family
planning issues with a larger objective of
reducing maternal and infant mortality.
1) Demonstrate a model for reducing the prevalence of IDA among adolescent girls in
the age group of 12–19 years through control of worm infestation and BCC 2) Empower
adolescent girls with increased knowledge on IDA, reproductive and sexual health and
family planning 3) Scale up the project based on the outcomes 4) Increase awareness of and
access to contraceptives for married adolescents.
Improve the child sex ratio.
1) Raise awareness on relevant laws in favour of safe abortions and against sex-selective
abortions 2) Develop capacities of local institutions of governance like panchayats to
monitor sex ratio at birth and involve them in the campaign against sex-selective abortion
3) Provide support at the community level through peer groups like the Mahila Mandal
in helping women take independent decisions against sex-selective abortion and in favor
of safe abortion 4) Advocate with public institutions in the health and women and child
development departments to ensure support for activities related to reducing sex selective
abortions.
Ensure reproductive rights that should
1) Create ownership of the issue at the community level through organizations like Mahila
result in better reproductive health,
Mandals, Ekal Nari Shakti Sangthan and SHGs 2) Promote change in the health-seeking
improved sex ratio at birth, and increased behaviour in the context of RTI/STIs 3) Increase women’s access to information on
adoption of non-terminal methods of family reproductive and sexual rights, enabling them to choose methods for spacing or limiting
planning.
family size 4) Monitor public institutions like government health facilities, anganwadi
centres to ensure necessary support and services, as a measure to reduce gaps in reproductive
health services 5) Create larger forums in the form of Mahila Gram Sabha to address gender
discrimination and promote gender equality.
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Community Action:
Empowering Communities to
Plan and Monitor
Population Foundation of India has played a key role
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 of eminent public health professionals
constituted by the Ministry of Health and Family Welfare,
to provide oversight and guidance on community action
under NRHM.
PFI has also been involved in building the capacities of
the community’s representatives – panchayat leaders,
community-based and voluntary organizations – to plan
and monitor public health services. The work is beginning
to show results as communities become more aware of
their entitlements.
Rolling out Community Monitoring
in Bihar
PFI was involved in the implementation of the pilot on
community monitoring in 2007-09 in nine states. It has
now been designated as the State Nodal-cum-Technical
Agency for the roll out of the Community Based Planning
and Monitoring (CBPM) under the National Rural
Health Mission (NRHM) in Bihar. The project is being
implemented in Bhagalpur, Darbhanga, Nawada, Gaya
and Jehanabad districts of Bihar.
The health of the community improves when people begin to plan and
monitor the quality of health services.
In the first phase, the project will cover a total of 300
villages, 50 panchayats and 10 blocks in the five districts.
The goal is to bring about significant improvements in
the delivery of health care, and improve the health status
of the people in the rural areas through increasing their
participation.
A State Advisory Group for Community Action
(SAGCA) and a State Technical Assistance Group
(STAG) had been formed to guide the overall
implementation of the CBPM project and work on the
technical aspects, such as, adaptation of training manuals
and tools in the context of Bihar.
This year, the following work was undertaken –
• A screening committee formed with PFI as the
convener under STAG went through the proposals
from NGOs which had expressed interest in being part
of the process. Field appraisals were undertaken using a
detailed checklist and five district-level NGOs and 10
block-level NGOs were selected after reference checks.
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• The community monitoring tools were shared with
STAG members, pretested and adapted to Bihar.
• 300 village planning and monitoring committees
(VPMC) have been formed and their members trained
on community monitoring and the enquiry process.
• Block and district-level planning and monitoring
committees have been formed and their members
trained in community monitoring.
• Community enquiry tools and modules have been
developed.
• Scripts for Kala Jathas were finalised and the teams
trained by a professional agency.
• Community mobilization through Kala Jathas in all
villages of the project area has been done.
• Village profiles have been prepared through the ‘know
your village’ process, which involves the community
and is facilitated by the nodal NGO.
• Participatory community enquiry which led to the
generation of report cards in all 300 villages, have
been shared at the village and panchayat levels.
• Workshops have been held with religious leaders
and women members of Self Help Groups on
communitization, health rights and community
enquiry .
A health service providers meeting in Bihar.
A village profile is being prepared.
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I mpact
An aware community demands better
services
The training of the members of Village Planning and
Monitoring Committee (VPMC) has helped generate
awareness among the villagers regarding their health
rights. This has brought about a number of changes.
Earlier, they used to pay money for getting their
entitlements like the health card/ JBSY (Janani Evam
Baal Suraksha Yojana) card, but after the training they
and other villagers have been refusing such payments.
The community enquiry process has generated
awareness among women and other marginalised
sections about health rights and entitlements and they
have started to demand services. ANMs report that the
community members now demand four ANC check-
ups, post natal care/post delivery home visits. They
are reluctant to pay for services, which they know are
provided for by the government. Disbursement under
JBSY is becoming regular and more frequent. Health
care service providers are becoming more accountable
towards the need of the community in these areas.
Earlier, VHSCs had only the ANM and the mukhiya,
but after the community monitoring process has been
initiated, VHSCs have been restructured and include
more members.
The community plans and utilizes
untied funds
Before the training
on community
monitoring, the
village mukhiyas did
not know how to plan
and spend the untied
fund of the VHSCs.
The Mukhiya of Jaipur
panchayat says he did
not know about
untied funds at all as he had been elected for the first
time. The training has helped him plan for his village.
VPMC members who have also been trained now realise
the importance of the untied grant and pressurize the
mukhiyas, ASHAs and ANMs to utilize the money in an
effective manner. Ms Sangeeta Devi, VPMC member
of Kafarpur village of Dharnai panchayat, stated that
untied funds were not being used by her panchayat as
the members were not aware of the entitlements. She
went to the mukhiya and demanded that the funds be
used. They were spent on improving the sanitation in
the village.
Motivating community to use and monitor
government health services
At many villages, VPMC members are actively raising
awareness on immunisation and motivating the
community to utilise government health facilities. They
are also motivating them to monitor these services.
Strengthening the VHSND concept
Efforts are on to make the VPMC members aware of the
Village Health, Sanitation and Nutrition Day (VHSND)
concept and services to be provided to the community.
The involvement of VPMC has helped the community to
access a range of services provided on VHNSDs other than
immunization and routine check-up. The departments of
Health and Women and Child Development have started
collaborating in providing the services.
Active engagement of
elected representative
Elected representatives have
begun participating actively in
various community meetings,
enquiry processes, endorsement
of VPMC and in strengthening
the Rogi Kalyan Samitis.
As a next step, jan
samwads will be
organized where the
community shares
its experiences
with the
providers.
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Action on the ground
As a part of a national pilot in 2007-09,
Community Monitoring was implemented
in Barwani district under the guidance of
the AGCA. The community was made aware of its
entitlements, and empowered to monitor health services
and seek redressal. Therefore, when there were 25
maternal deaths in Barwani, a predominantly tribal
district of Madhya Pradesh between April and December
2010, mass protests were held under the banner of Jagrit
Adivasi Dalit Sangathan (JADS), a community based
organization. The people wanted corrective measures and
accountability from the district and state health officials
for its gross failure to deliver services as mandated under
National Rural Health Mission (NRHM).
Fact Finding by the AGCA
An AGCA team led by the PFI Executive Director, Ms
Poonam Muttreja, visited Barwani in March 2011 to
review the reasons for the maternal deaths. The AGCA
team shared its report and key recommendations with
the Ministry of Health and Family Welfare (MoHFW)
and state health officials for corrective action.
Subsequently, in November 2011 a Public Interest
Litigation (WP- PIL NO -5097/11) was filed by Smt
Duna Bai with support from JADS in the Madhya
Pradesh High Court regarding maternal health services
in Barwani district. The High Court in its interim order
on the PIL petition took cognizance of the AGCA
team’s report and directed the MP government to
implement the recommendations contained in it.
The state government invited the AGCA to discuss
the PIL and identify actionable steps for improving
health services in Barwani in February 2012. Among
the measures discussed were the drawing up of a one-
year plan for the district by the state government to
implement the AGCA recommendations and a short-
term plan (over the next two months) for the most
doable recommendations like initiating help desks at
the District Hospital; community and facility-based
maternal death reviews and a plan for corrective action;
improving knowledge/skills of ANMs on antenatal care;
and the compilation, analysis and redressal of issues and
complaints made by the patients. The AGCA offered to
design and operationalise a Grievance Redressal System
and develop modules for training on Community Action.
The AGCA members expressed their concern
regarding the delay in the appointment of specialists
and construction work, which in turn, had delayed the
provision of a range of services as mandated under the
NRHM at the District Hospital and the Community
Health Centre. The State Mission Director instructed
the civil works department to provide a detailed
time frame for the completion of all civil work in the
district. He also instructed the HR department to issue
notices to all doctors not attending duty, or on leave,
to report back to their duty station immediately.
The AGCA members advised that given the
shortage of doctors, especially gynecologists, and the
increasing demand for institutional deliveries, it was
important for the medical staff to focus attention on
emergency obstetric care. Instead of pursuing targets
for sterilization, contraceptive choices for temporary
methods should be encouraged, and the quality of
care for family planning services be improved and
monitored.
Committee to monitor action plan
A committee comprising state NRHM officials and
AGCA members has been constituted to review
and monitor the implementation of the action plan
submitted to the Madhya Pradesh High Court.
The Madhya Pradesh government submitted its
response on the PIL to the High Court in April 2012.
Subsequently, the High Court directed the state
government to appraise it of the progress made on the
implementation of AGCA’s recommendations. A team
led by the state Health Commissioner visited Barwani
to assess the progress. The key measures taken by the
state government to improve health services in the
district include posting of 40 doctors, completion of
infrastructure work in four CHCs and the PHCs, and
addressing gaps in procurement and distribution of
essential drugs.
The AGCA Secretariat is providing technical support
to the state government in developing training
modules for state, district and block level mentoring
groups on community action. This will strengthen the
implementation of Community Based Monitoring and
Planning (CBMP).
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Research:
The Foundation of our Work
Research informs PFI’s advocacy efforts. It gives
direction to our work, and helps us influence and
shape policies and programmes based on ground
realities. Periodic evaluations are carried out on our field
projects, so that promising practices and key learnings can
be incorporated in our programmes. In addition, this year,
two vital researches were undertaken.
A Systematic Review of Evidence on Family
Planning Policies and Interventions
A Systematic Review of Evidence on Family Planning Policies
and Interventions based on National and International
Experiences has been initiated. This will strengthen the
evidence base to inform and guide policy advocacy,
programme implementation and support PFI’s long-term
strategic plan (2011-16) for repositioning family planning
within a women’s empowerment and
human rights framework in India.
The review is focussed on four key areas
of our Strategic Plan – (i) delaying age at
marriage (ii) delaying age at first pregnancy
(iii) promoting spacing between births
and (iv) improving quality of care of
family planning and reproductive health
programmes. A Technical Advisory Group
(TAG) has been set up to guide the process
and help inform policies, programmes and
identify areas for further research. The first TAG meeting,
held in May 2012, helped to finalise the scope of the review
and the methodology.
The review has shortlisted 167 of the 230 documents
which were downloaded from various databases and
grey literature. In addition, evidence was also generated
through discussion on Solution Exchange MCH
Community. TAG will meet to discuss the findings of the
review and make recommendations.
A similar exercise has been initiated in Bihar to analyse
existing policies, interventions and partnerships on family
planning in the state. This includes a review and analysis
of the state NRHM Programme Implementation Plan and
stated outputs in the last three years to identify trends,
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strategies and implementation gaps/bottlenecks around
population stabilization efforts. The results will feed into
advocacy efforts at the state level so that appropriate
strategies can be adopted to address the gaps and increase
focus on family planning.
The research is being done under a grant from the David
and Lucile Packard Foundation.
Evaluation of a GoI scheme on Home Delivery
of Contraceptives by ASHA
PFI evaluated the national pilot scheme – Home delivery of
contraceptives (condoms, oral contraceptive pills, emergency
contraceptive pills) by Accredited Social Health Activists
(ASHAs) at the doorstep of beneficiaries.
The Government of India had wanted an independent
and objective evaluation of the scheme for necessary
corrections and scaling up to other districts. The Family
Planning Division of the Ministry of Health and Family
Welfare approached PFI to conduct the review.
The scheme was launched in August 2011 as the uptake of
contraceptives had been low despite a significant unmet
need for spacing methods. Twenty percent of couples
were having children they did not want as contraceptive
services did not reach them. Eighty three per cent of
Indian women who had two or more children did not
want any more. But only 48.5% were using modern
family planning methods. The delay in making supplies
available at the sub-district level and below was a major
barrier in making contraceptives accessible to families.
The pilot scheme covered 233 districts across 17 states.
It aimed at improving accessibility and availability of
contraceptives to eligible couples by getting ASHAs to
deliver contraceptives to households at their doorstep.
The scheme gave incentives to ASHAs to undertake this
additional responsibility.
PFI conducted the review in three states – Odisha, Bihar
and Madhya Pradesh. Three districts were selected for
the purpose, and two blocks were picked in each of the
districts based on their performance. While one block
had good performance, the other block had not done
so well. A quantitative survey of 491 households spread
across the three states and a qualitative data collection
through focus group discussions and in-depth interviews
was undertaken. The results have been shared with the
government.
Visiting Scholar
Abhijit Visaria, a visiting scholar of demography from
the University of Pennsylvania spent eight weeks at PFI
exploring Religion and Gender Bias: An Exploration of
Hindu-Muslim Differences in Son Preference in India.
During his time at PFI, he interacted with the
programme staff and made use of the extensive material
available in the library.
Abhijit is examining data from two waves of the
nationally-representative National Family and Health
Surveys, 1998-99 and 2005-06 to determine if and to
what extent does son preference differ between Hindus
and Muslims, the two largest religious groups in India.
Using women’s self-reported preferred sex composition
of their children and stratifying the sample by ideal
parity, his findings show that Muslims in general have
a lower son preference compared to Hindus. While a
strong educational gradient is seen, household wealth
appears to be unrelated to son preference.
There is also evidence supporting previous research
which suggests that exposure to media and women’s
empowerment in the household are both associated with
lower levels of son preference. The religious difference
in son preference remains strong and significant after
controlling for these known socioeconomic determinants
of son preference, and suggests that religious identity,
beliefs and practices, especially among the majority
Hindus in India may be a key cultural explanation for
the persistence of son preference. The results have an
impliction for understanding whether son preference
will affect Hindu and Muslim demographic trends
differentially in the future – in particular, the effectiveness
of family planning programmes, further declines in desired
fertility, and future trends in sex ratios.
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Advocacy and
Communication
A CSO consultation in Patna.
PFI functions as a think-tank. Ideas, discussions and
debates are an inherent part of our work. We are at
the grassroots listening to the unheard, getting the
voiceless to speak up, and we engage with the best minds
in the country and abroad on issues of maternal and child
health, family planning and development. We use our
research findings and field experiences to advocate and
shape policy formulation and its implementation at the
state and national levels. This makes advocacy a critical
component of our work, vital to achieving the goals we
have set out in our five-year strategic plan.
PFI encourages public dialogue addressing information
gaps that might exist to build consensus among different
stakeholders to stimulate the required change.
PFI provides technical support to the government and
other civil society organizations on behaviour change
communication (BCC), and also develops publications
and other print and audio-visual material to generate
awareness on issues of family planning, reproductive and
child health. Behaviour change communication is an integral
component of projects supported or implemented by PFI.
The Community Based Planning and Monitoring programme
that we are implementing is fuelled by behaviour change
communication to a large extent. Through information, it
gets the community and its members to act in ways it did not
earlier. (For more, see Section on Community Action page 22)
Regular updates are posted on our website - www.
populationfoundation.in. Our facebook page and twitter
accounts have been activated.
PFI’s participation in activities and events held during
the year for advocacy and communication around family
planning and reproductive health issues are described in
this section.
I. Advocating Change:
Repositioning Family Planning,
Promoting Birth Spacing
PFI launched a three-year advocacy project in October
2011 to reposition family planning within a women’s
empowerment and human rights framework, so that every
family is a planned family and every child a wanted,
healthy child. The project focuses on three of the six key
areas identified under PFI’s strategic plan. These are:
• delaying age at first pregnancy
• promoting spacing between births, and
• improving quality of care of FP/RH programmes.
The project works towards:
• Strengthening government programming for family
planning at the national level and in Bihar through
evidence based advocacy
• Informing the advocacy strategies by reviews and
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analyses of programmatic innovations and policies and
• Demonstrating a convergence approach at the district
level to change social norms and improve outcomes
around the three key issues.
In two districts of Bihar – Darbhanga and Nawada – the
project is working to make ASHAs, AWWs, ANMs, and
members of the village health sanitation and nutrition
committees and Panchayat Raj Institutions ‘advocates
for change’. They will operate at different levels –
village, gram panchayat, block and district. They will
be empowered to bring about change in social norms
related to early and high fertility, in delaying age at first
pregnancy, increasing the space between births, and
improving the quality of family planning and reproductive
health services.
The advocacy work of the project will be informed by a
review of international best practices and innovations that
have demonstrated results in delaying first birth, spacing,
improving the quality of services, expanding the basket
of choice, and efforts to reposition family planning as a
central intervention in maternal and child health (MCH)
programmes. (For more, see the Section on Research page
26). The review has been launched and its findings will
help identify gaps in policy and programmes and to find
ways of bridging them.
The project is being supported by the David and Lucile
Packard Foundation.
II. Participating, speaking, urging ... our
presence at significant events
PFI actively participates in and coordinates events that shape
national and international priorities around family planning
and reproductive health. PFI brings in 40 years of experience:
lessons learned, challenges faced and overcome and field
realities that need policy attention. These are shared at
various platforms and at relevant forums by the Executive
Director and the PFI staff to enrich recommendations on the
way forward. Some of the important meetings and events
attended or co-facilitated by PFI were:
a. Ending child marriage
Eminent Indian leaders to champion efforts
PFI brought together a group of eminent Indians in
New Delhi on February 8, 2012 to support efforts to
end child marriage in India. The leaders drawn from
the government, law, business, the arts and civil society
agreed to champion the cause of ending child marriage
at a meeting co-hosted by the Population Foundation of
India (PFI) and The Elders, a group of global leaders who
are working on human rights.
From left to right: Dr Syeda Hameed, Naina Lal Kidwai, P. D. Rai, Ela Bhat, Shantha Sinha, Leila Seth, Dr Gro Bruntland, Archbishop
Desmond Tutu, Poonam Muttreja, Mary Robinson, Sharmila Tagore and Mrinal Pande. (Photo: Girls not Brides)
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The Indian leaders discussed ways to address the issue of
child marriage with the Chair of The Elders, Archbishop
Desmond Tutu of South Africa; SEWA founder, Ela
Bhatt; former Norwegian Prime Minister, Dr Gro
Brundtland; and former Irish President, Mary Robinson;
who were in India to promote equality for girls and
women.
Those who have agreed to become champions to end child
marriage in India include Leila Seth, former Chief Justice;
Mrinal Pande, Chairperson, Prasar Bharati Secretariat;
Naina Lal Kidwai, Country Head of the HSBC Group;
P. D. Rai, Member of Parliament; Sharmila Tagore, actor
and UNICEF Goodwill Ambassador; Shantha Sinha,
Chairperson of the National Commission for Protection
of Child Rights; and Dr Syeda Hameed, Planning
Commission member.
PFI has warmly welcomed their support in raising
awareness about the negative impact of child marriage on
women and their families, and for promoting solutions to
end the practice.
National and regional consultations
Population Foundation of India participated in a national
consultation and two regional consultations organized by
the National Commission for Protection of Child Rights
(NCPCR) to work out strategies to end child marriage.
The Executive Director, Ms Poonam Muttreja, was the
moderator at the national consultation held on December
5, 2011 in New Delhi. The regional consultations were
held in Bangalore and Hyderabad on December 23, 2011
and January 7, 2012 respectively. The Joint Director,
Advocacy and Communication, Ms Sona Sharma, made
a presentation highlighting why it is imperative to work
towards ending child marriage. At these consultations,
senior state government officials and NGOs deliberated
on the challenges and the way forward to end child
marriage in their states.
b. Repositioning family planning
Sharing India’s experiences
PFI Executive Director spoke on India’s experience with
family planning at the International Conference on Family
The lessons from India’s experience
An extract from the Executive Director’s speech at the International Conference on
Family Planning, Dakar, November-December 2011
One – It is obvious that economic growth alone is
not sufficient to lower fertility rates. India has been
experiencing close to 8% GDP growth rate over the
past 15 years – and yet we find that women’s access to
reproductive health is limited.
Two – For a population policy to succeed, it is
important to count on people, and not simply count
people. In other words, fertility reduction is not about
numbers and CPR (Couple Protection Rates). It is
about investing in people and women, particularly in
their education, in their empowerment, in their access
to reproductive health, in their nutrition. It is for this
reason that some of us often say in India take care of
people, and population will take care of itself.
Three – India’s nasty experience with forced
sterilization and the success without use of coercion
clearly points out that use of force, use of penalties, etc.
in family planning programmes is unwarranted. The
proven path to reducing fertility is to improve child
survival, improve women’s access to education, family
planning methods, reduce poverty and so on.
Four – Fundamental to the success of any family
planning programme has to be the enhancement of
women’s freedoms. I refer to the freedoms that young
women need to exercise when it comes to deciding
when to get married (age at marriage), when to have
children, how many children to have, and so on. This
requires society to address the distortions of patriarchal
societies where the voices and rights of women are often
suppressed.
Five – Repositioning family planning requires strong
service delivery and technical support. Family Planning
should not be implemented as a vertical programme;
there is need to prevent infections (STIs, RTIs, HIV/
AIDs); there is need to improve women’s health and
nutritional status; there is need to fill quality deficits in
supply; and there is need to educate and empower women
to make informed choice; fulfilling the huge unmet need
for sexuality education for young people. These are the
concerns and discussions here in Dakar too.
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Planning, Research and Best Practices held in Dakar, Senegal,
on December 2, 2011. The Prime Minister of Senegal,
ministers and senior government officials from different
countries, were present. The conference examined cutting
edge research and programmes that are helping to advance
the health and wealth of families and nations worldwide.
While highlighting India’s population story over the
decades, Ms Muttreja went on to identify five lessons. (Box
page 30)
State consultations with civil society
PFI collaborated with the Family Planning Association
of India (FPAI) in organizing two state-level civil society
consultations in Chhattisgarh (May 26, 2012) and Bihar
(June 2, 2012) and a National Consultation in Delhi
(June 8, 2012). The consultations aimed at identifying
gaps in the family planning efforts and making necessary
recommendations. These consultations, were organized as
a prelude to the London Family Planning Summit so that
the voices of the Civil Society Organisations could bring
in a critical dimension to the debate at the global family
planning summit, which in turn, would impact the family
planning programme in the country.
London Family Planning Summit
The Executive Director, PFI was the civil society
representative at the Family Planning Summit held in
London on July 10, 2012 by the UK Government and
the Bill and Melinda Gates Foundation, with the support
of UNFPA and other partners. The summit aimed at
launching a global movement to give an additional 120
million women in the world’s poorest countries access
to life saving family planning information, services and
supplies, so that women could choose whether, when and
how many children to have. Leaders from developing and
developed countries, donors, civil society groups and the
private sector, attended the summit.
c. Improving child sex ratio
Contributing to policy and media strategy
The National Advisory Council (NAC) constituted a
Working Group on Gender and Declining Child Sex Ratio
in India to make recommendations around two specific
areas: 1) a national strategy for government advocacy,
communication and media messaging and 2) a critical stock
taking of the achievements and shortcomings of various
incentives schemes being implemented. The working
group with PFI as a member held its first consultation on
Government Advocacy, Communication and Media Messaging
on July 12, 2011 in New Delhi. PFI's Executive Director
was a discussant at the meeting on Elements of a Policy
Framework on Gender and the Sex Ratio: Towards a National
Consensus. Based on these consultations, the NAC
working group has drafted recommendations to tackle the
issue of child sex ratio, which includes the formulation
of a national policy on the declining sex ratio at birth, to
guide initiatives by the Central and state governments and
civil society stakeholders.
PFI is a member of the Sectoral Innovations Council
on Child Sex Ratio set up by the Government of India
to look at the entire gamut of issues connected with the
declining sex ratio. The council is mandated to identify
interventions that have worked and those that have not,
and to suggest innovative strategies and approaches to
address the issue in a time-bound and effective manner.
PFI participated in the meeting of the Innovations
Council organized on May 10, 2012 to review and seek
inputs on the draft report developed to address the issue.
d. Maternal health
Creating a buzz
PFI Executive Director attended the Maternal Health
Task Force (MHTF) Buzz meeting organized in New York
on October 3-5, 2011. The meeting discussed and debated
tough questions on maternal health and learnings from the
MHTF’s initiatives over the past three years. Ms Muttreja
was one of the four provocateurs at the meeting. She
made a 30-minute provocation on Creating a Buzz around
MDG5 – What Next? The presentation covered general
observations around maternal health and provocative
statements that questioned and highlighted deficits at the
macro level, community level and public action.
Family planning and maternal health linkages
A consultation on Ensuring Quality Services for Safe
Motherhood was jointly organized by the Ministry of
Health and Family Welfare, GOI, USAID, WRAI and
MCH-Star Initiative on April 11-12, 2012 at Jaipur,
Rajasthan to commemorate Safe Motherhood Day. Ms
Poonam Muttreja, Ms Jayati Sethi, Ms Sunita Singh and
Ms Sona Sharma from PFI attended the consultation.
The programme was co-hosted by the Ministry of Health
and Family Welfare, Government of Rajasthan. Ms
Muttreja shared reflections on some of the fundamental
linkages between maternal health and family planning.
Ms Jayati Sethi made a presentation on the results of a
systematic review of birth preparedness and complication
readiness. Two poster presentations – one on Community
Monitoring and the second on Repositioning Family
Planning were facilitated by Ms Sunita Singh and
Ms Sona Sharma.
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e. Reproductive and child health
Adolescent reproductive health and MDGs
Ms Poonam Muttreja, Executive Director, and Mr Alok
Vajpeyi, Acting Director, Programmes participated in
the international conference on Millennium Development
Goals related to Reproductive Health organized by National
Institute for Research in Reproductive Health, Indian
Council of Medical Research. A number of national
and international organizations participated in the
conference. The Executive Director was on the panel on
Adolescent Reproductive Health: Key to achieve MDGs and
made a presentation on repositioning family planning in
the context of adolescent health. The objectives of the
conference were to understand how far countries have
advanced, and are likely to achieve the MDGs related to
reproductive health; learn from the experiences of those
countries which are likely to achieve the MDGs and also
from those countries which are lagging behind; understand
the constraints and bottlenecks in achieving the goals;
and recommend strategies and interventions to ensure
that the MDGs are met.
ICPD 2014 review
PFI participated in the meeting India Civil Society Towards
ICPD@20 Review in 2014 organized by the YP Foundation
on March 22-23, 2012 in Mumbai. The meeting reviewed
the ICPD PoA in India, ICPD +5, +10 and +15; political
analysis and strategy designing of UNFPA’s Global plan
for ICPD+20, identified the next steps for key areas like
mobilization, evidence building/documentation and
advocacy; and discussed the modalities and membership of
the Steering Group Alliance beyond 2014.
Sharing experiences of working with PLHIV
A team from the PFI-GF staff participated in the XIX
International AIDS Conference in Washington D.C
from July 22 to 27, 2012. Dr Phanindra Babu Nukella,
Project Director, Mr. Raza Ahmed, Senior Program
Manager and Ms Debamitra Bhattacharya, Program-cum-
Documentation-Associate, attended the conference.
While Mr Raza Ahmed had a poster presentation on
Income generation opportunity for PLHIV,
Ms Debamitra Bhattacharya had a poster presentation
titled Decentralized community mobilization and quality of
care, support and treatment.
Researchers, program managers from around the world, and
individuals committed to ending the pandemic, had gathered
to share the latest scientific advances in the field, learn from
each other’s expertise, and develop strategies for advancing
collective effort to treat and prevent HIV infection.
f. Health of the urban poor
PFI facilitated participation of a team from India at the
International Urban Health Conference, 2011, in Brazil.
Three PFI staff members from the Health of the Urban
Poor (HUP) programme, and representatives from the
government of India and the government of Maharashtra
attended the conference. The conference focussed on
urban health action towards equity; action and evidence
of positive consequences in urban health interventions,
and the social and public policies required to address issues
related to urban health.
g. Access to health care and scaling up
The UN Foundation organized a panel discussion on
Reproductive Health Issues in India: Twenty years after
Cairo in New Delhi on March 29, 2012 for its board
members. Ms Poonam Muttreja facilitated the session on
Repositioning Family Planning in India.
Health for peace
Aman ki Asha, a bilateral non-governmental campaign
that advocates peace between India and Pakistan, invited
the Executive Director, Ms Poonam Muttreja, as a Track
Anchorperson at the Aman ki Asha Indo-Pak Health
Forum, a gathering of health
experts, on May 6-7, 2012 in
Lahore. Ms Muttreja was on the
panel Showcasing Innovations
– The paradigm shifts in
population reproductive health
in South Asia.
Engaging with the corporate sector
PFI shared views on Innovative Models for Enhancing Access
to Health Care at the Access to Health conference organized
by ASSOCHAM India on November 17, 2011. The
presentation by PFI discussed current realities of the health
care services, data on use of contraceptives, and new media
technologies for quality family planning services.
Scaling up
Ms Muttreja attended Achieving Lasting Impact at Scale:
Social and Behavioural Change and the Spread of Family
Health Innovations in Low-Income Countries, a
conference organized by Bill and Melinda Gates
Foundation, on November 1-2, 2011 in Seattle,
USA. The event provided an opportunity to
reflect on the challenges and opportunities
for scaling up of life-saving health
innovations.
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Training and
Capacity Building
Dr Rakesh Khattar, Chief Medical Superintendent, Jyotiba Phule
Nagar, UP and Dr Sultana Usmani from Advocating Reproductive
Choices handing out certificates for the Spitfire SMARTCHART
training in Lucknow.
As an organization engaged in advocacy, research
and behaviour change communication, PFI has
challenging tasks. To be able to perform these tasks
well, PFI lays emphasis on suitable training for its staff and
partner organizations. PFI is also actively engaged in building
the capacity of trainers to train ASHA workers in Bihar.
The following trainings were organized during the
reporting period (April 11, 2011 –July 31,2012):
Building a network of SMART advocates for
family planning
PFI has built the institutional capacity of organizations
in using the Spitfire SMARTCHARTTM tool to develop
effective advocacy strategies on family planning issues.
In all, 22 trainers and 55 programme planners and
implementers were trained in the two trainings conducted
in Bihar and Uttar Pradesh (UP).
PFI has collaborated with the Advance Family Planning
(AFP) project at the Johns Hopkins University,
Bloomberg School of Public Health, to strengthen the
SMARTCHART is a tool to help non profits make
smart communication choices.
capacity of potential leaders to plan, develop and manage
advocacy activities and campaigns related to reproductive
health and family planning in Bihar and Uttar Pradesh.
The partnership aims to create a cadre of programme
staff familiar with the use of Spitfire-based advocacy in
the two states and at the national level. It is expected
that participants, once trained, will be able to develop
effective advocacy strategies using a systematic approach
and principles of the SMARTCHART tool. The strategy
would then be implemented as part of their ongoing
programmes.
An expert group meeting and a Training of Trainers
workshop were conducted on January 17-18, 2012.
Dr Duff Gillespie from Johns Hopkins University led the
exercise of adapting the tool to the Indian context and
was the Lead Trainer at the training of trainers selected
from PFI and other organisations.
Subsequently, PFI organized two state-level Spitfire
SMARTCHART trainings, one each in Bihar and UP.
Representatives from the state governments and NGOs,
and PFI state office staff participated. The trainings were
led by the PFI staff. Trainers from other organizations
who had been trained in January 2012 co-facilitated the
trainings. A third training was also planned for NGO
representatives in Bihar.
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Learning about the power of positive deviance
enquiry
In June 2012, PFI organized a talk on New Directions in
Communication and Entertainment Education and a half-
day workshop in New Delhi on positive deviance by Dr
Arvind Singhal, Professor and Director of the Social
Justice Initiative at the Department of Communication,
University of Texas at El Paso in the US.
Dr Singhal showed how stories could be made into powerful
communication messages. The audience at this talk
included PFI staff, donors and partners. Ms Usha Bhasin,
Additional Director General, Doordarshan, also shared her
experiences on entertainment education in India.
Dr Singhal conducted a half-day workshop on using the
positive deviance (PD) approach to identify positive
behaviours and messaging that could enrich the story
plots. Among those who participated were PFI staff,
Producer and Director Mr Feroz Abbas Khan and
potential partners for undertaking a PD enquiry for PFI.
These included students/alumni and faculty from Lady
Irwin College, Mudra Institute
of Communications and the
Department of Communication
and Extension, Institute of Home
Economics, University of Delhi.
These stories will be identified from selected PFI project
areas to inform advocacy and communication efforts at
national and state levels. The learning from PD enquiry
could also help in strengthening strategies to address
family planning and reproductive health issues.
Orientation on gender and social inclusion
(GSI)
The purpose of the exercise was to build the capacity of
a core group of people at PFI to systematically apply and
institutionalize the GSI framework and tools into PFI’s
work. The session on February 1, 2012 was facilitated by
Ms Sreela Dasgupta, an external consultant working with
PFI under the Memorandum of Understanding (MoU)
with MCH-STAR. Ms Dasgupta also provided technical
support to PFI programme staff to strengthen their
capacity on GSI for specific projects.
Training trainers for scaling up
PFI is a scaling up intermediary organization, which
provides technical support to scale up various public
health pilots in India. Building a cadre of experts
and master trainers on scaling up
management (SUM) has been one of
its goals. Starting with its own staff, PFI
identified and trained a number of them
PFI will be using positive deviance
research to discover existing, but
uncommon wisdom in a community
for having small and healthy
families. The exercise will generate
new solutions to existing problems
that are ‘stuck’, through dialogue
with community members about
solutions that are possible, doable and implementable.
The approach can help us identify existing (but
uncommon) practices and micro-behaviours (at the level
of individuals, households, and the community) that lead
to delayed marriage and planned first pregnancy, spacing
between two children, use of contraceptives, gender
equality, and better women’s and child health.
Partners get oriented on new tools.
Positive Deviance is an approach to social change
based on the principle that communities already have
solutions to their problems. It uses observation and
interviews to find in a community, people who are
successful in dealing with a problem despite facing
similar challenges and having no extra resources or
knowledge than their peers.
to become master trainers in the processes of scaling up
management. Dr Richard Kohl and Dr Rajani Ved from
Management Systems International (MSI) co-facilitated
the workshop with the PFI team.
Taking this effort forward, PFI organized two Scaling
Up Training of Trainers workshops in October 2011
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and February 2012, in New
Delhi. The aim was to build
the capacity and knowledge
of PFI staff members and
representatives from other
non-government organizations
in using the scaling up
framework and tools, to assess
the scalability potential of
successful pilots in the area
of reproductive health and
family planning. Fifty five
professionals from various
national, international
organizations, government
departments, along with PFI
At the Training of Trainers workshop for Scaling Up.
staff and partners were oriented on the SUM framework.
members. One and a-half hour long practical sessions were
held over four days. Eight staff members participated.
These trainings have helped in creating greater
awareness and deeper understanding among public
Employing social media
health practitioners, on the concept of scaling up and
The David and Lucile Packard Foundation organised
PFI’s experience in applying the framework to support
a capacity building programme on social media for its
scale up of public health pilots in India. These trainings
Indian grantees titled – The Networked NGO: A Peer
also promote adoption and application of the SUM
Learning Exchange from June 11-14, 2012. The four-day
framework within wider public health programmes and
training programme was facilitated by Beth Kanter, an
institutions.
internationally recognized leader on NGOs and social
media. Three PFI staff members attended the workshop
Learning to do process documentation for
scaling up
that guided them on using social media for their work.
A three-day Process Documentation workshop specifically
On June 15, Beth Kanter, took a session for the PFI
tailored to scaling up was organized from May 30 to June 1,
programme staff on understanding and using social media.
2012. Twenty PFI and partner organization staff participated.
PRAXIS-Institute for Participatory Research facilitated the
The training helped the staff to start engaging with social
workshop with support from the Scaling Up team.
media. An inactive Facebook page has been energized,
and a Twitter account has been set up.
The workshop aimed to develop greater understanding
on the basics of process documentation – its relevance;
A first set of guidelines for use of social media by PFI staff
critical steps, including an awareness of multiple
has also been drawn up.
perceptions, contexts and realities; use of numbers and
statistics; and the ethics of documentation.
A documentation and interpersonal
communication and counseling (IPCC)
The workshop participants were taken through the steps of workshop for C-NES staff
process documentation. Then they worked on developing A three-day workshop aimed at improving IPCC and
three programme specific process narratives – for the
documentation skills was organized for C-NES field
Health of the Urban Poor (HUP), Health Education
workers. The trainers were from PFI. Participants included
Programme for Adolescents (HEPA) and Community
five district family planning counsellors and the district
Based Planning and Monitoring (CBPM).
programme officers (DPOs) of the 15 boat clinic districts.
Effective writing
An effective writing workshop was organised from April
16 to April 19 by consultant, Shree Venkatram. The
aim was to improve written communication skills of staff
The communication process and IPCC sessions were on
building skills for observation and establishing rapport,
encouraging dialogue, listening, questioning and using the
GATHER technique for counselling. Presentations on
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At the Staff Retreat: Building team spirit.
theoretical aspects were followed by role plays and mock
sessions to help participants build their skills in IPCC.
The training in documentation related to capturing the
processes and case studies.
Regional Resource Centres: Bihar and
Chhattisgarh
PFI has been a Regional Resource Centre (RRC) for
Bihar and Chhattisgarh since 2005, providing technical
assistance and support to the State NGO Committee,
Mother NGOs (MNGOs), Service NGOs (SNGOs) and
Field NGOs (FNGOs).
selected PFI as one of the training agencies for rolling out
the ASHA training programme in seven districts in the
state –Purnia, Madhepura, Saharsa, Supaul, Kishanganj
Araria and Katihaar (Kosi and Purnia division). So
far, 157 trainers have received the training in Modules
5, 6 and 7, which deal with building leadership and
communication skills, saving lives of the newborn, and
maternal health through community-based approaches.
PFI is partnering with a mother NGO, Bal Mahila Kalyan,
for logistic and management support to establish a
regional training site at Katihar.
PFI has been advocating for a revamping of the scheme to
enable RRCs to play a more meaningful role in next phase
of NRHM.
A three-day state level workshop on Community
Participation in RCH was organized for 43 representatives
from MNGOs and FNGOs in Bihar in July 2012. Some
MNGO representatives were also trained on advocacy
using the Spitfire SMARTCHART tool.
ASHA training
The National Health Systems Resource Centre
(NHSRC) and the State Health Society, Bihar have
PFI appointed Three State Master Trainers on December
15, 2011. They had been trained by the State Health
Society, Bihar in association with the NHSRC on the
modules.
Staff retreat with a focus on team building
PFI organized a two-day staff retreat on the banks of the
Damdama lake, Haryana on March 16-17, 2012. The purpose
was to bring middle and senior staff members from different
departments together, build team spirit and recognize the
importance of values and ethics through outdoor team
exercises. Thirty four staff members, including one each from
Bihar and Chhattisgarh, participated.
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At the retreat, facilitated by Step Consulting Pvt Ltd, the
staff members were taken through a series of fun activities.
Each activity was done in a team and had prescribed rules.
At times, different teams were formed and pitched against
each other. After the activity, the team members reflected
on their performance – the goals they had set and on what
basis, why they could or could not achieve them, how the
leader for each designated exercise had performed, the
collective strength of the group and what they could have
done better. Trained facilitators helped the participants
assess and connect lessons learnt to a day-to-day work
situation.
Through the interactive activities, Team PFI learnt the
importance of identifying the right person for the job, and
the necessity of good communication and active listening.
The activities showed that winning is possible only if
all put in their best, and there are helping hands and
empathy when team members falter. The team realized
the importance of being adaptive to situations, doing a
midterm correction when things do not work according to
plan and being open to taking advice from experts.
Some achievements of the exercise
Getting to know each other: The staff members, some of
them new, others who have been diligently working in
their respective departments, had the occasion to interact
with each other in an informal way and build camaraderie.
Building and strengthening
of a value system: The staff
members are conscious
that they work for the
underprivileged, and this
places different kinds of
responsibilities on them. The
activities drove home the
points of fair play and values,
that even while maximizing
performance, ethics and values
should not be lost sight of.
Learning to work better as a
team: Even never-done-before
and difficult tasks can be achieved if proper attention
is paid to planning and coordination. This was brought
home by the rope-bridge building exercise. None of the
members had ever built the army-type bridge earlier.
But by the end of two hours, not only was the bridge in
place, but some members had actually crossed it, putting
full faith in their team members that the bridge would
hold and they would be safe, as all instructions had been
followed.
Team PFI learns that winning is possible only if all
team members put in their best.
At the end of the programme, each
participant was able to identify certain
areas of development/improvement for him/
herself. Some samples:
“I will pause to think, plan and strategize,
before responding/acting.”
“I will be persistent.”
“I will improve my style of communication.”
The exercise was made possible from a grant for
organization transformation by the Packard Foundation.
The Hay Group was involved in the designing of the
programme, which is aligned with the overall organisation
transformation process.
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Strengthening Systems to Bring Better
Health to the Urban Poor
The Health of the Urban Poor
Program (HUP)
Through the HUP program, PFI works at improving
delivery and utilization of maternal, child health
and nutrition services; and promotes water supply,
sanitation and hygiene services to urban poor
communities. PFI is working in eight high-focus
states – Bihar, Chhattisgarh, Jharkhand, Madhya
Pradesh, Orissa, Rajasthan, Uttar Pradesh, and
Uttarakhand, and in five Indian cities – Agra,
Bhubaneswar, Delhi, Jaipur and Pune.
PFI emphasizes equity, participation and
empowerment of communities, particularly
of women; improved governance and active
involvement of all key stakeholders. The HUP
program has been providing technical support
to the Government of India in formulating the
proposed National Urban Health Mission.
The Health of the Urban Poor (HUP) program
is supported by USAID/India through a bilateral
grant, and is approved by the Ministry of Health
and Family Welfare, GOI.
Ms Melanne Verveer, U S Ambassador-at-large for
Global Women's Issues, meets with women at the
HUP slum site in Jaipur.
Strong focus on convergence
The health of urban poor is affected by their living
conditions and environment, which includes issues of
access to preventive and curative health services, nutrition,
clean water, proper sanitation and hygiene practices.
These services are provided in the urban context by
different ministries/departments like Health, Women &
Child Development (for nutrition), Urban Development
(for water supply), Municipal Councils/Committees (for
improved governance). It is necessary for these departments
to work together to bring better health for the urban poor.
Therefore, the HUP program worked closely with
these departments and urban local bodies to establish
convergence models at the following levels:
a. Institutional level
• An Urban Health Task Force or Cell has been created
in Odisha with the departments of Health, WCD and
Urban Development. The cell plans, implements and
monitors all activities in a coordinated manner to
maximize resources.
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• In Uttarakhand, the mandate of the State Health Task
Force, which was already in existence, was extended
to address urban health issues, and HUP was made a
member of the Task Force.
• The HUP program helped set up the City/Ward
Coordination Committee in Bhubaneswar. The
process started with a declaration by the three
secretaries of Health, WCD and Urban Development,
Government of Odisha that they would work
together in a coordinated manner to further urban
health in the state. Taking off from this declaration,
the Bhubaneswar Municipal Corporation decided
to constitute the city coordination committee to
oversee all efforts in health, nutrition and water and
sanitation. The committee is chaired by the Municipal
Commissioner and has members from the Health
Department, Integrated Child Development Scheme
and the Public Health Engineering Department
(PHED). Regular meetings are being conducted
to review the urban health activities by the three
departments. The preliminary meetings with the city
officials as well as the subsequent meetings of the city
coordination committee were facilitated by HUP.
Currently, HUP is involved in capacity building of the
committee by developing standardized guidelines and
terms of reference for operation, and the monitoring
framework for decision making.
b. Systems level
• Micro Plan for Immunization: The HUP state team
in Jharkhand facilitated the health department and
the Integrated Child Development Services (ICDS)
to draw up an immunization micro-plan for Ranchi
by involving the city municipal body. All children in
the area are counted and an immunization schedule is
worked out. The micro-plan template and process were
later shared with other cities.
• Joint monitoring and supervision: In Pune, the HUP
team reviewed the community outreach programme
for anganwadi centres, maternal, neonatal and child
health programmes and immunization sessions in
partnership with the Pune Municipal Corporation, the
health department and ICDS.
• Training: In Uttarakhand, a module on nutrition
developed by HUP is being used for training health
field workers (ANMs, Urban ASHAs) and anganwadi
workers.
c. Service delivery level
• In Jaipur and Bhubaneswar, the HUP team promoted
the concept of the Urban Health and Nutrition Day.
The anganwadi workers and ANMs know jointly
organise outreach sessions in the HUP intervention
slums on the lines of Village Health & Nutrition Days
under NRHM. This has helped promote integrated
services in health, nutrition and WASH (Water
Sanitation and Hygiene).
d. Community level
• IEC/BCC: HUP has developed IEC material on
WASH for Mission Convergence of the Government
of Delhi, which has been circulated to all Gender
Resource Centres (GRCs) in the slums of Delhi to
increase awareness on WASH. Mission Convergence
facilitates access to the welfare programmes throughout
the NCT of Delhi by providing welfare services in a
convenient and an integrated manner to the under-
privileged citizens.
When manpower and resources converge for a common
goal and then sustain, systems get strengthened. Efforts
of the Jharkhand team have led to anganwadi centres
becoming functional again and as sites for outreach
immunization.
Building the capacity of communities
Any public health intervention cannot be brought to its
logical conclusion without adequate community buy in and
support. Numerous strategies for engaging communities
have been developed to effectively cover the last mile in
delivery of health, nutrition and WASH services among the
most needy groups. One such strategy has been the setting
up of Mahila Arogya Samitis (MAS). Currently, HUP has a
network of around 160 MAS or women’s groups functioning
in its intervention areas in the five cities. MAS groups are
being oriented on maternal health, child health, nutrition
and WASH. Their capacity is being built to effectively
take charge of community level planning and monitoring
of maternal and child health services. Many MAS groups
have been using skype to talk to their counterparts in other
Indian cities and even abroad (currently Ethiopia and
Bangladesh). This has given them the opportunity to learn
from other cultural and social settings which strengthens
their own activities. The HUP program also uses film
shows, street plays and observation of special days for
community engagement.
Visitors
The Health of the Urban Poor program received a number
of high profile guests and delegations during the year.
Among them was a 13-member US Congress delegation.
The team including Senators Mark R. Warner, Michael
Bennet, Tom Udall, and Representatives Joseph Crowley
and Cedric Richmond. They visited the Jaipur city
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program and saw the convergence at an anganwadi centre,
and the functioning of a health camp. They also saw
the interaction between a women’s group or the Mahila
Arogya Samiti in Jaipur with another MAS in Agra, using
skype video call technology.
A 14-member Ethiopian delegation of senior government
officials from the health department, USAID officials and
program staff of the Urban Health Program of Ethiopia
visited Mumbai, Pune, Bhubaneswar, Agra and Delhi.
The delegation saw the working of various urban health
initiatives launched by the government, urban local
bodies, corporate bodies, civil societies and international
funding agencies.
The US Ambassador, Mr Peter Burleigh, and US
Consulate General, Hyderabad, Ms Kathy Dhanani,
visited the HUP city demonstration site in Bhubaneswar.
They saw the maternal and child health camp organized
jointly by HUP Odisha, Bhubaneswar Municipal
Corporation, National Rural Health Mission, Odisha, and
the Orissa Voluntary Health Association. Mr Burleigh was
appreciative of HUP’s work, especially on convergence at
the anganwadi centre. The U.S Ambassador was quoted in
Orissa Post, Bhubaneswar, as saying, “I am impressed with
the changes that have taken place in the lifestyle of the
urban poor and the improvement in their social life. The
project is making a positive difference in people’s lives.”
The United States Ambassador-at-large, Global
Women’s Issues, Ms Melanne Verveer, visited the HUP
program in Jaipur to see the delivery of maternal and
child health services and the role played by empowered
women’s groups in improving the utilization of these
services by the urban poor.
The then Joint Secretary (Policy),
MoHFW, GOI,
Mr Amit Mohan Prasad, visited
the Agra demonstration site. He
interacted with members of the
women’s group to learn about their
role and linkages with government
health resources.
US Ambassador, Mr Peter Burleigh’s noting in the Visitor’s Book.
These visits can be seen as the
growing importance and attention
the program is receiving nationally
and internationally.
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The Global Fund
Round 4 RCC Promoting Access to
Care and Treatment Program
PFI is implementing the Promoting Access to Care
and Treatment (PACT) program to improve
survival and quality of life of PLHIV and reduce
HIV transmission. The program currently operates in 18
states and one Union Territory of India. The states are –
Andhra Pradesh, Maharashtra, Tamil Nadu, Karnataka,
Manipur, Nagaland and nine highly vulnerable states of
Uttar Pradesh, Madhya Pradesh, Rajasthan, Odisha, West
Bengal, Chhattisgarh, Bihar, Gujarat and Jharkhand.
Assam, Punjab, Uttarakhand and Chandigarh were
handed over to PFI by NACO and the Community Care
Centres (CCCs) in these four states were taken over in
April 2012.
PFI as the Principal Recipient of the Global Fund grant
complements the national Antiretroviral Therapy (ART)
programme by providing care and support services to
PLHIV through District Level Networks (DLNs) and
Community Care Centres. While DLNs are registered
community based organisations of PLHIV, the CCCs are
10-bedded centres at the district level with facilities to
manage HIV-related minor illnesses and provide drug
adherence counseling.
A change in role – Direct Management
PFI works through its sub-recipients – Catholic Bishops’
Conference of India (CBCI), Hindustan Latex Family
Planning Promotion Trust (HLFPPT), Enable Health
Society (EHS) and the Confederation of Indian Industry
(CII). As per the Global Fund Round 4 RCC country
proposal, the Indian Network for People Living with HIV/
AIDS (INP+) was to implement the care and support
services through the District and State Level Networks
of PLHIV in nine states. However, in view of the
investigation into the alleged financial mismanagement
by INP+ in Round 4/Round 6 program, the Global Fund
directed PFI to not sign the Grant Agreement with INP+.
Accordingly, PFI did not enter into an MoU with INP+ in
RCC Phase I effective from April 2010.
As an interim arrangement and in the interest of the
program, PFI entered into direct agreements with 214
DLNs with whom INP+ had a valid agreement as on March
2010. The direct agreements with DLNs were an interim
arrangement initiated in August 2010. It was envisaged
for two months only. However, the agreements have
continued for more than 20 months, being renewed every
three months. During this interim arrangement period, PFI
managed the program with the same resources despite the
absence of two layers of management – the INP+ at the
national level, and the SLNs at the state level. This proved
to be very challenging. Though there were some delays in
implementing activities as per work plan, PFI could achieve
the targets fixed for this component.
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The evaluation
Original implementation structure
PFI has been able to establish strong
monitoring and evaluation, financial
and programmatic systems at all levels
Principal Recipient
PFI
of the program management structure.
On the programmatic side, targets
Sub - recipients
INP+ HLFPPT CBCI
EHS
CII
have largely been achieved despite
several challenges like uncertainty in
Sub - sub recipients 9SLNs
40 CCCs/3 60 CCCs/6
states states
5CETCs
the tenure of direct management, and
therefore ad-hoc arrangements, and
weak programme and grant management
230
DLNs
Corporate
ART Centers
capacity of the DLNs. The Global Fund
rated PFI ‘B1’ (adequate) for the period
April- September 2011. The Global
Fund provided ‘A’ rating (expected
or exceeding expectation) to PFI for
Change in implementation structure -
Direct management of DLNs by PFI
the Onsite Data Verification (OSDV)
exercise conducted by the Local Fund
Agents (LFA) to ensure data quality of
important programmatic results. LFA
Principal Recipient
PFI
19 States
verify the performance of grant-funded
programmes in a country each time
recipients report results, and report the
Sub- recipients
HLFPPT CBCI
EHS
CII
performance to the Global Fund.
Sub- sub recipients
214
DLNs
35
CCC/6
states
57
CCCs/7
states
3
CETCs
Monitoring performance of
Community Care Centres
PFI provides services through
Corporate
ART Centers
Community Care Centres (CCCs) at
the district level. CCCs act as a bridge
between the patient and the Anti
Retroviral Therapy (ART) Centres,
and ensure that PLHIV are provided
The information below reflects, in terms of the numbers,
counselling for ARV drug adherence, nutrition, treatment
what went in to directly managing the District Level
for minor opportunistic infections, management of initial
Networks from August 2010 till March 2012.
side effects through in-patient and out-patient services,
referral and outreach services, and social
No.
Particulars
Quantity
support services.
The National AIDS Control
1 Number of MOUs signed with DLNs
1466
Organisation (NACO) commissioned
the annual evaluation of the CCCs.
2 Number of quarterly reports received by PFI
6692
The evaluation committee had
representatives from NACO, PFI,
3 Number of monthly reports received by PFI
7731
KHPT, SACS, CBCI, HLFPPT and
other stakeholders. The team looked
into the CCCs’ performance, demand
4
Number of times finance review conducted (for all
DLNs) in the program area of 9 states
17
and service quality, whether they were
functioning in line with the objectives
and national CCC guidelines. Each
5 Number of PLHIV benefitted
100,604
CCC was graded – A (very good), B
(good), C (moderate) and D (poor). The
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grade provided was the decisive factor in continuing with
the CCCs, or deciding to close them down because of poor
performance. During this assessment exercise, care was
taken by NACO to ensure that no CCC was evaluated by
its own implementing agency.
The second round of assessment took place in 2011.
Jharkhand with three new CCCs was added to the list of
states. Out of 32 centres assessed, 5 secured grade ‘A’, 12
secured ‘B’, 10 secured ‘C’ and 5 secured ‘D’. Also, the
C-grade CCCs from Round 1 were re-assessed. The results
showed that out of the eight ‘C’ graded CCCs, six had
improved and were upgraded, while one CCC in Gujarat
secured the same rating, and one CCC in Chhattisgarh
closed its operations before being assessed.
NACO acknowledged that PFI supported CCCs, managed
by its SRs – HLFPPT and CBCI, have performed much
better than CCCs in the entire country managed by other
agencies. This reaffirms the intensive efforts put in by
PFI and its SRs in effective management and intensive
supportive supervision.
The table illustrates key programme indicators, targets and achievements (Indicators 1, 2,3 and 4 refer to the activities of
the DLNs, while indicators 5, 6, 7 and 8 refer to activities of CBCI, HLFPPT, EHS and CII:
No.
Indicator – Activities of the DLNs
1 Number of Support Nets of PLHIV formed
Number of newly identified PLHIV contacted at
2 community/household level for care and support
services through district level/support nets of PLHIV
3
Number and % of PLHIV undergone initial
assessment for ART eligibility
Number of infected and affected children receiving
4 educational support provided by district level
networks
Cumulative until March 2012
Target
Results
Achievement
(in %)
1255
1247
99.4
162,000
100,604
62.1
102,060
39,975
39.17*
13,800
12,970
94
Activities of CBCI, HLFPPT, EHS and CII
5
Number of PLHIV provided care at Community
Care Centres
6
Number of DLN staff and support net members
trained on peer education (Master trainers)
Number of staff at Community Care Centres trained
7 (including Doctors, Nurses, Outreach Workers and
project support staff) -Regular/Refresher Trainings
Number of corporate plants/units reached by
8 meetings to facilitate the set up of ART Centres at
corporate health facilities
6387**
1915
509
125
10414**
1790
169
76
163.04
93.5
33.2***
60.8****
Source: Program Update Disbursement Request (PUDR) PFI March 2012
* The shortfall in this indicator is mainly due to the interim arrangement being extended every quarter. This has led to low motivation
and a feeling of uncertainty among the DLNs.
** The targets and achievements reported against this indicator are non-cumulative.
*** The shortfall in this indicator is attributed to the delay in approval of the training plan from the Global Fund and the directive
issued by NACO not to setup new CCCs until a need-based analysis is conducted.
**** The target could not be met as the corporates are giving more attention to lifestyle diseases such as cardio-vascular as compared
to HIV.
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Number of PLHIV provided services in CCCs as
In-Patients and Out-Patients
6000
5000
4000
3000
2000
1000
0
5695
5617
3811
3524
4842
3249
Apr-Jun
2011
Jul-Sep
2011
In -Patient
Oct-Dec
2011
Out -Patient
5121
3252
Jan-Mar
2012
linked to social security schemes, or
given income generation training by the
DLN. This is also termed as the ‘give
and take process’. The group operates
at the sub-district level. Psycho-social
support, rather than the promise of
collective income generation activity,
holds the group together. There have
been instances of some good initiatives
undertaken, primarily due to strong
leadership and networking by the DLNs.
The findings of the study underline the
significant efforts by PFI in building the
capacities of the DLNs in terms of peer
education, programme management and
ensuring seamless service delivery in
the form of psychosocial peer support,
treatment education and linking to the
continuum of care across the nine states.
Monitoring and Evaluation
PFI engaged Ernst & Young in April 2012 to document
the experiences of the implementers during direct
management, and identify gaps in the decentralized
service delivery model. Interviews were conducted
with DLNs and key officials at PFI and Regional/State
Coordinators from the nine program states. Ten districts
from the three selected states were chosen for the study.
Six Support Net Groups from different districts were
selected for documenting emerging practices.
The study found:
• DLNs were appreciative of the systems and support
provided by PFI in the interim period. They
unanimously appreciated the ‘round-the-clock’ support
and prompt resolution to issues provided by PFI state
offices. The DLNs were unanimous in crediting PFI
for enhancing their capacities and boosting their self-
confidence. The experience of working directly under
PFI and managing the program through the robust
systems set by PFI has enhanced their self confidence.
• The DLN staff perceives the PFI state office as
a `single window’ solution centre for resolution
of their operational problems. The support has
helped the DLNs establish meticulous reporting
and documentation formats and systems under the
program.
• The Support Net Group (SNG) model has met
with limited success. In this, a group of 12 PLHIV
voluntarily come together to link other PLHIV to
the health service delivery system. In turn, they are
Improving income and providing support
Palamuru Support Net Group – Mehboobnagar, Andhra
Pradesh
The Palamuru SNG is an all women’s 12-member group.
The women reside within a radius of 10-15 km. The
SNG members are involved in both outreach and income
generation activities.
On PFI’s suggestion, the Mehboobnagar DLN approached
Jan Shikshan Sansthan, which conducted trainings on
various livelihood activities for the group. The group is
mainly involved in the production of detergent powder
and saris. It also undertakes small scale production
of petroleum jelly, pain relief balms and dishwashing
soaps. The group initially started with the production of
detergent powder. Six members together contributed Rs
2000 to purchase 50 kg of raw material which was used
to produce the detergent powder. The revenue collected
through this activity was reinvested to scale it up. Each
group member contributes Rs 100 per month to the
group’s saving account, which serves as a corpus against
which members can take loans.
The group gets names of the newly-detected PLHIV, ‘lost
to follow-up’ (LFU) cases, ‘missed’ cases and ‘not willing’
cases from the Integrated Counseling and Testing Centres
(ICTC) and the Anti-Retroviral treatment Centres
(ARTC). The group contacts and counsels PLHIV on care
and treatment, and further registers them for the PACT
program upon their consent. The outreach activity is
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primarily conducted by the Peer Educator (PE) /Positive
Speaker (PS). Since inception of Round 4 RCC PACT,
1070 clients have been enrolled in the DLN.
In conducting the outreach and income generation
activities, the group faces many challenges. There was an
initial resistance from bank officials in opening an account
given the status and susceptibility to a reduced life-span
of the members. They were also told they would not get
loans on the same grounds. The PE and PS felt that their
limited marketing skills reduced the efficiency of the sales
efforts made by them.
wherein women-headed DLNs approached district officials
and NGOs to contribute to the benefit of PLHIV.
The effort led to the linking of 170 SNG members with
a monthly ration scheme. Through this endeavour,
two women district programme coordinators were also
felicitated for their commendable work.
The DLN and Jan
Shikshan Sanstha then
guided the group in
working out a strategy
to sell the detergent
powder. The group
established links
with various hotels
and hostels in and
around the town of
Mehboobnagar, which
purchase the detergent
powder regularly. The
washing powder has
become popular in the local market and the demand for
it has been consistently rising. Each of the six members
involved in it make Rs 2000 a month. The sari business
was established recently by four members.
The Palamur Support Net Group showcases both the ‘give’
and ‘take’ processes. The group finds a firm foundation
in the leadership and support provided by the DLN.
Frequent visits and handholding by the State Coordinator
has helped the SNG in leveraging resource mobilization
opportunities like the International Women’s Day
Members of the Palamuru
Support Net group produce and
market detergent powder.
Strong networking by the DLN with organizations like
District Rural Development Agency (DRDA) and CARE
has provided an impetus to SNG members for initiating
income generation activities and being part of the group.
The SNG members value being part of the group for the
psycho-social support they get and can give. The PLHIV
are better informed about their condition and can access
to care and treatment.
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Publications
The following publications can be download from our website-
http://www.populationfoundation.in/
Demographic Transition in South India
How did the four South Indian States of Kerala, Tamil
Nadu, Andhra Pradesh and Karnataka, attain the Total
Fertility Rate (TFR) i.e. the replacement level of 2.1 in
the years 1986, 1996, 2004 and 2006 respectively.
Well-known demographer Leela Visaria examines the
factors that made the transition possible and the lessons
for the rest of India, especially the large economically
backward states.
Youth in Bihar & Jharkhand: A Situational
Analysis
PFI has analysed NFHS-3 data on the youth population
(15-24 years) by desegregating it by sex and place
of residence. The report provides a profile of the
youth population in the two states. It focuses on
their knowledge, attitudes and behaviour related to
reproductive health and nutrition.
Ranking of Districts in Bihar and Jharkhand
Understanding the need for area-specific planning and
the special attention needed for districts lagging behind
in human development, PFI has computed a composite
index called ‘The Socio-Demographic Development Index
(SDDI)’. The index ranks the districts in the states of Bihar
and Jharkhand based on a composite index derived from the
10 key indicators drawn from the Census 2011 and District
Level House Hold Survey-3, 2007-08.
The report would particularly interest policy makers,
programme managers, health care providers and civil
society organisations working in the two states
Healthy and Confident
Healthy and Confident was developed for NCC officers
for training cadets. But, it is a great resource for persons
working with young people. It details participatory
sessions, where methods like role play, games, group
discussions and a variety of innovative techniques are
used to help the young develop skills in communication,
manage emotions, work towards goals, resist peer pressure
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and build respect for self and others, so that they can lead
a healthy and an enriched life. It makes them examine
issues related to nutrition, hygiene, sexual health and
consequences of substance abuse.
Women’s Empowerment and Female-Headed
Households
Women’s Empowerment and Female-Headed Households
examines the relationship between women’s empowerment
and female-headed households in India from empirical
data sources like the decadal Census, the National Family
Health Survey-3 and the National Sample Survey (61st
Round). One-tenth of the households in the country have
females as household head and Kerala, Himachal Pradesh
and Uttarakhand have a high proportion of female-headed
households in the country.
• Operational Guidelines for Mahila Arogya
Samiti (MAS)
The documents detail the composition of the bodies,
roles and responsibilities of the members for the effective
delivery of Maternal, Newborn, Child Health and
Nutrition (MNCHN) and Water, Sanitation Hygiene
(WASH) services.
Operational Guidelines for Urban Health &
Nutrition Day (UHND)
The document details the Maternal, Newborn, Child
Health and Nutrition (MNCHN) and Water, Sanitation
Hygiene (WASH) services and associated roles and
responsibilities of Anganwadi Workers (AWW) and
Auxiliary Nurse Midwife (ANM), HUP Frontline Worker
(Link worker/ Cluster Coordinator).
The 5th JRD TATA Memorial Awards
The brochure describes the methodology used for the
selection of state/districts for the 5th JRD TATA Memorial
Awards. A profile of the award-winning districts and states is
included.
PFI Global Fund program annual report
The Annual Report 2010-2011 of the PFI-Global Fund
Program describes the activities under the Rolling
Continuation Channel (RCC) Promoting Access to
Care and Treatment (PACT) programme in six high
HIV prevalence states – Andhra Pradesh, Maharashtra,
Tamil Nadu, Karnataka, Manipur and Nagaland and nine
highly vulnerable states of Uttar Pradesh, Madhya Pradesh,
Rajasthan, Orissa, West Bengal, Chhattisgarh, Bihar, Gujarat
and Jharkhand. The report gives an account of how care
and support services have been provided to PLHIV through
DLNs and Community Care Centres (CCCs).
––––––––––––––––––––––––––––––––––––
Publications from the Health of
the Urban Poor Program
Water and Sanitation-Related Publications
State of the State Series 2012
Odisha: After Baby Steps, Run
The Odisha State Urban WATSAN profile analyses the
status of urban water, sanitation services and plausible
solutions within the current policy framework
Facts N Factors: State of Inclusive WATSAN
in Cities – Pune
Pune city WASH profile has been captured in
consultation with the Pune Municipal Corporation.
The Water and Sanitation Scenario in Urban
India
The document captures the urban drinking water and
sanitation status and challenges.
Point of Use: An Approach Towards Safe
Drinking Water
The approach paper elaborates on the
conceptual framework and utility of the
point of use (POU) model.
Operational Guidelines and Fact Sheets
• Operational
Guidelines for
City Coordination
Committee (CCC)
• Operational
Guidelines for
Ward Coordination
Committee (WCC)
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Financial Highlights
INCOME
Particulars
Interest /Dividend/Gains on Investments/Misc. Receipts
Rent for Premises
Grants in aid – International Agencies
Grants in aid – National Agencies
Total
2010-2011
Rs. (In lakhs)
160.52
543.82
3610.52
124.93
4439.79
2011-2012
Rs. (In lakhs)
198.02
543.82
4209.22
162.69
5113.75
Particulars
Programme Grants – Own Funds
Project Implementation Expenses
Management & Admin. Expenses
Grants in aid – International Agencies
Grants in aid – National Agencies
Total
EXPENDITURE
2010-2011
Rs. (In lakhs)
288.23
148.28
211.71
3610.52
124.93
4383.67
2011-2012
Rs. (In lakhs)
138.45
100.79
199.50
4209.22
162.69
4810.65
Particulars
Fixed Assets
Investments
Dividend/Interest Receivable on Investments
Cash & Bank Balances
Sundry Deposits
Advances ( Unsecured but considered good)
Total
ASSETS
2010-2011
Rs. (In lakhs)
116.44
2645.69
24.28
1879.19
1.46
18.84
4685.90
2011-2012
Rs. (In lakhs)
106.53
3116.28
48.89
860.35
1.46
50.65
4184.16
Particulars
Corpus Fund
Society Fund
Project Grants – International Agencies
Project Grants – National Agencies
Current Liabilities & Provisions:
– Current Liabilities
– Provisions
Total
LIABILITIES
2010-2011
Rs. (In lakhs)
500.00
2283.48
1485.45
69.36
293.41
54.20
347.61
4685.90
290.31
65.67
2011-2012
Rs. (In lakhs)
500.00
2586.57
642.66
98.95
355.98
4184.16
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Expenditure during 2011–12
Description
HIV/AIDS PACT
(Global Fund)
HUP (USAID)
Other Foreign grants
Local grants
PFI Core grants
Project Development (PFI Core)
Monitoring & Evaluation (PFI
Core)
Advocacy & Communication
(PFI Core)
Management, Administration &
Estate management
Fixed Assets
TOTAL
Amount
(Rs. in lakhs)
3,020.82
1,045.32
143.07
162.70
138.45
35.50
29.35
35.94
199.50
5.36
4,816.00
1%
0%
1%
0%
4%
3%
3%
3%
22%
63%
HIV/AIDS PACT (Global Fund)
HUP (USAID)
Other Foreign grants
Local grants
PFI Core grants
Project Development (PFI
Core)
Monitoring & Evaluation (PFI
Core)
Advocacy & Communication
(PFI Core)
Management, Administration
& Estate management
Fixed Assets
Description
Local agencies (Central & State
Govt., Foundations & Trusts)
Foreign Contribution (FCRA)
Foreign Contribution (Global
Fund)
Rental (Building)
Income from Investments
Others
TOTAL
Receipts during 2011–12
Amount
(Rs. In lakhs)
192.28
0%
5% 4%
13%
30%
1,310.28
2,056.15
543.82
192.75
5.27
4,300.55
48%
Local agencies (Central & State
Govt., Foundations & Trusts)
Foreign Contribution ( FCRA)
Foreign Contribution (Global Fund)
Rental (Building)
Income from Investments
Others
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Description
Local agencies
(Central &
State Govt.,
Foundations &
Trusts)
Foreign
Contribution
(FCRA)
Foreign
Contribution
(Global Fund)
Rental
(Building)
Income from
Investments
Others
TOTAL
Description
HIV/AIDS
PACT (Global
Fund)
HUP (USAID)
Other Foreign
grants
Local grants
PFI Core grants
Project
Development
(PFI Core)
Monitoring &
Evaluation (PFI
Core)
Advocacy &
Communication
(PFI Core)
Management,
Administration
& Estate
management
Fixed Assets
TOTAL
Receipts during 2010–11 and 2011–12
Amount (Rs. in lakhs)
2010–11
2011–12
128.57
192.28
730.44
3,671.63
1,310.28
2,056.15
4,000.00
3,500.00
3,000.00
2,500.00
2,000.00
1,500.00
1,000.00
500.00
-
543.82
543.82
154.63
5.89
5,234.98
192.75
5.27
4,300.55
2010-11 2011-12
Expenditure during 2010–11 and 2011–12
Amount (Rs. in lakhs)
2010–11
2011–12
3,034.06
441.75
134.71
124.93
286.48
58.53
3,020.82
1,045.32
143.07
162.70
138.45
35.50
3,500.00
3,000.00
2,500.00
2,000.00
1,500.00
1,000.00
500.00
43.61
29.35
46.14
35.94
213.45
29.03
4,412.69
199.50
5.36
4,816.01
2010-11 2011-12
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PFI’s Partners
Donors
• Ministry of Health and Family Welfare, Government
of India
• John D and Catherine T MacArthur Foundation
• The David and Lucile Packard Foundation
• The Global Fund
• The John Hopkins University
• USAID
Implementing Partners
• Agragami India
• Arthik Atma Nirbharta Samajik Vikas Abhikaran,
Patna
• Bhairabi Club, Khurda, Odisha
• Bhoruka Charitable Trust (BCT), Jaipur
• BREAD, Patna
• Catholic Bishops’ Conference of India, New Delhi
• Centre for Health Resource Management, Patna
• Centre for Development and Population Activities
(CEDPA), New Delhi
• Centre for North East Studies and Policy Research
(C-NES), Guwahati
• Centre for Urban and Regional Excellence (CURE),
New Delhi
• Confederation of Indian Industry (CII), New Delhi
• Enable Health Society, New Delhi
• Hindustan Latex Family Planning Promotion Trust
(HLFPPT), Bhopal
• Family Planning Association of India (FPAI),
Bhubaneswar
• Foundation for Research in Community Health, Pune
• Gopinat Juba Sangh, Khurda, Odisha
• Gram Nirman Mandal, Nawada, Bihar
• Gramoday Veethi, Darbhanga, Bihar
• HOPE Worldwide, New Delhi
• Institute of Health Management Research (IHMR),
Jaipur
• International Institute of Population Science (IIPS),
Mumbai
• J.K. Lakshmi Cement Ltd.,Sirohi, Rajasthan
• Jan Jagran Sansthan, Nalanda District, Bihar
• JK Tyre Limited (A division of JK Industries Limited),
Rajsamand, Rajasthan
• Karuna Trust, Bangalore
• Krishi Gram Vikas Kendra (KGVK) – CSR division of
Usha Martin Ltd., Ranchi
• March of Youth for Health, Education and Action for
Rural Health (MY-HEART), Bhubaneswar
• Micro Insurance Academy (MIA), New Delhi
• Multi Applied Systems (MAS), Bhubaneswar
• Muskan, Jehanabad District, Bihar
• Narayani Seva Sansthan, Vaishali District, Bihar
• Neha Gramin Mahila Vikas Samiti, Nawada, Bihar
• Orissa Voluntary Health Association (OVHA)
• Parivartan Mokimpur, Nalanda District, Bihar
• Plan India, New Delhi
• Samagra Seva Kendra, Gaya District, Bihar
• Sarvo Prayas Sansthan, Madhgbani District, Bihar
• Shri Nirotilal Budhha Sansthan (SNBS), Agra
• SMILE Foundation, New Delhi
• Social Uplift Through Rural Action (SUTRA),
Himachal Pradesh
• Socio-legal Information Centre (SLIC), New Delhi
• The Himalayan Institute Hospital Trust (HIHT),
Dehradun, Uttarakhand
• Voluntary Health Association of Punjab (VHAP)
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Head Office
New Delhi
Population Foundation of India
B-28, Qutab Institutional Area, New Delhi-110016,
Tel: 91-11-43894100
Email: info@populationfoundation.in
PFI’s state offices
Andhra Pradesh
Plot No. 14 – B, Gandhian School Street
Vasavinagar – B, Picket
Secunderabad – 500015
Tel: 040-65999770
pfiapsco@yahoo.com; pfiapsco@gmail.com
Bihar
123-A (First Floor), Pataliputra Colony
Patna – 13. Tel: 0612-2270634
Chhattisgarh
C-5 and C-6, Sahni Vihar
Raipur – 492006. Tel: 0771-4013065
Karnataka
1657/A, Saurabha Building
3rd Cross, Prakash Nagar
Bangalore – 560021. Tel: 080-41279018
karnatakapfi@gmail.com
Madhya Pradesh
E-1/119, Arera Colony
Bhopal – 462016
Tel: 0755-2429787/0755-4008895
pfi.madhyapradesh@gmail.com
Maharashtra
214, 2nd Floor, Raiker Chambers
Govandi, Mumbai – 400088
Tel: 022-65029710
mahapfi@gmail.com
Manipur
Saga Road, Thouda Bhabok Leikai
(Near Royal Sound)
P.O. Imphal – 795001, Imphal West
Tel: 0385-2445072
pfimanipur@rediffmail.com
Nagaland
OC-15, 2nd Floor, Naga Shopping Arcade
Near Town Hall, Dimapur – 797112
Tel: 03862-234009
popfound_nagaland@yahoo.co.in
Odisha
M-76, Madhusudan Nagar, Unit – 4
Bhubaneswar
Odisha – 751 001
Tel: 0674-2392595
Rajasthan
Plot No. 66, Geejgarh Vihar
Hawa Sadak, Jaipur – 302019
Tel: 0141-2210680
pfirajasthan@gmail.com
Tamil Nadu
Old No. 89, New No. 109
South West Boag Road
T. Nagar, Chennai – 600017
Tel: 044-24329074
pfichennai@gmail.com
Uttar Pradesh
A-743, Ground Floor, Indira Nagar
Lucknow – 206016
Tel: 0522-2353838
pfiuttarpradesh@gmail.com
West Bengal
House no. 87, Bina Apartment
Block-B, Bangur Avenue
Kolkata - 700055
Tel: 033-40679066
pfikolkata@gmail.com
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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 behavioral 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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Population Foundation of India
B-28, Qutab Institutional Area, New Delhi-110016,
Tel: 91-11-43894100 Fax: 91-11-43894199
Website: www.populationfoundation.in Email: info@populationfoundation.in
Facebook: http://www.facebook.com/pages/Population-Foundation-of-India/144526792274343
Twitter: http://twitter.com/PFI3