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Focus 1997 January - March |
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EMPOWERING PANCHAYATI RA] INSTITUTIONS
anchayati
Raj Act 73rd,
Constitutional Amendment has
placed greater responsibilities upon
panchayats to participate in social
development programs and community
welfare activities in the country. The
panchayats duly endowed with
autonomy and the resuurces
are expected to perform
within the framework of tasks
assigned to them \\ and take
decisions. The act has
identified 29 items as a new
responsibility for gram
panchayat, some of these are
- development of fishery,
small scale irrigation and
water management, primary
and secondary education,
health and sanitation,
primary health centre and
medical dispensary, family
welfare, women and child
development etc. Will
panchayat be able to cope-up
with all this on their own?
Do they have expertise to
decide collectively and
perform their role effectively?
There are no tools about how
this can be done except
perhaps empowering Panchayati Raj
Institutions' by providing systematic
training and developing management
capabilities among panchayat members,
so that they exercise their rights, power
and take appropriate decisions.
With a view to empower panchayat
members, the Population Foundation
of India in collaboration with M. S.
Swaminathan Research Foundation
(MSSRF) had organised a two-day
workshop on January 27-29, 1997 at
Chennai, to discuss suitable strategies,
methodology and development of
training and educational material in the
field of general health care, family
welfare, reproductive heal th, MCH care,
social development etc. This would be
based on the needs and the socio-
economic and educational background
of the people.
Consi dering the enormi ty of
providing training to estimated 3.5
million panchayat members, the
workshop stressed on the Deed to
identify expertise and resources in states
such as Rajasthan, Uttar Pradesh, West
Bengal, Tamil Nadu, Karnataka, which
would be involved in undertaking the
programs on pilot basis and provide
consultancy services to the state training
infrastructures. These states were
selected keeping in mind their ethno-
linguistic-cultural
diversities and
different political parties in governance.
This workshop on 'Training and
Project Design for the Empowerment of
Panchayati Raj Institutions on Issues
.Related to Population Health and Social
Development', being the first {exercise
of its kind, focused attention on
empowering of Panchayati Raj through
institutions by training them
using modules developed by
MSSRF on issues such as
Gender
Equity,
Environment, Nutrition,
Health, Population etc. These
contained
necessary
information to be imparted
to the Panchayat members at
different levels that would
not only help in training the
trainers but also provide
opportunity for Panchayat
members to have information
on the vital issues, so much
needed for population
stabilisation in the country.
The workshop was
attended by representatives
from Academic and Training
Institutions of the States,
specialists from NGOs, the
Population Foundation of
India and MSSRF. Shri Surya
Kant Mishra, Minister of Panchayat Raj,
West Bengal, delivered the valedictory
address.
Emphasising the need for the
empowerment of the Panchayat
members, Dr. (Mrs.) Mina Swaminathan
in her welcome speech said that many
of them were new to their jobs and
needed support to perform their
responsibilities effectively.
In his address Dr. K 5rinivasan,
Executive Director of PFI said that the
Panchayats had been overloaded with
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many responsibilities, which neither to be more effective for dissemination life situation before their mass
had the n@c@ssary resources nor the of information to Panchayat members. production.
competence to undertake such activities
professionally. There was a need to
inform them about the available
resources and its rational utilisation, he
said. Besides, these members were also
to be imparted skills in evolving a
socio-demographic charter for their
respective village communities, he
added.
The need to identify suitable
organisation for the production of video
programmes based on the selected
contents of the modules, was
emphasised. It was also suggested that
the main focus could be on training the
educated leaders and use them as
resource' persons for transfer of
knowledge to other members.
In his concluding remarks,
Dr. M.S. Swaminathan emphasised the
need for developing low cost replicable
models for the human resource
development in the Panchayats.
Training of the trainers and the process
of continuous interaction would ensure
total participation of the Panchayat
members.
Referring to the training module
developed by MSSRF, Dr. Srinivasan
said that such modules were useful in
In his valedictory address,. Shri
Surya Kant Mishra, the Minister for
Panchayati Raj in West Bengat said that
The outcome of the two-day
workshop resulted in emphasising :
imparting necessary information and
skills to the Panchayat members.
However, he stressed on the need for
evolving situation specific strategies
for training and use of modern
real democracy did not lie in conducting
elections but in promoting people's
conscious participation in the process
and their continued involvement. He
said that democracy evolves according
• the need for training an estimated
3.50 million Panchayat members on .
issues such as reproductive health,
family welfare, sanitation, gender
quity, and population .
communication
technologies for
reaching all Panchayat members in
shortest possible time.
Spread over five ,sessions, the
participants of the workshop presented
to the local ethos and it can not be
sustained unless it is equitable. In this,
the gender issues could not be taken as
independent of other issues but as an
integral part of all the movements.
• evol ving region specific training and
reorientation strategies;
• developing suitable informative and
educational material to meet the
needs of Panchayat members;
statewise status paper on Panchayat Raj
in order to assess their training needs,
the magni tude of the task and the
available infrastructure. The modules
developed by MSSRF were presented
and subsequently discussed in core
groups to suggest modifications to suit
the regional needs of Panchayats.
The core groups also worked on
developing project proposals on the
basis of gUidelines prOVided to them by
PFI. It was decided at the workshop that
While describing the structure and
salient features of training of Pancha yat
members in West Bengal, Shri Mishra
said that such training had played an
important role in empowerment process
of Panchayati Raj in his state.
Mr. T. V. Antony, emphasised the
need for developing the field based
training programme as against the
present practice of institution based
training. According to him, there was a
need to train selected members of
• using modern communication
technologies, especially video
cassettes for effective dissemination
of information;
• having a multi-tiered strategy for
training the trainers and imparting
education to individual Panchayat
members;
• treating resource persons as the
primary sources of information for
other Panchayat members;
participants from Rajasthan, Uttar Panchayats and resource persons in the • undertaking pilot projects in five
__ -Pradesh, West Bengal, Tamil Nadu and use of video cassettes. Mr. Antony
states - Rajasthan, Uttar Pradesh,
Karnataka, would prepare pilot project suggested that it would be useful to test
West Bengat Tamil Nadu and
proposals and develop methodology the capsuled video programmes in real
Karnataka .•
and strategies for demonstrating
effective coverage of Panchayat
members in one district in each state.
There was a consensus on identification
of an appropriate Non-Government
Organisation which could undertake
the project and also a suitable
organisation for consultancy.
Providing training to empower Panchayati Raj Institutions is a gigantic task. About 3.5
million Panchayat members in the country need to be trained to carry out 29 items of
responsibilities listed in the eleventh schedule of the constitution.
Following the decision taken at the workshop, the Population Foundation has undertaken
a m~ssive training programme in five states to motivate and involve Panchayats to effectively
participate in the population'stabilisation, public health and social development programmes.
The proposals worked out at the
workshop by the state representatives
presented wide variations in approach,
methodology and budget estimates for
training. While working out the
modalities, video cassettes were found
The states like Karnataka alone has 84,886 members to be trained, where as Uttar
Pradesh has 6,79,706 members. Moreover, the members at Zila Parishad, Taluk Panchayats
and Gram Panchayats require different types of training. The PFI will take only pilot projects
for the first year in each of five states covering a district and a block through local NGOs.
Suitable strategies for training and educational material, video film are being prepared by the
PFI for dissemination of information to the Panchayat members of the states.
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-llii*-------------------INSIGHT
SLUMS BENEFITED FROM REPRODl1CTIVE HEALTH AND
FAMILY PLANNING PROGRAAIMES
The Population Foundation of India has been actively playing a supportive and innovative role in helping
solve India's population problem. The Foundation aids projects and programmes which have replicative
and high feedback value. Four such projects recently completed in the slums of Bombay, Bangalore,
Hyderabad and Delhi have succeeded in creating awareness and promoting family planning and have
provided a base for their sustainability. The outcome of these projects have implications for wider
applications. A brief report:
QUALITATIVE EVALUATION
The qualitative reviews of these
projects indicated that the Non-
Government Organisations
had
effectively carried out the programme
activities inspite of several- obstacles
and problems. They could be entrusted
with specific responsibilities like
- - community mobilisation, education and
rr:rotivation, counteracting rumours and
removing doubts, misconceptions etc.;
and broadly social mobilisation of new
behaviour.
Equipped with such
capabilities NGOs could function as
effective adjuncts to the Government's
programme.
It was observed that the project
staff had not only succeeded in
generating favourable community
response ,in all the slum areas but also
.created a felt need for the programme.
To a great extent it had also been
successful in bridging the hiatus
between the people and service provider
Cand bringing about convergence of
needs for the programme.
But inspite of successful results,
will the programme susfain after the
withdrawal of the project from the
area? The sustainability itself depends
upon a number of factors such as the
community's unmet demand for the
services, a hostile attitude of the service
providers towards the project staff or
even lack of recognition of their work
and loss of initiative among voluntary
workers who had initially helped" in
bUilding the programme. It was
suggested that the sustainability of the
programme would be possible if a
follow-up contact is maintained with
the leaders and the volunteers who are
also ensured recognition for their work
by the authorities.
The success of slum projects also
depended on the manner in which local
level Community Health Volunteers
(CHVs) were identified, enrolled and
trained to carry out health and family
planning programme. They were
recognised as local resource persons on
whom people can rely for support on
such matters. It was observed that 'in
many cases the CHVs succeeded in
maintaining "liaison with the health
functionaries for providing services on
demand. This had created a conducive
climate for the effective implementation
of programme and also provided
encouragement to some CHVs to
continue work in their respective village
communities even after completion of
project activities.
However, the promotion of family
planning by the NGOs had not been as
encouraging as expected. Perhaps, the
primary focus of some project was on
many other aspects of health care than
on family planning alone, which was
taken up in the later stages of the
programme. In the beginning of the
projects NGOs did not place much
emphasis on family planning because
of apprehension of losing their
credibility.
Acceptance of family planning
would require a relativel y longer period
and in many projects family planning
acceptance increased significantly only
after 2-3 years of work by NGOs in
other public health and development
areas.
The reports from four slum projects
provided rich experiences and insight
into the methodological innovations,
which contributed to the success of the
reproductive health and family welfare
programme in these areas.
DEPRIVED ONES CHANGE
ATTITUDE TOWARDS
REPRODUCTIVE HEALTH
The project
IIPromoting
Responsible Sexual Behaviour among
Youthll run by the Parivar Seva Sanstha
(PSS) financially supported by PH, has
achieved some notable success in
promoting knowledge and to some
extent in achieving changes in
behaviour related to reproductive"
health, safe sex, contraceptive practice
among socially and economically
deprived population of the slums in
Bangalore city. It is significant to note
that the Muslim population, whi~h is
generally considered to be resistant to
such interventions has responded
positively.
The project entirely through an
educational strategy aimed to impart
reproductive health, family life
education to young men and women, to
"educate the youth on merits of adopting
responSible
sexual behaviour,
prevention of HIV / AIDS infection
among boys and girls. The project also
strives to reduce the number of teenage
pregnancies, delayed marriages to
motivate adolescents in seeking safe--
sex services and good quality
contraceptives.
The programme was implemented
in Bangalore city spreading over four
slums namely, Yarabnag"ar, Bhavani
Nagar, Cauvery Nagar and Karisandra
with a population of 40,000 liVing in
apprOXimately 6,300 households, the
average family size worked out to be
over 6.5. The target for education were
boys and girls in the age group of 13-16
years, 17-20 years and 21-24 years for
purpose of education assuming the
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lRD TATA MEMORIAL LECTURE
training programme and counsellino
and learning about child spacing, sexual
maturity, child development, AIDS and
its prevention and were aware of social
evils related to sex. However, boys
lacked enthusiasm. There were many
drop-outs among them, due to their
involvement in anti-social activities or
haVing employment.
educational needs of each age group
being different.
This target population was
considered very important from the
point of restricting teenage pregnancies,
promotion of spacing methods of
contraception, safe abortion as there
was a high sexual activity in the
community, especially among the
adolescent boys and the youth. This
posed a serious problems within these
slums - where promiscuous sexual
relations lead to teenage pregnancies,
some of which could be out of wedlock
and might be terminated
by
unscrupulous quacks.
Preparing
adolescents
for
responsible parenthood and safe-sex
life becomes all the more important in
-the wake of their exposure to the risk of
sexually transmitted diseases like STD
and HIVs. Keeping these facts in mind,
the programme had met the felt needs
of the target group.
Consequently, the main thrust of
the programme was peer group
counselling, screening and identification
of high risk cases for education and
service, mobilisation of IEC activities
based on the local beliefs and practices
using local language. The basic message
throughout the programme, regardless
of age variations, was on imparting
knowledge of contraceptives, promotion
of safe and responsible sex ual beha viour,
avoidance of unsafe abortions,
unwanted pregnancies, STD and HIV
infections.
The educational activities carried
out by the PSS were quite useful and
effective, though the frequency of the
training programme was not sufficient
as reported in the external evaluation
report. The desire for continuity of the
programme for at least 3 -5 years was
expressed by the community members
who had received training during the
project period.
It was heartening to note that there
was a general atmosphere of
permissiveness and co-operation for
such a training programme for
adolescents and .youth :n the
community. The parents and elders in
the family had not only permitted their
younger ones to take part, but also had
themsel ves taken part in the
programme.
One of the major findings of the
project as revealed by the trained
adolescent girls was that educational
programme conducted by PSS were
useful to handle responsibilities, but
qui te inadequate and infrequent.
However, they could learn about
puberty, sex life, induced abortion, age
at marriage, spacing of children, STD
and in particular about AIDS and its
prevention.
The adolescent boys and youth
had admitted being benefited from the
Int~restingly, boys were sexually
more active and were reported to be
chasing girls, who had matured and so
the parents felt more concerned about
the safety of their girls. Condoms were
collected more often by boys than girls,
whether married or not. Boys sought
more information on STD and AIDS.
Some STD cases were identified among
the boys on the basis of symptoms and
they were referred to hospital for
treatment. Boys sought testing their
blood for AIDS also.
The married and unmarried women
found the training and information
pragmatic. Although they were aware
of age. at marriage, safe-sex life,
complication of early pregnancies, AIDS,
family planning methods, very {ew had
adopted these methods. They also felt
hesitant to discuss with their grown up
daughters about such matters.
SurpriSingly, elderly ladies felt
that such educational activities were
necessary for the younger generation to
free themselves fmm social evils. They
also stressed on the need for organising
such training classes more frequently,
closer to their residence, so that,
knowledge gained could be applicable
in their day to day-living, especially the
adol.escents.
The educational activities carried
out by PSS had mef the felt need of the
target group. The programme was
found to be quite effective. It could
have made greater impact if it was held
more frequently with greater IEC input.
The findings clear! y indicated that many
respondents had adopted safe sex
practice, used contraceptives -to space
the children and took to terminal
methods of contraception. However,
AIDS related interventions needed
strengthening for greater clarity and
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--=--------~~--------II-SIG-HT
understanding of the issue. The
behavioural changes noticed in the
reproductive health could have been
strengthened to promote sustainability,
if co-ordination could be established
wi th local heal th a uthori ties, the Famil y
Planning Association of India,
beneficiaries and the community.
WOMEN STEP OUT
FROM RELIGIOUS &
CULTURAL TRAPS TO
REGULATE FERTILITY
This action oriented project took
up the central issue of Fertility
Reduction through p'romotion of Family
Welfare, Health and Family Life
Education among women of Darulshifa
slum in the inner-eity of Hyderabad.
Through intervention the heal th seeking
behaviour had improved in the
community. The women who were'
earlier denied basic health and education
had started seeking ante-natal, natal,
post-natal advice and check-ups services
more frequently than before.
Considering the poor socio-
economic background of women and
their reproductive health care needs,
Family Life Education centre was set in
Darulshifa by Taj Mahal Welfare Society
with PH support. The project was
implemented to raise awareness about
Family Planning and motivate·women
to regulate their fertility. It also aimed
to raise the age of marriage and age at
first p[egnancy and to bring about
partnership between community and
organisations prOViding health and
family planning for a sustainable
reproductive health programme.
The Darulshifa area predominantly
inhabited by Muslims, with 9,703
household and an average size of about
5 to 6 persons, presented a picture of
utter poverty and neglect. It covered 14
slum localities situated within 5 km:
radius of project office with no health
infrastructure. The people were poo,J
and were liVing in inadequate, congested
and unhygenic conditions. Women
were in a disadvantaged position as
they had to depend on men socially and
economically, deprived of basic health,
education and income generating
opportunities at home and in the
«immunity.
The low incomes and high illiteracy
were the most outstanding features of
these slum residents. This was
compounded
by large-sized
polygamous households with low status
of women. Understandably,
the
morbidity record included anaemia,
leukorrhoea, skin diseases, intestinal
worms, diarrhoea, seasonal fevers and
general weakness. Unfortunately, family
planning was not a highly felt need of
these slums but the general. health
conditions.
In order to promote the
reproductive health and family planning
in slum communities, the project's
outreach ac~ivity included intensive
family planning interventions and
reproductive health education through
effective communication campaign,
systematic counselling, linkaging and
partnership arrangements. A team of 14
Community Health Volunteers (CHVs)
in 14 localities were trained to provide
ground support for the 8 member team
of di rector , doctor, counsellor and
sisters.Their main task was to educate,
m\\Jtivate, and enable women to choose
appropriate means to regulate fertility
and improve reproductive health while
using services actually made available
by government, corporation and other
agencies.
As a result of such interventions
the health seeking behaviour among
slum dwellers had improved. The
services and medicine prOVided through
project resources had also increased the
attendance of patients. On an average
clinic received 30 to 50 patients daily
and 4 to 6'pregnancy related cases that
needed immediate attention. The
patients also included infants, children,
and general health complaint cases.
There was a felt need of the society to
have 6 bed hospital in the community
for deliveries and emergency cases,
which were normally referred to. the
Government hospitals of the city. Still
the orthodox among the community
would not go to the hospitals for
delivery. In such cases medical kits
were given to them by the sisters.
The situation with respect to
reproductive health in contrast to the
general health concern was seen better.
However, health education needed more
emphasis in the areas of worm'
infestation, 'dehydration problems
specially in summer and MCH
counselling.
There was a considerable amount
of adoption to family planning methods
across the urban slums, with an
appreciable level of awareness and
willingness, mostl yon steriLisatiul1. This
was achieved through commu:1ity
volunteers reinforced by medica [ C3m ps
which were very popular a.nd other
means of communication such as
dramatics, street plays, movies and
interpersonal contacts by the CHVs.
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Ii SIGHT
Another gain of the project was the HEALTH IMPROVED IN
immunisation
children.
of a large number of DRARA VI SLUMS
The project "Promoting Health and
Under this programme, 1044 Family Welfare in Dharavi Slum :
women were provided ante-natal and • Community Participation Strategies",
post-natal care. Many men and women aimed to create awareness and promote
also benefited from Family Planning health and family welfare in Dharavi
interventions. 600 women underwent
slum of Palghar Taluka, Thane district,
tubectomy; 780 persons were enrolled Mumbai. With PFI support, the Society
. as acceptors of condoms; 100 IUDs were for Human. and Environment
inserted ; 865 women accepted oral Development (SHED) implemented the
pills; and 13 men underwent vasectomy project for three years covering around
operation.
60,000 slum population inhabiting eight
sectors.
Evaluation of the project suggests
that the perceptible changes are taking
place in the attitude and behaviour of
the people of Darulshifa. The project
interventions'
had an effect of
reinforcing, legitimating and stabilising
those changes.
Besides, the initial resistance about
the family planning programme,
adolescent sexuality, etc., have been
broken down. The women are now
corning out of their religious and cultural
traps and realise the need to regulate
fertility in order to avoid the adverse
and negative consequences of too early,
too soon and too many children. The
boldness and conviction with which
they are corning forward on their own
is perhaps a significant step towards
improving their lot and that of their
children.
In order to improve the quality of
life of slum dwellers of Dharavi, a
package of heal th and social
development services were provided.
The methodology of the programme
was based on promoting community
participation by creating leadership and
organising interest groups of women,
youth, adolescent girls etc. and provided
services through camps. The project
also organised training for volunteers,
traditional birth attendants, community
animators etc. to identify and educate
people in the high risk groups to take
the modern health practices including
reproductive health.
Dharavi needed such services
which could be well knitted into their
community life for acceptance and
practice: As such people lived in abject
poverty and appaling unhygienic
environment. Inhabited on a low-lying
marshy land, Dharavi has rows of
houses facing each other across narrow
drains usually filled with stagnant water
- a heaven ground for mosquito
breeding. Nearly 80 per cent of children
were victims of gastroenteritis, typhoid,
malaria, measles, hepa ti ti sand
tuberculosis.
With a population of about 1.2
millions, Dharavi is one of the biggest
sprawling and perhaps the oldest (1890)
settlements on the periphery ofM urnbai.
As it is, an unauthorised settlement, the
health and development services do not
reach the people of Dharavi because
they do not have claim over civic and
other social services. Their misery is
compounded by filth and neglect of
public toilets. Safe drinking water is
also a big problem at the settlement.
The squalor, filth, overcrowding,
pollution are the cause of ill health,
poor growth, disease and death.
Poverty is the main underlying cause of
this tragedy.
The different ethno-linquisitc -
cultural background of Dharavi clusters
had also made the task of community
participation in the programme more
difficult. The inhabitants migrated from
different states through the network of
Village, kinship, caste or community, .
lived in pockets belonging to their own
states speaking their own language,
follOWing their own customs and hardly
intermix with other. It was reported
that during the communal riots of 1992-
93, there were frequent inter-locality
clashes in which the people of different
communities
participated
that
completely destroyed the social
harmony of the area.
Besides, the deep rooted values
and beliefs, particularly among those
migrants from Uttar Pradesh, the
modern health practices had not been
adopted. People still preferred to go to
the diviners in case of sickness.
Occupation related hazards also were
the cause of various types of chest
diseases among people.
IMPACT
In the light of prevailing health
conditions in Dharavi slum dwellers,
SHED the NGO which had been
implementing the projects for three
years, could bring about improvements
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-------------------INSIGHT
in most of the health indicators. The couple thereby increasing the demand workers in particular and people in
programme was quite successful as far for family planning services, especially general, the project workers could
as immunisation of children was spacing methods with a view to reduce mobilise people's opinion in their
concerned.
the fertility level.
favour. Gradually women developed
It is difficult to assess accurately
the impact of the MCH programme
since people changed their residence
quite frequently and new members
inhabited their places. The acceptance
of family planning, however, appeared
to be quite low. There was a general
resistance towards terminal methods
though, reportedly, many women took
to ruCD or ,oral pills without informing
The main components of the
programme included Health, Hygiene,
Family Pla!1ning, MCH Care,
Immunisation and Nutrition Education.
This was achieved through training of
volunteers, traditional birth attendants,
community mobilisation, community
education on health issues, networking
with the Government functionar(es,
private medical practitioners and adult
faith in the project personnel and started
visi ting tri-weekl y clinic organised
under the project. An integrated health
service facility was provided in the
clinic by a Obstetrics and Gynaecology
specialist and a Paediatrician (Project
Director). This resulted in a significant
rise in ante-natal chec~~up, considerable
reduction in home deliveries and
complicated delivery cases.
others in the family.
The groups of trained adolescent
girls have been functioning fairly
effectively and people appreciate their
work. However, the same could not be
said about the Mahila Mandals or the
youth clubs. The community
mobilisation work and organisation of
camps had been primarily done by the
community health volunteers who had
succeeded in educating and motivating
people to accept family planning.
literacy.
The slum dwelling inhabitants of
Dakshinpuri needed health services
because they lived amidst unhygenic
'and poor sanitary conditions. Although
Dakshinpuri had a Delhi Administration
dispensary, family welfare centre and
ICDS centre which were supposed to
provide health, family planning and
other services, in reality, only
immunisation and sterilisation services
were prOVided and that too under the
IMPACT
The impact of the project was
significant among the target population.
In all, 460 couples were found using
family planning m~thods, out of which
more than 51 per cent took to it during
the project period.
The project had succeeded in
spreading awareness about the
importance and utility of nutritious diet
for women, children and proper MCH
There has been considerable impact compulsion of meeting the targets.
of the programme as it could ensure Consequently, people lacked knowledge
mass support to the programme; create about spacing methods and had irregular
awareness and promote acceptance of ante-natal and post-natal check-ups. In
immunisation and family planning
the aqsence of such services, deliveries
methods; and mobiltse women's groups, were conducted at home by untrained
youth clubs and the groups of adolescent
Dais. The large family size, poor
girls for female Iiteracy including higher maternal and child health, high
age of marriage for girls and freedom of mortality and mobidity were attributed
choice for vocations in life.
\\ to lack of health services and acute
poverty in the area.
However, weakness of the
programmes has been the low priority
being given to family planning, and
A baseline survey carried out in
Dakshinpuri identified the health
comparatively
less
effective
performance by the women and youth
groups.
problems, particularly those of women
and children. Seven selected volunteers
- six female and one male - were trained
fo~ 10 days in reproductive health by
REALm OF WOMEN
the ACORD. With assigned areas these
AND CHILDREN IMPROVES
The project "Fertility Reduction in
a Low-Income Resettlement Colony in
Delhi", was carried out with PFI support
by SPARSH in two phases in 11 blocks
and three slum'clusters of Dakshinpuri
covering a population of28,259. Broadly
the project could raise the health
conditions of women and children by
regula ting fertility level.
trained volunteers were able to proVide
education and counselling to different
groups. They also started community
based literacy centres, where along with
literacy oth~r information regarding
MCH care, reproductive health etc.
were shared with the participants. For
crea ting mass awareness abou t
reproductive
health and family
planning, meetings, film shows, street
plays, puppet shows and baby shows
The project aimed to create health were organised from time to time.
care during the pregnancy. It was also
. successful in creating a general
f~vourable climate about the advantage
of practising family planning for the
health of women and children. The core
group of female volunteers had
general! y been effective in creating right
~ype of attitudes towards MCH practices
and Health Care.
However, the acceptance of family
planning was not upto the expectation.
The main reason for this could have
been the preference for son and
dominance qf men in decision making
process. It is noteworthy that almost all
the volunteers were women, as such,
the male education remained only
incidental in the project.
The study revealed a marked
resistance towards the terminal methods
of family planning though women
preferred oral pills, IUDs and a few of
them had also resorted to abortions to
get rid of the unwanted pregnancies.
The weakness of the project was
the inadequacy of the available resources
to take care of the various components
of the programme. Because of this, the
Dai training programme was not
consciousness and enhance family
Inspite of initial resistance from effective and the family life education
planning awareness amongst young the Government health staff, Anganwadi of the adolescents could not take off.•
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STFAILTE E-------------------
iMAHILA DAKIA' - A PLACE TO GROW IN !
What does one do in the event of
rape? How does one prevent
tetanus? Why should girls go to school?
All this finds place in a local broadsheet
called 'Mahila Dakiya' doing the rounds
in Uttar Pradesh's Banda district.
Significantly, it is being indep~ndently
brought out by a group of women
called 'sakhis' - from the so-called lower
caste, which mainly comprises semi
literate and the poor. Equal! y significant
is that, this is happening in Banda, one
of u.P.'s most backward districts,
ranking amongst the worst records for
law and order, poverty, literacy and
crime against women.
The 'Mghila Dakiya' story is a part
of the project initiated by the National
Institute of Adult Education in
collaboration
with the Mahila
Samakhya, which has been working for
the empowerment of women for the last
six years. At the core of the structure
are village workers, called 'sakhis', aided
by the 'sahyoginis' at the block level, all
of whom are motivated to discuss local
issues and hold village meetings.
Strangely enough, 'Mahila Dakiya'
grew from another innovative project
of training women as hand pump
mechanics, as water is central to the life
of village women, they learnt fast. "We
no longer wait for days to the Jal Nigam
mechanics to arrive", explains Sita, a
local 'sakhi'. "We repair the hand
pumps ourselves and don't waste time
treking long dista~ces for water till the
mechanics arri ve".
-
As the women's confidence grew,
they began to feel irked about haVing to
rely on male mechanics to do things like
updating their log books merely because
they couldn't read or write. So women's
literacy camps were organised fOJ:them.
Samakhya officials explain that this
close link between literacy programmes
and the hand pump project created an
environment for the use of literacy
skills. Women began to exchange news
about their villages and homes. When
the idea of written communication came
up, they were guided to write their
day's experiences and draw on walls.
From this came the idea of 'Mahila
Dakiya'.
The mood was cheerful, if nervous,
as neoliterate 'sakhis' and 'sahyoginis'
grappled with the intricacies of the
written mode. The women were apt
learners and responded to the informal,
teaching methods. When they had to'
choose the format of the newslettef,
they were shown a newspaper, a
magazine and a . broadsheet.
Articulating their needs, the advantages
and disadvantages of the various forms,
they finally settled on a broadsheet.
Dummies were presented, anafysed,
the basics of balancing visuals, printed
one such man tells his Wife, but she
rides on confidently. There is a didactic
piece on the need to keep water areas
, clean. A picture story depicts how a
child molester was dealt with, are some
of the iterns seen on the pages of the
broadsheet.
Best of all, 'Mahila Dakiya'· has
evoked grudging response in Banda.
People first refused to believe that
women had actually produced and
written it, Lacchmi a 'sakhi' says,
laughing. "But our names convinced
them". Even literate headmen - the
ultimate bastion of male power in the t
village - have patronisingly said, "If
this is what women can do, it is useful".
Says a 'gram pradhan', "News from
everywhere now gets into the paper.
We better see that our village doesn't
get a bad name". Curious travellers at
bus stops ask for copies. "Mahila
Dakiya' has clear! y provoked a reaction.
matter and content were explained. A
folksy, informal combination of direct
text, information blurbs, poems, songs
and picture stories emerged - worked
out by the women as their confidence
grew. In the process, there was a
transformation in their analytical skills,
thinking and confidence. -
In one issue, there is a humorous
song about how women now ride
bicycles, their men perched on the
pillions. "Let me get down as we near
the market so that people won't laugh ..."
There have been tremendous spin-
offs, excited Samakhya officials tell you.
Women now want to learn screen·
printing, to know about mainstream
media and alternative networks. The
scheme has been largely successful
because it has emphasised creativity,
not mechanical post literacy skills. The
language and experience of neoliterate
women are validated by the written
word. They now feel they have access to ••
information instead of being passive
recipients of it. But above all - though
they don't articulate it much - it has
given them valuable space to grow .•
Social Develop1!!ent. Fair at Pragati Maidan
The PopUlation Found~tion of India is participating in a Social Development Fair to be
held at Pragati Maidan from April 12-20, 1997. One of the important display item being
exhibited is a population clock developed by PFI, which will use multi-media projector to flash
population of the country every second alongwith effective messages related to popUlation
control. Another interesting item on display would be projection of PFI's projects on India's
Map through computer: It would cover about 350 projects and activities of ·PFI done in last
25 years.
The Fair first of its kind organised by India Trade Promotion Organisation, has provided
an opportunity to interact with other International Government and Non-Government
organisations working in the field of Population Stabilisation, Reproductive Health, Family
Welfare, 6oducation, Environment, Social Development and other related areas of development.
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1.9 Page 9 |
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People of Ghaziabad district of Uttar
Pradesh witnessed a unique health
feat, health mela with a difference.
Surrounded by canopy of pendals at
huge Ram Lila Grounds of Ghaziabad,
the festivity resembled any fair at a big
metropolis. It was a great opportunity
for the rural folks to see for themselves,
what it meant to have a healthy
environment and a small family.
A large turnout of women
panchayat members added guiety and
purpose to a day-long lecture-cum-fun
oriented health programme. About 1,000
people from the rural' areas which
included grassroot leaders like
Panchayat Pradhans, Panchayat
members, and the Tehsildar actively
participated in various reproductive
health and the family welfare related
programmes.
, The "Health Mela" first of its kind
in the region was a part of the activities
under the intensive reproductive health
and family welfare project, jointly
undertaken by FICCI, Socia-Economic
Foundation and Population Foundation
of India. Held on January 4, 1997, the
purpose of the mela was to sensitise the
local population about the various
schemes of the Government for enSuring
good health to the masses.
Clad in fine clothes; though ethnic
in appearance, men and women looked
confident while they went through the
registration, coffee and lunch break.
What struck everyone the most, was
the determination and confidence,
women had to get something from the
show. They showed great enthusiasm
in events like lectures, skits, puppet
show and the magic shows. Women
were seen collecting printed material
and handing them over to their male
counterparts. "These material are
useful. I will read them at leisure", said
Zubeda ofMaki.mpur village of Bhojpur
block. Ramwati from the same village,
however, took no interest in the printed
matter and quickly turned towards the
magic show. Women were also seen
taking keen interest in the Baby show,
painting and fancy dress competitions.
The most exciting part of the mela
was a play, which was performed by
Jan Shakti Vahini on reproductive
health. The young artists presented
facts on sensitive issues such as
marriage, dowry, early pregnancy,
family planning methods, spacing, etc.
Although embarrassing at times, the
play was watched by elderly villagers
with rapt attention. Maya Devi, a
widow and Panchayat Pradhan of
Almpur village of Hapur block was
heard discussing with her brother-in-
law, the need for such education in their
village. "We should have such plays
performed at our village 'Chaupal"'.
The health mela proVided variety
of programmes which not only served
the purpose of orienting Panchayat
Pradhans and members but also as
vehicles of communicating health
messages to the people, an effective
forum for interaction between
Goyernment,NGOs, Voluntary agencies
and the grass root level elected
representatives of the people. Many
industries such as DHL Division of
Airfreight Ltd, Apollo Hospitals, Mohan
Meakins and SmithKline Beechan
Consumer fIealth Care Ltd. participated
and supported the mela. In all 28 stalls
were put up by both the Government
and Non-government organisations.
The response from Panchayat·
members was tremendous as about 85
per cent of them committed for making
arrangements for 'Zacha-Bacha' centre.
In fact, Raja Ram of Rajpura block
promised to give his building for setting
up 'Zacha-Bacha' centre at his village.
Surprisingly,
almost all women
members showed willingness to
supervise such centres.
The health mela was inaugurated
by Ms Rita Menon, Vice-Chairpetson,
Ghaziabad Development Authority and
Shri Sharada Pras.ad, District
Magistrate, Ghaziabad made the
keynote address. Other speakers at the
function were Dr. K. Srinivasan,
Executive Director, PFI; Shri Y. P.
Srivastava, FICCI; Dr. Ram Babu, CMO,
Ghaziabad; Prof. O. P. Agarwal and
'!!l
,.~~~~._
~?d:::r-.-;;-~- _ ~-:-:---._
~,
""'\\1'>\\\\m:;;;;;'
0' Pi~;
~~~~~
')',,~~,\\~~
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STATEmE=========--~~-------
Shri Dharambir Singh, District
Panchayati Raj Officer.
Speaking on the occasion, Ms. Rita
Menon stressed that in family welfare
programme, the government, NGOs
and industry should work in tandem to
reach the goals under the project. She
said such health programmes should be
taken up in other blocks also and health
camps should become a regular feature.
She also stressed on a close monitoring
and evaluation for better results.
Dr. K. Srinivasan, in his special
address emphasised the need for
involvement of industries in such
projects for at least five years to serve
their own employees, as well as the
community at large. Highlighting the
role of PFl in reproductive health and
family welfare projects, he said that PH
had funded about 300 projects all over
the country and the Ghaziabad project
was in collaboration with FlCCI, to
meet the health needs of the region. He
sought the co-operation of the women
panchayat members to shoulder
responsibilities of spreading literacy
and health messages to the people in
their villages.
In his key note address,
Mr. Sharada Prasad said that the aim of
building a healthy nation was being
slowed down, while the solution to it
lied in the fact of fighting against the
population and illiteracy problems.
He further added that to achieve
the targets of the five year programmes
it was essential that a people's
_ _ ~ovement alone can make it a reality
and called upon every body to start a
movement .•
15 LAKH GIRL INFANTS
KILLED IN BIHAR EVERY YEAR
In Bihar about 15 lakh girl infants
are killed every year. Dowry seems
to be the reason for this heinous crime
according to a report published in 'Jan
Satta', a leading Hindi National daily.
The report is based on a sample
survey conducted in four blocks of
four districts of Bihar by a Voluntary
Organisation 'Adithi', which revealed
the seriousness of the problem of
female infanticide in the state. Survey
conducted on 'dais' who have been
helping in delivering babies in blocks
Dhumra, Gopalpur, Bhawanipur and
Katihar of. district Sitamarhi,
Bhagalpur, Purnia and Katihar
respectively, revealed horifying tales
of how these babies were killed.
The killing of a female baby takes
a few agonising minutes. Dai is called
soon after the female child is born. The
doors and windows of the room are
closed and then three spoon of salt or
urea is put in the baby's mouth which
is pressed until she breaths her last.
Another method of killing is twisting
her neck. The act is done under the veil
of secrecy and seldom become public.
Dais reportedly admitted that the
crime they committed were at the
behest of the family members. If they
refuse they would be beaten up
mercilessly, even deprived of money
and property. They were willing to
leave the profession if alternative
employment was available to them.
The morbid greed for dowry is
one of the major factors afflicting
death on young lives. Ironically, what
started centuries ago by the Rajputs as
an attempt to preserve their honour at
the time of arranging suitable match
for their daughters and the humiliation
faced for want of dowry thereafter,
gradually assumed a most inhuman
and dastardly tool to combat the dowry
menace. As the other economically
weaker, forward and backward castes
are getting richer, the social evil of
dowry is taking deep roots in these
communities.
As a result of infant infanticide
and other atrocities committed on
women, the sex-ratio in Bihar is on
gradual decline. According to 1981
census, there were 946 female per
1,000 males. The 1991 census showed
decline at 911 female per 1,000 male.
In Bihar out of 42 districts, in 39
districts the number of women is
declining steadly.
The high incidence of female
infanticide reported in Bihar and
declining sex-ratio needs serious·
attention. If a measure similar to
Tamil Nadu's 'cradle' scheme is
adopted in Bihar which is to leave an -
unwanted child in state care, it is a
genuine way of saving female babies
from death. •
.
NEXT INTERNATIONAL CONFERENCE
_____
ON REPRODUCTIVE HEALTH TO BE HELD AT MUMBAI
_
Indian Society for the study of Reproduction and Fertility along with the UNDP/UNFPA/WHO/World Bonk Special Programme of
Research, Development and Research training in Human Reproduction is organising an International Conference on Reproductive Health
at Mumbai from March 15-19, 1998 ..
Researchpapers on the following topics is being scheduled to be presented: Fertility regulation; Infertility; Sexually transmitted diseases;
Unwonted pregnancy and abortions; Materna~ morbidity and mortality; Adolescent reproductive health; Uses and abuses of reproductive
technologies; Gender and sexual violence; Safe motherhood; Menopause and hormone replacement therapy.
For further information, pleose contact:
.
Dr. Chander P. Purl
Secretary, Indian Society for the Study of Reproduction and Fertility, Institutefor Research in Reproduction, Parel, Mumbai 400012, India.
Telephone: (0091 22) 4132111, 4132117; FAX: (0091 22) 4964853, 4139412; E-mail: vichin @ giasbma.vsnl.net.in .
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2 Pages 11-20 |
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:=~_--------------PFI
NEINW BR SIE
PEASANT
WOMEN
FERTILITY
AND
Dr. Kiron Wadhera, The Asian Centre for Organisa-
CONTRACEPTIVE BEHA VIOUR-A STUDY OF THE
tion Research & Development (ACORD), Delhi.
SCHEDULED CASTES.
Prof. P. Ramachandran,
University, Tirupati.
Sri Venkateswa.ra
8.
\\..//
PROMOTING REPRODUCTIVE
HEALTH- AN
EXTENSION PROGRAMME IN THE INDUSTRIAL
COLONIES FO JK PAPER MILLS.
THE CRISIS OF MIGRA TION: POPULATION POLITICS
Mr. Sanjoy Hazarika, Centre for Policy Research.
Dr.K.G.N. Kumundan, JK Paper Mills Welfare
Centre, Jaykaypur, Rayagada, Orissa.
NewDelhi.
RURAL .FAMILY WELFARE PROJECT.
HEALTH DEVELOPMENT OF THE SLUM DWELLERS.
MR.P.K. Sharma, ADHITHI, Patna.
Mr. K. Mohanrao, Society for human and 10. EMPOWERMENT OF RURAL WOMEN WITH FOCUS
Environment Development, Mumbai.
ON FAMILY WELFARE.
4. /PROMOTING REPRODUCTIVE HEALTH IN THE
/ ORGANISED SECTOR: A PROPOSAL FOR
INDUSTRIAL WORKERS AT KOTA.
Mr.U. C. Jain, Rajasthan Chamber of Commerce &
Mr.M.M. Raja, Daudnagar Organisation for Rural
Development, Bihar.
11. SUKHI PARIVAR.
Dr. P.M. dubey, Parivar Mangal Trust, Pune.
Industry and Kota Divisional
Association.
Employers
12. INTENSIFYING F P ACTIVITIES BY MEANS OF
INTERGRATED FAMILY PLANNING, HEALTH AND
}- PROMOTING REPRODUCTIVE HEALTH IN THE
:r ORGANISED SECTOR: PROPOSAL FOR INDUSTRIAL
WORKERS IN THREE CONTIGUOUS DISTRICTS OF
SOCIAL DEVELOPMENT PROGRAMME IN TONTK,
RAJASTHAN.
DRK.K. Verma, Pariva Seva Sanstha , New Delhi.
UITAR PRADESH, i.e. GHAZIABAD, MEERUT AND
MUZAFFARNAGAR.
Dr. B. Sarkar, PHD,Family Welfare Foundation.
13. MICRO COMPUTER BASED REPRODUCTIVE
HEALTH PROJECT.
Dr.P. Majumdar, Liberal Association for Movement
6./ INTENSIVE REPRODUCTIVE HEALTH AND FAMILY
of People, Calcutta.
~WELFAREPROGRAMMEFORGHAZIABADDISTRICT.
14. PROMOTION OF RURAL POPULATION CONTROL.
Dr. (Ms.) N.Hamsa, Socio-Econonic Development
Mr. Mohd. Baniyamin, South Eastern Rural
Foundation, FICC!.
Development Organisation, Wangjing, Manipur.
7. CREATING CONDITIONS FOR FASTER FERTILITY
REDUCTIONS-IN
BHARATPUR DISTRICT OF
RAJASTHAN THROUGH INTEGRATED HEALTH &
DEVELOPMENT STRATEGIES.
15. COMMUNITY RESOURCES MOBILISA TION FOR
IMPROVING REPRODUCTIVE HEALTH
Dr.-B. S. Garg, Mahatma Gandhi Institute of Medical
Sciences, Wardha.
* REPRODUCTIVE HEALTH PACKAGE FOR MARRIED
WOMEN IN INDUSTRIAL RURAL AND URBAN
(SLUMS) AREAS AND ITS EFFECT ON THE USE OF
SPACING METHODS OF FAMILY PLANNING.
Mrs. Indira Varadarajan, Nischal Foundation, Anand
Welfare Centre,Aurobindo Marg, New Delhi.
* AN INTERGRATED PROGRAMME FOR OUTREACH
HEALTH SERVICES AND PROMOTION OF SMALL
FAMILY NORM.
National Institute of Human Research and
Development (NIAHRD), Cuttack, Orissa.
* EMPOWERMENT
OF P ANCHA YA TI RAJ
INSTITUTIONS ON ISSUES OF POPULATION HEALTI I
AND SOCIAL DEVELOPMENT.
Satyamurti Centre for Democratic Studies, Madras.
Council for Health Education and Rural Upliftment,
Dindigul, Tamil Nadu.
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2.2 Page 12 |
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PH NEWS IN BRIEF
PFI EVENTS
A SUSTAINABLE PROJECT
Dr. K. Srinivasan, Executive
Director, PFI participated in the
following Seminars/Conferences in the
Mohth of January, 1997 :
A PFI funded project "Promoting Family Planning through the Practitioner of
Indian Medicine System", has been successful in promoting family planning
at Udaipur. It has not only generated strong desire among ISM practitioners to
continue the work with minimum support but also can supplement the main
stream heal th and famil y planning programme without much recurring expenditure.
• 8 January 1997, "Fifth Conference of
the Central Council of Health &
Family Welfare" at Parliament
Annexe, New Delhi.
Another significant finding of the project is its innovative approach and
methodology which can be used as a replicable model. Besides, wide publicity
given to the project and involvement of the ISM practitioner, has brought about
a social legitimisation of their activities.
• 16 January 1997,A Seminar on "Role
of different donors working on
Population and Reproductive Heal th
in India", organised by Population
Council, New Delhi.
The project also culminat~d into formation of an "Association of the
Practitioners of Indian Medicine System", by the workers under the project to
implement health and family welfare related projects in the rural areas of
R:ajasthan. This was disclosed by Mr. K. S. Natarajan, Joint Director, PFI, who
participated at an orientation meeting of the Practitioner's of IMS held.at Udaipur
• 20-21 January, 1997, A Seminar on on January 15, 1997 at which ISM practitioners involved in the project also
"Social and Economic Changes participated.
under New Economic Reforms in
India", at Bangalore, wganised by
the Institute for Social and Economic
Change.
At the Seminar, he also presented
a paper on "Social and Economic
ChaRges in Health & Family Welfare
Sector under Economic Reforms in
India".
* PROMOTION
OF FAMILY WELFARE PLANNING
THROUGH
PRACTITIONERS OF INDIAN SYSTEM OF MEDICINE (ISM) IN THE
RURAL AREAS OF RAJASTHAN.
Dr. Mohan Advani. Population Research Centre, Mohanlal Sukhadia
University, Udaipur.
* STRATEGIC INTERVENTIONS
FOR ACCELERATING'
THE PACE OF
• 24 January,1997 delivered a lecture
at Nutrition Foundation of India at
DECLINE IN INFANT MORTALITY AND FERTILITY ..
Dr. (Mrs.) Mawizuala, PHULNA, Landour Community Hospital.
New Delhi on "Population Issues:
New Insights from NFHS".
Mussoorie.
* STRATEGIC INTERVENTIONS
FOR ACCELERATING
THE PACE OF
SHARE
WITH US
DECLINE IN INFANT MORTALITY AND FERTILITY.
Mr. R. D. Lall, Grameen Navjagruti Yojana, Damoh, Madhya Pradesh.
* PROMOTING RESPONSIBLE SEXUAL BEHAVIOUR AMONG THE YOUTH
We invite from our readers
IN BANGALORE.
research findings, success stories
and articles along with photographs
Mrs. Sudha Tiwari, Parivar Seva Sanstha, Bangalore.
_* PROMOTING FERTILITY REDUCTION AMONG WOMEN IN THE INNER-
on population, environment and
development. We welcome feedback
. from our readers, to make FOCUS a
forum to exchange information and
knowledge.
CITY OF HYDERABAD.
Ms. Sajida Taj, Taj Mahila Welfare Society, Hyderabad.
* . FERTILITY REDUCTION PROJECT IN A LOW-INCOME RESETTLEMENT
COLONY IN DELHI (DAKSHINPURl SLUM) .
Dr. Anjana Das, SPARSH, New Delhi.
* PROMOTING HEALTH AND FAMILY WELFARE IN DHARAVI SLUM:
Editorial Direction &
Guidance:
DR. K. SRINIVASAN
Editor:
UMA YADAV
COMMUNITY pARTICIPATION STRATEGIES.
Mr.K. Mohanrao, Society for Human and Environment Devlopment,
® Mumbai.
COMMUNITY -BASED REPRODUCTIVE HEALTH NETWORK, ASSURING
QUALI;ry SERVICES IN DISTT. FARlDABAD, HARYANA.
Mr . Lajpat Rai, Escorts Ltd. PH
Published by the POPULATION FOUNDATION OF INDIA, B-28, Qutab Institutional Area, New Delhi-110016. Tel. : 6867080, 6867081
Typesetted and Printed by Reproductions India, 198/19, Sapna Apts., Ramesh Market, East of Kailash, New Delhi-110065. Ph.: 6233269, 6216287