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Focus 1998 January - March Egnlish |
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1.1 Page 1 |
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Focus
Volume XII No. 1
Jan.-Mar., 1998
Panchayat Training Project
To Be Extended To Four More States
The training programmes for elected Panchayat members to undertake added
responsibiiities of activities related to reproductive health and population
stabilisation, sponsored by PFI in seven districts in six States, is being extended to four
more States - Bihar, Orissa, Madhya Pradesh and Haryana.
One district in each of these States
will be selected for the project, for
which the Governing Board has
sanctioned an additional outlay of Rs
28lakhs.
The new programmes will follow
the same model as adopted in earlier
districts. Projects already undertaken
in those districts went through a phase
of temporary inactivity mainly due to
the mid-term electrons to the Lok
Sabha, but are expected to pick up
momentum from March onwards.
In BANKURA district of West
Bengal, the activities are, however,
likely to be delayed by some more
time due to the impending Panchayat
elections in May, after which training
for newly elected members will be
takenup. Already, 84resource persons
have been identified and trained to
work under the project. Training
material in the form of printed matter
and video cassette has been developed
in Bengaliand is ready for distribution.
In SAWAI-MADHOPUR district
of Rajasthan, training of resource
persons was resumed in early March.
Training material in Hindi, both video
and written, has been prepared.
In LALITPUR district of Uttar
Pradesh, where. the PFI is the
consulting body, training modules in
Hindi and video cassette have been
developed and are ready for
distribution. Sixty resource persons
have been identified and their training
was completed in March.
The Governing Board of PFI has
decided to extend the training
programme under all the projects
by three more months. It was felt
that the first phase of training
was not adequate and a second
round of training for Panchayat
members was necessary. State
level workshops are proposed to
be conducted during the
'extended period to assess the
efficacy of the' projects
undertaken by PFI.
Substantial progress has already
been achieved under the projects at
DHARMA PURl and DINDIGUL
districts of Tamil Nadu. Training
workshops for the lead NGOs, Zilla
Parishad Members and Samiti
Panchayats have already been
completed and resource persons in
both the districts have been identified
and trained. Here, the training
modules and the video cassette have
been developed in Tamil and are
ready for distribution. Training of
Panchayat members is to be taken up
shortly.
In CHITRADURGA district of
Karnataka, NGO members have been
trained. Training material and the
video cassette have been developed in
Kannada and are ready for
distribution. Resource persons have
been identified and their training is
expected to be completed by March.
Training of Panchayat members is
likely to be taken up in April. •
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EDITORIAL
Governing Board Holds Meeting In Goa
Yet another coalition government has taken over the
reins at the centre following the mid-term elections to the Lok
Sabha in February. The country has been going through a
period of political uncertainty in that the electorate had not
given a clear mandate to any party or a combination of parties
with an agreed agenda. The new government will, therefore,
have to hammer out a line which will ensure stability not only
of the political arrangement but also of policies which would
form the core of a national agenda standing above
controversies.
Population stabilisation is one such core item which
should be the priority with everybody concerned with the
future of the country. It has been long understood that a
population programme must have the identity of a people's
programme, for which a total commitment of all political
parties is needed. PFI has been tirelessly advocating the
cause to muster support from leading political parties, and
had appealed to them to spell out their role while approaching
the electorate. If the manifestos of the leading political
parties are any guide, then there is a clear indication that
they are now fully committed to the cause. The manifesto
of the BJP and the National Agenda of the BJP-Ied coalition
government are particularly conspicuous in their policies and
commitments to the population issue. It is a very welcome
development and gives tremendous encouragement to all
workers on the population front.
One realises that manifestos proclaimed and national
agendas are political documents full of pious wishes where
many promises are made mainly to attract voters and retain
power, without properly weighing the burden of such
promises. The winning parties do have a moral commitment,
but the ones not voted to power may not retain the same
fervour about the promises. One only wishes that the
population issue does not suffer on this account, because it
is a question of survival for the nation and not an election
issue.
PFI would entreat all political parties to live up to their
commitment and activate their powerlul machinery to
vigorously implement programmes of population stabilisation
including reproductive health, gender equity and ensuring
that quality services are available allover the country.
Elected leaders should demand that official health and family
welfare services function efficiently in their constituencies.
Their earnest will be further manifest if they all agree to
extend the cur'rent freeze on the number of representatives
to the Lok Sabha on the basis of the 1971 census beyond
2000 when it is due to expire. States which have set an
example in stabilising population should not be made to lose
their relative numerical strength to benefit States which have
been derelict in implementing population programmes along
with other social development programmes. The issue
should be cleared in the current Parliament, as the next
regular elections could be held on the basis of the 2001
census, if the freeze is allowed to lapse either through
carelessness or to reap narrow regional gains. Lifting the
freeze will send a wrong signal that our elected representatives
are not serious about reducing the population growth rate in
those States where the rates continue to remain high. The
prospects spell unmitigated disaster for the nation.
The 103rd meeting of the Governing Bonrd of PFI wns held at the
International Centre at Dona Paliin in Goa on Februnry 20.
Reviewing
the population
situation in the country, the Governing
Board found it heartening that all
national parties contesting the mid-
term elections to the Lok Sabha had
mentioned in their election manifestos
the need to take steps to contain the
rate of growth of population. The
Governing Board appreciated the fact
that the efforts of the Foundation to
activate the political leadership in this
regard have succeeded. The Governing
Board noted with satisfaction that the
political parties were alive to the
issues
of female
literacy,
empowerment
of women and
expansion of primary health facilities
and pledged political support to the
cause of population stabilisation.
Members felt that with a clear
conscience emerging among the
political parties about the urgency of
population stabilisation programmes,
it was necessary for the Foundation to
follow-up its efforts to remind the
parties in power to take concrete steps
for a ttaining the goal. In this
connection, the Board felt tha t the
existing freeze on the number of
representatives from each State at the
1971 census level, due to expire in the
year 2000, should be extended beyond
the date so that the States which had
done well to check the growth of
population were not unduly penalised
in terms of numerical representation
in future Lok Sabhas. The general
feeling was that the freeze should be
extended till 2026, or the year when
all States would achieve repiacement
level of fertility. The Board decided to
pursue the point with the political
parties so that a national consensus is
arrived at.
While reviewing the progress of
the projects sponsored by the
Foundation, the Board noted with
satisfaction the progress of the project
for training of Pancha"yat members in
seven districts of six States to enable
them to carry out programmes relating
to population stabilisation. The Board
decided to extend the training
programme to four more Sta tes as a Iso
to extend the training period by three
months to have a second round of
training for Panchayat members. (see
also page 1)
The Board approved
the
participation of PFI in the RCH
programme of the Government of
India as a national level NGO. The
extent of participation and modalities
are to be worked out. The Board was
apprised of a scheme under which
Wardha Medical College have placed
services of doctors at the disposal of
PFI for utilisation in its projects. It was
explained that for admission to post
graduate courses in Medical College,
Wardha, there is a precondition that
an MBBS doctor has to render two
years of rural service and the Medical
College has recognised service and
working in PFI projects as fulfilment
of the condition. The Board welcomed
the new development.
•
Prof Ranjit Roy Chaudhury, Member of the Governing Board of PFI has been honoured with Padmashri
by the Government of India in recognition of his valuable contributions to medical research.
Another member, Mrs Avabai B. Wadia has recently been selected by the Earth Times, New York as
one of the Top One Hundred Outstanding Personalities, whose influence is felt all over the world in
matters relating to Population, Environment and Development.
Prof. Ranjit Roy Chaudhury and Mrs Avabai Wadia were warmly felicitated by the Chairman and other
Board Members of PFI during its meeting at Dona Paula for the honours bestowed on them.
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Goan Model
Goa's Success in Population Stabilisation Reviewed
Board Members Meet Chief Minister and Deputy Chief Minister
The remarkable achievement of Goa in stablising population within a short period
of time was reviewed by the Governing Board Members during its February
meeting at Dona Paula, Goa. The Members also had an opportunity to meet the State
Chief Minister, Mr. Pratap Singh Rane and the Deputy Chief Minister, Dr. Wilfred
D'souza.
The Chief Minister received the
Board Members at his residence on
February 19. The Chairman of PFI, Dr
Bharat Ram, apprised the Chief
Minister of the activities of the
Foundation as one of the leading
NGOs in the field of population
activities. Complimenting the Chief
Minister on the success of Goa Dr
Bharat Ram requested him to give his
assessment of the factors leading to
the achievement so that other parts of
the country could derive lessons from
them.
Mr Rane said that Goa was
proud to be the first in India to achieve
the replacement level of fertility ( TFR
of 2.1) as far back as in 1987, even
before Kerala. Goa's Crude Birth Rate
is 14.1 as compared to 28.3 in the
country. The Crude Death Rate of 5.8
is one of the lowest in the country.
There has also been dramatic declines
in Infant Mortality Rate and Maternal
Mortality Rate. In 1996, the Infant
Mortality Rate in Goa was only 20
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agamst 79 of the country.
The Chief Minister attribu ted this
outstanding performance to two prime
factors: the first was the setting up of
a wide network of Government and
private hospitals, health centres and
sub-centres covering both urban and
rural areas to cater to the health
requirements of the people, which
included family planning services. The
second one was the priority given by
the State Government to primary and
secondary education.
The facts which came out during
the meetings with the Chief Minister
and the Deputy Chief Minister were
revealing. The State health
programmes laid stress on both
preventive and curative aspects
besides improving nutritional
standards. The Deputy Chief Minister,
Dr D'souza informed that the doctor
population ratio in the State was 1:800,
which was comparable to many
developed countries of the world.
There are no major communicable
diseases in the State; diseases like
malaria, tuberculosis and polio have
almost been eradicated. The State
laws have made it compulsory to
conduct blood· test for the immigrant
labour from other States and in case of
any positive indication, the immigrant
labour are administered full· anti-
malaria dose at the expenses of the
labour contractor. It is compulsory for
all contractors to maintain health card
of the workers . .DrD'souza informed
that the State outlay for health services
worked out to Rs 500/- per person per
annum, which was the highest in the
country.
A strong literacy programme in
the State has been contributing to
population stabilisation. As per 1991
census, 75.5% of the people in Goa
were literate, the literacy among males
being 83.6% and females \\ 67.1 %.
Contd 011 page 10
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P0litical Will
Population Stabilisation FigUl
Notwithstanding their differences in approaches to basic political, economic and ideological issues, all major political parties
which contested the mid-term elections to the Lok Sabha in Febr'uary showed a welcome unanimity in their resolve to strive for
population stabilisation as early as possible,
The election manifestos issued by BJP, Congress, Janata Dal and the Left Front comprising CPI(M), CPI, RSP and Forward
Bloc made direct references to the issue apart from including programmes on universal primary education with emphasis on female
education, gender equity, empowerment of women, health services etc. which have a direct bearing on fertility behaviours of the
population. The PH feels particularly gratified as it has been tirelessly advocating for total political commitment to population
stabilisation and had appealed to all political parties prior to the election to give prominence to the issue in their election promises
to the people.
A gist of the direct references made by the major parties and the corroborative programmes given here will bring out the varying
perceptions of the parties in respect of the priorities while agreeing to face the basic challenge. The BJP manifesto was a voluminous
I. Population Policy
The BJP views India's runaway population growth with all the
concern it deserves. The BJP believes that the country s runaway
population growth can be arrested and rolled back through increased
awareness, facilitating access to family planning measures, persuasive
Government policies and rapid development - it is an universally
acknowledged fact that 'development is the best contraceptive'. But
we realise that Government alone cannot fulfil this gigantic task. The
Government's efforts must be supplemented by a vigorous people's
movement. In addition, the BJP proposes to :,
• Formulate a National Population Policy by acting on the reports
of the National Development Council and the Swaminathan
Committee. This policy will seek to bring the population growth
close to stabilisation by the year 2010;
• Provide incentives to those who opt for the 'two-child' norm and
high incentives to those who embrace the 'single-child;' norm;
• Take all measures for reducing infant mortality rates and improving
child health;
• Promote women's education, employment and \\empowerment
since these can be effective means of population control as they will
allow women a decisive role in regard to their reproductive health
and family planning;
• Introduce disincentives which will apply to all sections of society
in order. to discourage large, unsustainable families;
• Ensure universal access to family planning information and quality
contraceptive facilities;
• Introduce family planning methods and facilities that wpl allow
women greater freedom of choice without imperilling their health
as well as support research relating to these methods;
• Encourage women to seek reproductive health services;
• Offer a special incentive in the form of a fixed deposit that will
mature in 21 years for those couples who have only a girl child or
those who adopt a girl child under a "Dattak Putri Yojana";
• Make family planning an integral part of our development policies;
• Ensure that the legal age of marriage is strictly implemented.
II. Social Development
The BJP will actively promote a casteless socio-economic order
that will effectively provide access to equal opportunity for all citizens,
irrespective of their caste, creed, religion and gender. The BJPwill :
• Review and vigorously implement the National Nutrition Policy.
• Revamp and expand the scope of Integrated Child Development
Services.
It will evolve a National Housing and Habitat Policy to provide
shelter to all by the year 2010.
• Strive for clean drinking water in all villages and slums
attaining 100 per cent universal immuni-sation of
children against preventable diseases.
• Spending more on pre-natal and
post-natal health care
programmes to
drastically
red uce
I.n f ant
morta-
•• \\\\1-
~:t.l\\
lit Y
rates.
• Providing
every
Panchayat
with a free
and truly
functional basic
health
care
centre, particu-
larly with facilities
for mother and
BJP . holds that
education is both a human right
and a means to bring about transformation to a dynamic, humane,
thinking society. The BJP will :
• Increase State spending on education progressively to six per cent
and more of GNP within five years.
• Achieve near complete functional literacy in five years.
• Accord priority to free primary education.
• Offer incentives in the form of free text books, mid day meals and
nutritional programmes and stipends to check dropout rates.
III.Women/Gender Issues
The BJPbelieves that true human devp]opment cannot take place
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Political Will
Agenda Of All Major Parties
document where every segment of national activity was dealt with in some details. Th~ other documents, relatively short, were
primarily concerned with the political future of the country ana lysed from ideological approaches. There were brief and pointed
references to sector-wise programmes. BJP called fora National Population Policy, stabilisation by 2010, and a whole host of
measures to curb the growth rate. Significantly, it wanted to make family planning part of the nation's development policies.
Congress, in a brief statement, pledged to provide visible, explicit and sustained political support at all levels and called for a
more determined effort in high fertility districts in north India. In a one line statement, Janata Dalpromised adequate steps. for
containing growth rate of population while the Left Front, in another brief statement, said it would conduct widespread campaign
for a two-child norm without gender bias.
All parties laid special emphasis on education and showed explicit concern for social development measures covering health,
attention to girls, children and youth, housing, employment, removal of gender bias etc. All these factors are essential for
improvement of higher qualities of life and are conducive to limiting the size of individual families.
without the empowerment of women. To harness the full potential,
the BJP will :
• Provide free education to women up to graduation;
• Immediately seek the passage of the Billreserving 33 per cent seats
for women in all elected bodies;
• Actively promote the legal and economic rights of women which
must be equal to those of men;
•
Entrust the Law Commission to
II
formulate a Uniform Civil code
based on the progressive
/'OH' .,
practices from
/irOn GI~l ' ,
all tradi-
Cl/;IV(.
filt.' SS/?O(}JS
. i/c' Ill'. .
/.1{ 8tl
Bitl1',.,
tions inclu-
ding
•
Property
:----.."
rights
to
If!&
women;
•
Equal
opportunities to
women
in
matters
of
employment and
promotion;
• Principle of
equal wages for
equal work;
health
care
non-reproductive health needs of
•
Promotion of
system focusing on
women;
• Special functional literacy programmes for women who have been
denied access to education;
• Strict enforcement of the existing laws prohibiting pre-natal sex-
determination tests, female foeticide and infanticide;
• Investment in the girls child's health, nutrition and education,
from infancy through adolescence;
• Universalisation of primary and secondary education to narrow
the gender gap.
IV. Children's Issues
The BJPbelieves that children are born and have the right to be
happy; they have the right to food, shelter and clothes and education.
The BJPwill protect :
• Children's right to the highest attainable standard of health care
through compulsory health check and by strengthening the ICDS;
• To be registered immediqtely after birth;
• Children's right to education;
• Children's right to shelter.
BJPwill achieve the goal of wiping out the scourge of child labour
in factories and fields.
While providing free and primary education to all children, the
BJP promises that by the year 2000, no child who attends primary
school will go to sleep hungry.
CONGRESS
I. Populatiofl Issues
~~ 1
The rate of growth of our popUlation has fallen below 2% per year.
But it is still very high. Every year, we continue to add 1.5 crore to
our population.
The Congress believes that the spread of female literacy, the
empowerment of women, the provision of nutrition, the expansion in
primary health facilities and an innovative communication campaign
will all help in reducing the rate of growth of population.
A more determined effort is needed in north India and in the 150-
odd districts where fertility declines are taking place at a very slow
pace. The Congress will address the limitations of the current family
planning programme in a systematic manner, involve the non-
governmental and corporate sector in a meaningful way and will
provide visible, explicit and sustained political support at all levels.
II. Social Development
The desire (of the people) is not for benevolence but for
participation, for social justice.
The Congress has always been sensitive to these concerns. It has
championed equal opportunity. It has consistently believed that equal
access to the best education and health is the foundation of a truly
egalitarian society.
To further harness the energy and enthusiasm of our youth in
critical nation building tasks, the Congress will launch a new scheme
Desh Ke Liye - Ek Saal. Educated youth will be mobilised and paid for
their involvement for a year in mission-oriented projects in areas like
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PaUtical Will
literacy drives, afforestation schemes, family planning
programmes, social reform movements, legal rights awareness
campaigns. The choice of opting for this programme after school
or college will be a matter of individual choice.
JANATA DAL
III. Women/Gender Issues
The Congress sees women not just as beneficiaries of
programmes but as critic"l agents in achieving development
objectives. It will continue to strive for the full legal, economic
and political empowerment of women. Gender biases in
education·and employment will be removed. Specific schemes
to drastically reduce female mortality and morbidity will be
introduced. The Congress will be in the forefront of a new social
reforms movement againstsati, dowry deaths, female infanticide
and child marriage.
The Congress will launch a political campaign for ending
discrimination against women and girls through a process of
education, empowerment and provision of legal rights.
Schemes for distributing assets
like house sites and land jointly or
singly in the name of women will be
introduced.
.
The Congress will strengthen and
expand existing programmes to increase
access of women to credit.
In its national agenda, the BJP-Ied coalition
Government pledges to fulfil the
commitment on population issue by
presenting a suitable and judicious mix of
All anti-poverty programmes like
the IRDP will have women as their
special target group. Women will be
given a central role in watershe'd~
development and forestry projects.
The Congress Party will be in the
forefront of a campaign to combat
atrocities on women like sati and dowry
deaths and social evils like child
marriage.
IV. Children's Health and Education
incentives and disincentives for population
control. Some 'other points include:
education for all, making primary education
free and compulsory, free education for
girls upto college level, health for all, supply
of potaple drinking water in all villages and
eradication of unemployment.
The level of investment in education
.will be raised to at least 6 per cent of the
GNP, as recommended by the Kothari
Commission. At least 50 per cent of the
funds allocated for education shall be invested in elementary
education. And half of all funds allocated for education shall be
utilised for promotion of girl's and women's education.
The Integrated Child Development Programme will be
expanded to all community development blocks in the country
and a~rangements made to ensure adequate nutritional support.
Janata Dal recognises the need to review and amend all laws
which thwart the customary rights of the rural poor over
environmental resources. All programmes of environmental
The National Mid-Day Meal Programme launched by the protection and development shall be built upon this basic
Congress government in 1994will be consolidated and will cover understanding.
all elementary schools in the country, with particular emphasis
in the poorer States.
Laws against child labour will be strictly enforced. Special
educational facilities will be created in areas where child l~bour
prevails.
III. Women/Gender Issues
Though Indian culture gives prominence to women, in
actual practice women have been deprived of their rightful share
in social, political and employment roles. The Draft Ninth Five
Year Plan has rightly indicated empowerment of women as 'me
The Congress will launch a special scheme for the welfare
of street children through voluntary agencies and non-government
organisations. Street children must be provided shelter, nutrition
and education.
Strict measures will be taken for the protection of the girl
child. Stringent punishments will be introduced for female
infanticide and foeticide.
of its objectives. In pursuance of that objective, we must give
equality of political opportunity by providing women reservation
in the Parliament and State legislatures, on the lines that has been
done under the Panchayati Raj institutions, as per 73rd and 74th
Amendments of the Constitution. The Janata Dal will make all
efforts to provide 33% reservation for women in the Parliament
and State legislatures, and 30% reservation for them in
Government jobs and jobs in public and private sectors.
Special insurance and social security schemes for the girl
Subsidised Distance Education will be provided to those
child among weaker sections will be launched.
women who would be interested in improving their educational
levels and skills. More vocational training centres will be opened
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Political Will
exclusively for training girls.
The Janta Dal will introduce a Centrally-sponsored national
widow pension scheme to protect destitute widows with income
security.
The Janata Dal will introduce a scheme by which Rs 10001
- will be invested in a long term deposit scheme of 18 ye:1rsat
the time ofthe birth of girl child. The matured amount would be
given to the girl is she remains unmarried upto the age of 18
years. This scheme will be open only to the second .::hild.
The Janata Dal will provide drinking water, sanitation for
the women near their houses, smokeless chulas and will
endeavour to encourage bio-gas schemes all over the country ..
The Janata Dal will start Maternity Benefit Scheme for self-
employed women in rural areas.
Larger recruitment of women in police services, appointment
of women in senior police positions in sensitive areas to check
atrocities against them will be undertaken.
LEFT PARTIES ~
~
~
(CPIM, cPt RSP AND FORWARD BLOC) ~
I. Population Policy
~
Conduct widespread campaign for a family size norm of
two children per couple without any gender bias. Withdraw the
proposed 79th Constitutional Amendment Billfor disqualification
of all those who have more than two children as it will militate
against women's interests.
II. Social Development
The Left parties pledge to:
• Introduce compulsory primary education
accompanied by free mid-day
meals, provision of text
books and other education .
materials.
• Free and universal educationll"t
must be guaranteed for all ... _~::'3
children upto the age of 14
.
years. The 83rd Constitutional
amendrr.cnt making education a
basic right should be adopted for
children up to the age of 14.
• Rapid expansion of primary school network.
• Allocation of 10%of Union Budget and 30% of States' budget
for education.
Health
• Immediately increasing the expenditure on public health to
5% of the GDP (at present it is a miserable 1.12 per cent).
• Provision of adequate networking of primary health centres
with sufficient stocks of medicines as laid down by the
Ministry of Health itself.
• Ensuring supply of essential drugs at prices affordable to the
common people.
• Increasing the outlay on:preventive medicine and eradication
of diseases like malaria, tuberculosis etc.
Water Resources
• There should be a National Water Policy. Provide for
community IPanchayat role in management of water resources.
Exercise control on indiscriminate use of ground water.
• Drinking water is a problem in 2 lakh villages. Provision of
potable drinking v"ater to all villages must be a priority task.
Housing
• Housing to be accorded the status of a basic right; housing
schemes for urban and rural poor to be stepped up.
Environment
• Formulate an environment policy which is integrated with
the needs of rapid and sustainable development.
III. Women/Gender Issues
Women are struggling to acquire equal status in all spheres
- social, economic and political. The Left parties have been the
firmest"champions of women's rights and for ending gender
discrimina tion.
• Implementation of equal rights and other legal and
constitutional guarantees.
• The Left parties have consistently fought for the adoption of
the constitutional amendment providing for one-third
reservation for women in legislatures, in the last parliament.
The Left parties are committed to see this is implemented in
the new parliament expeditiously.
• Special schemes for female-headed households in rural areas
and increasing employment opportunities for women.
• Strict measures against atrocities on women and legislation
to check sexual abuse of children.
•
Equal legal rights for women of all
communities should be provided.
'/I/~...'.•.
I
•
Equal rights in
property
and joint
matrimonial property rights;
compulsory registration of
marriages.
• Abolition of child labour.
• Universal provision of child
care services.
Youth
• A national youth policy must
be adopted which comprehensively deals with issues of
special concern to youth.
• The State should provide for an adequate network of sports
and cultural facilities for youth in all parts of the country"
Employment
• Guarantee right to work as a fundamental right.
• Provide food-for-work programme to generate employment.
• Ensure adequate credit for self-employment schemes for
educated unemployed, artisans and handicapped persons.
• Scrap freeze"in recruitment and cuts in existing employment
in the Government sector.
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NGO
NGOs Prove Important Adjunct To Official
Health And Family Planning Programme
A qualitative evaluation and analysis done by Pn of 14 different projects
sponsored by it in the recent past has brought out the important role played
by NGOs in the effective implementation of the official health and family planning
programmes.
The selectedprojects were executed
in different parts of the country,
covering people with wide variations in
ethno-cultural background, status of
economic development and relative
.importance in the social hierarchy. The
target groups included rural areas and
urban slums, people in the plains and
the hills as well as tribal people and
workers in industrial areas.
The analytical study brought out
the strengths and weaknesses of the
NGO movement and the vital links
needed to be established between official
and non-official efforts.
The case studies indicated that the
NGOs, despite their differences in
structure, functioning patterns and the
areas of specialisation were able to
cqrry out the assigned responsibilities
of health and family planning
programmes very effectively. They, in
fact, proved to be a very important
adjunct to the official programmes and
effectively supplemented the efforts of
the health functionaries at the
community level. Invariably, the
demand for health services and the
acceptance level went up in all the
project areas with prospects of long
tern: sustainability.
NGO programmes at the grass
root level become successful as their
inherent strength lies in their flexibility,
capacity to develop programme
s tra tegies accor-
Inherent Strength ding to the local
condi tions, in-
depth understanding of the crucial
issues and their underlying causes, and
their ability to determine critical areas
for action. The rapport that the NGOs
enjoy with the community cannot be
matched by the workers under
government departments where the
functioning is more or less strait-jacketed
due to rigid rules and procedures and
large number of responsibilities. NGOs,
catering to the felt needs of the people
at the local level, enjoy the confidence of
the cornmunity and are thus in a better
position to bring about attitudinal and
behavioural changes. However, the
favourable ground conditions created
by the NGOs need to be backed up by
quality services in time, according to
the need and on demand. The analysis
pointed out that NGOs would have to
maintain some sort of liaison with
health functionaries at the district, block
and sub-centre levels to maintain the
momentum.
The analysis indicated that the role
of NGOs as catalysts of change could be
classified under a few distinct categories.
Much of the modern health care
practices and available facilities remain
under-utilised as they do not fit into the
value system of a
Favourable Climate community. The
NGOs
have
generally succeeded in breaking these
resistances and also in social
legitimisation of new behaviours.
Generally, a gap exists between
the utility of health and family planning
services as visualised by policy planners
and as perceived by the people. When
Convergence perceptions vary, the
of Views
progran:mes appear to
be supenmposed. NGOs
have helped in bringing about a
convergence of views which promoted
acceptance of modern health care.
The official documentation and
data retrieval systems do not provide
sufficient information about the
qualitative aspects of the
Feedback programme at the field level,
the problems of resistance
or the patterns and processes of social
changes. The NGOs have provided the
type of feedback which can help in
bringing
about
qualitative
improvements in the programme.
The NGOs were able to establish
an efficient working relationship with
the functionaries of the
Co-ordination health department at
the various levels,
including the field level, ensuring a
multiplying effect of the combined
efforts.
The experiences gathered by NGOs
can provide a good research base for
development related programmes.
Research findings can be shared among
government depart-
Research Base ments and reviewed
periodically to assess
their relevance and applicability.
Besides, the project areas can also be
used for demonstration and training.
The analytical study identified a
few crucial issues relating to
involvement of NGOs in the field of
health and family planning.
The NGOs generally operate at the
micro-level
whereas
official
programmes are planned for bigger
geographical units. A mechanism is
required to be evolved through which
the NGO experience could be integrated
wi th and uti lised under official
programmes.
While many of the NGOs possess
all the credentials to carry out socially
useful programmes, they may not have
the expertise to undertake specific health
related activities. A system would be
required to develop the professional
competence of NGOs.
A suitable
management
informcition system needs to be evolved
M
I
af nagemrent
to monitor the progress
of the programmes
norma IOn under the NGOs and
also to identify the problem areas where
they require professional guidance or
support.
So far, NGOs involved in
government health and family welfare
programmes have been selected on
adhoc basis, with the result that a
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1.9 Page 9 |
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SlumPro~
Project for Women
Slum Dwellers in Orissa Gets Underway
hazardous, women do not eat well
during pregnancy. Deliveries are
carried out by elderly women or
The project for women slum ·dwellers in selected rural areas of Balipatna
Block of Khurda District and urban slums in Cuttack, Orissa, funded by PFI, has
got on stream with the completion of baseline surveys to determine the priority
components of the programme.
untrained Dais under unhygienic
conditions in dark places out of fear
that the mother and child are to be
protected from evil spirits.
In rural areas also women go in
The project is being carried out of family planning and are going in for for immunisation of children in a
through the National Institute of spacing methods but there is a lot of routine matter without understanding
Applied Human Research and ignorance about the usage of the the significance. Village women
Development (NIAHRD) in Cuttack methods, reducing their effectiveness. possess some knowledge about the
for a duration of three years. It has
been taken up in Orissa as the State is
reiatively backward in terms of health
and nutritional status. The problem is
more acute in the rural and tribal
areas and in urban slums where people
do not have easy access to sources of
scientific information on modern
health care.
After a preliminary interaction
The baseline survey in rural areas
revealed a more dismal picture. In
addition to unhygienic living
conditions, poor sanitation and
personal hygiene, women in general
were not conscious of the importance
of ante-natal care or immunisation.
Under a mistaken notion of having
large-size babies making delivery
advantages of small families but
express their helplessness to take
initiative in this miltter under a variety
of compulsions - social, personal or
situational. Some do practise spacing
methods but are not sure of their
proper use. Most women have the
mistaken notion that RTIproblems are
natural to women and feel no necessity
to seek medical advice.
•
with different official and non-official
agencies working in the project area, a
baseline survey was completed in
RCH Project Launched in Tughlakabad Slums
December 1997 to collect relevant
information from the urban slum areas
of Cuttack. This was followed by a
similar survey in the rural and tribal
areas covered by the project and was
In pursuance of the Governing Board's decision to run projects with a crash
programme to promote acceptance of reproductive health care and family planning
in selected urban slums on an experimental basis, a project was launched on January
19 in the Tughlakabad slums in Delhi.
completed in January 1998.
The programme for one year is
The project will aim to cover a
The baseline surveys revealed that
the urban slum areas suffered from
known maladies of unhygienic living
conditions, inadequate water supply,
lack of sanitation and general
indifference to personal hygiene. Most
being executed through PMR Research.
Centre, a Voluntary Organisation of
Delhi which has past experience of
working among slum dwellers. The
project cost of Rs 4.38 lakh will be
equally shared by the NGO and PFI.
population of about 45000 in some
8000 families. In the first phase, a
house to house census is being
conducted to collect information about
of the women were aware of the need
to have ante-natal care but they are
not sure about the specific purpose of
such care including that for
immunisation. Most deliveries take
place at home by untrained Dais
assisted by elderly women, who are
generally ignorant of the measures to
guard against risks during pregnancies
or deliveries. There is little knowledge
about post-natal care. They are going
in for immunisation of children in a
routine
manner
without
understanding the significance of such
measures.
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1.10 Page 10 |
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NGO
number of them are functioning in the
same area with different objectives and
methodologies. At times, their activities
overlap, causing an avoidable waste of
precious resources. It is necessary to
identify all NGOs in a given area and
pool their resources through a system
of networking, . giving specific
assignments to each, which lead to a
common goal through complementary
efforts.
The analytical stUdy also revealed
some of the weaknesses of the NGOs.
In projects funded by other
agencies, NGOs appear to lose interest
once the funding is stopped. They also
tend to toe the pattern prescribed by
donor agencies making compromises
with their own field experiences.
Secondly, with identified project areas
where the NGOs remain active for a
number of years, the new project does
not lend to objective assessment as it
is executed practically in a control
area.
The most disturbing aberration in
NGO functioning is the tendency of
converting the NGOs into parallel
bureaucratic organisations at the cost of
voluntary action. The NGOs cannot
assume the role of a government agency,
particularly in
Voluntary Approach the field of
health
and
family planning, and should develop
them-selves as complementary agencies
for better implementation
of
programmes. The role of NGOs should
be viewed as an instrument for initiating
voluntary action for a self generating
community programme. It was noted
that those NGOs who had a long time
commitment, enjoyed rapport with the
people and had specialised operation,
were more successful
than those
whose commercial
interests in a
project took precedence over
commitments to social development.
The study suggested that for better
success of the health and family
planning programmes, there had to be
far greater co-ordination Idetween
official and non-official efforts. This
can be achieved through joint planning,
joint training, effective supervision and
allocation of specific areas of action.
The Foundation supported projects
conclusively proved that there was a
far greater impact of the programme
wherever the health functionaries and
the NGOs were able to co-ordinate
their activities under a joint command
from the district to the community
levels.
The qualitative evaluation of the
projects included in the study and the
critical analysis of the experiences under
different projects to find out long term
implications of involvement of non-
government agencies in health and
family planning activities will be soon
brought out as a publication by the
Foundation.
•
• The PFI is sponsoring publication
of a companion study on vol~ntary
agency operation in Madhya
Pradesh. The study carried out by
Ravi and Kaval Gulati, Srikrishna
Ayyanagar and Vinita Nagar points
out that the conditions in Madhya
Pradesh are not conducive to
voluntary agency operation. The
agencies work in a dependency
situation', on grants provided by
donors and thus hardly enjoy an
independent role or identity. There
are notable exceptions where
voluntary agencies are self-initiated
. to serve a s'pecific goal in a local
area. These self-help groups are
highly motivated, enjoy rapport
with the people and can well act as
agents of change. The study points
out the need on the part of bigger
State agencies for closer interaction
with ~hese self-help groups to
promote cohesive action and to
build-uF
self-management
capacities.
• A similar PFI sponsored study in
Hindi covering voluntary agencies
in Rajasthan done by Ravi and
Kaval Gulati with two others has
already been published.
Primary education is compulsory and
covers all villages and towns.
Education up to the secondary level is
free. Every Taluka in the State has a
college and institutions for vocational
training and professional education.
The State spends 13% of its budget on
education.
In contrast to other parts of the
country, only 13% of the population in
Goa is dependent on agriculture. The
entire industrial development is in ~
private sector, which enables the State
Government to allocate higher funds
for education and health. The per
capita income and the savings in the
form of deposits with the banks in Goa
were reported to be the highest in the
country.
Goa is leading the country in
social security measures. Under' a
scheme of subsidy to help needy
people in old age, a programme of
medical insurance for families has
been initiated under which families
having income upto Rs. 20,000/- p.a.
are provided a subsidy up to Rs
1,00,000/- for undergoing treatment
outside the State, in cases where such
treatment is not available in Goa. The
law and order situation in Goa has
been commendable and women enjoy
high sodal status.
•
Tughlakabad Slum Project
Contd from page 9
the specific needs of the people in
relation to reproductive and child
health, studying their health habits
and life style. The NGO is running a
clinic to provide free medical check-
up and treatment where necessary. A
gynaecologist, an ANM and three
social workers have started working
with the assistance of a visiting
physician.
A questionnaire-cum-check list
has been prepared to identify RTI and
STD cases along with collection of
basic information from all the
households in the project area. •
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2 Pages 11-20 |
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2.1 Page 11 |
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Fertility
Symposium on Fertility Transition
A half-day symposium on Fertility Transition in India was held at the
annual conference of Indian Society fur Medical Statistics in Jaipur on
December 14, 1997.
The session was held in the form
of a panel discussion, moderat~d by
Dr K Srinivasan, Executive Director
of Population Foundation of India.
There were three panelists : Prof.
Devendra K Kothari of the Indian
Institute of Health Management
Research, Jaipur; Dr S C Gulati of the
Institute of Economic Growth, Delhi;
and Dr Y P Gupta, Director,
Population/Reproductive Health,
CARE-India, New Delhi.
The first two panelists discussed
the factors which had brought
differentials in fertility transition in
different States in India. Each panelist
took one State from each of the three
clusters of States formed on the basis
of their current level of fertility. The
to achieve the goal of NRR 1.0
(or TFR of 2.1) in India.
Dr K Srinivasan set the tone of the
discussions with his thoughtful
remarks on fertility transition in India.
Dr Kothari, the first panelist,
emphasised the role of the programme
infrastructure in the field. He
compared programme performance
of the States and linked
~gramme them with their strength
anagement or otherwise in
management. This led to his
suggestion for the need of
strengthening programme manage-
ment. His main argument revolved
around the need for better
management of the programme
services and, therefore, the need for
TWO SEPARATE WINGS AT
STATE/DISTRICT LEVEL ARE
NEEDED -- ONE FOR
PROGRAMME ORGANISATION,
THE OTHER FOR PROVISION OF
QUALITY SERVICES.
use of contraception tends to reduce,
both wanted and unwanted
components of fertility, (ii) children's
morbidity tends to have positive effect,
both on wanted and unwanted fertility,
(iii) infant mortality rate tends to
positively affect unwanted component
of fertility without significantly
affecting wanted fertility, (iv) greater
utilisation of ante-natal and natal care
services negatively affects unwanted
component of fertility, and (v) female
literacy and socio-economic status
negatively affected wanted component
of fertility. These findings have direct
relevance for policies and strategies to
influence both wanted and unwanted
components of fertility.
three clusters were based on Total
Fertility Rate (TFR) of less than 2.6,
between 2.6 and 3.5, and those with
TFR greater than 3.5. The experts
compared/ determined the factors for
differentip.l level of TFR.
The third panelist discussed the
results of a computer simulation
model to suggest various alternatives
having two separate wings at State/
district level - one for management/
organisation of the programme and
the other for provision of quality
services.
Dr Gulati's paper emphasised the
role of socio-economic factors in
bringing acceptance of the programme
services. It was pointed out that (i)
The third paper by Dr Y P Gupta
presented very interesting analysis of
the alternate pattern of programme
acceptance to achieve TFR = 2.1. The
analysis showed that India will be
able to achieve the target by 2021 if
current method mix continues but the
Contraceptive
Alternate Pattern Prevalence Rate
(CPR)
is
increased to the level of 74%.
However, it is possible to achieve the
target by the year 2013 by bringing
about changes in the method mix-
increasing the percentage of users of
clinical methods, especially that of
IUD and hormonal methods and
corresponding reduction in tp.euse of
condoms which are less effective. The
proportion of sterilisation acceptors
each year in the revised method mix
remains the same as currently. The
effective CPR in this revised method
mix will be 66.2% and the national
goal will be achieved by 2013.
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2.2 Page 12 |
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Training
PFI Develops Training Modules
For Community Leaders
Under the PFI-sponsored scheme for training of elected members of Panchayats to
take up added responsibilities promoting health and family welfare programmes
in rural areas, one of the first tasks before consulting organisations and NGOs ill each
State was to develop suitable training material to equip the Panchayats with scientific
information and correct approaches.
The PFI, which -is :the
consulting organisa tion for the
Lalitpur project in Uttar
Pradesh, has developed a set
of training modules to fulfil
all the basic requirements. It
is now ready for distribution
among Panchay.at members
·and resource persons for
whom the material will serve
as a guide to correct
approaches and provide all
basic information about
health, including reproductive
health, hygiene and
population issues.
The material is in simple
language for easy understanding of
even those not familiar with these
issues. It not only deals with the
commonly faced problems, their
prevalence and extent in the project
area and the possible causes of the
problems but also gives suggestions
on how to tackle and overcome the
problems.
There are eight modules in the
training material, each one of which is
self contained and can be made use of
by a persoI) exclusively dealing with
the relevant area. The eight modules
are:
PRIMARY HEALTH CARE - this
deals with the essential health practices
required to be developed and adopted,
particularly in relation to the diseases
covered by the National Health
Programme;
HYGIENE AND SANITATION
which deals with community and
house-hold sanitation issues with
special reference to water borne
diseases;
REPRODUCTIVE HEALTH - with
emphasis on pre-natal, delivery and
post-natal health requirements and
immunisation necessities;
REPRODUCTIVE HEALTH - with
particular reference to Reproductive
Tract Infections, Sexually Transmitted
Diseases, AIDS and problems related
to repeated pregnancies etc.;
NUTRITION - includes general
problems of nutrition, special attention
needed by pregnant women, issues
related to breast feeding and weaning,
development of child and the optimum
use of locally available food~
POPULATION ISSUES - their links
with community welfare and
development, family planning
measures and devices including the
different contraceptive methods with
their purposes, proper use etc.;
GENDER ISSUES - their socio-
cultural implications including such
issues as age at marriage, girl education
and·women's status in society,
gender equality in work and
pay etc.; -and
ENVIRONMENT - with its
socio-economic implica tions,
pollution, ecological balances
etc.
In the material developed
for Lalitpur, PH took care to
relate the issues and problems
to local experiences so that the
Panchayat Members and
resource persons can easily
identify their own experiences
with the written material. But
the main content of the modules
can be easily adapted to any
other area with suitable modifications
based on local experiences and
priorities. The training material can
thus serve as a model for any group of
community leaders and workers, even
other than Panchayats, as the approach
and the basic information lend
themselves to universal applicability.
The PFI will be happy to send
specimen copies of the training
material to any organisation or groups
such as youth clubs or mahila mandals,
who may be working in the field of
health and family planning.
All the PFI sponsored projects to
trainPanchayat members have
similarly developed their training
material in local languages and the
whole training programme has been
videotaped by all projects for field
demonstration.
•
Published by the POPULATION FOUNDATION OF INDIA, B·28, Qutab Institutional Area, New Delhi·110016. Tel. : 6867080, 6867081
Typesetted and Printed by Reproductions India, 209·A Pocket C, Sidharth Extn., New Delhi-110014. Ph.: 6840953, 6931025
EditorialDirection& GuidallCE:l Dr. K. Srinivasan
Editorial·Consultant: Asim Chatterj'