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Focus 1998 April - June |
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Volume XII No. 2
April-June 1998
A BULLETIN
OF POPULATrON
FOUNDATION
OF INDIA
Seminar Recommends Close Interaction between
Government, NGOs
Population Foundation of India
organised a seminar on "Role of
Non Government Organisations in
Promoting Reproductive and Child
Health Services in Delhi Slums" on
May 14, 1998 at the Foundation
premises. The objective of the seminar
was to bring the NGOs, government
agencies and experts in the field to
share their experience and difficulties
faced by them while working among
slum dwellers in Delhi. The seminar
highlighted the important role that
PFI could play in promoting RCH
activitiesand Matri Suraksha Abhiyan.
Dr Bharat Ram, Chairman, PFI
urged the participants to work towards
promotion of basic health care services
in slums in Delhi.
Dr Harsh Vardhan, Minister of
Health, Government of Delhi, in his
inaugural address, said that Matri
Suraksha Abhiyan currently being
held in 500 government centres and
100 voluntary organisations aims to
provide ante-natal care to every
pregnant woman by trained doctors,
free medicines and check-ups and
information on diet, nutrition, and
On Other Pages
• PFI Participates in Social
Development Fair
3
• Radio Serial Reveals
Adolescents' World
4
• Freezing oi Parliament
Seats Urged
5
PO
1
.
SEMINAR ON
BOLE OF \\ON'G()Vm~~IE\\O1RGANlSAnONS IN PROMO
~!::PRODlCTlVr& Cnll.!) HEAD H CAllE SERVICES IN DELHI
\\.JAY 1..tI998
Dr Harsh Vardhan, Minister of Health, Government of Delhi at the seminar on "Role of Non-
Government Organisations in Promoting Reproductive and Child Health Services in Delhi·
Slums". Others (from left) are: Prof. Ranjit Roy Chaudhury, Dr K Srinivasan, Dr Harsh Vardhan,
Dr Bharat Ram and Dr Meera Shiva.
issues related to family planning and
child care. He said that the need of
the hour was to strengthen preventive
systems through primary health care
and bring about positive change
towards health attitudes amongst the
people, more so at the grass root
level.
Earlier, in his welcome address,
Dr K Srinivasan, Executive Director,
PFI, highlighted the grim situation of
health care facilities in slum areas and
• Workers have Limited
Access to Health Facilities ..........•. 5
• Trafning Organised for
Reproductive, Child Health .....•..... ,.7
~ Daydnagar Project
. M~kes Progress
,.•....... : ;.,.
stressed the important role of NGOs
in improving the health status of slum
population.
The first session on "NGO's
Experience and Networking with
Government" was chaired by Dr Meera
Shiv a, Head of Public Policy,
Voluntary Health Association of India.
She spoke on Reproductive Tract
Infection (RTI) management for
individuals and couples and said that
more male involvement was needed
for the programme. She also pointed
out the gap between service delivery
system and follow-up procedures.
Dr CD Parasher from the PMR
Research Centre spoke about the
problems of sanitation, housing and
increash"'lg migration to slums and
their impact on health delivery system.
He suggested community participation
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Family Planning activities are now considered to be
an integral part of Reproductive and Child Health Services.
This has been made an official policy of Government of
India since October 1997. The Reproductive Health
Services include a wide range of activities; identification
and treatment of Reproductive Tract Infections (RTls).
Sexually Transmitted Diseases (STDs) and HIVs; treatment
of subfecundity and infertility; early detection of cervical
cancer and treatment; education of adolescents on
sexuality and sexual health in addition to provision of
conventional maternal health care and contraceptive
services to couples for spacing and limitation of children.
The Child Health services part of the programme
includes immunisation of children against preventable
communicable diseases. advice on breast feeding and
nutritional supplementation, growth monitoring and advise
to parents. Thus, it one takes seriously all the components
of the Reproductive and Child Health Care Services, listed
above, this would necessarily involve incurring enormous
expenditure, both at the infra structural level in terms of
equipments, buildings, laboratory facilities, transport
facilities and referral services at the sub-centres, PHCs
and referral hospitals and also in the development of
proper skills in the personnel involved in the programme
through appropriate training and re-training facilities in
addition to recruitment of new categories of specialists.
The per-capita expenditure on family planning
programme has fluctuated between Rs 15 to 17 between
the years 1993-94 10 1996-97 (or about US 40 cents). It
is obvious that all the above tasks listed under the
Reproductive and Child Health Programme cannot be
carried out within any acceptable norms of quality care on
such a budget. It is doubtful that even quality care services
for family planning methods, spacing as well as sterilisation
services, can be carried out within the above amount.
From our experience, treatment of Reproductive Tract
Infections, even if carried out by syndromic approach,
requires a minimum !1s 50/- per woman towards
identification, diagnosis and treatment of the case. In
India. as of July 1998, there are 235 million females in the
age group 15-44 and surveying them for RTls and
initiating treatment could alone cost Rs 1175 crores. The
total budgetary provisions for the Department ot Family
Welfare is at present only around Rs 1100 crores per year.
These estimates highlight the need for a substantial
increase of budget allocation and manpower needed to
upgrade Reproductive and Child Health Services in the
country.
There is already an enormous unmet need for family
planning. both for spacing and limitation on children in the
country. In Uttar Pradesh, it is as high as 30% and in many
States, it is over 20%. With the noble goal of promoting
reproductive and child health services, which is a legitimate
concern for this country, we should not lose sight of the
existing enormous unmet need for family planning and
allow this need to increase by bringing in more unwanted
births in the society. Such a situation will compound the
problem of not only population growth but also of RCH.
High quality contraceptive services provided in a socially
and psychologically acceptable manner to couples who
need them should be an important reproductive health
activity in its own right.
-- k(l:f~
DR. K. SRiNiVASAN
and training as a solution to this
dilemma.
Ms Parinita Paul, CASP PLAN
spoke about the importance of creating
mass awareness and improving
existing service delivery system.
Dr S Nath from Sulabh
International said that focus on women
and children in Reproductive Health
Care must be understood in the long
run as a human empowerment process.
He said most of community based
programmes of Sulabh were linked to
academic institutions, cooperatives
and public undertakings.
Dr Jai Pal Tarang, Family Planning
Association of India, Delhi spoke on
t:-eatment of infertility, Medical
Termination of Pregnancy (MTP),
Sexually Transmitted Disease (STD)/
AIDS and HIV infection. He focused
on child health clinics, immunisation,
treatment ofvarious ailments,nutrition
supplements and education to be
carried out at community level. He
also drew attention to gender equity
and awareness programmes among
youth regarding family welfare
programmes and old age care.
The second session of the seminar
on "Magnitude of RCH Problems in
Slum Population of Delhi" was chaired
by Dr Saroj Pachauri, Asia Region
Director, Population Council. She
presented a vision of 'from the cradle
to menopause' and spoke about the
paradigm shift in family welfare
programme.
Dr S C Gulati of Institute of
Economic Growth presented a study
highlighting the linkages between
women's socio- economic status,
reproductive health rights, children's
health and the role of NGOs.
Mr K S Natarajan, Joint Director,
PFI spoke on the extent of prevalence
of RTI in PFr funded project areas in
Wardha district, Solan dis trict,
Tuglakabad in Delhi and slum areas
in Cuttak and Gwalior. He also
presented findings from the NFHS
surveys and other independent
studies. Dr Sanjay Kumar, Programme
Officer, PFr presented comparative
analysis of the conditions in slums
and non-slum areas of Delhi utilising
NFHS data and determinants of
differentials in fertility, MCH care and
family planning p;:actices between
slum and non-slum areas.
The third session of the seminar "
on "RCH Issues : Perspective of
Government on the Experiences and
Networking with NGOs" was chaired
Cuntinued on page 6
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Panchayat Raj Institutions and
Mobilisation and Empowerment of
Communities.
Union Minister of State for Welfare, Ms Maneka Gandhi inaugurates the PFI stall at
the Social Development Fair.
PFI Participates in Social
Developmenf~-Fair
P FI participated in the second
Social Development Fair, held at
Pragati Maidan in New Delhi from
May S to May 17, 1998. A number
of NGOs, Government Departments
and international agencies working in
diverse develop men tal fields
participated in the Fair which was
organised by the India Trade
Promotion Organisation.
The Fair was formally inaugurated
on May 8,1998 by the Union-Minister
of State for Welfare, Ms Maneka
Gandhi.
The PFI stall had displayed panels
based' on broad classification of
projects being supported by PFI.
Information was classified under four
project heads : Reproductive Health
and Development in Slums, Projects
undertaken with Industries/
Corporate Sector, Empowering
The design of the panels combined
a mix of visuals and text. The
population clock, a computer
programme developed by PFI
displayed the population in 14 major
States along with other relevant
demographic data. A display stand
stocked information brochures,
publications, news letters brought out
by PFI. The staff members of the
Foundation were present throughout
the Fair to provide additional
information to visitors.
Ms Gandhi was the first visitor to
the PFI stall on the first day. She came
to the stall after the formal
inauguration of the Fair and cut a tape
at the entrance of the PFI stall. The
Executive Director of PFI, Dr K
SrinhTasanwelComed Ms Gandhi and
explained the display to her. !I
o ., ~arl~tnentar[ans Dlscuss
iQn,.S~y~u~m~mt.
The 14.thAsi~n P~ia~entaria~i' me;;ting on
Population;and Development was held in New
Delhi from April 4 to AprilS, 1998. The meeting
was organisedjointly by the.Indian Association of
Parliamentarians on Population and Development
and Asian Population' and Development
AssociatiQ~i;Japari. _." _
_.
Deli~~'rihgthe valedicto~ address at the
day meeting; Mr SureshWabhu. Union Minister of
Environmentand Forestssaid the Asian countries
accounted for nearly l\\~0 thirds of the world's
population and urged experts to find out the nature
of relationships- between population growth, the
. social ethos'and environmental degradation in the
region. He §~i9thatGoi~~m~nt w9ul~acpord top.~
•priority tdpopulation:c6~trol in keep'ing wrthth~;
emphasis laid on the' subject in the national
agenda for governance adopted by the ruling
alliance. Mr Prabhu noted that the- policies on
population. environment and forests had to be
integrated into a single:89Iicy.
Mr Shin SakuraI, Chairman, Asian Forum of,
Parliamenta~~s for Population:andDevelopment:-
i (AFPPDl called forgreater'st;ess on the various
aspects of food security. Dr'Urmilaben Patel, MP
and vice-president of AFPPD also made a
presentation.
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Radio Serial Reveals Adolescents' World
Population Foundation of India
(PFl) and All India Radio (AIR)
have collaborated to produce a radio
soap opera Dehleez (threshold) which
was broadcast by Yuva Vani station of
AIR and 30 other AIR stations in Hindi
speaking areas. Around 8 million
people listened to the programme
which was broadcast twice a week.
Each episode carried a brief
introduction by a film celebrity, recap
of the previous episode and a brief
introduction about the next episode. In
addition to the main serial, a parallel
support programme utilising listeners' .
letters and expert advice was also
broadcast fortnightly. The best letter
writers were invited at their respective
radio stations to participate in a radio-
bridge programme (a radio exercise
where several stations are linked
through satellite, microwave and are
on air at the same time) for interaction.
This was done to assess the active
participation in the programme by the
target audience besides providing
feedback on the issues and problems
which could be taken up in subsequent
episodes.
Ir;itially, it was decided to complete
Dehleez in 26 episodes. However,
because of demand from the target
audience, listeners' interest and their
enthusiastic participation, it was
decided to extend it further by 26
episodes. Thus, Dehleez completed its
first broadcast in 1994 having remained
on air for 52 episodes. It was broadcast
from 30 stations of AIR in the Hindi
speaking areas. Encouraged by the
success of experiment, it was decided
to translate all the episodes in ten
regional languages and broadcast these
through regional stations. This only
goes to show that Dehleez continued
to be popular for a long time, much
after it was conceived and broadcast
for the first time.
The following themes, relating to
adolescent behaviour were dealt with
in different episodes of the soap opera:
self-esteem, aspira.tionj achievement
and conflict, gender bias and gender
inequity, ignorance of biological
changes, poor status of girls, physical
attraction, menstruation, masturbation,
drug addiction, influence of elders,
intolerance towards elders, inability to
comprehend and resolve conflicts in
value system, pre-marital sex and its
consequence, hazards of backstreet
abortion, consequences of irresponsible
sexual behaviour,
unreliable
information from semi-pornographic
reading and visual material, role
models, safe sex,problems of school
drop-outs, juvenile delinquency, AIDS
and sexually transmitted diseases,
homosexuality, child marriage and
dowry, etc.
The serial was appreciated for
highlighting the emotional, social and
physiological problems as well as the
maladjustments of the adolescents with
their environment.
It was suggested that:
i. fear psychosis, timidity and
inhibitions of adolescents as well
as role of domineering parents be
dealt with in' greater detail;
ii. incestuous sex rela tions be covered
in these episodes;
iii. wrong types of attitudes,
perversion and self abuse be
included;
iv. sex problems of the adolescents be
discussed by specialists; and
v. the sensitive issues be presented
in a manner that these do not
offend the sensibilities of other
family members.
Some of the listeners also felt that
the serial primarily depicted problems
of the adolescents in the urban set up
while majority of the population
belonged to rural areas.
By and large, the listeners could
identify themselves with the situations
as depicted in various episodes. The
fan mail clearly highlighted two points.
One, there was a general lack of
scientific knowledge and because of
that the listeners were curious for
information on sensitive issues; and
two, the adolescents, by and large,
accepted Dehleez as some sort of a
guide to L'1eir own code of conduct.
The main points emerging out of
fan mail were replied in special
broadcasts once in a month. The
Audience Research Unit of the AIR
undertook a quick feedback study of
Dehleez in the service area of nine radio
stations.
Girls were very clear in their mind
about the correlation between marriage
and sex. To them marriage was a pre-
condition to have sex. So, there was
no question of pre-marital sex. While
they did not favour sexual intercourse
before marriage, other overtures such
as hugging, caressing and kissing could
be tolerated. This clearly showed the
confusion in the minds of the listeners.
The girls felt that at the first suggestion
of sex, the friendship howsoever close
may be, should be terminated. A 'love-
cum-arranged marriage' would be the
ideal kind of marriage.
There was a strong belief among
most of the group members that the
mother or sister-in-law should be the
one to tell her daughter about the
female anatomy, facts of menstrual
cycle, and how to deal with it when
it happens the first time. At present,
this information is mostly sought from
friends and peers of the same sex. All
the girls firmly believed that they
should be told about the menstrual
cycle, family life education and other
rela ted adolescent changes much before
the onset of the first period. They felt l >-
that the ideal age to impart such
information would be between nine
and ten years.
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Freezing of Parliament Seats Urged
According
to the 42nd
. Amendment of the Constitution,
the number of representatives of each
State in Lok Sabha would be frozen
at the 1971 census level till the year
2000. This was done to check unequal
representation with the hope that the
population would stabilise by 2000
and no State wouid have additional
advantage in representation because
of growing numbers. The situation at
present is far behind that target and
the earliest that one could hope for
population stabilisation would be 2026
(r>AD.
The Chief Minister of Andhra
Pradesh recently asked the Central
Government to continue the freeze on
.~ delimitation
of parliamentary
constituencies until a formula is
evolved giving higher weightage to
States whose performance
in
controlling population growth has
been good. Inaugurating a conference
of Health Ministers of the Southern
States at Hyderabad,
Mr N
Chandrababu Naidu said if the
parliament constituencies
were
delimited on existing population
norms, the Southern States would
have less representation in the Lok
Sabha and Rajya Sabha, as these States.
have achieved tremendous progress
in population control. On the other
hand, those States which failed in this
regard would have greater
representation, if the 'freeze' is lifted
by the year 2000.
"It will be an irony that those
States which add to the problem of
the country get more representation
whereas those which have contributed
more to the improved demographic
indices are penalised for better
performance," Mr Naidu said. He
suggested that the better performing
States should be given an incentive
by increasing representation
in
Parliament.
In this connection, the Chairman
of Population Foundation of India, Dr
Bharat Ram has requested the
members of Parliament to press for
extension of the existing freeze beyond
2000 and till 2026 or till all States reach
the level of population stabilisation.
In a letter addressed to all the members
of Parliament, Dr Bharat Ram has
drawn their attention to the adverse
political and social implications of the
problem and said, "It will be a disaster
if the freeze is allowed to lapse".
He has therefore urged the MPs to
take up the issue in the current Lok
Sabha.
Papulation Foundation of India
supported PHD Family Welfare
Foundation (PHDFWF) to develop a
project in the area of Reproductive
Health and Family Welfare for industrial
workers employed in seasonal and
casual jobs. The project was approved
by the Governing Board in April 1995
( f"""1 for a period of three years.
"'"""
The project was launched by
PHDFWF which is working among the
industrial workers. In course of its work,
it identified a major problem in reaching
the group of labourers who are seasonal
and casual and who are not reached by
regular public health system for general
health as well as for family planning
and reproductive health. This
experimental pilot project was
implemented in the three contiguous
districts of Ghaziabad, Meerut and
,Mazaffarnagar, which are very close to
)1 Delhi.
The initial contacts with the District
Industrial Association indicated that in
all there were 2284 small and medium
-- -scale industries. The districtWise break-
,
Seasonal and Casual Workers in Industries
have Limited Access to Health Facilities
up was 1231-Ghaziabad; 613-Meerut;
and 440-Muzaffarnagar. It was also
revealed that most of these industries
were concentrated in five clusters:
Ghaziabad, Modinagar, Meerut,
Shahibabad and Muzaffarnagar. With
the help and co-operation of District
Industrial Association, a baseline sample
survey of labourers was carried out to
assess their health needs and status of
the potential target groups, i.e. seasonal
and casual workers,. It was found that
the industrial workers lived in slums
near to their work places. The slums
predominantly represented a young
population of reproductive age group.
The survey recorded a total fertility rate
of around 7 indicating insignificant
practice of family planning. Such a high
total fertility rate suggested high
maternal and infant morbidity and
mortality, closely spaced repeated
pregnancy, poverty, poor nutrition and
lack of environmental and personal
hygiene. The survey also found high
prevalence of a peculiar eye problem
among workers working in and around
sugar mills.
Two highest priority health needs
were revealed by the baseline survey
- (0 treatment for everyday common
health problems, like - fever, headache,
diarrhoea, back pain, scabies, dressing
for wounds, eye problems. This was
closely followed by (ii) need for
additional information, clarification of
doubts and fears and assurance of
follow-up for accepting family planning
and limiting the family size and
provision of contraceptive services.
Surprisingly, the workers had very good
awareness about family planning and
family planning methods in general
through every day radio and TV
broadcasts. And yet, the actual practice
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was insignificant. The awareness created
by radio and TV also raised several
questions in their minds. These questions
were specific to each family. "If I am
to do family planning, who should do
it ! Myself or my husband ? What
method will suit best to my individual
health, parity, living and work
conditions? Where will I get these
methods and services? What will happen
if something undesirable happens to my
health ?" etc. etc. In other words, the
very wide awareness-practice gap was
created by these unanswered questions.
The workers could not get clarifications
of these from radio and TV. No public
health worker ever visited their colony.
They could not ask these questions to
any other persons living in the slums
because they were similarly ignorant
about these details ... This st):"ongly
suggested
the
need,
for individual
and . small
. group 'counselling'.· for promoting
, . family planning and .r~pr:OO-uctivheealth
-arid provi.si<;m of ·services. intbeir
- proximity.
The third nee~ revealed by the
survey' was of <'difficult retlch~ which'
prevented:' these groups of potential
beneficiaries from using the services of
the government health centres. The
users have no time and interest to reach
the distantly located health centres after
their hard and long hours of work. The
women could not visit the centres
because of insecurity. The very formal
behaviour and casual approach of health
staff discouraged the users to seek help
from government health centres. The
non-availability of medicines causing
workers to spend money on prescriptions
further reduced the chances of their
going to these service centres. Similar
factors operated on the side
of government health workers
- Auxiliary Nurse Midwives, Local
Health Volunteers etc. who very
safely kept themselves away from
visiting these slums for providing the
services.
In brief, the isolation of service
providers and service receivers from
each other was complete and the
labourers learned to live with their
general health problems and family
planning doubts, fears, misconceptions,
anxieties and questions and
consequently necessitated high fertility.
It was reported by labourers that in
situations when they are compelled to
go to sub-centre/PHC, they usually do
not find the ANM and the doctors at
the centres while they lose one whole
day's wages in coming to centres and
going back home . If luckily they find
the Health Officials at the centre, they
get prescription instead of medicines in
most of the cases. Non-availability of
female doctors discouraged woman
clients to discuss their doubts and
problems of RH and FP. Another
dimension of the quality of service
which was found lacking related to
assurance of after care particularly in
cases of family planning operation,
inserti(;m of Intra Uterine Device and
use of Oral pilL The people repeatedly
.said, '~Wedo not accept family planning,
undertake operation or use un;:> because
we -have seen govet:I)I;1~t. offiCials
.viSitirig the workers several Jimes before
operation or IUD 'insertion and
cO!Jlpletely' forgettin'g them after
operation or IUD ,insertion. The poor
lady goes on SUffering' In case any
trouble arises."
by Prof Ranjit Roy Chaudhury,
Emeritus Scientist, National
Institute of Immunology. Dr Ashok
Kumar, Officer on Special Duty for
Matri Suraksha Abhiyan presented
his experiences in Matri Suraksha
Abhiyan and said that NGOs must
identify high risk cases in cluster
slums and arrange to give them
institutional
care. He also
emphasised the urgent need to
train personnel recruited for Matri
Suraksha Abhiyan.
Dr H Helen of National Institute
of Health and Family Welfare made
some specific recommendations at
the end of the seminar. She
suggested that the following could
be incorporated as part of a broad
strategy for the role of NGOs
in promoting reproductive and
This meant providing
of
information, service and referral for
both the common general health
problems and for family planning and
reproductive health. For overcoming
the problem of reach, the intervention
through specially set up Reproductive
Health Centres (RHCs) was tried. These
centres were located right within the
industry's premises and very close to
slums of labourers. The RHCs were
staffed by a male and a female social!
paramedical worker with regular visits
by medical personneL For the problem
of quality of services, it was ensured
. that contraceptives and medicines for
general ailments were always available
with the RHCs and with the worker -
motivators. The RHCs remained 'open
almost throughout the day and even
during the lunch break so that no
worker remained unattended due to the
<1!'sence of staff.
. Th.e project was implemented
. dUring a period of three years (1995-
1998) during which the Contraceptive
Prevalence Rate increased from about
10% to between 40% and 45%
in a workforce population of, about
1,00,000.
II
child health care services in Delhi
slums.
i. The government and NGOs
must formulate a positive
working partnership with
clearly demarcated respon- (
sibilities.
ii. Identification and mapping of
existing facilities and resources
in slums is essential for the
success of health and family
planning programmes.
iii. Sharing of experiences, lEC
material, strategy models
between government agencies
and NGOs is important.
iv. Individual health cards should
be issued for effective follow
up services.
v. Each programme should take
into consideration its long-
term impact and sustainability.
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Training Organised for Reproductive, Child Hea th
he Population Foundation of
India project with Sri
Venkateswara University, Department
of Population Studies, to identify
factors goverriing the fertility, sex
combination and contraceptive
behaviour of the peasant women
belonging to scheduled castes has
organised a number of activities
during th.e period January 1998 to
May 1998.
.~ ~
Besides sending a report to the PFI
analysing the socio-economic and other
characteristics of the scheduled caste
women and identifying the factors
governing fertility as well contraceptive
behaviour, the Department of
Popula tion Studies of Sri Venkateswara
University organised orientation
training programmes on reproductive
and child health for the active and
other women of the 18 revenue villages
in the three project Mandals. Group
discussions and meetings were
organised by the Active women with
the help of Auxiliary Nurse Midwives
(ANMs), local teachers, Anganwadi
worker and Research Assistant of the
Project. Research Assistant helped the
active women in conducting the
meetings and discussions with the
help of IEC material such as posters,
charts, pamphlets etc. The Principal
Investigator, Co-investigator and
Research Assistant of the Project,
participated in the Mahila MandaI
meetings along with the local doctors
and teachers to educate them on
reproductive health and other related
matters. Health education programmes
and medical camps were also organised
to promote better health.
The active women organised group
meetings for the other women,
adolescent girls and mothers of their
respective villages and hamlets on the
importance of nutri tion, environmental
cleanliness, immunisation, pregnant
women and child welfare schemes,
care at delivery and family planning
methods. The active women with the
help of Research Assistant identified
the women with unmetneedfor family
planning and children who have not
been immunised and advised them on
the services available. They also
informed the ANMs of respective
areas to provide the ante-natal,
post-natal and family planning
services.
Some of the private doctors and
voluntary organisations working in
the project area were contacted to
provide services and were involved in
the project programmes. Due to the
efforts made by the project staff, the
Primary Health Centre (PHC) staff
took more interest in conducting
medical camps in the remote villages
at periodical intervals. The frequency
of visits by the ANMs to the localities
improved. The women in the project
area have demanded the services from
the health personnel. Due to the IEC
programmes organised by the project
personnel, the ante-natal and post-
natal care and immunisation improved.
Because of the project, specific
intervention on health education of
the adolescent and educational
programme on oral rehydration
solution (ORS) and environmental
.cleanliness etc. were focused for the
scheduled caste and scheduled tribe
groups. One noteworthy feature of
this project is the ability to involve the
government machinery as also other
NGOs and private doctors into the
programme.
The University
Department prepared the IEC material.
In particular the active women
appointed in each village identified
the women who needed family
planning and children who needed
immunisation and advised them
about the services available and also
informed the ANMs to provide the
services.
In order to provide better health
services in the villages covered by the
project, three medical camps were
organised during this period. Eight
health educational programmes on
different aspects suc..l-ats immunisation,
breast-feeding, ORS, communicable
diseases, nutrition and welfare schemes
of the government were also
conducted. Apart from these
programmes, group discussions and
meetings were organised by the active
women in their respective village.
With project intervention, 10 tubectomy
operations and 3 IUDs insertions were
undertaken while ante-natal care
services were given to 107 pregnant
women.
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Daudnagar Project
.Makes Progress
Population Foundation of India
has supported a project of
Daudnagar Organisation for Rural
Development (DORD) in 20 villages
of Daudnagar block of Aurangabad
District in Bihar. The project aims at
organising 1000 poor rural married
women under 30 years of-agein small
cohesivegroups for creating awareness
and educating them about general
health and family welfare. The project
is also to provide small credits for
micro economic activities to around
200 women as part of income
augmenting programme.
According to a report received
recently, 1,642 out of 12,000 eligible
couples, have been motivated to accept
family planning first during the last
quarter. The couple protection rate
which was around 12.8per cent in the
first quarter increased to 28.8per cent
in the second quarter and finally
increased to 38 per cent in the third
quarter. Among the new acceptors of
family planning methods, 24.6 per
cent have undergone sterilisation
operations; 17.7 per cent are using
Intra Uterine Devices (IUDs) and 27.8
per cent have accepted oral
contraceptives. The rest are condom
users.
The deliveries conducted by
Trained Birth Attendants (TBAs)have
increased from 12.2in the first quarter
to 30.9 per cent in the second quarter
to 41.5 per cent in the third quarter.
Infant mortality which was reported
to be 119 in the first quarter has
reduced sharply to 41 in the third
quarter.
Maternal and Child Health centres
in three different remote villages are
working successfully due to the health
insurance scheme. The services of a
lady doctor have been provided to the
centres The lady doctor makes three
visits in a week, visiting one centre
weekly.
Youth groups in each of village
have also been organised.
•
There appeared to be considerable
mis-information about menstruation
and other physiological changes taking
place when puberty sets in. Many of
the girls even felt ashamed of talking
about their periods to others. When
probed to get insights about their
knowledge, some girls believed that
the bleeding during menstruation was
the normal process of expelling the
toxic wastes from the body. If it does
not take place regularly, eye sight gets
weakened. Obviously, the right type
of guidance was not available to them
and Dehleez acted as a good source of
information.
The boys appeared to be more
aware of the physiological changes
during puberty and also the physiology
of reproduction than the girls. They
were more articulate as compared to
girls who found discussions on sexual
matters vulgar. The boys felt that the,\\ ~
issues dealt with in the serial were of ."
relevance to their own lives.
II