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Popfocus 2007 January March English |
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National Conference on Health, Population and
Social Development
The Population Foundation of
India (PH) organized a National
Conference on 'Population,
Health and Social Development:
Experiences from the Southern
States' on February 12 - 13, 2007
at Hotel Taj Krishna in Hyderabad,
Andhra Pradesh. Smt Panabaaka
Lakshmi, the Union Minister of State
for Health & Family Welfare,
Government of India inaugurated
the Conference. Around 160
participants including representatives
from the Government, NGOs,
donors, academicians, scholars and
experts were present at the
conference, which was well covered
by the media.
Objectives of the conference were to
(i) get a clear perspective of the
demographic and health transition
process in Kerala, Tamil Nadu,
Andhra Pradesh and Karnataka,
(ii) recapitulate the initiatives
undertaken over the
last decade in the
light of the current
situation and the
status of sexual and
reproductive health
including HIV /
AIDS, and (iii)
lessons for other
states, particularly
Uttar Pradesh,
Bihar, Jharkhand,
Rajasthan
and
Madhya Pradesh.
The two-day deliberations included
state-specific presentations by each
state i.e. Kerala, Karnataka, Andhra
Pradesh and Tamil Nadu on
'Demographic and Health Transition'
in their respective states. There was
a separate session on HIV/ AIDS,
where the State AIDS Control
Societies from the four states and
the PFI, New Delhi made their
presentations. The concluding session
included a panel discussion on the
'Lessons Learnt and Way Forward'
from the above four southern states.
The Union Minister of State
for Health & Family Welfare,
Smt Panabaaka Lakshmi inaugurated
Mr Hari Shankar Singhania, Vice-Chairman, PFI Governing Board and
Mr A R Nanda, Executive Director, PFI join the Union Minister of State for Health
and Family Welfare, Smt. Panabaaka Lakshmi in releasing the wall chart.
State Level Thematic Workshop on
Immunization
.... 3
Campaign against Coercive
Two Child Norm
4
Rayagada Project Launched
5
Scaling up Pilot Projects in
Reproductive and Child/Adolescent
Health in India
.... 6
Converging Efforts to Improve
Child Sex Ratio
.... 7
Mid Term Evaluation in
CINI Project Areas
.... 10
Global Fund Round 4 Programme:
Access to Care and Treatment .... II
Accolades at the National
Youth Festival 2007
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Social Responsibilities Make Good
Business Sense
'Business can not succeed in societies that fail' has probably
been the most important message issued by the World
Business Council for Sustainable Development (WBCSD), an
alliance of about 180 international companies from more than
30 countries. Successful businesses need a healthy society.
Education, health care and equal opportunity are essential to a
productive work force. A healthy society ultimately helps expand
business as more human needs are met and aspirations grow.
Most corporate houses have responded to the demands for social
responsibility; however, the understanding and definition of
Corporate Social Responsibility (CSR) is still under debate. It is
agreed though that CSR goes well beyond its earliest
manifestation of corporate philanthropy. WBCSD uses the
following definition for CSR: "Corporate Social
Responsibility is the continuing commitment by
business to behave ethically and contribute to
economic development while improving the quality
of life of the workforce and their families as well as
of the local community and society at large."
CSR is an effective tool that synergizes the efforts of the corporate
and social sector agencies towards sustainable growth and
development of societal objectives at large. That India is a fast
growing economy and is booming with national and multinational
firms is an undeniable fact. At the same time, social challenges
like poverty, population growth, poor health, corruption and
illiteracy are to be faced. It is imperative for companies in India
to be sensitized to CSR in the right perspective in order to
facilitate and create an enabling environment for equitable
partnership between the civil society and business.
While the CSR wave has long swept boardrooms across the
world resulting in major alliances including WBCSD and its
regional networks, issues of reproductive and child health often
take a back seat to larger 'pressing' concerns like environment,
energy and climate. Corporate houses interested in initiating
programs on issues of RCH have often found and reported a
dearth of guidelines and models for effective implementation of
RCH programs. A recent study done by GIVE Foundation on
'Corporate Health Interaction in India' involving 17 leading
corporate houses in the country revealed that most corporate
houses wished to scale up their existing health programs. With
this as a backdrop, PH , with its given mandate of supporting
corporate partnerships in RCH and family planning, is in the
process of developing an assistance package on RCH for
corporate houses. This package would provide guidelines for
various aspects of project proposal development, capacity
building, strategic planning and monitoring mechanisms.
The overall goal of the initiative is to foster corporate participation
in integrated health and development with a focus on
reproductive and child health.
Popfbcus
the Conference,
by lighting the lamp.
Mr A R Nanda, Executive Director, PFI welcomed
all the participants .. The inaugural session was
chaired by Mr Hari Shankar Singhania, Vice-
Chairman, PH Governing Board. In his remarks,
Mr Singhania informed that the Foundation since
its inception had focused on family planning and
he provided a brief about other activities of PH
including HIV / AIDS, RCH and other population
programmes.
He expressed hope that the
conference would throw light on the critical issues
concerning population, health and development.
A wall chart and publication on 'Population, Health
and Social Development - Andhra Pradesh,
Karnataka, Kerala and Tamil Nadu.', which includes
state and district profiles of all four states was
released by the Chief Guest, Smt. Panabaaka
Lakshmi.
In her inaugural address, Smt Panabaaka Lakshmi
mentioned that the success of the southern states
has been a long process and the lessons learnt from
the progress of these states would be helpful for
alternate strategies for the rest of the country.
Quoting National Family Health Survey (NFHS) III
data, she said that simple and preventable conditions
like anaemia and malnutrition were still areas of
concern for the southern states.
Smt. Panabaaka Lakshmi also mentioned that
although the achievements of the southern states
in population and health sector are significant, the
HIV / AIDS situation continues to be a cause for
concern.
Dr Leela Visaria, Member, Advisory Council, PFI in
her key note address mentioned that the
demographic transition is completed in all the four
southern states. The mortality transition that
occurred in Kerala, Tamil Nadu and Karnataka was
very much on the path to completing this transition.
In Andhra Pradesh, the infant mortality rate (IMR)
is still quite high. The IMR ranges from 14 in Kerala
to 60 in Andhra Pradesh. She explained the main
reasons for the mortality transition are political,
bureaucratic commitment and high status of women.
Quality of care must be the focus to achieve the
desired results. This session was concluded with the
remarks and vote of thanks by Prof Ranjit Roy
Chaudhury, Member, PH Governing Board.
Kerala
Dr S Irudaya Rajan, Professor, Center for
Development Studies, Thiruvananthapuram made
a presentation on 'Demographic and Health
Transition in Kerala.' He highlighted that the major
contributing factors towards the determinants of
fertility decline are education, health, age at
marriage, political awareness, social reforms, land
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Pop.!bcus
State level Thematic Workshop on Immunization
Astate level thematic workshop
on 'Immunization' was organized
by Regional Resource Centre (RRC),
Bihar on March 17, 2007 at Hotel
Chanakya, Patna. The workshop was
inaugurated by the State Health
Minister, Shri Chandra Mohan Rai.
Other dignitaries present at the
workshop were Dr Anil Kumar, the
Science and Technology Minister,
Dr Manoranjan Chaturvedi, Director-
in-Chief (Health Services), Dr Veena
Pandey, Health Education Officer,
Dr Almas Ali, Senior Advisor, PH,
representatives from MNGOs, Bihar,
State Level NGOs, European
Commission, UNICEF, CARE-India,
Pathfinder International, CHARM,
and the Media.
Objectives of the workshop were to
(i) build perspectives on routine
immunization, (ij) involve different
stakeholders in immunization
programmes in .the state, and (iii)
develop action plan to improve the
quality of immunization.
While delivering the inaugural
address, the State Health Minister,
Sri Chandra Mohan Rai mentioned
that qualitative improvement has been
observed in the Routine Immunization
programme in the state, however, on
this the state is far behind the national
progress. The Government of Bihar
had declared the year 2006 as the
'Year of Immunization' and to
commemorate the year 2006,
immunization weeks were also held
in the state. Two days in a week,
Wednesday and Saturday were
chosen as the Routine Immunization
Day and six vaccines for preventing
diseases were made available.
He stated that the high growth rate
of population is of great concern to
The Honourable Health Minister, Bihar, Shri Chandra Mohan Rai addressing
the participants at the workshop.
the state, as the resources are limited
and they should be used optimally for
sustainable development. He further
informed that the Government of
Bihar has taken a policy decision to
involve more NGOs in health and
other related developmental activities.
A strategy has to be formulated based
on the constraints and challenges of
Routine Immunization Programme in
the state, he added. He hoped that
the collective efforts of the state
government, NGOs and other
agencies like PFI would improve the
health situation of the state within a
short period of time.
Dr Anil Kumar, Science and
Technology Minister, Bihar focused
on the need of child immunization.
Though the coverage of the child
immunization has improved in the
state, the state is lagging behind the
national coverage. He emphasized
that the huge population is a major
concern for the state and the
Government has taken the issue as a
challenge and the activities have been
planned under the National Rural
Health Mission.
Shri Ram Updesh Singh, the
Honorary Advisor, PH said that the
RRC, Bihar has taken up the issue of
child immunization considering the
existing poor health indicators of the
state and the RRC is also providing
technical inputs to the government
and other agencies.
Dr Veena Pandey, State Health
Education Officer said that the
government has been implementing
the immunization programme since
1978, the progress, however, is still
very poor. A tracking system for
children and mothers needs to be
developed, so that all the children
could be immunized. With a priority
of social mobilization, a compr-
ehensive strategy needs to be
formulated based on the past
experiences and constraints for poor
immunization coverage to achieve the
desired results.
The workshop was concluded with
the vote of thanks by Shri R U Singh,
Honorary Advisor, PH
•
Meeting of the Advisory Council
A meeting of the Advisory Council of PH was held on March 23, 2007 under the chairmanship of Prof. M S
Swaminathan. Members of the Council, who attended the meeting included Mr T V Antony, Ms Meenakshi Dutta
Ghosh, Prof Gita Sen, Dr Leela Visaria, Ms Rami Chhabra, Dr Ragini Prem, Dr K Srinivasan, Dr Usha R Krishna,
Dr Bobby John and Mr Yashodhan Ghorpade. Prof Ranjit Roy Chaudhury and Dr Abid Hussain, members of the
Governing Board of PH were also present at the meeting. Key recommendations made by the members included:
exploration of successfulpilot projects of the Government for scaling up, making communication more innovative
by use of community radio and new Information and Communication Technologies (lCT) and a strategic planning
exercise to chart future directions.
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PoP./OCUs
Campaign against Coercive Two Child Norm
The Population Foundation of
India was actively involved in the
campaign against two-child norm in
the Municipal Ordinance of Bihar
where-in the eligibility criteria
debarred people who would have
their third child born after the passing
of this Act to contest in the elections.
PH helped facilitate the process of
mobilising civil society groups in the
state which included advocacy with
the Health Minister, State Election
Commission, media and NGOs.
The Foundation was part of the
meeting organized on February 22,
2007 in Patna where over 30
persons representing more than 10
states and national level networks and
forums attended the meeting and
discussed on how such population
based norms are a clear violation of
democratic rights, reproductive rights
and overall human rights and affected
the marginalized. At the meeting a
one-month intensive campaign plan
was drawn up with the objective of
stopping the ordinance from being
enacted into law in the ensuing budget
session of the state assembly. A joint
forum called "Jan Adhikar Manch",
consisting of representatives from
ABHA, Bihar Voluntary Health
Association, Healthwatch Forum,
Dalit Adhikaar Manch, FORCES,
Human Rights Law Network,
Population Foundation of India,
Confederation of NGOs for Rural
India, Wad a Na Todo Abhiyan,
Hunger project, Swechhik Sangthan
Morcha and A-one Bihar, was created
in Bihar.
The Plan of Action had three key
prongs - Legislative Advocacy; Media
Advocacy and Letter Campaign.
The Forum approached people's
representatives and head of the
parties. A total of 60 MLAs were
influenced and convinced to oppose
this bill. The Forum also maintained
a continuous dialogue with media
through press conferences. Media
played a positive role in creating a
congenial atmosphere.
Around 5000 postcards opposing this
legislation from different districts and
villages were collected by this Forum.
The Forum organized a "Pratirodh"
on March 28, 2007 in Patna, which
went up to the state secretariat.
A group of representatives met
Deputy Secretary and gave him 5000
postcards and a Memorandum
against the bill. They were assured by
the Deputy Secretary that their
demands would be communicated to
the Chief Minister.
There was an immense opposition of
the ordinance by the MLAs in the
assembly. On March 28, 2007, the
Honourable Chief Minister Mr Nitish
Kumar gave a statement in the
assembly that an all party meeting
shall be called and on the basis of the
decision taken at the meeting, the
ordinance shall be withdrawn. •
4th Asia Pacific Conference on
Reproductive and Sexual Health and Rights
29th to 31 st October, 2007 - Hyderabad, India
India willhost the Fourth Asia Pacific Conference on "Reproductive and Sexual Health and Rights" at the International
Convention Center in Hyderabad on October 29-31,2007. The Conference will provide a platform for people with
diverse perspectives, expertise and experience to exchange ideas, discuss and debate issues of concern, and learn
from each other about sexual and reproductive health and rights, with specific reference to the implementation of
the Programme of Action of the International Conference on Population and Development (ICPD, 1994).
The theme of the Conference is "Exploring New Frontiers in Sexual and Reproductive Health and Rights".
The scientific programme will include parallel sessions, plenary sessions, symposia, satellite sessions, poster
presentations and skills building and empowerment workshops. The Conference is organized in parallel sessions
within the following six tracks:
• Expanding and Empowering the Sexual and Reproductive Health and Rights Movement.
• Moving Beyond Tokenism - Enabling and Realizing Young People's Potential in Improving Sexual and Reproductive
Health.
• Equalizing Sexual Relationships: Gender, Sexuality and Sexual Diversity.
• Responding to Emerging Issues in Sexual and Reproductive Health and Rights: Technology, Ethics and Policy.
• Addressing Un met Need for Sexual and Reproductive Health Services.
• Making Pregnancy Safe and Wanted: A Non-negotiable Entitlement for Women.
For more information, please visit the website at: <http://www.4apcrsh.org>
Abstracts may be submitted online through the Abstract page. Registration for the conference is ongoing.
Please visit the registration page for details.
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Ravagada Proiecilaunched
PopJOcus
A launch ceremony of the project
"Advocacy to Action: Promotion
of Maternal and Neonatal Survival in
the Tribal Areas of Rayagada District,
Orissa" was organized by PFI in
association with Orissa Voluntary
Health Association {OVHAj,
Bhubaneswar at the Community Hall,
Christian Hospital, Bissamcuttack on
January 29, 2007. Mr Basudeb
Panda, Executive Director, OVHA
welcomed the guests and Mr P C
Mishra, President, OVHA presided
over the ceremony. The Chief Guest
Mr A R Nanda inaugurated the
ceremony by lighting the lamp. A total
of 265 participants from diverse
spectrum were present at the launch.
Mr Basudeb Panda, Executive
Director, OVHA elaborated that the
project is being implemented in
selected villagesof Bissamcuttack block
of Rayagada district for a period of
three years. The project focuses on
(a) ensuring essential ante-natal care,
intra-natal, post natal care and neo
natal care, (b) promoting family
planning methods by increasing access
to contraceptive choices, (c) ensuring
community participation and
ownership, (d) strengthening referral
systems for high-risk pregnancies,
obstetric emergencies and institutional
delivery, (e) imparting education on
hygiene, pregnancy, family planning
methods and new born care to eligible
women, and (f) documenting and
disseminating lessons learnt at the
district/state level.
Mr Panda stated that
after the advocacy
initiatives at the
Gram Panchayat
level, block level,
districtleveland state
level by PFI, this
project is designed
to promote the
maternal
and
neonatal survival in
Bissamcuttak block.
Dr John Oommen,
Director, Mitra,
Christian Hospital, Bissamcuttak
emphasized that our main target
should be to ensure that not a single
mother faces the dangerous situation
of death while giving birth. He
strongly felt that no goals, no
objectives are required to ensure
survival of mothers and children, we
only require dreams - dreams for
mothers, infants and patients, love
and affection for them. Our love is
the much-needed medicine to cure the
patients.
Dr Almas Ali, Senior Advisor, PFI
defined maternal mortality and infant
mortality in detail. He highlighted the
main causes of mortality as illiteracy,
ignorance, poverty, poor hygiene, poor
economic condition, lower standard of
livingand lower social status.
In his address, Mr A R Nanda narrated
his first experience of the area when
he was posted in the
district as an IAS officer.
Undivided Koraput
district is the most tribal
dominated area. The
ANMs are appointed to
give treatment to the
mother and children and
facilitate the provision
of government health
facilities and benefits.
For 60 villages,there are
60 CHVs and 60 TBAs
to carry out the work, if
the present activities are
Mr A R Nanda, Executive Director, PH flagging off
the project vehicle.
to continue, maternal
and child mortality can
be reduced.
Dr A M M Pattanaik, ADMO (FW),
Rayagada informed that the
government has planned various
actions to improve the present
condition in rural areas; the ANMs,
AWWs, ASHAs, TBAs are appointed
and in the medical institutions, the
medical doctors, nurses, LHVs,
BRRs, pharmacists and laboratory
technicians are appointed to carry out
various activities and to serve the
people. The National Rural Health
Mission is being implemented to
improve the condition and
institutional delivery is being
promoted under Janani Surakhya
Yojana. It was followed by the
remarks of well known dignitaries.
In his presidential address, Mr P C
Misra, President, OVHA mentioned
that Orissa is culturally a rich state,
where SC, ST, OBC and General
caste people are living in large
numbers. Undivided Koraput is the
district of Kondhs (a type of
Scheduled Tribe). The Kondhs live in
poverty and their improvement in
social, economical status is essential.
Their health status and health related
problems are to be dealt with
seriously.
Mr Uttam Kumar Sahu, GB Member,
OVHA gave the vote of thanks to all
concerned for making the
programme successful. After the
launch ceremony, the Executive
Director, PH inaugurated the project
vehicle to carry pregnant women and
to promote institutional delivery at
Christian Hospital, Bissamcuttack. •
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Popfbcus
Scaling up Pilot Projects in Reproductive and
ChildlAdolescent Health in India
Training of ASHAs on Home
Based Newborn and Child
Care (HBNCC)
Under the Norway India
Partnership Initiative (NIPIF,
1 00 000 ASHAs are to be trained
o~ H~me Based Newborn and Child
Care (HBNCC). The chair of the
advisory committee on training
strategy for ASHAs has invited PH
to facilitate development of the
ASHA training plans. The PH along
with CARE and SEARCH has
developed a strategy for training of
the ASHAs on HBNCC. However,
to make the strategy more feasible
and to know the ground realities, the
PH commissioned a scoping study to
assess the environment in the five
NIPI focused states viz, Madhya
Pradesh, Uttar Pradesh, Bihar, Orissa
and Rajasthan. Objectives of this
study were to assess - (1) existing
training infrastructure, (2) available
training capacities and (3)
political environment in
each of the five states.
Findings from the study
were presented to the core
group of HBNCC and then
fed into the NIPI's plans for
training around 100,000
ASHAs across the five
selected states. The
modified training plan is
a multi-stage training
strategy where ASHAs
will be trained through
a stepladder mechanism. This
mechanism also seeks to strengthen
the support system for ASHAs. The
training plan along with the budget,
which was shared with the advisory
group for HBNCC and the NRHM
Mission Director, has received their
approval in principle.
The Home Based Newborn Care
model is a pilot intervention to reduce
Findings from the Environmental Assessment
TopicalAreas of Assessment
• Status of ASHA component: recruitment, training, functioning
• Assessment of Training Systems - Infrastructure, Human resources
• State readiness to integrate HBNCC into ASHA training
• Potential challenges to integration
OverarchingFindings
• Most states were open to the idea, especially the idea of ASHA
strengthening
• HBNCC training was viewed as an opportunity to retrain/refresh or
even train ASHAs
• Some apprehensions regarding content of HBNCC and institutional
mechanisms of NIPI prevailed
• Performance pressure for NRHM is high in the focused states
• Training not seen as human development, but as an adjunct function
• No grip yet on current ASHA training quality-more preoccupied with
numbers
• ASHA's remuneration and field conflicts with other grassroots workers
is a potential issue
• Fair amount of openness to involving NGOs- extent of involvement
varies
• Sufficient precedence exists to recruit suitable trainers and link them
to the system
1 NIPI is a five-year bilateral cooperation between India and Norway for providing catalytic support
to India's efforts towards achieving the Millennium Development Goal 4 of '·reducing infant
mortality'.
neonatal mortality by providing
essential and emergency care to
newborn through semi-literate
women in the community.
Quality and Safe Delivery
Services through Nurse
Midwives
As part of the National RCH II
program, the ARTH's skilled birth
attendants for maternal and neonatal
health training module is being used
for training 15,000 ANMs in
Rajasthan. Recently, in collaboration
with the government's health
department, the ARTH has begun an
intervention to train, equip and
support 20 auxiliary nurse-midwives
in their sub-centre areas in 2 interior
tribal blocks of Udaipur district.
From the visioning workshop that the
PH and MSI conducted with ARTH,
four key areas emerged as immediate
steps for action - (a) Costing and
Pricing of the services, (b) Client
profiling, (c) Developing a service
package, and (d) Identifying location
of the clinics.
Following the workshop, the ARTH
formed a core discussion group for
scaling up their model. The group has
evolved criterion for identification of
districts, which includes various
demographic and socio-economic
indicators for location of the clinics.
In January 2007, PH undertook a
costing exercise to help ARTH in
estimating the cost incurred for each
service under the MCH package .•
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PopJOcus
Converging IOorts to Improve Child Sex Ratio
PH has been working intensively
at micro level since 2004 on the
issue of 'Missing Girls' in the states of
Punjab, Haryana and Himachal
Pradesh. Advocacy interventions have
been implemented at various levels
with stakeholders like policy makers,
PRls, mahila mandals, media and the
community. Cross border and inter-
district practice of sex selective
abortions was a major hurdle identified
during the course of these
interventions. To address this hurdle
and to encourage convergence of
efforts both within the state and
between bordering states, PH along
with state level partners the Voluntary
Health Association of Punjab (VHAP)
and SUTRA organized a series of
consultative meetings of senior
Government officialsof the concerned
departments of the three states as well
as Chandigarh UT.
The third consultative meeting of the
series was held in Chandigarh on
February 5, 2007. The meeting was
attended by senior Government
officials from the departments of
Health, Women and Child
Development, Youth Affairs and
Panchayati Raj of the three states and
Chandigarh UT. The objective of the
meeting was to share the state level
status and progress made towards
improving Sex Ratio and the
emerging models and strategies being
adopted to deal with this issue.
Possibilitiesand status of inter-sectoral
and inter-state coordination were
also explored in the meeting.
Presentations were made by repre-
sentatives from Government of
Punjab, Haryana, Himachal and
Chandigarh UT.
Ms. Anuradha Gupta, Secretary,
Women and Child Development
(WCD), Government of Haryana
presented two models (a) the Village
level monitoring committee and b) the
Sakshar Mahila Samooh (SMS)
models developed by the Government
of Haryana to tackle various social
issues. Ms Gupta highlighted that
there has been a Paradigm shift in
Haryana in that the focus is now on
Social Mapping at Village Level. The
village level monitoring committee
consisting of a group of active women
Consultation on 'Missing Girls' in progress.
Inset: Ms Anuradha Gupta, Secretary, WCD, Government of Haryana.
representing every group in the
village, including women Panchayat
heads, members, Mahila Mandai
members, ANMs, AWWs and
ASHAs. The main objectives of these
committees are to (a) capture trends
in every village in Haryana and (b)get
insights into social issues and enable
and empower communities and
health functionaries to monitor the
status in their villages. Ms Anuradha
Gupta then provided detailed steps of
the model which sought to equip
women to take charge of the issue at
the village level. The innovative
aspects of the committee are the
Child Tracking System through a
register that tracks a child from birth
to six years. The committee has been
provided with tangible functions,
funding and the power to monitor
health functionaries. This committee
has been declared as a sub committee
of the Gram Panchayat under Section
22 of the Act. This has led to
democratization of the functions
under the Gram Panchayat and
enables the Gram Panchayat to
delegate to the sub committee.
The second model is the SMS Model
which proposed to make Sex Ratio
monitoring as a key agenda for
educated women and young girls in
the village. It proposed to organize
educated women into a social group
which would be registered and
therefore functions as an NGO at the
village level. The formation of SMS
in villages was ongoing and likely to
be completed within a month. Five
key issues have been identified for the
SMS to track, viz, Dowry, Sex Ratio,
Age at marriage, Breastfeeding
and Anemia. This model is being
implemented by the Department of
Women and Child Development in
collaboration with the Panchayati Raj
Department.
Presentations from the Government
of Punjab and Himachal Pradesh
highlighted the new strategies for
implementing the PCPNDT Act
especially through incentive based
schemes coupled with monitoring by
the Appropriate Authority at the state
and district level.
The Haryana status report highlighted
the fact that there has been a decline
in sex ratio in previously better
performing districts. This was a cause
for serious concern and strategies
need to be developed to monitor this
trend. There needs to be better
regulatory mechanism along with
the incentive based schemes.
Representatives from the Directorate
of Youth Affairs - Punjab and
Haryana revealed the immense
potential of involving the youth
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PopJOCUs
reforms, universal immunization etc.
He also mentioned that the
population transition would cause
negative growth rate among children
(0-9 years), increase of elderly
population, decline in poverty and
unemployment, migration issues - in
and out, and a rise in communicable
diseases.
This was followed by a presentation
on "Health Care in Kerala" by
Dr Viswas Mehta, Secretary, Health
and Family Welfare Department.
Dr Mehta appreciated the previous
presentation for providing the status
and facts on health in Kerala. He
presented the unique features of
Kerala as women's empowerment,
excellent public distribution system,
health care delivery network, high
dependency on private hospitals and
and challenges such as high rates of
suicides and an ageing populataion.
The Chairperson for this session,
Mr B G Verghese, Member, PFI
Governing Board facilitated the
discussion.
Karnataka
This session was chaired by
Mr J C Pant, Member, PH Governing
Board. Dr S Pruthvish, Professor,
Department of Community Health,
M S Ramaiah College, Bangalore
made a presentation on 'Demo-
graphic and Health Transition in
Karnataka'. He highlighted that while
demographic transition in the state
had reached its last phase with fertility
levels registering a significant decline
during the last two decades, high
fertility continues to be a problem in
the northern districts of Bidar,
Bijapur, Gulbarga and Raichur. He
emphasized that adequate attention
is to be given to the issues like urban
health care and disability for the
overall performance of the State.
Andhra Pradesh
he session on Andhra Pradesh was
chaired by Dr Abid Hussain, Member,
PFI, Governing Board. Four
presentations were made at this
session. Mr CBS Venkataramana,
Commissioner, Family Welfare,
Government of Andhra Pradesh
made a decade-wise presentation on
'the Family Planning Programmes
and its Performance.' He stated that
the major thrust of the government
programmes was on strengthening
the existing Family Planning (FP)
Service Centres. This was followed
by a presentation on 'Demographic
Transition in AP.: Determinants and
Consequences' by Dr Leela Visaria.
Her presentation focused on the
population profiles, fertility and
mortality trends, their determinants
and the consequences of fertility
transition. Dr Prakasamma made the
third presentation on the 'Socio-
economic and Cultural Determinants
of Fertility in Andhra Pradesh'
followed by a presentation by
Dr Rama Y Padma on the
'Consequences of Early Age at
Sterilization: Rural Women's Health
in Andhra Pradesh.' The above
presentations highlighted the
following:
../ Family planning achievements in
Andhra Pradesh are attributed to
the political commitment of
successivegovernments, leadership
role of district collectors and
intensive mass media campaign.
../ The weaknesses were a decline in
the use of temporary methods of
family planning, low age at
marriage and low mean age at
sterilization.
../ A significant difference was seen
in health status of women by age
of sterilization.
This session was chaired by Prof Gita
Sen, Member Advisory Council, PH
In this session, Dr K Kolanda Swamy,
Dy Director, Department of Public
Health and Preventive Medicine,
Government of Tamil Nadu made the
first presentation on 'Policies and
Programmes of Tamil Nadu.'
He highlighted the present activities
of the Government of Tamil Nadu
towards improving quality of health
care and the PHCs rendering 24 hours
delivery services with three staff
nurses' model. He also shared the
efforts being made to implement
PCPNDT Act at the PHCs through
Scan Centre Audits.
A presentation on "Fertility transition
and women's health in Tamil Nadu"
was made by Dr Sundari Ravindran,
Honorary Professor, Achutha Menon
Centre for Health Science Studies,
Kerala. Dr. Ravindran emphasized that
fertility decline has not necessarily
improved women's health status.
Sterilization is the only method of
contraception adopted by the
Government. The participation of
men in family planning appears to be
limited for fertility control and
reproductive morbidity is also found
to be very high in some districts.
Women, who have adopted
permanent methods of contraception
are vulnerable to STIs and HIV
infections however, no attention is
being paid to reduce this risk.
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Popfbcus
The next presentation on "Fertility
Transition in Tamil Nadu" was made
by Prof Padmini Swaminathan,
Director, MIDS, Chennai, who
highlighted the need for a synergy
between the health and other
departments such as the department
of industries. The process of
industrialization and its adverse
impact on health requires urgent
attention.
HIV/ AIDS Status in the
Southern States
Ms Nina Puri, Member, PH Governing
Board chaired this session. The State
AIDS Control Societies of Karnataka,
Kerala, Tamil Nadu and Andhra
Pradesh presented the HIV/ AIDS
programmes initiated by each state.
A presentation on Access to Care and
Treatment (ACT) by Dr Mary
Verghese, Project Director and
Mr Sub rat Mohanty, Programme
Manager, PH for the Global Fund
supported HIV/ AIDS programme.
Highlights of all the presentations are:
• Tamil Nadu contributes 42% of the
total HIV cases in India and
prevalence of the HIV/ AIDS in
Karnataka as well as in Andhra
Pradesh has been gradually
increasing since 2001, all of which
is a cause for concern.
• Kerala is a low prevalence but
highly vulnerable state owing to its
proximity to high prevalence states
of Karnataka and Tamil Nadu.
• Key strategies and programme
components are targeted inter-
ventions, prevention and care,
alliance and partnership building
• Innovative approaches such as Red
Ribbon Clubs and Be Bold
Campaign have been formed in
Andhra Pradesh and Tamil Nadu
by involving students with
the objective to reduce the
risk behaviour of the students,
promote them as ambassadors for
better health and to fight against
stigma.
• Challenges and future plans are
integration of departments,
programmes for young people,
involvement of NGOs and district
level networks, expansion of
services including strong referrals.
Panel Discussion
Critical issues emerging from the
presentations over the two days were
deliberated at the panel discussion
chaired by Ms Justice Leila Seth,
Member, Governing Board, PFI.
Ms Seth concluded with a plea to
identify areas of priority to move
forward and be innovative in our
approach.
Dr Kumudha Aruldas, Additional
Director, PFI, summed up the
discussions. The following were key
recommendations of the deli-
berations:
• There is a need to unravel the
positive and negative conse-
quences of fertility decline.
• The middle age group is bulging
and there is a need to train and
POPULATION
1.'i1.'1.
rOUNDi\\TION OF INIJI,\\.
NATIONAL CONFEHLNCE
()
POPULATION. HEALTH A.
EXPERIENCE 0
F
"JEW DElli
Panelists at the Plenary Session. (From left); Mr R U Singh, Dr Sudhir Verma,
Dr Leela Visaria, Prof Gita Sen, Justice Leila Seth, Dr Rama Y Padma,
Dr Sundari Ravindran and Dr Almas AlL
upgrade their skill appropriate to
development. There is a window
of opportunity to reap the
demographic dividend.
• Changes in family size, structure
and kinship relationship and how
these affect women need to be
looked at - e.g. there are fewer
relatives to support in care giving
for the family, which includes old
people as well.
• Health transition is well on its way
but is still a worrisome issue in this
country since we haven't been
able to eliminate communicable
diseases.
• Quality of health care/maternal
care needs improvement. The
woman disappears from the radar
of the health personnel after
sterilization or child birth, when we
know that 60% maternal deaths
occur in the post partum period.
• In Family Planning - sterilization
is the main method in all four
southern states. There is need to
promote use of spacing methods
especially condoms.
• There is need to bring
Reproductive Health (RH) and
HN / AIDS together. RH needs do
exist for an HN +ve woman but
they are not addressed. Some of
the vulnerable groups such as
sterilized women and newly
married women need special
attention.
In the valedictory session,
Mr A R Nanda, Executive Director,
PH emphasized the need to prepare
an advocacy strategy for policy
makers and programme managers
that would be gender sensitive, rights
based and women friendly. The chair
of this session, Prof Ranjit Roy
Chaudhury gave his concluding
remarks and made the following
suggestions:
• Our greatest weakness is that we
are not innovative and we copy.
We must think "out of the box".
• We must approach and adopt
policies and processes with
caution.
The conference concluded with a vote
of thanks by Mr S Ramaseshan,
Secretary and Treasurer, PH. •
II
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PopJOcus
Mid Term Evaluation in CINI Project Areas
The project "Strengthening NGO
1capacity to improve maternal
and child health though life cycle
based approach", initiated in April
2004, is being implemented by the
Child in Need Institute (CINI) in
Churchu block of Hazaribagh district
in Jharkhand. The project envisages
improvement in the maternal and
child health outcomes as well as
improvement in the general health
status through a community based life
cycle approach. Community
involvement in the project is ensured
through the Village Health
Committees (VHCs) and the
Saahiyas, who work as represent-
atives for promoting health within the
community.
A mid term evaluation was conducted
to assess progress on knowledge,
attitudes and practices on Sexual and
Reproductive Health issues among
ever married women with live birth
after the baseline survey in June 2004.
The survey had both qualitative
and quantitative components. A
questionnaire based survey,
observation of field camps and
Focussed Group Discussions (FGDs)
were the tools used for the evaluation.
The evaluation revealed that there is
very high level of awareness on the
importance of ANC and TT
injections. The knowledge about
delivery care, such as five cleans and
danger signs of pregnancy have also
increased from the baseline survey.
The overall percentage of women,
who received any antenatal check-ups
has increased to 89 percent from the
baseline status of 56 percent out of
which 65 percent has availed ANCs
for three or more times. About 54
percent women consumed all IFA
tablets the corresponding figure in the
baseline was 34.6 percent. Similarly
the vaccination coverage of at least
one for the pregnant women
increased to 95 percent from a
baseline status of 74.5 percent. The
percentage of safe deliveries is 37
percent, which showed an increase
SaahiVas new role in the
communitY has buiU a new
found confidence in them
and thev are now able to
liaison with the
government health
service providers in
their village.
by 12 percent from baseline to mid
term survey. The number of women,
who are going for postpartum check-
ups, has also gone up by 25 percent
from a baseline status of 13 percent.
It has been observed that knowledge
on female sterilization (99 percent)
had almost become universal and
there was a visible improvement in
keeping record as compared to
baseline data. However, the current
use of any contraceptives in the block
is 21 percent among the eligible
couple and the unmet need for family
planning is 39.6 per cent.
Immunization scenario has improved
significantlyfrom baseline to mid term
survey - the complete immunisation
has increased from 33 percent in the
baseline to 83 percent in the mid term
evaluation. Colostrum feeding to the
newborn has increased to 79 percent
from 64 percent in the baseline.
Focus Group Discussions (FGDs)
showed that the community has well
accepted the Saahiyas and it was
found that the Saahiyas are
performing very important and
commendable task in the community.
They said that their new role in the
community has built a new found
confidence in them and they are now
being able to effectively liaison with
the government health service
providers in their village.
VHCs are functioning in line with the
project. VHCs are also maintaining
a Village Health Kosh to meet the
recurring expenses of the committee
as well as the Saahiya and also to
assist in case of emergency health
needs of the community. Overall, the
project seems to be moving forward
to achieve its identified objectives. •
Contd. from page 7
through existing youth clubs and
regular camps held by the
department.
Some of the broad recommendations
that came up for future action were:
• Since the overall Sex ratio and
Child Sex Ratio figures are diverse
across districts in the states of
Haryana, Punjab and Himachal
Pradesh, generalizations in
strategies cannot be made. There
needs to be district specific
strategies taking into account
village and block level realities.
• Need for stronger and continuous
advocacy at the block and village
level.
• Need for greater coordination
across various departments such as
WCD, Panchayat Raj, Youth and
Health.
• Greater involvement of the Youth
department and youth based
organization such as Nehru Yuvak
Kendra through their youth clubs
in mobilizing and building
awareness and participation of
young people at the village and
tehsil levels.
• Develop strategies for monitoring
working of various departments to
track the progress at the grass root
level. This becomes increasingly
important in the light of the current
SRS data and NFHS 3.
• Need for follow-up on involvement
of religious leaders/groups in
building awareness on the issue.
The meeting ended with a voice vote
to continue convergence of various
concerned departments of all the
three states and UT.
•
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iAi
Pop./Ocus
Global Fund Round 4 Programme: Access to Care and Treatment
The Global Fund project on
HN / AIDS - 'Access to Care and
Treatment' has completed two years
in March 2007. Key activities of the
last quarter of year 2 are as follows:
Strengthening Capacities in
Grants Management
A two-day workshop on Grants
Management was organized by PFI
on February 26-27, 2007 at the
Qutab Hotel, New Delhi. Financial
guidelines, financial reporting and
Global Fund requirements were
deliberated at the workshop with all
partner agencies implementing the
programme.
Review and Future planning
The quarterly Programme Manager's
meeting for the 'ACT Programme'
was held at the Qutab Hotel, New
Delhi on January 18, 2007.
Programme Managers of all the sub-
recipients participated at the meeting.
The Phase I programme and the
plans for Phase II were reviewed.
Project Advisory Board
(PAB) Meeting
The Project Advisory Board meeting
was held on January 19, 2007 at
the Qutab Hotel, New Delhi. The
members of the PAB and the sub-
recipients participated at the meeting.
The advisory members provided
guidance on future strategies.
Corporate India's Response
to Care & Treatment
The Confederation of Indian Industries
organized a conference under the
Aegis of the programme "Access to
Care and Treatment: Corporate India's
Response to Care & Treatment" on
March 30, 2007 at the Hotel
Le Meridien, New Delhi. The deli-
berations focused on the issues on care
and treatment in HIV/ AIDS. 190
representatives from the industry and
other stakeholders were present at the
conference. The key speakers at the
conference were the consortium
partners and leading corporates, who
have set up the ART centres.
Visit to Andhra Pradesh
The Global Fund consultants,
Mr. John and Ms. Lucy Williams
visited the state of Andhra Pradesh
and documented (photo docu-
mentation) the activities of the ACT
project service delivery points set up
by Indian Network for people living
with HIV/AIDS (INP+) and the
Comprehensive Care and Support
Centre by Freedom Foundation in
Guntur district, Andhra Pradesh.
Events
State level peer conventions were
organized in all the six high
prevalence states in coordination with
the Indian Network of People
Living with HIV/ AIDS (INP +) in
March 2007. The objective of the
convention was to share and learn
from the experiences of peer
educators working in the high
prevalence states.
•
Accolades at the National Youth Festival 2001
The 12th National Youth Festival
2007, organized by the Ministry
of Youth Affairs, Government of India,
was held at Pune during January
12-16, 2007. The five-day festival
was divided into various segments
such as athletic and sports, art and
culture, food festival, and adolescent
health exhibition. Over 10,000 youth
from all the states of India and from
abroad participated at the festival.
(NYKS)and Mr Yogendra Choudhary,
Executive Director, NYKS. PH along
with about 25 national and
international organizations took part
in the national adolescent festival.
Independent stalls were given to each
organization to exhibit their activities
and display their publications.
Around 400 visitors, mostly youth
and adolescents, visited the PH stall.
An exhibition
on adolescents
titled 'National
Adolescent
Festival' was one
of the special
features of the
festival, which
was
jointly
inaugurated by
Dr Shakil Ahmed
Khan, Deputy
General, Nehru
Yuvak Kendra
San gat h a n
Mr K L Rao from PFI briefing the visitors.
A visitors' book was also kept at the
stall to record their comments,
suggestions and recommendations.
The PFI publications were widely
displayed at the festival. Special
arrangements were made to screen
PH films/spots. Visitors were given
the choice to click-and-watch films of
their choice.
Publications developed by PFI's
partner organization, NMP+, Pune
on HN / AIDs were also displayed and
distributed during the exhibition.
Organizers of the Youth Festival
constituted a distinguished panel to
select the best stalls in the exhibition
for an award. PH stall was selected
as the second best stall at the festival
basis the quality of programs
implemented, quality of materials
developed and overall display in the
stall. The first prize was given away
to Centre for Youth Development
Activities (CYDA), Pune and the third
prize to Chetna, Ahmedabad. •
III
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From the Executive Director's Diarv ...
Mr A R Nanda, Executive Director (ED),PH attended the Consultative Meeting on 'Scaling
Up of Home-based Newborn Care in India' on January 10, 2007 at PH, New Delhi.
The ED was invited to chair the concluding session of the National Dissemination
Workshop for 'Reproductive and Child Health, Nutrition and HN/AIDS (RACHNA)
Programme,' organized by CARE India, New Delhi on January 11, 2007 in New Delhi.
The ED was invited as a Chief Guest to inaugurate the District Level Workshop on
"Role of Civil Society and Local Self Governments in the Implementation of NRHM in
the Districts of Koraput and Nawarangpur" organized by the Kalinga Centre for Social
Development (KCSD) on January 28, 2007 at Jeypore, Orissa.
Mr A R Nanda was invited to attend the launching ceremony of the project 'Promotion
of Maternal and Neonatal Survival in Bissamcuttack Block'on January 29, 2007
organized by Orissa Voluntary Health Association, Bhubaneswar, Orissa.
The Executive Director was invited to attend the 1st workshop to discuss the draft
papers for the Urban Poverty Report on February 18-19, 2007 at Surajkund, Faridabad,
organized by Prof. Amitabh Kundu, Jawaharlal Nehru University, New Delhi.
Mr A R Nanda was invited to be a part of the review workshop related to the ongoing
project "Modes of Service Delivery, Collective Action and Societal Regulation: Making
Public Services Responsive to the Poor in Brazil, India and Mexico" on March 1, 2007
at the India International Centre, New Delhi organized by Centre for the Future State,
Institute of Development Studies, New Delhi.
Mr A R Nanda was invited to attend the workshop on "Gender Sensitization" for the
top management of the Indian Audit and Accounts Department on March 12, 2007 at
the A K Chanda Committee Hall, office of the Comptroller & Auditor General of India,
New Delhi, organized by the International Centre for Information Systems and Audit
(ICISA) New Delhi.
Mr A R Nanda attended a workshop on "Decentralized HN/AIDS Services in Rural
Settings: Opportunities and Challenges" on March 29, 2007 in New Delhi, organized
by Institute of Health Management, Pachod.
PopJbcus
Ms Chandni Malik,
who has joined
the Foundation as
Programme Officer,
Advocacy and Communi-
cation in March 2007.
She has a Masters degree
in Social Work from Tata
Institute of Social Sciences in Bombay and
prior to this, has worked at the UNFPA
headquarters at New York as a youth fellow
and a consultant. She brings with her,
experience in training and advocacy in the
field of Adolescent Reproductive and
Sexual Health (ARSH) and gender.
Mr. Satya Ranjan
Mishra has joined the
PFI as Project Manager,
Advocacy and Communi-
cation in March 2007.
Mr. Mishra has a Masters
Degree in Social Work
from Utkal University, Orissa with an
additional qualification in Personnel
Management & Industrial Relations and
Computer Technology. He has been
working in the development sector for
more than 15 years. His last assignment
was with DFID supported Poorest Areas
Civil Society (PACS) programmes as
Programme Manager (Capcity Building).
Apublication on "India-Socio-Demographic Development Index" and
its related Wall Chart were released by Mrs Justice Leila Seth, Member,
Governing Board, PH at its 134th Governing Board Meeting held on March
22, 2007 at PH The Executive Director, PH Mr A R Nanda introduced
to the Board members, Dr Almas Ali, Dr Sanjit Nayak and Ms Sudipta
Mukhopadhyay, who assisted him professionally in the production of the
above publications.
The above documents compute the socio-demographic development index
for 593 districts in India.The socio-demographic development index 2007
shows 290 districts have index value below 50 thereby reflecting the dismal
scenario of reproductive and child health and social development in the
country. These publications will be useful for policy makers, planners,
civil society organizations, academicians and researchers to prioritise
their efforts on
reproductive
child health and
population
stabilization in
the backward
districts in the
high
focus
National Rural
Health Mission
(NRHM) states
in India.
Ms. Anuradha Banerji, Consultant
(IEC/ Advocacy) working in the
Advocacy and Communication division at
the PFI, in March 2007.
Editorial Guidance
Mr A.R. Nanda
Editor
Ms Sona Sharma
Editorial Committee
Ms Usha Rai
Dr Almas Ali
Dr Lalitendu Jagatdeh
Dr Kumudha Aroldas
Dr Sharmila G. Neogi
Editorial Assistance
Ms Jolly Jose
Published by
Population Foundation
of India
B-28, Qutab Institutional Area
New Delhi-110016, India
Tel: 91-11-42899770, 42899771
Fax: 91-11-26852766
e-mail: popfound@sify.com
website: www.popfound.org