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PFI Annual Report 2015-2016 |
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Governing Board
Dr Vinay Bharat Ram, Chairperson
Mr R V Kanoria
Ms Justice (Retd) Leila Seth
Dr M S Swaminathan
Mr K L Chugh
Dr Nina Puri
Mr Kiran Karnik
Dr Ajai Chowdhry
Dr Syeda Hameed
Mr Rajiv Mehrotra
Mr Keshav Desiraju
Dr Pramath Raj Sinha
Mr Ratan N Tata
Secretary, Ministry of Health & Family Welfare
Government of India
Ms. Poonam Muttreja, Executive Director, PFI
Advisory Council
Dr M S Swaminathan, Chairman
Ms Aruna Kashyap
Ms Leela Visaria
Ms Mrinal Pande
Dr Saroj Pachauri
Prof Suneeta Mittal
Ms Mirai Chatterjee
Ms Srilatha Batliwala
Dr Gita Sen
Dr M K Bhan
Mr Sanjoy Hazarika
Mr P D Rai
Ms Karminder Kaur
Additional Secretary, Ministry of Health &
Family Welfare
Ms. Poonam Muttreja, Executive Director, PFI
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CONTENT
Chairperson’s Message
02
From the Executive Director’s Desk
04
PFI’s Strategic Plan 2016-20
08
Towards our Goals of Advocacy and Communication
10
• Main Kuch Bhi Kar Sakti Hoon
• Realising Commitments to Family Planning
• Advance Family Planning
• Advocacy, Communication and Accountability
Bringing Public into Public Health : Community Action for Health
36
Sharing the Learnings: Health of the Urban Poor
41
In the Field : Our Partners on the Ground
45
PFI at the International Conference on Family Planning (ICFP)
49
Financial Highlights
57
Collaborations and Partnerships
59
All images used in the report are courtesy of Population Foundation of India
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Chairperson’s Message
As I reflect upon the year just gone past, I would say that 2015 was a landmark year in terms of the global
development scenario. It marked the end of the Millennium Development Goals (MDGs) and the adoption of
the Sustainable Development Goals (SDGs), which build on them in the new ambitious universal agenda that
world leaders adopted in September 2015. Indeed, wide-ranging preparatory processes had been undertaken
the world over to support their formulation. This was a process in which PFI, as a recognised key civil society
voice on family planning and reproductive health issues, had been closely engaged in, at the national, regional
and global levels.
The global report card presented by the 2015 MDG Report shows us that globally, both the MDGs 4 and 5,
pertaining respectively to reducing child mortality and improving maternal health, made significant progress.
The global under-five mortality rate declined by more than half, between 1990 and 2015; and the maternal
mortality ratio by 45 per cent worldwide over the same period. At the national level too, in this regard, India has
fared well and a rapid improvement was noted in the key indicators of MMR, IMR, TFR and CBR.
However, despite these positive achievements made over the last 15 years, a closer look tells us that the work
is far from complete and the agenda remains unfinished. The MDGs have played their part in driving the
progress achieved - but it is now time to use the lessons learnt, build on the successes achieved and accelerate
efforts towards meeting goals that remained out of reach. We stand at the threshold to welcome this opportu-
nity to introspect, assess our strengths and weaknesses, identify our challenges and set our course accordingly.
For PFI, this means continuing to strengthen its evidence base to fuel policy advocacy on its areas of thematic
priority, deepening its component of community mobilisation on health which is linked to the government deliv-
ery system, scaling up proven models and building on Entertainment Education as a way to catalyse and sustain
social and behavioural change. And most of all, continue to ensure that women’s empowerment and gender
equality remain central to its work, repositioning family planning within a reproductive health and human rights
framework.
The year 2015-2016 was also noteworthy, because it saw the organisation of the Fourth International Con-
ference on Family Planning at NuaDua in Indonesia in January. This provided an extraordinary opportunity
for PFI to facilitate an interaction for representatives of the India Caucus in Bali. Thus, diverse stakeholders,
including India’s highest political leaders, policy makers, programme planners, implementers and donors,
came together on a common platform. Learning and sharing were promoted as was a better understanding of
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India’s priorities for family planning programmes and strategies. The Minister for Health and Family Welfare,
Government of India, reiterated India’s commitment to meet the FP2020 goals.
The partnership with the Ministry of Health and Family Welfare, Government of India (GOI), continues in a
deepening mode. There is added focus on women’s rights and choice, and acknowledgement that a large pop-
ulation is still left with an unmet need in family planning. To fill this gap, it is focusing on increasing contraceptive
choices, ensuring quality services, improving the supply chain and commitment to providing services. The new
strategies of the GOI are directed at influencing the demand and generating the supply for family planning in
the country. This includes increasing the basket of choice of contraceptives as also introducing the injectable
contraceptive in the public health system. It places particular focus on the quality of care and training to avoid
tragedies such as that of Bilaspur last year.
It is a matter of great satisfaction for us all to note that PFI’s flagship programme, ‘Main Kuch Bhi Kar Sakti
Hoon’, which had already shown results last year, has convincingly proven that behaviour change communica-
tion is an extremely effective tool in successfully influencing norms and mindsets leading to a shift in attitudes.
It has won appreciation for its 360 degree and positive deviance approach, the impact demonstrated by the
evaluation results and the overall quality of the programme. It embarked on an expanded Phase 2 of this initia-
tive in 2015, targeted at the 356 million youth of the country, challenging social norms and behaviours around
issues of mental health, substance abuse, family planning and gender-based discrimination which continue to
burden our society.
This year, we have had the misfortune of losing a very valued member of the Governing Board and Chairman
of the Executive Committee, Prof Ranjit Roy Chaudhury, who passed away on 28 October, 2015. Aged 84,
he was one of India’s foremost medical scientists, who was instrumental in guiding and mentoring PFI in vari-
ous capacities for over two decades. A recipient of several prestigious awards, including the Padma Shri, Prof
Chaudhury was a man with a huge heart and generous spirit. He leaves behind a large vacuum.
My message would be incomplete if I did not acknowledge the tremendous support that PFI has received from
several organisations in order to be able to meet its objectives. On behalf of the Governing Board, I take this
opportunity to thank the Ministry of Health and Family Welfare, Government of India, for their exceptional part-
nership and the state governments of Bihar and Uttar Pradesh for their close association. I extend my grateful
thanks to Doordarshan and All India Radio for continuing our collaboration on MKBKSH. I thank DfID, UNFPA,
Bill & Melinda Gates Foundation, USAID, UK Aid, the David and Lucile Packard Foundation, International Cen-
ter for Research on Women (ICRW), Johns Hopkins University, Bloomberg School of Public Health and the John
D. and Catherine T. MacArthur Foundation for believing in our work and partnering with us.
In line with its track record and comparative advantage, I feel that PFI should continue with its pioneering work
in research, in the development of knowledge products and evidence-building for policy advocacy and in scal-
ing up the medium of edutainment to bring about social change.
Dr Vinay Bharat Ram
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Executive Director’s Message
By all accounts, the year 2015-2016 has been a remarkable one for PFI. A time of endings and un-
foreseen achievements, it saw a large programme of ours, Health of the Urban Poor, reach completion;
it saw the transmedia edutainment initiative, Main Kuch Bhi Kar Sakti Hoon, designed to change social
norms and attitudes, scale appreciable heights; it saw a further strengthening of our collaboration with
the Ministry of Health and Family Welfare, Government of India and the state governments of Bihar and
UP; it saw a heightening of our work with the media; and the emergence of Quality of Care as an area
of prime consideration in family planning initiatives. In addition, high quality knowledge products and
evidence building continued to enrich and promote PFI’s work.
Organisationally speaking, there are two major developments that I would like to share with you. PFI’s
Five-year Strategic Plan (2016-2020) was approved by the Governing Board and is now being executed.
The end result of an exhaustive participatory exercise, it builds on our past work and provides a blueprint
for action for the next five years. Its driving focus is the repositioning of family planning within the wom-
en’s empowerment and human rights framework in national development and in the maternal and child
health policies and programmes of the country. Also, for the first time, since PFI’s inception, we have a
compelling historical document that traces PFI’s journey from the beginning to the present day, available
as a monograph. Prepared by Dr Radhika Ramasubban, it brings together scattered information in an
arresting and cohesive manner.
The enabling policy environment makes it possible to continue to take steps towards empowering women
and men, so that they are able to take informed decisions related to their fertility, health and well-being.
The partnership and understanding between PFI and the Ministry of Health and Family Welfare (MoHFW)
have led to significant progress in terms of choice in family planning services. It is noteworthy that the
National Family Planning Summit in 2016 focused upon a rights-based approach to family planning. PFI
was privileged to be invited as a civil society representative to make a presentation on it at this important
event.
The close collaboration between PFI and the Advocating Reproductive Choices (ARC) coalition and the
strategic positioning of its secretariat in PFI, made possible sustained advocacy to expand contraceptive
choices and improve the Quality of Care, which remains a key and lasting lesson from the Bilaspur trag-
edy of last year. Equipped with an advocacy strategy, the coalition sought to identify strategies to support
the Government of India in the roll-out of injectable contraceptives. It also flagged the Quality of Care
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in family planning services and the introduction of modern spacing methods as areas requiring priority
focus in the family planning programme.
This year saw the completion of the Health of the Urban Poor (HUP) programme and I am pleased to
record that it has left behind lasting imprints which will impact the future of urban health in India. Its
achievements are many, not the least of which is the design support that it provided to the National Ur-
ban Health Mission (2013), which was non-existent at the time that HUP (2009-2010) was initiated. In
addition, it brought out the inadequacy of urban community processes for addressing issues, which are
peculiar to its setting and vastly different to the rural. The most vulnerable populations and their issues
were visibilised and this was no mean accomplishment. The legacy it leaves behind includes, knowledge
tools to address this category of population and operational and training manuals that can be used by
the states and the Centre. The programme also supported states in preparing programme implementa-
tion plans (PIPs) that have helped advance the urban health agenda.
We successfully completed Season One of our flagship programme, Main Kuch Bhi Kar Sakti Hoon
(MKBKSH), the entertainment education based transmedia initiative of PFI. The findings of the endline
evaluation which sought to assess changes in the Knowledge, Attitude and Practices (KAP) on family
planning, child marriage, son preference, gender discrimination, domestic violence and sex selection,
have far exceeded our expectations. They distinctly show that the programme has had a measurable and
positive impact on the knowledge and perception of the viewers and women’s agency. We are therefore
now clearly in a position to endorse the model as one that has been tested and found to be effective. It
provides the evidence that MKBKSH has delivered well and is in a position to aspire for a higher reach
and impact. With this in view, PFI commissioned a sustainability study to explore its potential in an
edutainment universe, define a new aspiration and recommend an appropriate strategy. This was carried
out by 9.9 Media under the leadership of Dr Pramath Sinha and Ms Anuradha Das Mathur.
In line with its role as a learning and sharing organisation, the achievements of the television series have
been shared at various national and international fora, including the 2016 International Conference on
Family Planning. These have helped in shaping an acceptance of the intervention as a tested edutainment
model for social change. In a tribute to the scalability of MKBKSH, PFI was given the responsibility of re-
branding the Rashtriya Kishor Swasthya Karyakram (RKSK), the National Adolescent Health Programme
of the Government as “Saathiya” or companion; and of establishing and promoting an identity for the
800,000 peer educators under it.
A major milestone this year has been the finalisation of the new UP Population Policy (2016-2030). This
was a process in which PFI was honoured to be involved at the invitation of the state Government of
Uttar Pradesh. I take this opportunity to thank the Government of UP for their confidence in PFI and the
distinguished members of the review and drafting committees for their insights and dedication. There is
considerable satisfaction in the fact that the objectives of the end product, which are derived from the
ground realities and tailored to not only overcome challenges but also meet the aspirations of the people
in the state, have been organised by life stage and include gender equality and quality of care, as sep-
arate cross-cutting issues.
At the ground level as well, we have a major achievement, which I’m pleased to share with you. Family
Planning District Working Groups have been formed in select districts in both UP and Bihar, a clear tes-
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tament to the partnership enjoyed between PFI and the Mission Directors of the NHM in the respective
states. Essentially multi-stakeholder in composition, the DWGs under the Chairmanship of the Chief
Medical Officers, have representation from different government departments, which include Panchayati
Raj, Education and ICDS along with civil society organisations and other development partners.
In yet another milestone in Uttar Pradesh, PFI has been able to successfully work with the National Health
Mission (NHM) to introduce a review mechanism at the divisional level. In addition to facilitating updates
on the programme’s progress, this will also provide an opportunity to identify issues and challenges and
come up with solutions. It gives me great pleasure to inform you that the National Health Mission of UP
has nominated PFI to provide technical support to the 18 divisions in organising these meetings.
At the community level as well, there have been positive developments. The Advisory Group on Com-
munity Action (AGCA), constituted by the Ministry of Health and Family Welfare (MoHFW), to provide
guidance and support for community action initiatives under the National Health Mission (NHM), focused
efforts to strengthen and scale up implementation of the component, across 22 states. Among others,
this included capacity development and mentoring of state level institutions to strengthen and scale up
implementation and the development of tools and communication materials. It also involved providing
inputs in the development of the community action for health component of the State NHM Programme
Implementation Plans (PIPs), conducting periodic reviews and strengthening accountability mechanisms.
In addition, PFI developed a monograph on grievance redressal, capturing experiences, lessons learnt
and challenges encountered in the implementation of other such initiatives in India. Both sharing and
learning received an impetus through two regional consultations that were organised on community ac-
tion for health, bringing together 82 participants from 24 states.
In an another example of the footprints it leaves, PFI left a marked one at the 2016 International Con-
ference on Family Planning in January this year. Through the India Caucus meeting that it organised, it
successfully facilitated a fruitful interaction between delegates from India and high level officials of the
Government of India led by the Minister of Health and Family Welfare, on key government priorities in
family planning.
And this brings me to a partnership that PFI has always considered special. Though the media has always
been an important partner for PFI, we took that partnership to another level this year through efforts to
increase their understanding on family planning and its linkages with the health of women and children.
Attempts were also made to ensure greater media coverage of and attention to stories and articles on
the issue of family planning to make it more visible in the development dialogue. Several editorials and
articles were written by PFI and placed in the national and regional media.
In line with policy advocacy, the heart of its work, PFI commissioned a study to assess the resource re-
quirements for meeting India’s FP2020 commitments. This has made available a resource that can be
useful for stakeholders to plan for bridging the gap in terms of making available contraceptive supplies,
outreach services, and trained manpower to address unmet needs.
As always, programmatic changes also lead to the induction of new employees and we are no exception.
At PFI, we celebrate new energies and a fresh way of looking at things. After a gap of three years, PFI
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organised a two-day all-staff retreat, which included the state offices, in February, 2016. This served to
bring everyone together and to collectively plan for the way forward, team-wise and organisationally.
In addition, all PFI staff were oriented on the sexual harassment policy by Ms Vrinda Grover, a lawyer,
researcher, and a human rights and women’s rights activist of repute based in New Delhi.
Within the backdrop of this rich tapestry, what do we plan for the coming year? As of now, efforts are
ongoing to facilitate improvements at the policy level for increasing investment and choice in family plan-
ning services that meet a certain standard. Our immediate plan is to focus primarily on consolidation
in terms of Social and Behaviour Change Communication, Community Action for Health, Urban Health
and Advocacy. I see issues related to the continuum of care, quality of family planning services, expansion
of the basket of contraceptive choices and male engagement, as areas of priority for us. At the same time
we would be ready and willing to respond to any unforeseen challenges or opportunities that may occur.
May I say, that we would not have been able to achieve much of what we have, without our valued
partners, viz., the Government of India and state governments, our funding agencies, our implementing
partners and civil society and research organisations. I would also like to take this opportunity to express
my warmest appreciation to the PFI Governing Board, the Executive Committee and Advisory Council for
their unqualified and generous support at all times - without which, achievements would remain a distant
dream.
Poonam Muttreja
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STRATEGIC PLAN
2016-2020
The Strategic Plan of the Population Foundation of India (PFI) has emerged from an extensive participato-
ry process, and is based on research and situational analysis. A series of in-house consultations were held
in April-May 2013, to conduct the situational, stakeholder and SWOT (Strength, Weakness, Opportunity
& Threat) analysis to identify gaps, learnings and future priorities. A workshop facilitated by Srilatha Batli-
wala (well-known social activist, advocate of women’s rights and expert in gender-based monitoring and
evaluation) was held over two days in June 2013 to reflect, review and revise PFI’s vision, mission and
goals as well as identify key thematic areas, strategic priorities, critical strategies and the way forward.
PFI further worked on developing the theory of change that suggests the pathways for accomplishing the
goals of the Strategic Plan and drew up an M&E plan for evaluating its success.
The five-year Strategic Plan (2016-20) provides an overarching framework articulating the vision, mis-
sion, goal and strategic direction for the Foundation. It is designed to guide PFI in the optimal application
of its technical, human and financial resources to support efforts towards advancing its objectives in the
next five years. Providing a blueprint for action, the Plan lays down PFI’s strategic priorities, key strategies
and activities in order to achieve its objectives. The organisation’s projects are linked to the Strategic Plan
through areas of priority and staff roles, which have been identified through the RACI (Responsibility,
Accountability, Consultative and Information-sharing) exercise.
Our Vision
PFI envisions a world with just and equitable societies where all people can enjoy their reproductive rights
and pursue their aspirations with optimal health, wellbeing and quality of life enabled by these rights.
Our Mission
PFI will advance people’s reproductive rights within a human rights and women’s empowerment frame-
work, by building leadership and public accountability, influencing social movements, reframing dis-
course, and promoting an enabling programme and policy environment.
Our Goal
PFI’s long-term goal is to reposition family planning within the women’s empowerment and human rights
framework in national development and maternal and child health policies and programmes in India.
Our Core Values
We are committed to excellence in pursuing our vision, mission and goal. In doing so, we are committed
to the following core organisational values:
l Teamwork and mutual respect
l Commitment
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l Honesty and integrity
l Excellence
l Innovation and collaboration
l Transparency and accountability
l Respect for diversity
l Gender sensitivity
l Being a learning organisation
l Responsive to emerging challenges
Our Objectives
l To respond effectively to demographic trends and needs and correspondingly promote changes in
the policy environment to reposition family planning and population issues within a women’s em-
powerment and human rights framework.
l To promote people’s participation and governance accountability in public health with a focus on
family planning.
l To improve health outcomes among the urban poor with a focus on enabling access to quality health
care.
Our Priority Areas
l Promote access to reproductive and sexual health services including family planning to address un-
met need – particularly of poor rural and urban women – with a focus on continuum of care, quality
of family planning services and expansion of the basket of contraceptive choices.
l Develop and strengthen mechanisms to enable community involvement, particularly of women users,
in monitoring access and utilisation of health services under the National Health Mission.
l Generate evidence to support improved health outcomes among the urban poor, particularly poor
women and girls.
l Influence cultural norms, attitudes and social practices to address issues of the declining Child Sex
Ratio, child marriages and gender-based violence.
Our Six Overarching Strategies
To reach its objectives and achieve overall impact, PFI will use six key strategies:
1.
Knowledge management
2.
Advocacy
3.
Communication
4.
Capacity building
5.
Scaling up; and
6.
Grant-making
It is envisioned that these six pillars of PFI’s Strategic Plan will create the right conditions and support
structures for generating knowledge and evidences to inform advocacy, improve the policy environment,
mobilise resources, build capacities and promote transparency and accountability in health governance
to help accomplish the changes that PFI is committed to making.
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A Frontline Worker interacting with the beneficiaries
Towards our Goals of
Advocacy and Communication
Advocacy and Communication informed by evidence is the bedrock of PFI’s work.
The Foundation works towards positioning family planning as an issue of women’s
health rights and advocates for the need to expand choice and improve the quality
of family planning services. Its advocacy efforts focus on enhancing knowledge and
eliciting the interest of policy makers, the media and the private sector on identified
priority social issues, such as child marriage, sex selection, violence against women
and family planning. These advocacy initiatives are aimed at influencing relevant
policies at the national and state levels.
The Foundation undertakes strategic and innovative communication activities, which include social and
behaviour change communication through entertainment education, outreach interventions, engage-
ment with the media (including social media) and development of print and audio-visual materials. These
aim to call attention to issues related to women’s fertility and rights and sexual and reproductive health
by increasing public dialogue and media interest to catalyse a change in social norms and individual
behaviour.
To steer change in societal attitudes towards girls and women, PFI embarked on the development of a
social and behaviour change communication (SBCC) initiative, `Main Kuch Bhi Kar Sakti Hoon’ or ‘I, A
Woman, Can Achieve Anything’, based on the format of entertainment education. Using a 360° com-
munications strategy, the intervention has reached out to intended audiences across the country. This
has enhanced knowledge, changed perceptions and shifted attitudes on child marriage, sex selection,
reproductive health and family planning in communities.
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The Power of
Main Kuch Bhi Kar Sakti Hoon
Following the success of Phase 1 of the edutainment initiative Main Kuch Bhi Kar
Sakti Hoon (MKBKSH), which included Season One of the teleserial and radio
adaptation, and other engagements via the Interactive Voice Response System
(IVRS) and community outreach, Population Foundation of India (PFI) embarked
on an expanded Phase 2 of this initiative in 2015. This was targeted at young
people and challenged social norms and behaviours around the issues of health,
family planning and gender inequality, which mar our society.
The initiative used mass media (television and radio), conventional outreach activities as well as an IVRS
and social media to reach out to the youth, who today are connected through their mobile phones. Joint-
ly, both these mediums have the potential to reach out to a large number of young people in the country.
In addition, using celebrities (with a strong youth connect) has been an important strategy.
The PFI team has presented the achievements of the intervention at various national and international
forums, including the 2016 International Conference on Family Planning (organised by the Bill & Melin-
da Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public
Health and the National Population and Family Planning Board of Indonesia), the International Summit
on Social and Behaviour Change Communication (organised by the Health Communication Capacity
Collaborative (HC3), the Ministry of Health, Federal Democratic Republic of Ethiopia and USAID) and
the Evaluation Conclave (organised by the Community of Evaluators, South Asia); these have helped in
shaping an acceptance of the intervention as a tested edutainment model for social change, globally.
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Season Two: Broad Strokes
While Season One tackled sensitive issues which em-
anated from patriarchal mindsets and are reflected
in practices, such as child marriage, age at first preg-
nancy, birth spacing, quality of care, domestic vio-
lence and sex selection, Season Two focused on the
adolescents and youth of the country. Every fifth per-
son in our country is aged between 10 and 19 years.
The Season Two episodes dealt with issues related to
nutrition, mental health and physical changes during
adolescence, substance abuse and gender-based vi-
olence. The episodes seek to help the adolescents
face multiple anxieties and insecurities that arise due
to various socio-economic and environmental pres-
sures that come their way. Comprising 79 episodes,
the Season sees the protagonist Dr Sneha continue
her crusade to ensure the finest quality of health care
for all. Additionally, under her leadership, women
find their voice through collective action.
The adolescents face
multiple anxieties
and insecurities that
arise due to various
socio-economic and
environmental
pressures that come
their way
The engagement of Farhan Akhtar, Bollywood actor
and director, UN Women Goodwill Ambassador for
South Asia and founder of the organisation, ‘Men
Against Rape and Discrimination (MARD)’, added to its popularity and success. Main Kuch Bhi Kar Sakti
Hoon, representing women’s empowerment, and MARD, representing responsible masculinity, came to-
gether as Hum Kuch Bhi Kar Sakte Hain (We Can Achieve Anything) to reflect the aspirations for a more
equitable society.
Season Two Watched by an estimated
57 mn
viewers
Led to
0.7 mn
calls
The telecast of Season Two on Doordarshan National started
on April 4, 2015, and ended on January 24, 2016. Watched
by an estimated 57 million viewers, it led to more than 0.7
million calls (till March 31, 2016) on the IVRS from across
the country. The period also saw Doordarshan dubbing Sea-
son One into 11 regional languages and telecasting on 16
regional channels under its National Resource Exchange
Pool scheme. In addition, discussions have been initiated
to telecast Season Two on regional channels as well. Along
with the online viewership (through YouTube and Vimeo), the
Doordarshan regional channels telecast will further increase
the cumulative viewership of the Season. The broadcast of
the Season Two radio adaptation began on February 6,
2016 on 101 channels of All India Radio and is expected to
continue till November 2016.
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Rashtriya Kishor Swasthya Karyakram
and MKBKSH
Aligned with the Government of
India’s National Adolescent Health
Programme - the Rashtriya Kishor
Swasthya Karyakram (RKSK), initiat-
ed by the Ministry of Health & Family
Welfare (MoHFW), PFI was given the
responsibility to establish and promote
an identity for the eight lakh (800,000)
peer educators under the programme.
To this end, MKBKSH introduced
Saathiya, literally companion, in the last
26 episodes of Season Two. These were
peer educators selected from the com-
munity and trained to act as a support
system for their friends and fellows.
MKBKSH created the entire branding for them – from the name to the logo, both of which are now being
adapted by the Ministry. Through a creative storyline and endearing characters shaped by positive devi-
ance research, the series established the need for Saathiya and demonstrated the process of change that
can be triggered by them.
Eight short films culled out of MKBKSH, along with a visual diary developed by PFI, are going to be part
of the training kit to be provided to these 800,000 peer educators across the country. These films, now
dubbed in 13 regional languages, will reach out to over 300 million youth across the country. The set of
8 short films culled out of
MKBKSH, along with a
visual diary developed by
PFI, are going to be part
of the training kit to be
provided to these
8lakh
peer educators across the
country
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26 episodes in Season Two, for which scripts were modified to accommodate the Saathiya component in
the show, had information culled out from RKSK’s peer educators’ training manual. Six of the films have
been created using a game show called Kishor Ka Shor (The Voice of Youth) based on adolescent health
issues specified in the peer educators’ manual; a collection of epilogues with messages for youth, named
Farhan for Saathiya; and another film called Saathiya, which elaborates on the role of a peer educator.
In addition to English, these films have been adapted into 12 Indian regional languages, viz., Kannada,
Konkani, Nepali, Malayalam, Manipuri, Mizo, Tamil, Telegu, Bengali, Marathi, Assamese and Odia and
will be used as part of the training for the Saathiya peer educators across the country.
Keeping in mind the focus of the teleserial on adolescent health issues, and collaboration with the MoHFW
to promote RKSK/ Saathiya, it was crucial for the programme to attract youth viewership. Accordingly, a
communication package has been developed, which is to be used as part of the kit for peer educators.
Innovative visual diaries and leaflets/ jackets with messages on adolescent health issues and branded
USBs (with the Saathiya films) have been produced and shared for dissemination with peer educators
across the country.
Evaluation: Season One
An Evaluation Study was carried out after the telecast and broadcast of Season One. This reveals changes
in people’s attitudes towards early marriage and pregnancy, wife-beating, adequate spacing between
children, the use of contraceptives and other social parameters.
MKBKSH: Collaborations, Events
and Presence on Social Media
PFI’s collaboration with Farhan Akhtar and his non-profit initiative, ‘Men Against Rape and Discrimina-
tion (MARD)’, helped increase the reach of the programme. As part of the collaboration, Farhan Akhtar
was introduced as the “narrator” for the serial, and made his entry in the 99th episode (Season Two
– Episode 47). He appears at the end of the serial, and shares his thoughts to reinforce the messages
communicated through the episode, and also motivates viewers to watch the next one.
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Farhan’s entry in the serial was
widely publicised in the media,
both electronic and print, and
through a digital campaign as
well. The coverage spanned
38 publications - online, print
and digital. Simultaneously, a
contest was launched on the
IVRS and Doordarshan. The
IVRS audience was invited to
share a pledge or slogan on the
theme: Desh Ko Badalna Hai
Toh Mard Ko Badalna Hoga (To
bring about change in the coun-
try, men will have to change).
Approximately 8000 callers
heard the campaign recording
and 126 pledge entries were
received, including 72 entries
from women. Six entries were
awarded. More than 100,000
social media users on Twitter
and Facebook also viewed and
participated in the campaign.
Farhan Akhtar at the Main Kuch Bhi Kar Sakti Hoon Season Two launch in Mumbai
100,000
social media users
Season Two was launched in Bihar with much hype on April
10 and 11,2015. On April 10, Feroz Abbas Khan and Meinal
Vaisnav (Dr Sneha, the protagonist) met over 25 journalists. On
April 11, PFI in collaboration with the Asian Development Re-
search Institute (ADRI) hosted a meeting on ‘Health, Gender and
Development in Bihar‘, with editors and senior journalists sup-
ported by the Packard Foundation. Fifteen editors of all the lead-
ing English, Hindi and Urdu papers endorsed the workshop. Mr
Nitish Kumar, Chief Minister of Bihar, attended the meeting and
flagged off Season Two of Main Kuch Bhi Kar Sakti Hoon.
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PFI hosted the national launch of Season Two in Mumbai on April 16 with Farhan Akhtar present at the
event. Another state launch was organised in Bhopal, Madhya Pradesh on May 29, which was graced
by Sharmila Tagore, a socially committed actress, who had reaffirmed her commitment to the serial. On
the occasion, five real ‘Heroes’1, who had been selected from the field intervention received the MKBKSH
awards from her. Another event, in collaboration with Dainik Jagran (a leading Hindi newspaper) was
organised in Patna in December 2015, to release the Evaluation Study of Season One. Malini Awasthi, a
renowned Indian folk singer, captivated the audience with her voice and songs on the occasion.
The film documenting the Nirbhaya incident, produced by PFI and developed by Feroz Abbas Khan and
Pracheta Sharma, was digitally released on the 3rd anniversary of the incident through the MKBKSH
platform on December 16th. The film included an interview with Jyoti Singh, Nirbhaya’s mother, who
shared her family’s struggle for justice over the past three years and their advocacy to make cities safe
for all women and girls. Since MKBKSH dealt with the issue of violence against women, a social media
campaign was launched as part of the release with the hashtag #IPledgeNow giving social media users
an opportunity to light a candle using #LightACandle on the Main Kuch Bhi Kar Sakti Hoon social media
platform. Close to 3500 candles were lit with support from prominent celebrities, which included, Sha-
bana Azmi, Javed Akhtar and Soha Ali Khan. Organisations such as MARD, ActionAid, Women Deliver
and Breakthrough supported the campaign, which was able to reach out to 2.9 million people through
the posts and the Nirbhaya film posted on social media.
Real heroes being facilitated at an event in collaboration with Dainik Jagran in Patna, Bihar
1.Community champions or Real Heroes were identified during the initiative. They were people who had taken some positive action in their communities to promote family
planning and women’s empowerment. The identification and recognition of community champions was intended to enhance the recall of messages of the series within com-
munities. It has been a very successful component of the outreach initiative.
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Getting Ready for Season Three
In addition, two studies were conducted during this
period. Maraa - a Media & Arts Collective tried to
understand the communication flow in the states of
Bihar and Madhya Pradesh, the two key states where
the outreach initiatives, as part of MKBKSH, were un-
dertaken. It targeted young people (between ages
15-24) at peri-urban, semi-rural and rural parts
of both the states. The study proposed digital and
non-digital models of communication, which can be
used by PFI, to not only increase outreach, but also
create alternative spaces for dialogue and knowl-
edge production.
It targeted young
people (between
ages 15-24) at
peri-urban,
semi-rural and
rural parts of both
the states.
The second study related to the sustainability plan and scale up strategy. Titled ‘MKBKSH: Scaling New
Heights’, the study was commissioned to 9.9 Media, who submitted the final report in January 2016. It
studied the MKBKSH model, looked at other relevant edutainment initiatives in the country and across the
world, and the available Indian Readership Survey (IRS) media reports to prepare its recommendations. It
was carried out in two phases: the first looked at an option analysis for reaching scale and sustainability;
and the second offered a resource mobilisation strategy. This study, along with the Maraa Report, will
guide the planning for Season Three and beyond.
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What they say
Raju Rainkwar with his family
“This serial shows how wom-
en, who receive education,
can do better than men, just
like Dr. Sneha Mathur, who
supports her family financial-
ly, while her alcoholic broth-
er does nothing and is disre-
spectful to his parents. The
biggest learning from the se-
rial is that there should be no
discrimination between girls
and boys. Girls are as capa-
ble as boys, if not more. Girls
can do anything!” says Kishori
Godbole, a viewer from Mad-
hya Pradesh.
“The serial has brought a great change in my family. My wife and I have decided to wait
for three to four years for our next child. I hope noticing my family, others in the community
will also accept the importance of family planning and adopt suitable methods. We must
feel confident about discussing and using methods of contraception with partners. Family
planning should be the top priority among couples”, says Raju Rainkwar, a Hum Kuch Bhi
Kar Sakte Hain Real Heroes Awardee from Chhatarpur, Bihar
Nirma Devi hailing from Batasi village in Barachatti district, Gaya is a regular viewer of MKBKSH.
She has two children - a son and a daughter. From the time, the local NGO Samagraha Seva
Kendra (SSK) formed Sneha clubs, Nirma Devi has been participating in all the meetings. Watch-
ing MKBKSH, she realised the significance of a spacing of at least 3 years between two preg-
nancies. She also learnt about the range of family planning methods available by watching the
serial. This gave her enough confidence to discuss available contraceptive methods with her
husband. She has been using the copper-T after consulting with the local ASHA and ANM. Go-
ing forward, Nirma Devi plans to motivate other women in her vicinity (even outside the Sneha
clubs). She says, “I want women to be more confident discussing the use of contraceptives with
their partners or health worker”. She also counsels couples who are interested in planning their
pregnancy.
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Minister of Health & Family Welfare, Mr. J.P Nadda at the meeting of the India Caucus in Bali, Indonesia
Realising Commitments
to Family Planning
The Realising Commitments to Family Planning in India is an advocacy and communica-
tions programme aimed to expand investment in family planning and increase engage-
ment of elected representatives on family planning and women’s health. It also strives to
extend support towards improving policies that expand quality services, including birth
spacing methods, using a human rights and women’s empowerment framework. Further,
it seeks to support the government and engage with civil society organisations to achieve
the commitments made by the Government of India at the Family Planning Summit in
London in July 2012 that views family planning as the core of the Universal Health Cov-
erage Initiative. Through its activities and strategies, the Population Foundation of India
(PFI) engages with a range of stakeholders, including elected representatives, senior
officials in the Ministry of Health and Family Welfare (MoHFW), members of Niti Aayog
and related departments, the media, and civil society organisations. The year 2015-
2016 marked the second year of its implementation and was an eventful period.
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Highlights
Minister of Health & Family Welfare, Mr. J.P Nadda at a Meeting of the Parliamentarians in New Delhi
Partnering with the Government
PFI works in collaboration with the government to facilitate improvements at the policy level for increasing
investment and choice in quality family planning services. Meetings and discussions were conducted with
the Joint Secretary, Reproductive and Child Health and other senior representatives of MoHFW. PFI was
also invited to represent the civil society at the National Family Planning Summit in 2016, which focused
upon a rights-based approach to family planning. The FP Summit was significant as it marked the Minis-
try’s paradigm shift towards enabling access to spacing methods of contraception and improving quality
of care in family planning.
Working with Elected Representatives and Key Opinion Leaders
The programme engaged with parliamentarians in the past year through
one-on-one as well as group meetings and interactions. A presentation on
PFI’s work was made to the Parliamentary Committee for the Empower-
ment of Women. A ‘Forum for Parliamentarians for Population and Health’
was proposed in the year and was supported by a group of senior mem-
bers of parliament.
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Media Exposure Visit
The programme team also organised an exposure visit for the media to
the Karuna Trust, a civil society organisation that works in remote loca-
tions of Arunachal Pradesh. The visit was intended to sensitise and align
media persons on initiatives and activities being carried out in family
planning and maternal health by civil society organisations and govern-
ment agencies.
Media Engagement and Advocacy Workshops
The programme worked with the media towards increasing their under-
standing on family planning and its linkages with women and child health
along with ensuring greater coverage of family planning. Innovative ways
to engage the media were used, including a series of media workshops
aimed at creating awareness, dispelling myths and misconceptions on
family planning and building capacity around population issues. The two
workshops with close to 30 media persons yielded many positive stories
and a resource pool of senior journalists in national and regional publica-
tions who interact with the team for stories and media products on popu-
lation and family planning.
FP2020 Resource Requirement Study
PFI commissioned a study on the FP2020 resource requirements as part of
the programme’s advocacy strategy to develop evidence to advocate for
an increased investment on family planning. The objective was to forecast
the resources that would be required to meet the commitments made by
India at the London Summit in 2012, based on a review of the family
planning budgetary allocation patterns and expenditure. The study shows
that going by the current rate of increase of mCPR (modern contraceptive
prevalence rate), India would have about 32.8 million additional users,
i.e., about 15 million short of the committed FP 2020 goal of 48 million.
Therefore, India would have to do much more to bridge the gap in terms
of making available contraceptive supplies, outreach services, and trained
manpower to address the needs.
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Advocating Reproductive Choices (ARC) strategic planning workshop in Neemrana
Advocating Reproductive Choices (ARC) Coalition Secretariat
Soon after it was located in PFI, the team of the ARC Secretariat undertook
a number of activities last year. At the same time, it continues to synergise
and amplify the strengths of its members to advocate collectively for ex-
panding contraceptive choices and improving the quality of care.
ARC Members Meet
Efforts were made to strengthen communication and interaction among
members of the coalition through the organisation of regular meetings of
core and general members, and civil society organisations. Meetings with
specific objectives, including strategies to support the Government of In-
dia in the roll-out of Injectable Contraceptives, Progestogen-only Pills and
Centchroman were organised and worked upon.
Strategic Planning Meeting Workshop
The ARC Secretariat team organised a strategic planning meeting to en-
able members of the core committee of the coalition to revisit, review and
update the ARC advocacy strategy for the coming years. This meeting was
significant for developing its course of action for the next phase of its opera-
tions. The team is working to operationalise the Work Plan which emerged.
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Advance Family Planning (AFP) SMART Workshops
To plan the strategy for ARC’s state chapters, AFP SMART workshops were
conducted along with representatives of these chapters as well as ARC core
committee members. The AFP SMART tool is an advocacy planning tool
which outlines a step-by-step approach to developing a focused, collabo-
rative advocacy strategy that leads to quick wins.
ARC Advocacy Initiatives
ARC has sent a memorandum to the Union Health Minister on the urgent
need to focus on the quality of care in family planning services and the in-
troduction of modern spacing methods in the family planning programme.
A media response to the incident of sterilisation camp deaths in Bilaspur
(Madhya Pradesh) was released.
Educational Collaterals
The team created a number of communication resources and educational
products. These include, infographics on the method mix for contraceptive
use, an analysis of the Union Health Budget, a series of cards on popula-
tion and family planning indicators, and a booklet on all available family
planning methods in India. These have been widely disseminated and have
helped the team explain and demystify the advocacy and technical asks.
Additionally, comprehensive notes on the quality of care and budgets were
developed and used for desk-side briefings and in one-on-one interactions
with the media.
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Plans for 2016
The team is working to re-strategise its advocacy and communication
framework in an effort to consistently engage with champions and
government stakeholders in pursuit of India’s population goals, using a
rights-based framework and women’s empowerment approach. The aim is
to effectively use the media and digital space to sharpen the advocacy and
communication initiatives at the policy level.
The most cost-effective
development investment
“Reproductive health and family planning can positively influence
and advance the newly laid out Sustainable Development Goals by
addressing multiple targets and ushering in an era of development.
Access to voluntary family planning has the potential to save lives
and help break the cycle of poverty, stabilise population growth and
ease the pressure on the environment. It is the most cost-effective
development investment.”
Dr Sanjay Jaiswal, MP from Paschim Champaran, and member of
the Committee for Health and Family Welfare that was set up at the
India Caucus organised at the 2016 ICFP Meeting
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Delegates from India in a meeting with Family Planning District Working Group (DWG), ICFP, Indonesia
Advance Family
Planning (AFP)
AFP is an initiative that builds on the momentum of the 2012 London Family Plan-
ning Summit to achieve the goals of the Family Planning 2020 (FP2020) partner-
ship. The Bill & Melinda Gates Institute for Population and Reproductive Health
at the Johns Hopkins Bloomberg School of Public Health is the lead agency for
AFP. PFI leads the AFP programme in India, with a focus on the states of Bihar
and Uttar Pradesh. Its objectives are to increase financial investment as well as
political commitments needed to ensure access to quality family planning through
evidence-based advocacy in both the aforementioned states. AFP is currently in the
fourth year of implementation.
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Highlights
State Consultation for Revision of UP Population Policy
PFI has partnered with State Innovations in Family Planning Services Project
Agency (SIFPSA) in Lucknow for the revision of the UP Population Policy.
Four regional consultations, jointly facilitated by PFI and SIFPSA, were or-
ganised with participants from all the 75 districts in UP. These regional
consultations culminated into a two-day state consultation in Lucknow. This
meeting had the participation of senior government officials from the state
and the Government of India, non-government organisations, national
and state academic institutions and experts. The two-day deliberations
brought forth recommendations which are being incorporated in the re-
vised Population Policy.
Drafting Committee of the Revised Population Policy
Review Committee
A drafting committee comprising of distinguished members from the civil
society, the government and the academia was constituted by the Govern-
ment of UP under the Chairmanship of Mr Keshav Desiraju, former Sec-
retary Health, Government of India, to draft the revised Population Policy.
The drafting committee members have, in fact, taken the lead in writing
the chapters. They will also contribute to the development of an Implemen-
tation Plan which will help the decision makers in effectively implementing
the Policy.
The Review Committee met under the Chairmanship of the Chief Secretary,
UP, on February 15, 2016 to discuss the draft. The meeting was attended
by the Principal Secretary, Department of Health & Family Welfare, Gov-
ernment of UP, the Mission Director of NHM, UP and other members of the
Review and the Drafting Committees. Along with them, officials represent-
ing the departments of Rural Development, Finance, Planning and Educa-
tion, also participated. Mr Keshav Desiraju made a detailed presentation
on the draft Policy.
Family Planning District Working Groups (DWGs)
The DWGs were formed in both UP and Bihar. These are multi-stakeholder
groups based on a convergence model, which use the AFP approach to
develop district specific strategies for strengthening the family planning
programme.
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Uttar Pradesh
The Mission Director of NHM UP approved the formation of Family Plan-
ning DWGs in the three pilot districts of Agra, Jhansi and Lucknow. PFI con-
ducted AFP SMART facilitation (an advocacy planning tool of AFP) in these
districts and helped the DWGs in developing district specific strategies.
Under the Chairmanship of the Chief Medical Officers, the DWGs have
representation from different government departments, which include Pan-
chayati Raj, Education, Integrated Child Development Services (ICDS) and
Public Relations, as well as from civil society and development partners.
Bihar
The State Health Society, Bihar approved the formation of six DWGs in
districts which have a high total fertility rate and unmet need. PFI facilitated
a two-day AFP SMART (an advocacy planning tool of AFP) facilitation with
the DWGs and developed district specific strategies.
Technical Support
To bring family planning on top of the health agenda, PFI advocated with
the National Health Mission (NHM) UP to introduce a review mechanism
at the divisional level. The review meeting is an important mechanism not
only for facilitating updates on the programme’s progress, but also for pro-
viding an opportunity to identify issues and challenges and come up with
solutions. The budget for the Divisional Level Quarterly FP Review Meetings
was approved. The NHM, UP nominated PFI to provide technical support
to the 18 Divisions in organising these meetings.
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Advocacy, Communication
and Accountability:
Increasing Access and
Demand for Quality Family
Planning Services
The initiative is supported by the David and Lucile Packard Foundation and is di-
rected at advocating for appropriate policies, improving programmes, and creating
change in Bihar. The programme is being implemented in 306 villages of Bihar
spread across 55 panchayats/wards in 13 blocks in the five districts of Darbhanga,
Nawada, Bhagalpur, Gaya and Patna. The long-term aim of the two-year grant is
to increase demand for and access to quality family planning services in the state
and nationally, so that every family is a planned family and every child is a
wanted, healthy child.
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To achieve the long-term plan, PFI has adopted a three-pronged strategy to strengthen the family plan-
ning programme at the state and national levels. It seeks to:
1. Address social norms and individual behaviours by providing access to information and increasing
engagement on issues around sexual and reproductive health, adolescent health and health entitle-
ments through community outreach and digital platforms.
2. Increase accountability through Community Action for Health.
3. Amplify voices through the ARC coalition to ensure a facilitating and enabling policy environment
both at the state and national levels.
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Highlights
Programme Scale Up
The programme has been scaled up from 60 villages in two districts to 306
villages in six districts. It has also been scaled up within the larger advocacy
strategy of PFI, wherein the youth and adolescents have been identified to
volunteer as peer educators to support the strengthening of the Rashtriya
Kishor Swasthya Karyakram (RKSK) in Bihar.
Sharing Experiences from Pilot Project
The experience and findings from the mShakti pilot, an Interactive Voice
Response System (IVRS) initiated to undertake community enquiry at the
village level, as well as the findings of the Efficacy Study on Family Planning
Counsellor Services in Bihar, were shared at the 2016 International Con-
ference on Family Planning.
A second round of community enquiry, using “mShakti”, was completed at the
field level. The findings from these processes were shared with the government
and other stakeholders at the block and district levels to close the loop.
Orientation Workshop for NGOs
A two-day orientation and residential training was organised for all six
NGO partners in Bihar. The objective was to discuss community outreach
and the process under community action for health.
Qualitative Assessment of Communication Package
As most of Bihar is media dark, a dipstick study of a qualitative nature has been
completed to understand the perspective of the youth and adolescents on the
communication package developed by PFI. This also aimed to strengthen the
overall PFI communication strategy, with youth and adolescents at its centre.
Support was provided to the ASHA Resource Centre at the District Health So-
ciety (DHS), Siwan district and Project Concern International in adapting the
additional training materials developed to local needs. These focused on three
key issues: delaying first pregnancy, encouraging spacing between children,
and improving quality of care in family planning services.
AFP SMART Workshop
An AFP SMART (an advocacy planning tool of AFP) workshop was organised,
where national core committee members and representatives from ARC’s state
chapters in Bihar, Jharkhand, Madhya Pradesh, Rajasthan and Uttar Pradesh
developed a strategy for their respective states. In a follow-up, each state chap-
ter organised similar workshops with their respective ARC members.
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Persistence Pays
in Changing Behaviour
Monowara Khatun with her husband
Md. Jillur Rahman in Assam
Centre for North East Studies and Policy Research’s (C-NES) Bapeta
Boat Clinic, Unit-I covers almost 30 chars, or islands on the Brahma-
putra river with a total population of 25,569.
The Population Foundation of India supported project (Phase II) was
included under this unit in 2013. One of the most efficient communi-
ty workers of the unit, Mr Nurjamal Haque, was promoted as Family
Planning Counsellor to popularise modern family planning methods
among the 4,352 eligible couples, by generating awareness and
carrying out the programmes of the project so as to improve the
health of mothers and children.
Bhelengi East Mot is one of the 30 chars under the unit. The C-NES
team surprisingly failed to motivate eligible couples here to adopt
family planning methods despite their best efforts through awareness
programmes and individual counselling. The main reason for this
failure, it was found, was Md. Jillur Rahman (60), a religious leader,
who was dead against the adoption of family planning methods. He
believed that family planning is against the tenets of Islam and that
the souls of those who adopt family planning methods would go to
hell. Not only did he demotivate others in the char, he also started
threatening Nurjamal Haque and instructed him not to propagate
family planning issues and information among the villagers.
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But Nurjamal was hopeful and tried various ways to motivate him as well as the villagers. Monowara
Khatun, wife of Jillur Rahman, who became a mother of five children by the age of 32, was found to
be severely anaemic. Nurjamal started meeting Jillur on a regular basis and talked to him on a range
of issues with the exception of family planning methods. Monowara was quite interested in undergoing
sterilisation, but she kept quiet due to her husband’s opposition. Gradually, Md. Jillur started believing
Nurjamal and the team members of the Boat Clinic, who convinced him that his wife’s health would
improve if she adopted family planning. Finally Jillur and Monowara decided to adopt a permanent
method. On February 27, 2016, Monowara Khatun underwent sterilisation at the Barpeta First Referreral
Unit. This was a great achievement for the team. Md. Jillur Rahman has now turned into a great motiva-
tor and has been able to, within a short period of time, encourage several other women to accept family
planning methods.
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Stories of change
Communication: To
Strengthen FP Services
and Save Women’s Lives
Rina Devi is a 24 year-old woman from the Lohsinghani village of Majhila Panchayat of Kawa-
kol Block, Nawada district, who is married to Sanjay Yadav, a farmer. They are a happy couple
blessed with two sons. Rina was a healthy girl when she began her married life. However, very
soon after her marriage she had her first child and within two years she became a mother to two
children. Since the gap between the two births was small, it affected her health. After the delivery
of the second child, she always felt tired and even attending to her day-to-day chores became
exhausting for her.
Rina Devi visited the Anganwadi Centre located at the village for immunisation of her newborn
son in the month of October/ November 2015. The Village Health and Nutrition Day (VHND)
had been organised that day by the government frontline health worker. She listened to Sunaina
Devi, an ASHA and one of the members of Advocates for Change (AFC) formed under the Advo-
cacy for Change programme, explaining the benefits of maintaining a gap of at least three years
between two children and the advantages of using temporary contraceptive methods, to lactating
mothers like herself and others.
Rina Devi consulted the ASHA and the ANM at the VHND, telling them about her sickness and
the perennial feeling of tiredness that she was suffering from. Both of them explained that a
possible reason could be the two births with little gap. They advised her to have a nutritious diet
required by lactating mothers and the easily available sources of iron and protein locally, while
underlining the importance of rest. She was counselled on family planning methods and why it
was important for her to opt for one of them in consultation with her husband. The ASHA and the
AWW extended their support by offering to visit her place and talk to her family members. But
Rina declined and said that she would talk to them herself.
In February 2016, on the eve of Saraswati Puja, a festival for worshipping the goddess of knowl-
edge and education, Sunaina Devi followed up with Rina Devi about her health. She re-em-
phasised the importance of avoiding another pregnancy and advised her about various contra-
ceptive choices, suggesting that she could take Oral Contraceptive Pills, or get an intrauterine
contraceptive device (IUCD), or have her husband use condoms. Rina shared that she herself
didn’t want to get pregnant but her husband didn’t care. In spite of discussing the need for con-
traception with him on several occasions, not only did he refuse to use any method, he also did
not allow her to use one.
She requested Sunaina, the ASHA, to talk to her husband and make him understand the reper-
cussions of having too many children, not only on their married life but also on the wellbeing of
the family. Sunaina met Rina’s husband Sanjay Yadav and discussed his wife’s health and the
possible consequences if she were to conceive again with a six-month old baby in her lap. She
also shared information about the various methods of family planning, where they are available
and how they are being provided under the family planning programme of the government. Her
effort paid off and finally Sanjay Yadav agreed to let his wife have an IUCD insertion, after re-
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ceiving full information about this method of family planning. On February 18, 2016, Rina Devi
along with Sunaina visited the Primary Health Centre, Kawakol for the IUCD insertion.
Rina Devi has adjusted well to the method, after experiencing some side effects, for which she
was counselled by a trained ANM.
Battling Myths and Beliefs
Tabassum Khatoon is a 25-year-old woman from Najli Bigha village of Kewali Panchayat in the
Kawakol block of Nawada district in Bihar. An educated girl, she is the wife of Taslim Khan. Very soon
after their marriage, the couple was blessed with two children. The gap between the two children,
however, was barely 15 months. As Tabassum was educated and knew the benefits of a small family,
she wanted to adopt a permanent family planning method but did not know which method to use,
where it was available or about the government programme.
An anganwadi worker named Salma Khatoon and Sunita Devi, the ASHA of Kewali village, listed
as Advocates for Change (AFCs) by the Cluster Coordinator under the Advocacy, Communication
and Accountability programme being implemented by the Population Foundation of India through a
partner, Neha Gramin Mahila Vikas Samiti, contacted Tabassum immediately after the delivery of her
second child. They suggested the adoption of some family planning method and learnt that Tabassum
was willing to take on a permanent method and had already broached the topic with her husband.
But he was adamant about not using any method as he believed that this was against their religion
and that children are a gift from God.
After talking to Tabassum, Salma and Sunita were convinced that they needed to talk to Taslim Khan
about his belief and why it was important to have adequate spacing or limiting of births. Using a
friendly approach and without stepping on his beliefs, both the AFCs met with him and talked about
religious myths, the benefits of a small family as well as various methods of family planning. Salma
gave him examples of other couples who had small families and how it helped in improving the qual-
ity of their lives. The AFCs also shared information about the availability of services being provided
under the family planning programme of the government.
As Taslim Khan was rigid and insisted that children are a blessing from God and should not be
stopped, the AFCs changed their approach and counselled him that in such a case, a couple should
at least ensure a planned child birth; and only when they were ready for it. They made him realise that
his two children were very small and needed the love and care of their mother and financial support
of their father. This line of reasoning managed to satisfy Taslim. The AFCs then suggested the use of
“Copper T”, a temporary method of contraception. Other than being a temporary method, it resonat-
ed with Taslim’s religious beliefs and the effort fetched a positive result. He accepted this suggestion
and agreed to let his wife have an IUCD insertion. On March 3, 2016, Sunita Devi accompanied
Tabassum Khatoon to the Primary Health Centre at Kawakol and after the necessary check-up, the
IUCD was inserted.
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Stories of change
Advocates for Change2 :
An Initiative to Strengthen
Family Planning Services
Kawakol block in the Nawada district of Bihar is one of the blocks under the Advocacy Commu-
nication and Accountability (ACA) project.
The success story is a result of consistent and persistent efforts by Ruby Devi, one of the Advocates
for Change (AFC) in the project, working in Pandey Gangout village. One of the major compo-
nents of the ACA project is building the capacity of the AFCs so that they realise the importance of
family planning, the methods available for it, the existing government programme and schemes
on it. Their capacity and skills are built on effective communication and counselling on a regular
basis through structured training and supportive supervision by the NGO partner staff and the
Population Foundation of India.
Under one such capacity building initiative, Ruby Devi underwent a two-day intensive programme
where she learnt about the Adarsh Dampati Yojana3, one of Government of India’s schemes. She
realised that if this scheme proved to be successful and she was able to motivate a couple to
delay the first birth, provide spacing between the two children and limit their family size, it would
not only make available the benefits of the scheme to her but also accomplish the AFC project
expectations.
She identified two couples from her village who had recently got married and focused her coun-
selling efforts on them to delay the first pregnancy. 1) Soni Devi, married to Brajesh Pandit, had
a daughter who was one-year-old after one and a half years of marriage. She used the pill as
a contraceptive so that she could maintain an adequate gap before she got pregnant again.
2) Rinku Devi, married to Nakhu Pandit had a daughter who was six months old after fourteen
months of marriage. They too were convinced about the benefits of spacing and Rinku also used
oral contraceptive pills as a method of family planning.
Ruby Devi constantly followed up with both the couples and kept them motivated to re-
main on track and continue using the method, resisting community pressure to conceive
again in the hope of a male child. She shared that earlier getting pills and condoms from
the Primary Health Centre used to be very difficult due to irregular supplies and stock-
outs. In the case of these couples, she went to the extent of keeping a buffer of a two-
month supply for them. She comments that when the social marketing of non-clinical
contraceptives4 started, it made their work easy because this allowed them to counsel and at the
same time fulfil the requirement for providing the contraceptive of choice as well.
2.Advocates for change are the front line workers such as ASHAs and AWWs, (ANMs very rarely), along with PRI Members and SHG members from the identified community.
Given that they are already working with the government health system, a little extra support will add to advocacy for the cause i.e. delaying first conception, increasing birth
spacing and improving quality of care in FP and support community in planning and monitoring through the CBPM structures.
3.Adarsh Dampati Yojna : This programme was launched on May 16, 2012. Under this scheme, a sum of Rs. 500 is paid to an ASHA for ensuring a gap of at least two years
between marriage and the first child, another Rs. 500 for ensuring a spacing of at least three years between the births of first and second child, and, finally, Rs. 1000 in case
the couple opts for only two children.
4.Non-clinical contraceptives stands for condom and oral contraceptive pills being used by male and female respectively
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Frontline health worker with the beneficiary at a health camp in Tamil Nadu
Bringing Public into Public
Health : Community
Action for Health
The Advisory Group on Community Action (AGCA), constituted by the Ministry of
Health and Family Welfare (MoHFW) in 2005, to provide guidance and support for
community action initiatives under the National Health Mission (NHM), focussed ef-
forts to strengthen and scale up implementation of the component across 22 states5
in the country. The AGCA consists of eminent civil society representatives and pub-
lic health experts and is housed in the Population Foundation of India, which serves
as its Secretariat. It receives funding support from the MoHFW, Government of
India, for providing technical assistance to states on strengthening implementation
of community action for health (CAH) under the NHM.
5.Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Delhi, Gujarat, Himachal Pradesh, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Meghalaya, Mizoram,
Odisha, Punjab, Rajasthan, Sikkim, Tripura, Uttarakhand, Uttar Pradesh, West Bengal
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Highlights
National Level
Development of Resource Material on Community Action for Health: The AGCA developed the following
resource materials:
i. Translation and Adaptation of the Guidelines for Programme Managers
and the User Manual on Community Action for Health: Upon request
from the states, the guidelines and manual were translated into Hindi
and shared with them. In addition, the AGCA also facilitated adapta-
tion of the documents for Punjab, Mizoram, and Meghalaya.
ii. Bi-annual Newsletter: The first issue of the newsletter was finalised and
disseminated to State Health Secretaries, State NHM Mission Directors,
State Nodal Officers, State and District Level Nodal Organisations and
development partners.
iii. Information Education and Communication (IEC) Material: A set of IEC
material on a) Village Health Sanitation and Nutrition Day (VHSND)
services b) role and responsibilities of Village Health Sanitation and
Nutrition Committees (VHSNCs) c) health entitlements in Health
Sub-Centre and Primary Health Centre, and d) community action for
health, were finalised and shared with the states for adoption.
iv. Documentary Film on Averting Maternal Deaths: Upon request by the
State NHM Madhya Pradesh, the PFI team developed a documentary
film to sensitise health providers and programme managers on avert-
ing maternal deaths. It will be used in ongoing training and orientation
programmes for doctors, paramedical staff and frontline providers.
State Level Processes
In the FY 2015-16, the MoHFW as part of the State Programme Implementation Plan (PIP) approved
an amount of Rupees 27. 7 crore for 19 states6 in their Recording of Proceedings. This is a 23 per cent
increase in the allocation of funds for the component over the previous fiscal year.
Key updates from the states are as follows:
i. Madhya Pradesh: The AGCA team facilitated a State Level Training of
Trainers (ToT) on Scaling Up Community Action for Health in January
2016. The Regional Directors, Chief Medical and Health Officers (CM-
HOs), District Community Mobilisers (DCMs) and District Project Man-
agers (DPMs) from 46 districts participated. In addition, support was
6.Assam, Mizoram, Tripura, Meghalaya, Sikkim, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Jharkhand, Gujarat, Maharashtra, Karnataka ,Odisha, West Bengal, Kerala,
Punjab, Himachal Pradesh, Uttaranchal, Arunachal Pradesh (Source- Recording of Proceedings of State PIPs, MoHFW www. nrhm.gov.in/nrhm.in. state.stateprogrammeim-
plmentationplans)
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Events
38
provided to complete the community enquiry processes and organise
Jan Samwads in the five intensive community monitoring districts of
Barwani, Betul, Bhind, Chhindwara and Sidhi.
ii. Uttarakhand: Community action processes are being rolled out across
all 13 districts in the state through the District ASHA Resource Centre
(DARC). The AGCA team facilitated a State Level ToT for the State Nod-
al Officers and the DARC staff in March 2016.
iii. Punjab: The community action processes have been scaled up from
2 to 11 districts and district orientations organised. In addition, state
wide trainings for the VHSNC members were facilitated by the State
Institute of Rural Development (SIRD).
iv. Kerala: Support was provided to develop a structured plan for the col-
lection and compilation of community enquiry data, and organise a
social audit of health services in four districts. Discussions are in prog-
ress with the Kerala Institute of Local Administration (KILA) to undertake
trainings of PRI functionaries on community action processes.
v. Assam: Implementation is being scaled up to 2,676 villages across 18
districts in the state. Technical support was provided for a) setting up
processes for the selection of implementation organisations b) orienta-
tion of the State ASHA and Community Action Group c) facilitation of
a state-level ToT on the process and implementation details in Febru-
ary 2016, and d) undertaking a baseline to assess functioning of the
VHSNC and Rogi Kalyan Samiti (RKS).
vi. Meghalaya: The State AGCA meeting, chaired by Mr Y. Tsering, Addi-
tional Chief Secretary, Government of Meghalaya, was organised in
December 2015. This had the participation of senior officials from the
Departments of Health, Women and Child Development, Education
and Public Health Engineering. The community enquiry processes and
Jan Samwads were completed in two districts, viz., Jaintia Hills and
East Khasi Hills.
vii. Sikkim: The AGCA team provided support in developing a comprehen-
sive strategy for communitisation processes. A state-level orientation
was facilitated by the AGCA team in November 2015, wherein State
Nodal Officers, ASHA Trainers, District Programme Managers and
Block Programme Managers, from all the four districts participated.
In addition, technical support was provided to the states of Delhi, Odisha,
West Bengal, Gujarat, Maharashtra, Tripura and Mizoram.
i. Regional Consultations on Community Action for Health: The MoHFW
and the AGCA jointly organised two regional consultations in Kolkata
and Delhi on February 3 and February 10, 2016, respectively. The
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objectives were to deliberate on: a) updates on the progress of imple-
mentation in the states b) share recent innovations and their potential
for scaling up and c) identify constraints within the current environment
that inhibit effective scaling up. Eighty-two participants from 24 states,
including State Mission NHM Directors, officials from the National
Health Systems Resource Centre (NHSRC) and the North East Regional
Resource Centre (NE-RRC), State Nodal Officers of Community Pro-
cesses, Development Partners, Civil Society Organisations and Pancha-
yat Representatives, participated.
ii. Participation in the Ninth Common Review Mission (CRM): AGCA Mem-
bers and the AGCA Secretariat team participated in the 9th Common
Review Mission in 10 states7, organised by the MoHFW from October
30 to November 6, 2015. The team shared its findings, gaps and rec-
ommendations with the State Governments.
iii. Presentation at the National Workshop on Best Practices in Tribal Health
Care: The AGCA made a presentation on ‘Scaling Up Community Ac-
tion’ at a workshop organised at Shodgram, Gadchiroli (Maharashtra)
in October, 2015.
7.Assam, Delhi, Uttarakhand, Punjab, Haryana, Gujarat, Rajasthan, Karnataka, West Bengal and Odisha
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Making a Primary Health
Centre Functional
East Jaintia Hills, Meghalaya
Wapung Pamra PHC in the Khliehriat block of the East Jaintia Hills of Meghalaya is one of the
biggest PHCs in the state, serving a total population of 30,770. However, the facility was not
functioning as a 24x7 PHC as there was no potable water. The water that had been drilled earlier
on the premises had shown a high PH level (pH 4.2), due an adjoining coal mine.
The Medical Officer in-Charge, with support from the local community discovered a water source
high up on a hill, which was about 2 kilometres away. This catalysed a strong response from the
community who worked together to successfully convert the discovery into a viable alternative
source of water for the PHC. The District Level NGO, Mih-Myntdu Socio Cultural Welfare Associ-
ation undertook a detailed participatory planning process. The VHSNC and community members
along with the PHC staff voluntarily contributed their labour, digging pipes to transfer water to
the PHC between February – March, 2016. As a result, the facility is now functional and services
available.
In one of the Sub-Centres in the block, we observed that vaccination and other basic
health services were not being given by the ANM. Rather, the quarter provided for her
was being used by the community for keeping their cattle, while the ANM herself was living far
away from the Centre in a rented accommodation. The Block Planning and Monitoring Commit-
tee (BPMC) members and VHSNC members convinced the community members to vacate the
Sub-Centre so that the ANM could live there and provide the health services. Now the
ANM lives in the village, and community members are receiving all basic health services.
Mr Parashar Bulbule,
Member, Block Planning and Monitoring Committee,
Dharani, Maharashtra
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A Mahila Aarogya Samiti member working with the community
Sharing the Learnings:
Health of the Urban Poor
The Journey and its Achievements (October, 2009 - November, 2015)
1. Assisting the Government of India to Promote the Health of the Urban Poor: Before the adoption of
the National Urban Health Mission (NUHM) as part of the National Health Mission (NHM) by the
Government of India (GoI) in May 2013, the technical assistance (TA) component of the Health of
the Urban Poor (HUP) Programme was aligned with the Urban Reproductive and Child Health (RCH)
component of the National Rural Health Mission (NRHM).
The HUP Programme had several achievements. It helped to delineate national and state level policies
on urban health, in addition to broadening the participation of relevant stakeholders in the development
of NUHM policies, programme priorities and operational strategies. The Programme developed oper-
ational tools for enhancing access to urban services, strengthened behaviour change communication
(BCC) initiatives for urban health, and prepared systematic community mobilisation guidelines, in ad-
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dition to producing many policy documents and research reports. It also supported states in preparing
programme implementation plans (PIPs).
The HUP Programme was identified as a key nodal agency for providing technical assistance to the
government at all levels, and was also nominated to the government’s Technical Resource Group (TRG).
2. Private Sector Partnerships for Promotion of Urban Health: The results of efforts in developing PPPs
have been mixed, owing in part, to varying interest in PPP approaches across HUP’s eight states8, and
different levels of expertise within its own state and municipal level teams. A few successful examples
included: a partnership with ACC Cement, Jamul Municipality, HUP and a local NGO for manage-
ment of a community toilet in Jamul town; with Deepak Foundation for building the capacities of
anganwadi and link workers, and MAS members in Pune.
3. Promoting Convergence of Various Programmes for Urban Health: The focus of HUP Programme’s
convergence activities were more at the state and city levels. Convergence in states that had a clearer
vision on ways to address urban health (e.g., Odisha, Chhattisgarh, Uttarakhand) facilitated the for-
mation of urban health cells and city task forces, micro planning at the slum level, and vulnerability
assessments. The Programme’s efforts promoted greater inter-ministerial and interdepartmental con-
vergence in delivering maternal and child health (MCH) services, enhanced the WASH infrastructure
in urban slums and nutritional services in all the eight states.
4. City-level Demonstration Models: The HUP Programme also made significant progress in working
with local community organisations, most notably the Mahila Arogya Samitis (MAS) established in all
its intervention slum communities. The five demonstration city programmes covered 276 slum com-
munities of 450,000 people.
8.Empowered Action Group (EAG) states - Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Rajasthan, Madhya Pradesh, Chhattisgarh and Odisha
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Key Highlights of the Programme
1. The HUP Programme was the only donor supported programme to
assist the Ministry in designing the NUHM and work for its implemen-
tation.
2. Four out of the five HUP approaches (MAS, Urban Health and Nutrition
Day, the City/Ward Coordination Committee, and the City Health Plan)
were institutionalised in the NUHM Framework for Implementation be-
fore the launch of the NUHM.
3. PFI’s advocacy led to bringing vulnerable populations under the focus
of the NUHM.
4. The HUP Programme performed a leadership role in orienting and
training more than 200 senior state and city administrators and health
officials from across the country on the NUHM and urban health. The
training placed an emphasis on engaging slum communities and vul-
nerability mapping.
5. Showcasing Evidence
a. All the city demonstration sites in Agra, Jaipur, Bhubaneshwar, Pune
and Delhi were declared as learning sites by the respective states and
cities for community processes under the NUHM.
b. MAS and the frontline workers in the programme’s demonstration
sites were co-opted as MAS under the NUHM.
6. Integration of WASH in Urban Heath
a. The HUP Programme operationalised an integrated model of WASH
and MNCH interventions at community level through the promotion of
Point-of-Use water testing and treatment. This model was adopted as
community level innovation under the NUHM plans in Bhubaneswar.
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Overall Lessons Learned
• A city-specific Health Plan is essential to address urban health issues. The variations
and diversity among cities and intra-city should be kept in mind.
• Focus on the Vulnerable: Urban aggregates mask the vulnerability of the urban
poor. There is need for disaggregated data and a focus on the most vulnerable
populations.
• Geospatial mapping of vulnerable communities and health facilities are key for
planning outreach services and demarcating responsibilities.
• Community Engagement: Apart from being a platform for slum women to demand
better healthcare, the MAS is also an important empowerment tool. It needs contin-
uous hand-holding and supervisory inputs by local NGOs.
• Coordination Committee: The City and Ward Committees provide an important
platform of convergence between the different departments of Health, Women and
Child, and ULBs.
• Water Sanitation and Hygiene: Sustained behaviour change is essential for an
improved health outcome.
• A Point-of-Use focused approach is key to ensuring safe drinking water at the
household level. This can be promoted by frontline workers.
• Private Sector Engagement: There is a strong emerging need for alternate mech-
anisms to address urban health care delivery, especially through private sector
engagement and market-based interventions.
• Health Management and Information System: Reporting and monitoring should be
shifted from facilities to communities.
The HUP Programme produced new evidence in health systems strengthening and advocated for the
scale up of successful approaches. The initiative reinforced the view that improving the performance of
frontline workers and supervisors is critical for delivering quality MNCHN services. Also, that simple and
cost-effective systems improvement can have significant impact on the coverage and quality of these
services. The documents and tools developed by the programme can serve as useful resources for the
Government of India and the state governments for scaling up and strengthening the NUHM programme
and the MNCHN services in India.
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Hum Kuch Bhi Kar Sakte Hain club members
In the Field:
Our Partners on the Ground
Population Foundation of India (PFI) supports organisations that show the potential
of implementing innovative project interventions in family planning, reproductive
and adolescent health, which meet its programme priorities. The projects aim to
reach the most marginalised, vulnerable and underserved communities, with poor
demographic and socio-economic indicators when compared to the rest of the
country. Since its inception, PFI has funded over 375 projects across the country
and continues to make grants to non-government organisations (NGOs) focusing
on its areas of priority.
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Highlights
Public Private Partnership Ushers Improved Healthcare in Backward Districts of
Karnataka
Karuna Trust with support from PFI implemented an innovative health proj-
ect covering 14 Primary Health Centres (PHCs) in Karnataka catering to a
marginalised population in 12 backward districts, viz., Bagalkot, Bellary,
Bidar, Gulbarga, Raichur, Bijapur, Gadag, Darawad, Belgaum, Dayange-
re, Chamarajanagar and Uttara Kannada. All the 14 PHCs are located
in rural, hilly and remote areas, which lack basic facilities for health and
livelihood and have poor transport and education facilities.
From 2006 to 2011, Karuna Trust had implemented Phase I of the project
with technical support from PFI. During this time, the partnership brought
about considerable positive changes in the management and functioning
of the PHCs run by it. An evaluation of Phase I conducted by the Institute
of Health Management and Research (IHMR), Bengaluru revealed the fol-
lowing changes: an increase of 67 per cent of institutional deliveries from
baseline; a decrease from 77 to 11 per cent in home deliveries at the
endline; an increase in safe delivery by 49 per cent from the baseline; an
increase of home visits by health professional/ workers during the last 12
months by 11 per cent; and an increase in antenatal care by 5 per cent
from the baseline.
The programme has been able to strengthen existing government PHCs
in some of the most backward districts of Karnataka, transforming them
into model centres, maximising utilisation of sub-centres for the delivery
of primary Reproductive and Child Health (RCH) services, and facilitating
improved health-seeking behaviour in communities covered by them. This
has empowered women and men to lead healthy, productive and fulfilling
lives by exercising their right to regulate their own fertility through family
planning services at the village level.
During the project period, 12 PHCs received the International Organisa-
tion for Standardisation (ISO) certification and one PHC was accredited to
the National Accreditation Board for Hospitals and Healthcare (NABH).
There was also an increase in institutional deliveries and immunisation of
children at the PHCs. The endline evaluation of Phase II found that the pub-
lic perception on the quality of service delivery was good. The PHCs were
found to be well provisioned with almost all the necessary infrastructure.
The intervention brought about positive changes in the knowledge, attitude
and practices of women on reproductive health and family planning.
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Saving the Girl Child and Improving Women’s Health in Himachal
Social Uplift through Rural Action (SUTRA) scaled up its work in the second
phase of the grant from PFI, increasing from 55 to 300 Gram Pancha-
yats across 10 development blocks in 5 districts of Himachal Pradesh. The
project aimed at ensuring the reproductive rights of girls and women that
would lead to better reproductive health, improved sex ratio at birth, and
increased adoption of non-terminal methods of family planning.
The project sought to create an enabling environment for the Gram Pan-
chayats (GPs) by mobilising community-based groups known as Kanya
Bachao Samitis (Save the Girl Committees) comprising members of Ma-
hila Mandals, Ekal Nari Shakti Sangathan, Self Help Groups, anganwadi
and health workers. A Kanya Bachao Samiti (KBS) was formed in each
Gram Panchayat and this had the involvement of its women members.
These Samitis helped in increasing access to reproductive health services
for women and addressing issues related to gender discrimination, espe-
cially sex selection, by involving the Gram Panchayats. The project also
focused on early registration of pregnancy as a deterrent to sex detection
and sex selective abortion. The endline evaluation of the project found that
the project interventions had succeeded in broadening the scope of work
of not only the PRI members, but also that of the health and other public
service providers. Indeed, apart from addressing the declining child sex
ratio they also started focusing on a range of issues related to women’s
reproductive health.
KBSs have been formed in all the 300 Gram Panchayats under the project.
More than 80 per cent of these have passed a resolution in their respective
Gram Sabha meetings to take up the issue of the declining child sex ratio
as well as that of improving the provision of health services for women
in their respective communities. In addition, the Gram Panchayats have
seen an increased participation of women in the Gram Sabha meetings,
which have been made mandatory following the amendment to the PRI
Act of Himachal Pradesh (2014). The advocacy by SUTRA and its project
partners was a major contributory factor in getting the Himachal Pradesh
Government to amend the PRI law for making the holding of Mahila Gram
Sabhas mandatory.
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Key Approach of the PFI-SUTRA Project
The project began with a simple but a very effective step of putting up a notice board that displays
a five-year record of the child sex ratio in the 300 Panchayat offices. Displaying this at the gate
of the Panchayat office, gave visibility to the issue and increased the accountability of the Gram
Panchayats. The community members were encouraged to talk officially about women’s repro-
ductive health rights and the declining female child sex ratio issues in the Gram Sabha and Gram
Panchayat meetings.
The staff of SUTRA, including its male members like Bir Singh, have developed the confidence
to talk with women, both young and old, about these issues, individually and at meetings. They
have raised the issue of the gaps that exist in the data collection for sex ratio in the village. These
discussions have had a positive impact on the village community and has led to increasing their
awareness on the harmful impact of the declining child sex ratio on community development and
individual and family wellbeing. The need to have Panchayat-based recording and monitoring
systems from the top to the local level officials, inclusive of KBS members, has been impressed
upon.
Attitudinal and Behavioural Shifts
At a meeting held with women from the KBS and the village mahila mandals in Chamiya block,
Himachal Pradesh, the lone male health worker R S Kanwar says: “I have been working as a
health worker for four years. I have worked with female ANM workers. I have been sensitised on
the value of girls and women through my own life and work experience. After my marriage, for
five years we did not have a child, and when my wife conceived she delivered a seven-month pre-
mature baby. The doctors informed me that the child had pneumonia and high temperature and
should be shifted to a big hospital. It was midnight and we took the baby to Solan hospital. The
child was put in an incubator and we could not see the baby for a week. It was only after that, that
we came to know that we had a baby boy. After five more years we had our daughter. I felt, if not
more, certainly equally happy, when she was born. I have tried to bring her up equal to my son.”
“In the field, we congratulate people for the birth of both boys and girls with equal enthusiasm
and cheer. The Indian mindset is changing. This is why we have women taking on roles that were
earlier considered for men only. Now in Delhi, women are auto and taxi drivers. Daughters are
performing the last rites or doing pind daan, which was not the practice earlier.” The women listen
to him with interest and many nod in agreement.
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C-NES, Assam and Population Foundation of India working together to create awareness on Family Planning methods and RCH issues
From Evidence to
Policy Making
Population Foundation of India (PFI) has identified knowledge management as
one of the overarching strategies in the five-year Strategic Plan (2016-2020) for
achieving the organisation’s objectives. PFI promotes research, evidence gener-
ation and shared learning to improve programme quality, inform its advocacy
efforts and promote institutional learning.
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During the reporting period, PFI’s knowledge management activities focused on identifying, creating and
sharing knowledge and evidence through need-based research and evaluation. The Foundation spear-
headed the efforts for drafting the new Population Policy (2016-30) for Uttar Pradesh, and conducted a
study to assess the resource requirements for meeting India’s FP2020 commitments.
Though the endline evaluation of PFI’s Main Kuch Bhi Kar Sakti Hoon (MKBKSH), an entertainment
education based transmedia initiative, was completed just before the start of the reporting period, the
detailed data analysis was made available during the year. PFI also fielded an endline evaluation of two
core supported projects, implemented by Karuna Trust in Karnataka and SUTRA in Himachal Pradesh.
Knowledge Products
Increased evidence and knowledge products developed during the year helped in improving the under-
standing, perception and willingness of policymakers, programme planners, champions, the media and
other stakeholders to advocate and act on providing more choices and resources for family planning in
the country. Research and evidence informed the advocacy efforts of PFI.
The organisation developed knowledge products on a range of issues related to family planning. These
included products on contraceptive methods, counselling, quality of care, resource allocation and utilisa-
tion, historical approaches, and national and global best practices that have a bearing on maternal and
child health. These have been utilised to strengthen and support advocacy efforts.
Main Kuch Bhi Kar Sakti Hoon: Endline Evaluation
MKBKSH has a strong research element integrated in it, beginning with the formative research that in-
formed the content, message and production of the drama series.
These included a baseline and an endline evaluation for Season One of the programme, with a rapid
assessment in-between, which was qualitative in nature.
The research design for these evaluations was developed in consultation with national and international
media research experts and had two objectives:
• To assess the change in the knowledge, attitude and practices (KAP) of the community on age at mar-
riage, family planning, gender discrimination and sex selection, post-exposure to the drama series.
• To understand the reach and recall of the programme among the target audience.
The results of the endline evaluation in March 2015 were compared with the findings from the baseline
that was conducted in February 2014, before the programme went on air.
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Major Findings from the Endline Evaluation
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FP2020 Resource Requirement
PFI commissioned a study on the resource requirement for meeting the FP2020 commitments made by
India. The study by Prof Barun Kanjilal of the International Institute of Health Management Research,
Jaipur, reviewed the family planning budgetary allocation patterns and expenditure and forecast the
requirement. The study shows that India needs to significantly increase its budget for family planning if it
wants to meet its FP2020 pledge of covering 48 million new users by that year.
It further shows that India would need to spend about Rs 158 billion or Rs 15,800 crores, if not more,
during 2013-2020 to meet its commitment of providing additional family planning services through
public-funded providers. Any delay in doing so, or any gap that may result because of a paucity of re-
sources would cost the country dear in terms of high maternal and infant mortality and morbidity, and
poor child health resulting from poorly spaced pregnancies. In line with the rights-based perspective and
an empowerment approach, women need to be able to exercise their right to determine the number of
children they wish to have.
Eight Empowered
Action Group states
Uttaranchal
Rajasthan
Uttar Pradesh
Bihar
Jharkhand
Madhya
Pradesh
Odisha
Chhattisgarh
The states that need a greater focus and commit-
ment are the eight Empowered Action Group states
of Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh,
Odisha, Rajasthan, Uttar Pradesh and Uttaranchal
in addition to the states of Assam and Himachal
Pradesh.
The study notes that family planning, which is almost
fully funded by the Central government, has received
very little attention from it as compared with other
health programmes. Family Welfare, which includes
the budget for family planning constituted only 4 per
cent of the 2014-15 Health and Family Welfare bud-
get. The share for family planning within the larger
Family Welfare budget has been reduced by around
10-15 per cent with subsequent reductions in contra-
ceptive procurement and social marketing.
At FP2020, India had committed to reaching 48 mil-
lion new users in addition to sustaining the existing
100 million users of family planning. The focus was
to shift to spacing instead of limiting methods to meet
the needs of India’s young population reaching its
reproductive years.
The study shows that going by the current rate of in-
crease of mCPR (modern contraceptive prevalence
rate), India would have about 32.8 million additional
users, i.e., about 15 million short of the committed FP
2020 goal of 48 million. Therefore, India will have
to do much more to cover the gap in terms of making
available contraceptive supplies, outreach services,
and trained manpower to address the needs.
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UP Population Policy
The Government of Uttar Pradesh initiated the process of review and revision of UP’s Population Policy in
February 2014 and invited the State Innovations in Family Planning Services Project Agency (SIFPSA) and
PFI to lead the process. Uttar Pradesh thus became the first state to review its Population Policy in a very
proactive consultative manner.
The two organisations facilitated the formation of three committees set up for policy revision – a Core
Committee, a Drafting Committee and a Review Committee headed by the Chief Secretary. Senior offi-
cers from the Department of Health and Family Welfare, the National Health Mission, leading organi-
sations working in the field of population, and stakeholder departments are members of the Core and
Review Committees. The Drafting Committee supported by PFI led the process of writing the revised Pop-
ulation Policy of Uttar Pradesh. PFI has submitted the draft policy document to the Department of Health
and Family Welfare, Government of Uttar Pradesh, for sharing with the Cabinet for approval.
The revised policy is the result of an extensive and wide consultative process that included several studies
that reviewed the implementation of the Population Policy 2000-16, followed by four regional workshops
and one at the state level to seek feedback and suggestions from all stakeholders. The multi-layered con-
sultations contributed to debate, discussion and the development of a policy that promises to successfully
overcome the challenges encountered thus far in addition to meeting the aspirations of the people in the
state.
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Preformed panel on Entertainment Education: Key to Social and Behavioural Change
Population Foundation of
India at the International
Conference on Family
Planning (ICFP)
25-28 January 2016
Bali, Indonesia
PFI attended the ICFP 2016 held in Bali, Indonesia on January 25-28, 2016
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Meeting of the India Caucus
PFI organised a meeting of the India Caucus at the ICFP on January 25, 2016. The Minister of Health and
Family Welfare, Shri J. P. Nadda was the chief guest and two members of parliament, Mr P. D. Rai and Dr
Sanjay Jaiswal were guests of honour. Mr C.K. Mishra, Additional Secretary & Managing Director, Na-
tional Health Mission (NHM), Ministry of Health and Family Welfare (MoHFW) and Dr S.K. Sikdar, Deputy
Commissioner, Family Planning Division in the MoHFW were also present. The meeting was attended
by more than 100 participants representing the civil society, donors and the NGO community in India.
The Additional Secretary & Mission Director (NHM), MoHFW made a presentation on the Indian Gov-
ernment’s commitment to the FP 2020 goals and the road map for the country. This was well received
by all present. He informed that over the decade there had been a paradigm shift in the FP programme
in India, where family planning had moved from a population stabilisation agenda to a programme for
the wellbeing of mother and child. The core approach of any government programme, he underlined,
is a continuum of care, leading to a healthy mother, a healthy child and a healthy population. He drew
attention to the rapid improvement achieved in the key indicators of the Maternal Mortality Rate (MMR),
the Infant Mortality Rate (IMR), the Total Fertility Rate (TFR) and the Crude Birth Rate (CBR).
He agreed that India’s family planning programme had so far been skewed with an over emphasis on
terminal methods, and inadequate attention on spacing methods. Recognising that a large population
is still left with an unmet need for family planning, he informed, that one of the important strategies is
to fill this gap by increasing the contraceptive choices, ensuring quality services, improving the supply
chain and making services more accessible. Flowing from this, he presented the new strategies of the
Government of India (GoI), which are directed at influencing the demand and generating the supply for
family planning in the country. This included increasing the basket of choice of contraceptives, including
the injectable contraceptive, in the public health system.
The Health and Family Planning Minister’s commitment to meet India’s FP 2020 goals was a key high-
light and welcomed by all. This event was covered positively and expansively by the media. He reiterated
India’s commitment made at the 2012 Family Planning London Summit and elaborated on the efforts
being made to achieve the goals. With regard to some recent developments, he spoke of the Fixed Day
Static Services and increasing the basket of choice for contraceptives, which are to be given absolutely
free to 200 million clients in the reproductive age. The role played by the ASHAs in providing counselling
and contraceptives as well as pregnancy testing kits in the family planning programme, was mentioned.
A Panel Discussion on India’s Commitments, Strategies and Plan for FP2020 was moderated by Mr P. D.
Rai (Member of Parliament) with Dr Sanjay Jaiswal (Member of Parliament), Mr Amit Ghosh, ED/Mission
Director, State Government of UP, and Mr Jitendra Srivastava, ED/Mission Director, State Government of
Bihar, as panellists.
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Tuesday,
January
26, 2016
Poster Presentation
“Mobilising the Unreached: Using Behaviour Change Communication and En-
suring Quality Family Planning Service through Boat Clinics in Assam”
Presenter: Alok Vajpeyi
Tuesday,
January
26, 2016
Preformed Panel, entitled “Entertainment Education: Key to Social and Be-
havioural Change”
Panellists: Poonam Muttreja, Sanjanthi Velu and Amajit
Special Invitee: Feroz Abbas Khan
Session Moderator: Lester Coutinho
Tuesday,
January
26, 2016
Oral Presentation on, “Assessment of Efficacy of Family Planning Counselling
Programme in the State of Bihar” in the session entitled, `Building FP Workforce’
Presenter: Dr Sanjay Pandey
Wednesday,
January
27, 2016
Oral Presentation entitled, “Interactive Voice Response System as a Tool for Com-
munity Enquiry and Monitoring of Health and Family Planning Services Provid-
ed by the Public Sector” in the session entitled ` Point-of-Care Revolutionised:
mHealth solutions for Family Planning Service Delivery’.
Presenter: Madhavi Misra
The Government of India is committed to allocating increased resources as required to
achieve the family planning objectives. The Government is conscious of state-wise ineq-
uities and is working to address these.
Mr CK Misra
Additional Secretary, Ministry of Health and Family Welfare
Programmes that empower women to take decisions regarding their health and wellbe-
ing need to be a priority together with education and family planning.
Mr PD Rai
MP from Sikkim
Reproductive health and family planning can positively influence and advance the newly
laid out Sustainable Development Goals by addressing multiple targets and ushering in
an era of development. Access to voluntary family planning has the potential to save lives
and help break the cycle of poverty, stabilise population growth and ease the
pressure on the environment. It is the most cost-effective development investment
Dr Sanjay Jaiswal
MP from Bihar, and member of the Committee for Health and Family Welfare
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Financial Highlights
INCOME
Particulars
Interest/Dividends/Gains on investments/
Misc. Receipts/Incentives & Fees
Rent for Premises
Grants-in-aid: International Agencies
Grants-in-aid: National Agencies
Total
2014-15
Rs.(in Lakh)
515.20
317.50
2836.62
132.45
3801.77
2015-16
Rs.(in Lakh)
373.09
237.43
3028.98
97.83
3737.33
EXPENDITURE
Particulars
Programme Grants: Own Funds
Project Implementation Expenses
Management & Administration Expenses
Grants-in-aid: International Agencies
Grants-in-aid: National Agencies
Total
Excess of Income over Expenditure trans-
ferred to Society Fund
2014-15
Rs.(in Lakh)
187.96
50.49
229.30
2836.62
132.45
3436.82
364.95
2015-16
Rs.(in Lakh)
115.73
113.35
68.17
3028.98
97.84
3424.07
313.26
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6.10 Page 60 |
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ASSETS
Particulars
Fixed Assets
Investments
Dividends/Interest Receivable on Investments
Cash and Bank Balances
Sundry Deposits
Advances (Unsecured considered good)
Total
2014-15
Rs.(in Lakh)
172.13
3146.31
233.98
2078.00
1.84
382.26
6014.52
2015-16
Rs.(in
Lakh)
135.38
3333.62
364.69
1920.62
1.84
608.33
6364.48
LIABILITIES
Particulars
Corpus Fund
Society Fund
Project Grants: International Agencies
Project Grants: National Agencies
Grants-in-kind received
Current Liabilities & Provisions:
-Current Liabilities
-Provisions
Total
2014-15
Rs.(in Lakh)
500.00
3504.68
1717.25
39.16
70.58
159.20
23.65
182.85
6014.52
2015-16
Rs.(in
Lakh)
500.00
3817.94
1715.71
28.66
47.05
189.74
65.38
255.12
6364.48
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7.1 Page 61 |
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Collaborations and
Partnerships
The Government
PFI partners with various ministries of the Government of India and their corresponding departments at
the state level:
– Education
– Health and Family Welfare
– Housing and Urban Development
– Rural Development and Panchayati Raj
– Women and Child Development
– Youth Affairs and Sports
• Doordarshan, Prasar Bharati BCI, Ministry of Information & Broadcasting (MoI&B), Government of
India, All India Radio
• State Innovations in Family Planning Services Project Agency (SIFPSA), Lucknow, Uttar Pradesh
• State Health Society Bihar, Department of Health and Family Welfare, Government of Bihar
• State Health Mission, Department of Health and Family Welfare, Uttar Pradesh
Donors
• Apollo Trading and Finance Pvt Ltd
• BFL Investment and Financial Consultants Pvt Ltd
• Bill & Melinda Gates Foundation
• International Center for Research on Women (ICRW)
• Johns Hopkins University, Bloomberg School of Public Health
• Ministry of Health and Family Welfare, Government of India
• The David and Lucile Packard Foundation
• The John D and Catherine T MacArthur Foundation
• UK Aid
• United Nations Population Fund (UNFPA)
• US Agency for International Development (USAID)
Non-Governmental Organisations
• ActionAid
• Advocating Reproductive Choices (ARC) Coalition
• Agragami India
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• AARAMBH, Madhya Pradesh
• Bhoruka Charitable Trust, Rajasthan
• Centre for Development and Population Activities (CEDPA), New Delhi
• Centre for North East Studies and Policy Research (C-NES), Assam
• Centre for Urban and Regional Excellence (CURE), New Delhi
• Civil Society Online
• Child in Need Institute (CINI)
• Commitment to Kashmir Trust (CtoK)
• Darshna Mahila Kalyan Samiti, Madhya Pradesh
• Family Planning Association of India (FPAI)
• Federation of Obstetric and Gynaecological Societies of India (FOGSI)
• Ghoghardiha Prakhand Swarajya Vikas Sangh (GPSVS), Bihar
• Gopinat Juba Sangh, Khurda, Odisha
• Gram Nirman Mandal, Bihar
• Gramoday Veethi, Bihar
• Indian Association of Parliamentarians on Population and Development (IAPPD)
• Indian Institute of Health Management Research (IIHMR), Rajasthan
• International Institute for Population Sciences (IIPS), Maharashtra
• Jagori Rural Charitable Trust
• Karuna Trust, Bangalore, Karnataka
• Kshitij Society for Participatory Development and Research, Madhya Pradesh
• Loktantrashala - School for Democracy
• Neha Gramin Mahila Vikas Samiti, Bihar
• NIDAN, Bihar
• Nishtha Rural Health, Education and Environment Centre, Himachal Pradesh
• Pararth Samiti, Madhya Pradesh
• Plan India, New Delhi
• Samagra Seva Kendra, Bihar
• Samarpan, Madhya Pradesh
• Save A Mother Foundation, Uttar Pradesh
• Save the Children
• SEWA, Bihar
• Social Uplift through Rural Action (SUTRA), Himachal Pradesh
• Society for Rural Urban and Tribal Initiative (SRUTI)
• Socio-Legal Information Centre (SLIC), New Delhi
• The Institute of Development Studies, Rajasthan
• Voluntary Action Network India (VANI)
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About PFI
Population Foundation of India is a national NGO, which promotes and advocates for the effective for-
mulation and implementation of gender sensitive population, health and development strategies, policies
and programmes. The organisation was founded in 1970 by a group of socially committed industrialists
under the leadership of the late JRD Tata and Dr Bharat Ram.
PFI addresses population issues within the larger discourse of empowering women and men, so that
they are able to take informed decisions related to their fertility, health and well-being. It works with the
government, both at the national and state levels, and with NGOs, in the areas of community action for
health, urban health, scaling up of successful pilots and social and behaviour change communication.
PFI is guided by an eminent governing board and advisory council comprising distinguished persons
from civil society, the government and the private sector.
Vision
PFI envisions a world with just and equitable societies where all people can enjoy their reproductive rights
and pursue their aspirations with optimal health, wellbeing and quality of life enabled by these rights.
Mission
PFI will advance people’s reproductive rights within a human rights and women’s empowerment frame-
work, by building leadership and public accountability, influencing social movements, reframing dis-
course, and promoting an enabling programme and policy environment.
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Head office: B-28 Qutab Institutional Area, New Delhi-110016 | T: +91-11-43894100,
Regional office Bihar: 123A, Patliputra Colony, 1st Floor , Patna-13 | T: +91-612-2270634
Regional office Uttar Pradesh: C-3, Nirala Nagar, Oppsite Thandi Park, Lucknow, U.P - 226020 | T: +91-522-4005091