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Focus 2004 January - March English |
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POPULATION
FOUNDATION
OF INDIA
Volume - XVIII NO.1 January-March 2004
Population Foundation of India and
Plan India have launched a campaign
against Sex Selection and Pre-Birth
Elimination of Females in seven states,
namely-Haryana, Himachal Pradesh,
Gujarat, Maharashtra, Punjab, Uttar
Pradesh and Uttaranchal for a period of two
years. The strategy involves workshops with
corporates/industry leaders and the
Members of Legislative Assembly.
Female foeticide is not an issue in itself,
but is related to so many other issues, such
as, gender inequality, low status of women, early
age at marriage, female adolescent as a burden etc.
Gender imbalances have been so much
institutionalized in society that they have become
the norms that are inculcated in both men and
women. To reach to the people, to understand the
issues and help change their minds and attitudes,
it was decided to do advocacy programmes with
political representatives, such as Members of
Legislative Assemblies at the state-level. To create
a powerful consensus on the role of the organized
sector, in providing enlightened leadership to the
issue and to sensitise and establish employment-
based strategies to address the issue, it was
decided to do advocacy with Industry/Business
Houses through various regional Industry
Associations.
As part of the campaign, the first workshop with
the Industry/Business Houses of Haryana was
organized on March 13,2004 in association with
PHD Chwber of Commerce & Industry, at [he
PHDCCI House, New Delhi.
State'/elel ,\\dlOt all \\\\ork,hop ior Har~ana
\\\\ith Indu,tn Corporate Sertor
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· Objectives of the workshop:
• • To sensitize the target group
i.e. Industry and Business
Houses about the sex selection
and pre-birth elimination of
females.
• To generate awareness about
the PNDT Act and its proper
implications.
• • To advocate for birth, death,
ante-natal, pre-natal, marriage
and pregnancy registration.
• To make the target group
realize that more and more
efforts are needed towards this
cause and that they are
capable of doing more for the
cause.
• • To generate awareness about
disastrous demographic and
social consequences of pre-birth
elimination of females.
CON , EN' S
• Population stabilization in India:
Issues and concerns telating to
Govetnance
2
• Advocacy Campaign Extended to
Four More· States
.4
• New Initiatives of the
Foundation
5
• Genesis of the Foundation for Research
in Community Health Project at
Parinche, Purandhar Taluka
8
• National Level Consultation for
Young People
9
• 'Population Advocacy Essay Competition'
among School Students
10
• Intensive Efforts to Prom"1ce
Communiry Radio Progr••mm~
11
Continued on page 3
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~
111 lIldj~l~
Thepopulation issue has mostly been perceived as a
demographic or numerical concern of the elites rather
than as a genuine concern of the individual or the
responsible to meet these needs in an equitable manner. Such
a style of governance brought in quick results in all indicators
of social development including women's status; and the
family - particularly among the poor and the marginalized The : firtility rate came down very sharply by 1970s. Only with the
perceived needs and concerns of the vast multitudes of the lower
contagion of western education, the threat perception of
middle class, the poor and the marginalized sections have not
growing numbers took deep roots in the mindset of some
been realistically assessedand reflected in most of the policies,
Chinese scholars, and leaders, and they advocated many
strategies and programmes of governments and in the style of their
restrictive population policies like the "one-child policy" which
implementation directed towards tackling the issue of population. • appears to have created more societal and family problems like
A balanced non-judgemental two-way linkage between
skewed sex ratio, fimale infimticide and fOeticide, rather than
population stabilization and sustainable development laced
helping in smooth stabilization of population. There are thus
with cross-cutting perspectives of human rights and dignity as • lessons to be learnt jom the Chinese experience in governance.
well as gender equality, equity and justice, constituted the
we tend to misrepresent the Chinese story, whenever we compare
basic perception of Mahatma Gandhi, when he countered the • the Indian situation fOr advocating coercive policies like "two-
arguments of the exponents of international birth control
child norm" and the concomitment regime of incentives and
movement trying to make India an arena fOr their
disincentives to solve our population problem quickly.
experimentation in the 1920s and '30s. While stating that
The governance fOr implementing the strategies and
"uncontrolled reproduction was a social problem" and that
programmes/Action plan of the National Population Policy need
"Jndians should have smaller but healthier families';
to be suffUsed with a transfOrmation of the conventional mindset
Gandhiji advocated women's empowerment and gender
and style of fUnctioning of the bureaucrats, technocrats and
equality to enable women to take decisions on child bearing.
service providers vis-a-vis the approach to population issues,
He believed in "Gram Swara)" rule of the community, by the
accountability, planning, monitoring, and coordination and
community and fOr the community. The fundamentals of the
synergy - vertical as well as horizontal. Positioning family
paradigm shift in approach to the population and
planning in the wider canvas of Reproductive Health with a lift-
development problem in ICPD Programme of Action 1994
cycle approach and the overall arena of primary health care and
and the National Population Policy, 2000, are in tune with
other key programmes of education, nutrition, water, sanitation,
the spirit of Gandhi's vision in respect of the population
employment and poverty alleviation (in fact, the entire gamut of
problem in India.
gender-sensitive, rights-based and equitable social development)
The fiar of "population bomb" and ''population explosion"
with a participatory community needs assessment periodically
was unleashed on "the same pedestal of anxieties as the
fOr every village and fOr every ward of a town should be the
nuclear war'; which engendered quickjix, short-cut and
starting point in any exercise of planning and designing of
dehumanized policy prescriptions, and "top-down targets" of • programme implementation. The authoritarian top-down
family planning bereft of the recognition of a two-way linkage
target settings and bureaucratic monitoring of targets need to
of population and development, and the primacy of women's
be replaced with work-plans based on CNA with the active
health and rights in the process.
participation of PRls, urban local bodies and community
The evolution of population stabilization effirts in India
based organizations like self-help groups, particularly of
by Government goes back to the onset of 5-year development
women. Such holistic plan fOr health, population and social
plans in 1951-52. A national programme was launched
development should be prepared fOr each of the 6,40,000
which emphasized "family planning" to the extent necessary
villages and each ward of 6000 urban areas. The district
fOr reducing birth rates to stabilize the population at a level
plans, state plans and the central plan should be based on the
consistent with the requirement of national economy. A
community level plans reflecting the perceived needs of each
Family Planning Research and Programme Committee,
family, and each community. Implementation of the work
constituted in Mumbai, in its first meeting in July 1953
plans fOr each community should be monitored by the elected
emphasized that the family planning programme should not
members of the ward of the panchayat/urban body with
be conceived of in the narrow sense of birth control.
technical assistance jom Government-NGOs-private sector,
Around the same period China took many benign measures
and all elements of 'social audit' built into this. "Quality of
of social development towards equitable access to basic health,
Care" indicators should be the most important ones to be
education, assets (including revolutionary re-distribution of land) • monitored rather than the quantitative targets per se. Only
and income over next 20 years. The concept of family planning
then could the effirts at population stabilization proceed on a
services that China fOllowed was in tune with what the Mumbai
smooth course, and could turn into a peoples' movement
Family Planning Research and Programme Committee had
• producing the desired results.
conceptualized Instead of a top-clown prescriptive target
approach, China went in fOr a localized community approach
and became more alert to the needs of the communities and were •
(Gist of the Convocation address given in International Institute of Population Sciences, Mumbai, and the article by Mr.
Nanda published in the Indian Journal of Public Administration, Special Issue, January-March, 2004.)
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Mr. A R Nanda, Executive Ditector, PFI,
welcomed the participants. Showing his concern
over the issue he said that policies; like two-child
on
Female Foeticide (Pre-Birth elimination of femi1t9
MArch n, 2004
PHOHouse, Deli
norm, incentives and disincentives for family
planning, female sterilization; have proved
counter productive not only in saving the girl
child but also in stabilizing the population. He
singled out 'son-preference' as the main cause
behind the evil practice of female foeticide. He
added that the aim of the Workshop is not just
to sensitize on the issue of sex selection and pre-
birth elimination of females but also to address
other issues of wider implications like birth and
death registration, pregnancy registration, follow-up
Dr. B S Dahiya, Direcror General, Health
through ante-natal check-ups till safe delivery etc.
• Services, Haryana, while making a presentation
Advocating for an effective registration mechanism, • on the case studies and initiatives taken by the
he said that a proper registration mechanism could
State Government to check female foeticide, said
prove very handy for monitoring the demographic
• that the issue of female foeticide can be addressed
scenario and sex ratio at birth of any area, even
• effectively by collective efforts towards the
before the next Census in 2011. He also emphasized • campaign. Highlighting the state government's
on the need of advocacy on this issue and the need • initiatives, he said that in the last two years,
for a commitment to the cause. Giving due credit to
around 22 cases have been registered against
social responsibilities carried out by the corporate
doctors and nursing homes violating the
sector, he said that such initiative could be
provisions of the PNDT Act. He said that 40
transformed into a bigger movement. He appealed
• ultrasound machines have been seized, while the
to the media to give more importance to such issues.
registration of 31 ultrasound centres have been
Mr. J K Banthia, Registrar General and Census
• cancelled. A task force has been constituted to look
Commissioner of India, started his presentation with
into the matter and a surveillance system has been
the present scenario of Child Sex Ratio(CSR) in the
set up to keep a tab on the medical institutions.
country with a very positive note of togetherness and
Dr. Nalini Abraham, Country Health Advisor,
public concern about the issue by setting an example
Plan India, praised the industry for efforts
of so many people attending the workshop on a day • undertaken as a part of their corporate social
when India was playing against Pakistan in a histroric • responsibility. She gave the example of an Industry
one-day cricket match after 14 years. He made a
• in South India which has adopted a policy where it
special reference in his presentation to the overall
• is mandatory for all the employees to give an
deficit of women in India in the last 100 years, which • undertaking that they will not be a party to the
has increased from 3 million in 1901 to 35 million in : dowry system.
2001. With special reference to Haryana, he said that
Representing the Industry, Dr. B P Dhaka,
according to the Census 2001, the CSR there, is 820 • Secretary General, PHDCCI said that the sector is
girls per 1000 boys, the second lowest State in the
• aware of its commitment towards the society and is
country after Punjab. All the districts of Haryana have • making every possible effort for the upliftment of
CSR below 900 each. The gross distortion in this
: the society. Industry should take personal interest in
ratio has created an explosive situation and has been • their employee's health and education. He promised
the result of preference for the male child resulting in • full support from the Industry sector for the
female foeticide. He suggested that monitoring of the • same cause.
sex selective abortions should be taken on a regular
Addressing the participants, Mr. S P Sharma,
basis as India cannot take the chance of waiting for
• Financial Commissioner and Secretary, Women
the 2011 Census to analyze the situation. He
appreciated the efforts taken by the Haryana
• and Child Development, Government of Haryana,
• said that the PNDT Ad per lie canhOt Dive the
Government in this endeavour.
• problem as the age-old mindset of son-preference
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S"I"""I AdvOl,ICY Workshop for Haryana
with InduvlryCorporate Sector
fpfll~leloehdde (Pre,Birlh dimirld!ion
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oi fr-m;l!{,~)
coupled with modern consumerism has made the
situation very grim. He said that Haryana
Government is constituting a 20-member core
group in each village to create awareness among the
people about the causes leading to the alarming
decline in the state's child sex ratio. Each core
group would comprise 15 educated women and
five youth of the village concerned. The society
should first recognize the issue as a problem. Only
then this can be checked. He asked the industry to
adopt schools and colleges and start advocacy
programmes with like-minded students and
• teachers who can then reach out to the society and
fight against female foeticide.
There were around 125 participants. Senior
• members of the Indusrry in Haryana, government
• officials from the Centre as well as the State,
• experts from medical, legal and other related fields
: were present during the workshop apart from
• representatives of some non-government
• organizations from Haryana.
Suggestions and recommendations
• from the floor:
1. Rope in celebrities to address the issue of skewed
Child Sex Ratio.
2. Pre-marital counseling programmes in working
areas of the Industry should be started either
rhrough rheir social organizations or in
association with local non-government
organizations.
• 3. Every industry should start gender sensitive
programmes in their township and adopt nearby
villages for the same.
• 4. Indusrry should maintain the dignity and
respect of women while projecting them through
• their advertisements for promotion of their
products.
• 5. Religious leaders can be involved to change the
mindset of the people in relation to the issue of
importance of rhe girl child and curbing the
practice of female foeticide.
6. Industry should support NGOs working on the
Issue.
Industry can create the database of the health
status of their employees and their families.
Industry should make gender sensitive policies in
their companies.
In the Industry run schools and colleges,
sensitization of teachers and students,
primarily on the issue of female foeticide and
factors responsible like dowry and discrimination
against the girl child could be taken up.
PFI and Plan India is carrying the campaign
• further to four more states, namely Delhi, Andhra
• Pradesh, Madhya Pradesh and Chattisgarh in the
• next two years. During the first year, the campaign
will cover Delhi and Andhra Pradesh, which
• involves workshops, seminars and roundtable
• conferences with legislators, corporate leaders, media
• and other stakeholders. A total of 13 workshops/
• seminars will be organized in the two states. For the
• Parliamentarians/State legislators, two workshops
• will be conducted, one each in Delhi and Andhra
• Pradesh. There will be three workshops with the
• corporate sector, two in Delhi and one in Andhra
• Pradesh. To sensitize the media and other stake
• holders, four workshops will be organized, two in each
state. Four toundtable conferences are also scheduled in
• the campaign with professionalslteachers/film and radio
• producers, two each in Delhi and Andhra Pradesh.
Besides the above activities, mass media publicity
• through audio-visual and print also form a part of
the campaign. Priority is also given to student
• activities to sensitize the issue through plays,
• seminars, debates, competitions etc. The activities,
• issues, strategies, follow-ups and all other
• information on the campaign and otherwise will be
available on the Internet.
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Naya Savera
• of HIV/AIDS epidemic. Since the private and the
(Integrated Family Welfare Programme) - In
• NGO sectors are playing a major role in providing
collaboration with Lakshmi Cement (A Division of health care facilities, it was decided to form a
J K Corp. Limited)
• Consortium on RH-HIV/AIDS, T.B. and Malaria
The Foundation in association with Lakshmi
• so that their involvement is assured in reaching to
Cement, a division of JK Corp. Ltd, is planning to : the target population with ARVs as per the national
launch an Integrated Family Welfare Ptogramme,
• guidelines. Accordingly, a NGO/Private Sector
'Naya Savera', in Pindwara Tehsil of Sirohi district of • Consortium is being formed on RH-HIV/AIDS,
Rajansthan. The four year project will cover a
T.B., Malaria, in which Confederation of Indian
population of 27000 spread over 10 villages of the • Industry, Population Foundation of India, Engender
district.
Health, Freedom Foundation and the Indian
Parivartan
• Nerworking for People living with HIV/AIDS are
. the members.
(A Family Welfare and Population Development:
The Consortium will help articulate a
Project) - In collaboration with JK Tyee (A
common vision within the private and NGO
Division of JK Industries Limited)
sectors for strengthening RH-HIV/AIDS, TB
The Foundation and JK Tyres, a division of JK • and Malaria prevention and control programmes,
Industries Ltd, have joined hands to start a Family • and specifically to:
Welfare and Population Development Project in the • Address concerns on effective, safe and client-
Rajsamand district of Rajasthan. The five year
centered delivery of treatment and care of
project will cover around a population of 100,000
HIV/AIDS.
spread over 60 villages.
• IdentifY gaps in the current RH-HIV/AIDS, TB
and Malaria programmes and to suggest plans to
The objectives of these projects are:
plug such gaps.
• To build capacity of community level volunteers
• Initiate or support efforts to access resource from
on issues relating to general health & hygiene,
the Global Fund for HIV/AIDS, Tuberculosis
RCH and to ensure their involvement in making
and Malaria in order to strengthen and improve
services available on a sustainable basis at the
the prevention-to-care continuum in India.
grass root level.
• • Work in tandem with the existing nodal agencies
• To raise awareness and knowledge of the
tasked with addressing gaps in existing strategies
community stakeholders such as school teachers,
for HIV/AIDS, TB and Malaria prevention and
Anganwadi workers, ANMs, local elected leaders,
control.
opinion makers, RMPs and other members on
• Provide a mechanism for strengthening civil
general health and RCH issues through IEC and
society participation in reviewing existing and
BCC programmes.
forthcoming national programmes.
• To provide quality RCH services in the target
• • Act as a pressure group to ensure quick and
areas through mobile van.
timely movements of funds from grant making
• To organize socio-economic development
bodies such as the Global Fund, once these grants •
activities in the target villages to enhance the
have been approved.
effectiveness and acceptability of the programme. • Promote greater involvement of people living
with HIV/AIDS at all levels.
NGD/Private Sector Consortium on
RH-HIV/AIDS, T. B. and Malaria
· Delivery of Quality RCH Services
In tune with the global strategy of 3 by 5
· through Mobile Clinic in Urban Slums
(providing 3 million people with ARV treatment by
In order to provide quality RCH services to
2005), NACO is planning to provide free Anti
• people living in the urban slums, the Foundation is
Retr6 Vir;tl (ARV) treatment to 1,00,000 people, • p!:lnning to start two mobile clinics. A mobile clinic
which is an important aspect of the care continuum
will visit the Tigri resettlement colony and Nagla
Population Environment Oevelopment-A Bulletin of Population Foundation of India ~
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• effectiveness in accelerating family planning
programme in the EAG states (Bihar and
Jharkhand on a pilot basis in the first phase) and
• then scale up in the most vulnerable 20 districts
in the EAG states, in the second phase.
PFI will play the role of a coordinator/
facilitator and implement the national level
• programme in planning and producing
: innovative IEC/BCC materials for promotion of
Machi slums of Delhi, twice a week. This three year
project will be implemented in association wirh
SWASTHYA, Delhi and will cover a population of
30,000. As part of the second pr~ject, a mobile
clinic will visit the Badarpur slums of Delhi four
days a week and will cover 100,000 population. The
three year project will be jointly implemented by
PFI and Community Aid Sponsorship Program
(CASP), Delhi.
• family planning for next four years.
In order to come out with a detailed proposal
• for four years, PFI would initiate the following
• planning activities:
• Constitution of a Technical Advisory Group
• • Identification/selection
of consultants
• Desk review of past IEC/BCC strategies and
programmes
• • Organizing national level workshop on IEC/
BCC strategies
Innovative Communication Strategy
for Promotion of Family Planning in
EAG States
Communication media plays a significant role in
• promoting family planning programme. However, in
India in spite of vast amount spent on IEC
• interventions in the past, these have not succeeded
in achieving the central objective of creating ot
sustaining demand for contraception, and have
• Development of strategy papers by consultants
based on formative research
• Development of a draft IEC/BCC strategy for
EAG states
• Organizing a national level workshop to
discuss the draft strategy and
recommendations for its finalization
• Development of a detailed proposal for
implementation of the strategy.
• failed to produce the desired impact. Total Fertility
Rate (TFR) has not declined to the replacement
• level at many places and there is no significant
• increase in the Contraceptive Prevalence
Rate (CPR).
Against this backdrop, the Foundation has
taken the challenge to bring the IEC/
• Communication professionals together and
• explore the possibility of producing powerful
and innovative range of IEC/Media
communication messages and materials that can
be utilized through various means of
• communication channels at various levels of
• operation viz.
• Community/Block/Districts
• 8 EAG States
• National
Guided by this vision and mandate, the
Foundation has proposed to develop a three-
pronged innovative IEC strategy based on
• planning, implementation and monitoring. The
• strategy will also include the use of
• communication tools to demonstrate its
· Advocacy Programme on 'ICPD at Ten'
International Conference on Population and
Development (ICPD) at Cairo in 1994 was a
watershed in the direction of redefining the linkages
between population and development and
reorienting population policies and national
programmes of family planning. While the
• Programme of Action (PoA) is comprehensive and
• calls for action at various levels, the strategic focus of
the recommendations is on action at the national
• level.
The ICPD PoA emphasized that improving
• reproductive health services, empowering
• women and meeting peoples' needs were
central to population stabilization. Following
• ICPD, many countries embraced this
paradigm shift and redesigned their population
programme. National Population Policy (NPP)
• 2000 and Reproductive and Child Health
• (RCH) Programme reflect the paradigm shift
• with emphasis on gender, rights and
• development.
~
Population Environment Development-A Bulletin of Population Foundation of India
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The national component of Country
Programme-6(CP-6)
of UNFPA (2003-2007)
comprises a set of strategic interventions to be
implemented by Ministry of Health and Family
Welfare, UNFPA and some NGO partners to
promote a favourable environment for the
implementation of the National Popuation Policy
2000 and the UNFPA CP-6.
Three broad areas were suggested by UNFPA!
Ministry of Health and Family Welfare:
a. Policy Advocacy - related to NPP 2000 and
ICPD Programme of Action.
b. Issue-based Advocacy - on pre-birth elimination
of females, gender based violence, adolescent and
sexual and reproductive health, age at marriage,
infant, child and maternal mortality, prevention
of HIV/AlDS, quality of care, ete.
c. Management of Advocacy Grants Programme -
Grants for NGOs to support/implement
advocacy activities on population & development
and reproductive health.
To carry out the above interventions, UNFPA
and the Ministry of Health & Family Welfare have
joined hands with PFI for the implementation
process. The three areas of activities are:
• Policy Advocacy: National Consultation on
ICPD+IO - NGO Perspectives.
• Issued-based Advocacy: Building supportive
environment for improved quality of care
through advocacy initiatives.
• Management of advocacy grants to NGOs.
Objectives:
• To assess achievement, identifY challenges,
constraints and opportunities and formulate
lessons learnt in the implementation of the
ICPD PoA and recommend corrective
strategies for the next 10 years.
• To build supportive policy and programme
environment for improved quality of care
through advocacyinitiatives.
• To promoteissue-based advocacy initiatives
through non-government organizations by
providing them small grants.
Advocacy on Reduction of Maternal
Mortality in Tribal Areas in Orissa
Population Foundation of India has taken up a
project on 'efforts towards reducing maternal
morrality through adYo~aq' in four districts of the
erstwhile undivided Koraput in Orissa. The project
• is a part of the State
• Government/
project. The districts
• to be covered under
• the project are
Koraput,
• Nabarangapur,
• Rayagada and
• Malkangiri. The goal
• of this project is to create a supportive policy and
• programme environment for reduction of maternal
mortality and promoting safe motherhood.
· Objectives:
• To sensitize government, public-private health
care providers, PRIst NGOs/CBOs/SHGs etc to
address issues of maternal mortality and safe
motherhood by building a supportive
• environment at the district level.
• To document the outcomes and recommendations
and prepare the District Advocacy Plan (DAP)
through district-level workshops.
• To present at the state-level, the District
Advocacy Plan and develop a State Advocacy
Plan (SAP) through consultative process for a
period of two years.
• • To organize the consultation meeting with key
government officials to suggest the integration of
the findings that emerged from various levels of
workshops into the present health strategy of
the State.
• • Formulation of an implementation strategy/
monitoring plan of the DAP for two years.
God took the fragrance of a flower,
The majesty of a tree,
The gentleness of morning dew,
The calm of a quiet sea,
The beauty of the twilight hour,
The soul of a starry night,
The laughter of the rippling brook,
The grace of a bird in flight,
The tender care of an angel,
The patient of eternity,
The depth of a family's need,
Then God fashioned from these things,
A creation like no other,
And when his masterpiece was through
He called it simply; Motht:r
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rnImplementing the Concept of Community Health Care System (CHCS) of the ICSSR/ICMR
"Heath for All - An Alternative Strategy"
e Foundation for Research in Community
community who are capable of undertaking 80% of all
Health (FRCH) has been a pioneer in the
preventive, promotive and curative problems including
conceprualization and implementation of field-based
national disease programmes.
health care projects since 1975 and is adept to advocacy of the • 6. The engendering of community initiatives in health,
highest levels. The Foundation provided the Secretariat for
environment and sanitation and demands through the
the path breaking ICSSRlICMR Report "Health for All: An
catalytic presence of the health workers.
Alternative Strategy" in 1981 which provided the guiding
A concurrent rejuvenation of traditional health practices
principles of a people-based form of health care. The Report's
and systems and a=ptability of new introduced ones like
recommendations were incorporated into the National Eight
homeopathy.
Five Year Plan. Ten striking examples of demonstrations of
8. Development of a cadre of community master trainers
health care alternatives undertaken in the 1970s and 80s
who will be instrumental in the dissemination of this
throughout India (Antia and Bhatia, 1993) as well as in
concept at the national level.
China, Costa Rica and Sri Lanka (Rockfeller Report, 1985)
9. The transformation of rural women as repositories of
reconfirmed the Report's conviction that about 95-98% of all • knowledge and skills has been a singularly important tool
preventive, promotive as well as curative health care could be
in this quiet process of women's empowerment as well as
undertaken within the 100,000 population level in a
providing remunerative employment for women living in
decentralized people-based health system. Of these, the
their homes within their community.
• FRCH experiment in Mandwa, Wesr Maharashtra revealed
• that pre/semi literate village women when trained in an
Whilst the development of such Community Health
: appropriate manner could achieve in 1975 many of the
• Functionaries has been supported by HNOS (Netherlands),
• targets for national diseases put forth by the Government of • the John and Catherine MacArthur Foundation (USA) and
• India for the year 2000 (Antia, 1986). This approach
the Sir Dorabji Tata Trust, the dissemination of this successful
emphasized the prime importance of the social aspects of
• concept at a national level in Maharashtra, Orissa, Gujarat,
illness care with medical inputs playing a secondary
• West Bengal and Jharkhand has been facilirated by a grant
supportive role.
from the European Commission through the Ministty of
Health and Family Welfue, Government of India. This grant
The FRCH run project at Parinche, Purandhar Taluka in
was also instrumental in the establishment of a Resource and
Western Maharashtra has since 1995 conducted an
• Training Centre at Parinche. Since its inception in April 2002,
• intervention project with the aim of developing and utilizing
the Centre has conducted training and orientation courses for
village women as health and development workers of the
• community co-ordinators from 4 states and provided training
• community based health care system.
• to their grassroots health workers. Exposure of the Parinche
Project has also been undertaken through mass media,
The main outcomes of this health effort from the portal • introductoty publications and presentations. The ongoing
of overall community development have been:
work at FRCH concentrates on devising referral facilities for
1. The forrnation of a two-tiered cadres of health workers • the grassroots workers. A diagnostic sofTwarepackage for the
viz. the Gramsakhi and the upgraded Sahyogini.
grassroots is being developed for use through
2. The development of an innovative participatoty and
telecommunications. A rural hospital-cum-training centre
integrated training method.
(People's Health Complex) has been conceptualized in the
• 3. The development of formalized syllabi for training of
• ICSSRlICMR Report as part of a comprehensive decentralized
Gramsakhis and Sahyoginis that has been accredited and : people based health care system. Intervention projects are
adapted for the distance education mode by the National • being planned in the villages around Ralegan Siddhi in Parner
Institute for Open Schooling (NIOS). This provides
taluka, Maharashtra and the tribal area in Pal region ofJalgaon
professional space for health workers through national
• district with a strong research component to help advocacy
certification.
and permit analysis of logistics, costing and outcomes. It is
• 4. The highly effective incorporation of multiple non-
• only then that the chasm between "demonstrations" to
medical inputs into the training programme such as non- • "systems" will be crossed as per the Community Health Care
formal education, environment, water management, micro- • System conceptualized by the ICSSRlICMR report.
economic initiativesand severalother socio-culrural activities.
Dr N H Antia, FRCS, FACS (Honorary)
5. The increasing acceptance of these health workers by the
Director, FRCH, Pune
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1.9 Page 9 |
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1T~LtjDJla1Ltvel r'DI13Iut~1tjOJl
'fJeo r Ie
Young people between 10 and 24 years of age
constitucealmost one-third of the total
population in India. Yetservicesthat address
: to replicate proven strategies and best practices. The
• members of this alliance have organized state-level
• consultations in 12 states (see table below).
adolescent issuesrelating to health including sexualand
The National Alliance has organized a National
reproductive health, communication, education,
Consultation during 21-23 May, 2004 at New Delhi,
livelihood,life skill, employment opportunities, gender • to give young people the opportunity to voice their
inequity and participation in policy making are few and • concerns, hopes and aspirations, to take these voices
far in between. Absence of youth-focused information • to the policy makers and programme implementers.
and services,changing sexualactivityand low use of
contraceptivesare factors that puts young people at
· The purpose of the Consultation was:
particular risk of unwanted pregnancies and infection
• Collect and analyze various programmes and
with HIV and other STIs. Thete is a need to share
policies for youth being implemented by
experiencesof what works for adolescentsand youth and
various organizations, departments and
towards this end, a group of organizations,including, Bal • ministries;
Panchayats,Centre for Health, Education, Training and •• provide evidence on the situations and needs of
Nutrition Awareness(CHETNA), Centre for
young people;
Population and Development Activity (CEDPA), Child • suggest modifications in existing policies and
in Need Institute (CINI), Community Aid and
programmes, as needed;
Sponsorship Programme (CASP), Global Health
• develop a mechanism to share and disseminate
Council (GHC), MAMTA Health Institute for Mother
evidence-based effective practices and models;
and Child (MAMTA), National Foundation ofIndia
• establish a joint monitoring mechanism in
(NFl), Pathfinder International, Plan India, Population
consultation with various ministries and networks,
Council and Population Foundation ofIndia in
especially the Department of Youth Affairs;
collaboration with Ministry of Youth Affaitsand Sports . • create a space for open discussion on health and
and Ministry of Health and FamilyWelfare, have come
development issues of young people and diverse
together to advocate the formation of an alliance,
points of view; and
"Young people: Towards a Healthy Future".
• bring forward the concerns (evidence-based) and
The aim of this alliance is to improve policies, laws
measurable indicators of young people's health
and programmes at national and state levels in order
and development with focus on reproductive health.
S.No.
1
2
3
4
5
6
7
8
9
10
11
12
State
Maharash (fa & Goa
Uttaranchal
Unar Pradesh
Bihar
Jharkhand
Rajasthan
Gujarat
Delhi
Tamil Nadu & Pondicherry
Andhra Pradesh
Karnataka
Orissa
Dates
5-8 February 2004
10-12 March 2004
15-18 March 2004
5-7 April 2004
15-17 April 2004
19-21 April 2004
27-30 April 2004
29-30 April 2004
31 March-3 April 2004
3-4 May 2004
5-8 May 2004
1 June 2004
Lead NGO
CASP-Plan
HIHT&PFI
Mahila Samakhya
Pathfinder International
CINI & PFI
CHETNA
CHETNA
CASP-Plan
RUHSA
AGS
Myrada-Plan
CYSD
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1.10 Page 10 |
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The themes of the National Consultation
were:
• Health Risks for Youth.
• Communicating with Youm.
• Education, life skills and livelihood.
• Policy, programmes and participation.
• Communiry Aid & Sponsorship Programme
• (CASP), New Delhi. Population Foundation of
• India is me Secretariat of the Alliance and is
• planning ro release a special issue on these efforts.
Swami Vivekananda's
Expected outcomes were :
• Facilitate the development of a pressure group of
young people;
• Ensure yourh participation in the formulation of
policies and implementation of programmes;
• Enable advocacy and capaciry building of youth;
• Develop an action plan (with State Government
and Non-Government stakeholders) for effective
programming and implementation of yourh
programmes and policies.
This consultation has been organized by me
call to Youth of India:
"Be strong, my young friends; thar is my advice
ro you. Stand up, be bold, be strong. Take the
whole responsibiliry on your own shoulders, and
know that you are the crearor of your own
destiny. All the srrength and succour you want
are within yourself".
(From Noble Thoughts: Compilations of
Ramakrishna Mission, New Delhi)
The Population Advocacy Essay Competition
was organized by me District Population
Comminee on Advocacy of me Rotary
• higher secondary level. The ropies were:
Role of Adolescents: The essays were expected ro
• suggest pragmatic action plans for current group of
• District 3010 among the students at the higher
• adolescents ro prepare them for the next generation
• secondary level in schools. The students were from • of family builders.
• the schools falling within the area of RI District
Gender discrimination: The essays were expected
• 3010 comprising the entire National Capital
ro bring our the implications of gender
Terrirory of Delhi and parts of Haryana, Rajasthan • discrimination on qualiry of life in general and on
• and Unar Pradesh.
• poverry alleviation in particular.
The objective of the essay competition was ro raise.
Inter-relationships between population growth
awareness and assess me understanding of population
and qualiry of life: The essayswere expected ro bring
• related issues that impinge on me life in me short as • our me salient aspects of the interrelationship and
• well as me long term among me students of the
• suggest ways and means ro improve the qualiry of life
0)
"OI'IJUT ArNcx;.J;, fS Y COII'tm
IOO~ '100,
/>tIZE DlS~no.r..,~
ROTAIN CLW Of IlEUlI' T
• assuming mat people are free ro move from one place
• ro another wimin me country and ro choose the
• number of children mey would like ro have.
A prize disrribution function was sponsored by
• me Rotary Club of Delhi, Saket, and was organized
• at Gyan Bharati School, Saket, New Delhi, on
• February 7, 2004. Over 3000 students spread over
• District 3010 participated in the competition. 50
students coming from 26 different public and
government schools and 7 N.C.C. battalions were
• awarded the prizes.
This advocacy project was financially supported by
• UNFPA and Population Foundation ofIndia (PH).
~
Population Environment Development-A Bulletin of Population Foundation of India
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A;;In Five Districts of Bihar
terthe first round of broadcast of dramas
on health and social issues through All India
villages in the cwo Panchayats among themselves
to promore the programme.
• After the broadcast of each programme, shrotas
adio, Parna covering 14 districts of Bihar,
discuss the issues in the community and also in
the Foundation has repeated the broadcast along
their project meetings.
with intensive community support through local
• Two quiz programmes will be organized by each
organizarions for strengthening the listenership of
club during the six months' period and awards
the programmes in 5 districts of Bihar, namely,
will be given to encourage listenership. A
Nalanda, Pama, Vaishali, Gaya and Nawadah. The
memento will be given to each club as a token of
following local organizations have formed 6 listeners'
their service.
clubs each in and around their working areas and are •
promoting the radio programmes through rheir own
In Three Districts of Chattisgarh
necwork.
The Foundation has launched another
Community Radio Programme in three districts of
I. Board, Parna
• Chatrisgarh, namely, Jagdalpur, Dantewada and
2. Lok Prabhat, Nawada
• Kanker to empower the communiry with
3. Nisha Bunai Silai School, Nalanda
• information and knowledge on health, popularion
4. Jan Jagran Sansthan, Nalanda
and social development issues through a series of 52
5. RJSDTH, Parna
episodes in Halbi dialect.
6. Vaishali Samaj Kalyan Sansthan, Vaishali
Bastar True Light Samiri, a non-government
Janani, Pama is also promoting the community radio
organization in Jagdalpur, assisted in launching the
programme by forming the listeners' clubs through
• programme and in involving other local non-
their health workers in cwo blocks, namely Parut under
government organizations to bring the programme
Bikramganj and Nagwa under Naubatpur of Pama
at the door steps of the community. Initially, a
district following the same strategy.
baseline survey was conducted to know the
community and what issues should be addressed
Methodology:
. through dramas.
• The selection of members of the club called
Audio-cassetres have been distributed to 14
shrotas are selected by the NGOs. The shrotas are : NGOs coordinating the programme at the ground-
provided with a diary, a pen, identity card, caps
level. The programme is broadcast on every Sunday,
and a cloth bag with the logo of UJ ALA , and
from 6.30 to 7.00p.m. through medium wave from
blank casserres to record the voices of community
AIR ]agdalpur. The first programme was aired on 7,h
in relation to the programme. The members are
March, 2004.
the adolescent girls and boys in the age group of
Another programme Patrotar has been started
16-25 years.
• from AlR-Jagdalpur, in which the letrers writren to
• Audio cassettes of 26 episodes of U]ALA are
• AIR as well as the NGO are answered.
given in advance to the NGOs along with cwo-
in-one audio sets so as to enable them and the
shrotas to listen to each programme and note
Awards
down the issues addressed in the programme in
their diaries, clear their doubrs on health issues
and raise these issues in community discussions.
• The shrotas are mobilizig the community by word
of mouth and other lEe activities. These shrotas
after having mutual discussions cover different
PFI's Advisory Council Members,
Mr. T L Shankar and Mr. T V Antony have been
conferred with the country's prestigious Award,
Padma Bhushan for their outstanding
performance in their field.
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PFI in collaboration with Mahatma Gandhi Institute of
Medical Sciences, Wardha implemented a project namely
"Community partnership health initiatives to improve
Reproductive Health in Slums and rural areas of Nagpur in
May 2000 for a period of three years. The project was
implemented in eight selected slums of the city.
The objectives of the project were:
• To understand the attributes to Reproductive Health in
slum and rural areas of Nagpur.
• To decrease the morbidity and mortality among neonates
and in women of 15-49 year age group.
• Motivation and involvement of adolescents and informal
leaders in reproductive health activities by partnership with
health authorities and community.
The methodology of the project was:
Institute of Integrated Development (lID) was the
implementing agency at Nagpur and the staff of IID was trained
in a phased manner by CMD on various components of RCH,
especially on spacing methods and they in turn provided their
services to the slum areas. Two static clinics were established in
the two slum pockets to provide RCH clinical services.
Evaluation findings:
The end line evaluation was carried out in the month of
June 2003 in the 400 sample households of the eight slum
pockets. The evaluation findings are:
• A 2.5 point decrease in girls marrying below 18 years of
age between baseline and endline surveys.
• Majority of women (66%) possess immunization card and
about 85% children were fully immunized at the time of
• endline evaluation.
• • 96% women received at least two TT injections, which is
14 points higher than the baseline figure.
• • 87% women reported to have received IFA tablets.
• • Current use of FP is 64.5%, which is about 25 points
higher than the baseline figure of 39.2%. Out of which
• 77% women underwent female sterilization, 9% used
• condoms, 8% OPs and 3.2% women used IUD .
• 63% women availed ANC services from government health
• services, 13% are from the private health sector and 5%
• reported from the PFI sponsored clinics.
• • As a service care provider, PFI's clinic has served quite well as
• about 80% of the surveyed women cited that they were visited
by PHs clinical sraff
• • Findings of the endline survey suggest that only 44%
women were aware about the RTI/STD. Nearly one-fourth
: received the knowledge from PHs project staff.
• • 72% of the women reported to have reproductive health
• problem at the time of end line survey. About 52% of women
• who sought treatment for RTI problems, received treatment
• from PFI project clinic, followed by 27% in private clinics.
• • 77% women availed servicesfrom the PFI clinic Immunization
• service (41%) and PN C services (17%) tops the list, AN C services
• (6%) and FP services (7%) are at the bouom of the list.
• • Nearly 70% women rated clinical services as "Good",
whereas 17% women felt the services were "Okay" and only
• 3% felt they were "Not so good".
Mr A R Nanda, Executive Director, PFI delivered the George B. Simmons
Memorial Oration, 2004 on "Obsolescence and anachronism of
Popu!4tion Control· From Demograpby to Demology" during the XXVI
Annual Conference of The Indian Association fOr the Study of Popu!4tion
• (!ASP) on Popu!4tion, Health and Environment held during 9-11
February, 2004 at Annama!4i University, ChiMmbaram, Tamil Nadu.
Published by Population Foundation of India
B-28, Qutab Institutional Area,
New Delhi-ll0016.
Tel.: 26867080, 26867081 Fax: 26852766
e-mail: popfound@sifY.com / website: www.popfound.org
Editorial Direction & Guidance:
MrA RNanda
Editor: Mrs Geeta Malhotra
Editorial Committee:
Dr B P Thiagarajan
Dr Kumudha Aruldas
Editorial Assistance:
Ms R Vanaja
..•.1. ..... If uwkli~d pie"" "turn to,
~• a ~ ~
Population Foundation of India
B-28, Qutab Institutional Area, Tara Crescent, New Delhi-ll0016.