IIF’s Community Health Initiative (CHI) covers 1.5 million backward tribals in the State. CHI aims at the reduction of existing disabilities and incidence of future disabilities through prevention and cure using existing delivery systems and available infrastructure, in partnership with Government, NGOS and local community. IIF was specifically requested to impart health education on the social factors affecting malnutrition – discourage child marriage and delay conception of the first child; promote exclusive breast-feeding and registration of pregnant mothers at Health Centres, spacing of child births, improvement in hygiene and sanitation, etc. – and encourage immunization against childhood diseases amongst other interventions.
IIF deployed three diagnostic vans, donated by corporations, to identify vision problems, hold periodic health camps and identified several Referral Centres for the poor to avail of free-of-cost treatment. Today disabilities have reduced dramatically: Cleft Lips & Palates – by 100%, vision problems -by 80%, hearing - by 60%, and Orthopaedic – 40%.
Assess: IIF saw that villages, as compared to the cities, were poor in health. To reduce disability a model project in close partnership with the Government, needed to be introduced whose success could be replicated. A leading social work agency was commissioned to undertake a participatory baseline survey, understand the community’s needs and priorities and enlist support. The Government appointed a senior Deputy Director, Health Services, as a Liaison Officer for the Community Health Initiative, so that the Government health infrastructure and personnel worked with IIF to identify the lacunae necessary to bridge the gap. IIF appealed to the Corporate Social Responsibility components of the private sector to provide funding support and donation of professional skills.
Plan: Impact India’s mission is to initiate, augment and intensify action against those causes of massively prevalent disablement for which there exists a potential for prevention and control, which can be delivered through existing delivery systems and available infrastructure. To treat millions of people who are disabled by curable blindness, deafness and physical handicaps and facial deformities. With millions of rural Indians unable to afford the most basic surgeries such as for cataract removal, hearing correction, cleft lips or mobility restoration, a large number are compelled to live in darkness, or without sound, movement or with facial deformities. Thus IMPACT India has brought together the corporate sector, NGOs and other civil society organizations to work in partnership with the Government in mass health programmes of national priority.
The objective of the Community Health Initiative was the reduction of existing disabilities and the incidence of future disabilities using curative and preventive measures.
Act: IIF swung into action recruiting 40 staff, mainly locals, oriented to act as change agents to coordinate activities covering 1.5 million tribals (widespread over 5000 square kms) and mobilizing the community to avail of health services.
Meetings were held with Self Help Groups, Anganwadi (crèche) Workers, Bhagats (Traditional Medicine practitioners, Suhinis (Traditional Birth Attendants) and partnerships were fostered with Referral hospitals for free-of-cost treatment. Curative activities included detection and treatment of disorders and deformities related to vision, hearing, cleft lips & palates, orthopaedic and dental problems. Prevention activities focused on Health education programmes for mother & child with emphasis on malnutrition and anaemia reduction, sanitation & hygiene, and empowering women to benefit from government entitlements. IIF cultivated kitchen gardens to grow green, leafy vegetables and local fruits (for micronutrient supplementation), and undertook rain water harvesting projects to enhance water supply and make available clean drinking water.
Evaluate: A Process Evaluation was conducted by the Nirmala Niketan (NN) College of Social Work, Mumbai and a Final Evaluation by Centre for Leadership Development (CDL). Both studies revealed positive results and have been most encouraging. Suggestions from NN about the Health education sessions were incorporated such as – restricting discussions to only two topics per session, use of pictorial representations and the need to end sessions with a song / positive story, so that participants leave in a happy frame of mind. While CDL has recommended the formation of a Task Force for sustainability headed by the District Collector with local private sector representation. The Task Force, comprising privileged members of society, will commit time and resources to raise the health level of their disadvantaged brethren to create a just and equitable society.
Sustain: IIF has approached the District’s chief Government functionary – the District Collector to chair a Task Force for Sustainability of the Community Health Initiative. The Terms of Reference have been articulated. While the Government and private sector representatives will support with funding, IIF and other Non-Government Organisations in the area will make efforts to ensure the community is mobilized to create a demand on the public health system to ensure its effective functioning. Capacity building of the community assumes greater importance than ever.
Our Information, Education and Communication programmes on Health target women and adolescent girls using local folk art forms – Warli paintings on earthern pots, saris and walls, folk music, dance and theatre – to control Malnutrition caused by social factors. Now, more women give birth in Health Centres, immunise their infants, practise exclusive breast feeding for six months and include green vegetables in their staple (rice or finger millet) dominated diet. A Process Evaluation study conducted by College of Social Work, Nirmala Niketan in 2007 stated, “The programme has been successful in creating awareness amongst the tribal people on the importance of certain aspects of health such as cleanliness, hygiene, immunization and family planning. One important factor that has come out while interacting with all the stakeholders - tribal people, medical practitioners, Anganwadi (crèche) Workers and the staff of IIF, is that this programme is strongly need-based and relevant.”
Impact India Website: www.impactindia.org
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