PROGRAMME ON HEALTH Reproductive & Child Health (II) Programme Orissa is infamous for clocking one of the highest Infant Mortality Rates and Maternal Mortality Rates in the entire country. In the past few years several programme have been undertaken by the Government to reduce IMR which has come down, but still more have to be done. Reproductive heath care is more of a behavioural rather than a clinical problem. However, the people are not very much aware regarding health risks of the mother and the children. In order to educate the people, especially young mothers SEWA has been trying to provide counseling as well as various services to mothers and children. During the year the organisation was fortunate to be associated with the Dept. of Family Welfare, Govt. of India for undertaking RCH programme in Pakalpada & Babuchhipidihi Sub-Centre of Laikera Block of Jharsuguda district of Orissa as a Field NGO. Family Planning Association of India (FPAI) is the MNGO who provides financial and technical support to undertake the programme. Main objective of the programme - To increase the percentage of EC using modern FP methods to 100%. - To reduce the unmet need of the population to 25% from the current level. - To have 100% early registration of all pregnancies. - To increase complete ANC coverage to 90% from the current level. - To increase the institutional delivery practices to 75% form the current level. - To increase the deliveries conducted by the skilled attendants to 85%. - To increase the percentage of child immunization to 100%. - To reduce RTI/STI prevalence rate to 35% form to current level. - To increase the percentage of eligible women completed treatment to 75%. - To reduce the married girls conceived during adolescence to 15%. The Project Area and Beneficiaries Under the project all the villages coming under Pakalpada & Babuchhipidihi Sub-Centre in Laikera Block of Jharsuguda districts are are covered. More than 32 no. of villages are covered under the project. A little more than 10,000 people are the main target group for the project. 1 / 18
Activities undertaken on RCH Ø Intensive Training: In order to undertake the programme more efficiently the staff of the organisation were given several rounds of training by the organisation as well as by the mother NGO. This capacity building training programme was instrumental in implementing the programme more efficiently. - Mothers Meeting: As expectant and lactating mothers are the main target group of the RCH programmes the organisation undertook to sensitize the mothers and pregnant women on various aspects of as Pre-natal Care, Post-Natal Care, Child Care, Environment Cleanliness, diet and nutrition, self-hygiene practice, feeding techniques, behavioural change, contraception and prevention of contacting diseases such as RTI/STI/HIV/AIDS etc. - Adolescents Training and Meetings : Adolescents Groups for the girls have been formed in the project area who are provided counseling on various aspects of Reproductive Health. A number of adolescent meetings and trainings have been conducted in the project areas with adequate IEC to address adolescent reproductive health problem issues. Adequate education has been imparted on family life and normal sexual behaviour. - Eligible Couple Meetings (Target Couples) : Several meetings have been conducted for target couples on small family norms, contraception and infertility. Contraception dropouts have been taken proper care through special meetings for tracking of such behaviour. Contraceptive use has been very much successful with a substantial increase in Couple Protection Rate during the project period. - Immunization: The organisation is trying to ensure that all the children in the age group of 0-23 months are given all the immunizations under the Universal Immunization Programme. Expectant mothers were also immunized with two mandatory TT. The organisation is trying to help the local PHC/ANMs/AWWs to ensure that every child has been immunized on the scheduled date. - RTI/STI Screening Camp: RTI/STI and sexually transmitted disease is a major health hazard for women in the reproductive health age group. Besides, it has a direct bearing on the spread of HIV/AIDS as RTI/STD are regarded as opportunistic infections. So if RTI/STD infections are not identified and treated at the earliest it can lead to many serious health hazards including contraction of HIV/AIDS. To make the women aware regarding this infection and its affect on their health 12 no. of RTI/STD clinics were organised in which the women were made aware the symptoms of RTI/STD and what to do to prevent this infection. - CBD Centre: In the RCH area 32 numbers of Community-Based Depot (CBD) Centre were formed and managed by SEWA. For managing these centres people, ASHA workers and SHG leaders were made the stock holders of the depot and involved in social marketing of 2 / 18
contraceptives. This has increased the usage of contraceptive among the eligible people. With this innovation, contraceptives are available in the villages of RCH area which has encouraged its use. - Sensitization Workshop for AWW/ASHA/TBA: Aanganwadi workers, ASHA and TBAs are the grassroots level workers providing crucial services to the rural women for their good health. But it is felt many a times these workers are not skillful enough or motivated to work as effective workers. So the organisation conducted a series of training and motivation camps for the AWWs/ASHA/TBAs not only to enhance their skill level but also the motivational level so that they can provide the expected services in an efficient manner. - SRH Skill Education Session for Adolescent (Sathi Centre): Two Sathi Centres formed in 12 & 12 villages were strengthened by conducting regular meetings among the adolescent girls. Besides, vocational training were provided to them to economically self-independent. More than 30 young adolescents were enrolled in these centres. - IEC Campaign: IEC plays a vital role dissemination of right information to the people, especially in the rural areas. Need-base and appropriate development/procurement of posters/pamphlets/ booklets etc. were developed on RCH and are being distributed to the target group on a regular basis. Folk media and audio-visual based IEC programmes were also carried out. Monitoring and Evaluation: - Monthly, quarterly and half-yearly meetings with the staff for preparing monthly and weekly plan of action - Monitoring and reporting at the district level - Excellent co-operation with Govt. health providers & health functionaries. - Involvement of PRIs and male members in the RCH mainstream. 3 / 18
- Community participation. - Involvement of the SHG members Quantitative Achievement of the Programme APRIL 2007 MARCH 2010 4 / 18
Sl.no Activity BLS Target for Achivement during 1st yr Target for 5 / 18
Achivement during 2nd yr Target for Achivement 3 rd year Indicator 1st year Number % age 2nd year Number 6 / 18
% age 3rd year Number % age 1 Institutional Delivery 31.25 125 69 86% 106 96 7 / 18
90% 72 71 98.61% 2 Complete ANC 125 92 73% 106 8 / 18
87 82% 72 65 90% 3 Registration of Pregnacies 95% 125 125 100% 106 9 / 18
106 100% 72 72 100% 3.1 < 12 weeks 88% 29 29 100% 10 / 18
11 11 100% 0 0 0% 3.2 > 12 weeks 85% 96 96 100% 11 / 18
95 95 100% 72 72 100% 4 Complete PNC 27% 125 102 12 / 18
81% 106 95 89% 72 67 93% 5 Consumption of IFA tabs 63% 125 104 13 / 18
83% 106 95 89% 72 67 93% 6 Complete Immunisation status 65% 125 14 / 18
101 80% 106 88 83% 72 70 97% 7 Couple Protection Rate 2% 1526 15 / 18
211 14% 1529 318 21% 1528 377 25% 8 Early Marriage & Pregnancy 3.50% 16 / 18
2728 67 2.45% 3447 50 1.45% 3070 0 0 Qualitative Achievement of the Programme 17 / 18
Apart from the quantitative achievement the project was able to bring about a qualitative change in the outlook of the target group. The following qualitative change were noticed as far as reproductive and child health behavioiur is concerned. - Women became more aware regarding their reproductive rights - The people in the target area have started demanding their health rights from the authorities - Now people prefer institutional delivery as compared to home delivery - Women have a better status as compared to earlier as they have better access to food and rest during child bearing and child rearing - As immunization coverage has gone up, the maternal mortality and infant mortality rates have come down substantially. - The adolescent girls have become more aware regarding their health and personal hygiene - Morbidity and mal-nutrition among women have come down substantially. 18 / 18