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ASSEFA Fishery Promotion Project Garhi Block :

ASSEFA western Region have been implementing the fishery promotion activity at Garhi block of Banswara District with the collabrotion of Basix and RMOL since last November 2009 .

ASSEFA has identified 10 village ponds and 10 SHG formed with 104 fisherman members .One cluster level committee formed for monitoring of the project.

Fishery activity  covered total 115 hectare area and its stocking area is 64 hectare.

With the help of Govt. fishery Dept. Training given to 62 members at Bhimpur National fish farm to build their capacity in March 2010.

Exposure visit held at Ankleshwar Gujarat for 25 fish farmer in May 2010.In the exposure farmers learnt about procurement of input such as seed supplementary feed ,harvesting ,rearing and marketing of fish.

ASSEFA western region is giving handholding support on regular basis to fishery groups.

In the month of July 8.00 Lakhs fry and 1.60 Lakhs fingerling seed planed for stocking in the ponds.

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Expouser visit at Ankleswar
Assefa
Fish Harvesting
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Fish Tank
     
Assefa
Fishermen Traing
76
Net weaving training
97
Pond visit by RMOL
Communication on Health Advocacy in National Rural Health Mission for Grass root Empowerment”(CHANGE) :

Joint effort of

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ASSEFA BANSWARA
CHETNA Ahmedabad
Health & Family Welfare Department of Rajasthan

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Goal :
Communities have access to quality public health services through a process of community mobilization through effective use of participatory communication techniques under the National Rural Health Mission of the Government of INDIA.

Change :

   Objectives :
1    Development of a participatory communication strategy (including communication package) to advocate for health entitlements of rural communities.
2    To enhance the capacity of the service providers, civil society organizations, media and PRI on communicating and advocating for NRHM commitments.
3    To promote community awareness on NRHM entitlements.
4    Forums/round-tables among various stakeholders formed to promote exchange of experiences, innovations, learning and challenges.
5    Key processes and learning documented and disseminated.

Participatory Need Assessment (PNA) :

   Objectives :
1    To find out the knowledge of the community on NRHM and its entitlements.
2    To find out the existing knowledge of the community, service providers and PRI on communicating and advocating for NRHM commitments.
3    To find out the perception of the community on the functioning of the Sub-centre and PHC.

Profile of Anandpuri Block :
General Information :


Anandpuri is the block headquarter of Banswara District. It is located about 70 km from District HQ
   Total No. of Villages    :         136
   Total Population    :         11206
   Men    :         56613
   Women    :         54593
   Literacy Rate    :         44.60%
   Percentage of ST    :         72.27%
   % of rural population    :         92.85
   Gram Panchayats    :         26
Health Status :
   No. of PHCs    3
   No. of Sub-centres    31
   Ayurvedic Dispensaries    3 (Pithapura,Chandarwara,Falwa)
   Homeopathic Dispensaries    0
   Allopathic Dispensaries    4 (Udaipurabada,Chandarwara,Naharpura,Anandpuri)
   Maternity Homes    0
   Child Welfare Centres    0
   TB Clinics    0
   Private Doctors    15
   Institutional Delivery    62
   CBR    25.54
   IMR    52.13
   TFR    3.4
   MMR    1.3

Area Coverage :

   Sr.    Name of PHC    Nearest Village    Village at Moderate distance    Remote Village
   1    Udaipura Bada    Ratapan    Kataro ka Talab,Bhawanpura    Kajaliya, Pichawara
   2    Chandarwada    Chayna    Kelkuwa    Navagav
   3    Naharpura    Tori,Koba    Ganwawabada,PUnchiyawara    Chothmal

Sample Size

   Sr. No.    Activity    Total No. of Activities    Participants
F M Total
   1    Key Informant Interview    18       11    7    18
     ASHA    10       10    -    10   
     MO    4    3    1    4   
     BEE    1    -    1    1
     BHO    1    -    1    1
     District Collector    1    -    1    1
     CM&HO    1    -    1    1
   2    Focused Group Discussions    27    286    88    374
     Women of community    10    140    -    140
     Community    10    97    62       159
     PRI/VHSC    3    12    21       33
     ASHA Worker    2    32    0       32
     Health Service Providers    2    5    5    10
   3    Social Mapping    10    25    86    111
   TOTAL        55    322    181    503

Major Findings of PNA

Health Status

Community including Women –( No.237)  :


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All community members, including pregnant and lactating mothers, listed cough-cold, fever, TB, Diherria, Malaria and  body pain as a major health concern

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100 said the elderly and 154 said children(anemic and diherria) were more vulnerable to illness.

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During change in season and  monsoon Upper  and Lower respiratory track Infection among women and pneumonia, malaria among children were prevalent.

Health Service Providers  :


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All service providers said water pollution (water mixed with fluoride) led to  disease, eye problems and diseases related to respiratory tract in addition to waterborne diseases.

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Women and children were mostly vulnerable to illness.

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Problems like heavy menstrual bleeding, miscarriage, under nutrition and  premature delivery were reported by service provider.

Experience in utilizing govt. services :
Community


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Out of 237, only 181 community members availed private healthcare services.

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According to community members, PHC and Sub-centres are not functioning regularly.

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ANMs provide the services at village level.


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People usually availed services like vaccination, ANC-PNC checkups and IFA from PHCs.

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PHCs are located within 5-8 km from villages.

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For general treatment, people access private healthcare services.

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Deliveries are not conducted in PHCs .Community prefer to go nearest Private Hospitals.

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Proper medical facilities, lack of cooperation by staff and Dr. not available at PHCs

NRHM Status  :
Community members – (237)


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All community members only aware about  NRHM schemes like Janani Suraksha Yojna & MCHN day.

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Community members have not seen Charter of Citizen’s Health Rights.

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None of the community members have attended NRHM awareness meetings.

Key stakeholders  :


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All ASHA (32) and PRI (33) members were aware about the entitlements under NRHM

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Information on NRHM as stated by PRI are.




Janani Suraksha Yojna


108


MCMN Day


No PRI/VHSC members had heard about untied funds. 


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Untied funds have not been utilized for health initiatives by VHSC members.

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Generally VHSC formed but not active and unknown about untied fund.

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Untied fund used as purchases of furniture and toys for AWC by provided by ANM.
p>Health Service Providers 18 (Medical Officer-4, FHW, MPW, Malaria Worker, ANM,LHV ,IEC Incharge)  :
All the service providers had heard about NRHM and the various schemes under it.


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Health service providers listed the following information under NRHM




Janani Suraksha Yojna


MCHN Day


ANC-PNC care


Vaccination


Family planning


Hygienic food


Emphasis on institutional delivery rate


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To improve the utilisation of NRHM following initiatives done by PHC




Meeting


Personal contact


Mass awareness campaign

Communication -Sources  :
Community


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There is lack of IEC material and mostly posters not attract and message communicate to community.

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Lack of awareness to understand the use and massage of the posters.

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214 out of 237 community members said that ASHAs, AWWs and ANMs are the key sources of health information.

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Due to low level of literacy both the content and language of the available IEC need to be improved.

Service Providers and Govt. Officials  :


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Major communication tools used in health awareness programme are: Posters, flip charts, hoardings, banners, audio-video shows, wall paintings,

Existing Sources of Communication :

   Information received on    Medium of information       Sources
   Malaria    Posters    Anganwadi centre
   TB       Charts    ASHA worker
   Typhoid    Pamphlets    Sub-centre
   HIV-AIDS    Leaflets    PHC
   Janani Suraksha Yojna    Hand-outs    CHC
   108  Ambulance    Hoardings    Panchayats
   Seasonal Dieses    Banners    School
       Wall paintings    NGOs

Communication Needs Emerging from PNA  :


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Common understanding on various schemes and entitlements under NRHM

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Charter of Citizen’s Health

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Hygiene and sanitation improvement and pure drinking water facility in PHCs, CHCs and Sub-centres

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Role of VHSC and utilisation of untied funds

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Entitlements of women and children

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Importance of ANC, PNC and Newborn care

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Prevention of Diarrhoea

Suggestions received during PNA to strengthening govt. health services  :


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24-hour staff availability in the health facility

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Emergency services

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Sanitation, cleanliness and water facility

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Provision of privacy; separate male, female wards

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Adequate stock of medicines

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Sensitivity or positive behaviour of staff

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Proper services for migrant people.

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Referral services

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IEC material provided to PHC and Sub center but use of this material is not in priority

Training Needs  :
Key stakeholders – ASHA(32)
32 out of 32 ASHAs received training  .


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They want to receive training on RCH, maternal health, first aid, nursing, counselling, communication skills & record keeping, technical knowledge about TB & other diseases, child care, application and dosage of various medicines, how to give injections and information on NRHM entitlements.

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Roles and responsibilities of VHSC  use of untied funds.

Service Providers and Govt Officials (Medical officers-4 and Block Extension Educator-1) :


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NRHM entitlements, record keeping, technical training

FUTURE PLAN  :


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Data sharing

Block and District consultation; sharing of PNA findings

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Communication strategy
 

Discussion on  draft Communication strategy, with block health authority and explored the  possible  collaboration


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Capacity Building Training
  Capacity building training of ANMs/ASHAs/AWWs on their role   clarity in NRHM

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Staff Deputation From Govt. in Training
  Government officers will be invited for capacity building training
   Stakeholder    Activity    Expectation from Govt.
   ASHA    Training    Deputation of participants and support as resource person, facility of training venue
   ANM/FHW    Training    Provision of available funds
   PRI Members        Training    Training support
   Existing Forums    Meeting    Training support & funds
   Community    Meeting    Training support & funds
   Community Awareness    Programme    Joint planning, use of materials and facilities, such as vehicles

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FGD with ASHA
Assefa
FGD with ASHA
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FGD WITH WOMEN COMMUNITY
     
Assefa
Interview with ASHA
76
Interview with BCMHO
76
Interview with District IEC Incharge
     
76
Interview with MO
76
Interview with Service Providers
76
Maping with Community
Participation:

The district partner participate in all the meetings held by govt. health will centres and expect greater participation of govt. health officers as well as service providers in  meetings and training programmes organized by the project team.

Experience sharing

Monthly sharing meetings at block level and quarterly sharing meetings with the district will be organized on regular basis.

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