Community Health Initiative

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Registration Name : eINDIA2011/AN/253
Project Category : eHealth::Best Civil Society/ Development Agency Initiative of the Year
Project Name : Community Health Initiative

Details of Applicant
Name : Zelma Lazarus
Address : Nhava House, 1st Floor, 65, Maharshi Karve Road, Marine Lines, Above ICICI Bank
City : Mumbai
State : Maharashtra
Country : INDIA
Zip Code : 400 002

Details of Project/Implementing Agency
Name of Organisation : Impact India Foundation
Address : Nhava House, 1st Floor,,65, Maharshi Karve Road,,Marine Lines, Above ICICI Bank
City : Mumbai
State : Maharashtra
Country : INDIA
Zip Code : 400 002
Name of the head of Organisation : Mrs. Zelma Lazarus, Chief Executive Officer
Website : www.impactindia.org

Brief description of the programme/project/Initiative :
Impact India Foundation (IIF) has undertaken a highly innovative, unprecedented project – Community Health Initiative (CHI)to correct existing disabilities by curative measures and drastically reduce the incidence of future disabilities by half through prevention measures, in a predominantly backward, tribal population of nearly two million in Thane district, Maharashtra, India. The CHI is in partnership with the Maharashtra Government, which has specifically appointed a senior Government official – Deputy Director Health Services – as the Liaison Officer for this purpose.

Why was the project started :
IIF was invited by the Maharashtra State Government to commence the project in 2004 when malnutrition deaths in the Tribal Blocks of Thane District were reported in the press. IIF commissioned Tata Institute of Social Sciences to conduct a Baseline Survey whose findings revealed higher malnutrition and disability statistics than the state as a whole.

Objective :
To create a pilot, replicable and sustainable project for improving the overall health of the community and thereby taking care of avoidable disablement.

Target group : A population of nearly two million in eight Tribal Blocks of Thane District, Maharashtra.
Geographical reach : Eight Tribal Blocks, namely: Palghar, Dahanu, Talasari, Jawhar, Mokhada, Vikramgad, Wada & Shahapur spread across 6600 square kilometres (over hills and valleys) of rural Thane District, Maharashtra.
Date from which the project became operational : 1 February 2005
Is the Project still operational : YES

10 points that make the programme/project innovative?

  1. Geographical reach and size of the population was daunting but interventions initiated in selected Primary Health Sub Centres set off a ripple effect.
  2. Bringing the Lifeline Express hospital train on five occasions to drastically reduce existing disabilities by 65%, in partnership with the State Government – Doctors, medicines, infrastructure and medical personnel.
  3. Impact India has worked with the Government to address gaps in the public health delivery system and not created a parallel system. It has helped strengthen Government systems.
  4. Creating an ICT enabled Management Information System to record data and track progress on the field.
  5. Recording processes for replication in needy areas of India.
  6. Training of Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs) Pada Workers and other Government field health staff for sustainability
  7. Establishing associations with 15 Referral Hospitals for free of cost treatment of the rural disabled.
  8. Empowering the community to access the public health infrastructure and motivating it to create a demand for improved services, and utilisation of Government entitlements.
  9. Periodic reviews wiith Government appointed Liaison Officer to monitor and track progress.
  10. Measurement of progress through Health Inidicators in line with the National Rural Health Mission.

List the 5 achievements of the programme/project?

  1. Over 65% reduction in existing disabilities (Sight, Hearing, Cleft Lips & Palates, and Orthopaedic impairment)
  2. Mobilisation of community on Health issues using culturally appropriate media (street plays, Warli paintings on pots, sarees and walls, songa and films).School rallies and students as agents of change.
  3. Creating awareness in school children on early identification and treatment of illness through the School Health Monitor programme. See film “Rainbow of Hope” Weblink: http://www.youtube.com/watch?v=XEz-66MBGlc
  4. Creation of a replicable and sustainable project for improvement of the health of the community.
  5. Creation of a trained body of health professionals by training Government health staff and village volunteers for sustainability of the project.

List the 5 key challenges faced while implementing the programme/project/iniative

  1. Geographical reach of the project which covers 55 Primary Health Centres, 556 Gram Panchayats (Village Councils). Predominantly backward, Below the Poverty Line, population, resistance to change.Impact brought in the Lifeline Express to earn the goodwill of the population and followed up with patients to ensure their recovery.
  2. 80% Home deliveries of babies in unhygienic conditions performed by untrained Traditional Birth Attendants or “Suhinis”. Lack of faith in the Governments existing Public Health infrastructure and schemes.Lack of availment of Government entitlements such as “Janani Suraksha Yojana” due to lack of knowledge.Impact imparted IEC on Health to community using diverse media and emphasised the need for treatment at Primary Health Centres rather than recourse to Bhagats or Traditional Medicine Practitioners.
  3. Enlisting the support and participation of Government health staff. IIF mentored them as enablers in the field and built their confidence whenever needed.
  4. Enlisting the support of other NGOs in the field to work together for the upliftment of the disabled rural poor. This was met by IIFs immediate response to their cry for help through meetings and by making referrals to hospitals for free of cost treatment to patients.
  5. Creation of an ICT enabled MIS to record data and track progress. Tata Consultancy Services designed an MIS for this purpose as part of its CSR. See attached presentation and Note for more details.

List the 5 points how can the prgramme serve as a model that can be replicated or adapted by others?

  1. The Process Document under preparation captures the essential processes that led to the success of the project and can be used as a Manual whilst replicating the project elsewhere.
  2. The partnership with the Government – to create systems and processes to fill the gaps identified by the Government; for example 100% immunisation of infants and pregnant mothers. To nurture a partnership (rather than opt for a top-down relationship) in the common goal of service to the rural poor and therefore, an inclusive society required for the progress of the country as a whole.
  3. Empowering the community through regular IEC programmes on health. Using the community as change agents to access other members in remote, far off places. Rewarding and recognising enablers to inspire their performance as agents of social change.
  4. Using the service of Volunteers from India and abroad (computer professionals, social service and research students, medical doctors etc.) to join us in providing service and documenting their experience for mobilising resources and inspiring existing Government professionals in the field to perform better.
  5. Enlisting the support of social research agencies like Tata Institute of Social Sciences, Centre for Leadership & Development, to conduct Baseline Surveys, Process assessment programmes for review and mid course corrections of programmes.

List 5 points to elaborate on the scalability of the programme/project/iniative

  1. The political will of the Government needs to be ascertained and fuelled to ensure success in scale.
  2. Re design of Indicators to create new targets and measure the achievements of the project. Ensure that all stakeholders are in compliance with the Indicators to be measured.
  3. Resources to create systems to fill in the gaps – (manpower, materials, equipment etc.) are essential.
  4. Readiness of the community to see the importance of health as a priority to participate in the project.
  5. Compliance of schools and existing NGOs to share the vision and join in the project.

Documents publishing URL :
Emailed separately are two presentations and a brochure on Impact India Foundation.

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