Hundred Block Plan

Dr. Sundararaman, AIPSNKarunesh Pandey, Lucknow

Priya Ranjan, AID-MD

 Why a block? Small enough to manage Yet large enough to

Be visible Demonstrate replicability Be able to provide training, support

and monitoring

 What is a block? Administrative units within a district About 10 blocks per district About 100 villages per block About 1 lakh population About 20,000 households We take up about 30-50 villages

within a block

Why a Hundred Block Program? To create replicable models of

community mobilization that Shows measurable improvement in social

indices Strengthens advocacy for policy changes Provides relief to people in their suffering Strengthens people’s movements and

organizations Needs critical size for

demonstration/advocacy/inspriation

How are blocks selected ?

By state-level organizations based on needs matched with the organizational presence

Planned interventions In the areas of

Primary Education, School Science Education

Literacy, Health, Credit co-operatives Enterprise Development, Agricultural

Interventions Panchayat Level Planning and

Programme Implementation Local Economy Planning and

Development

Health as an example Better awareness on specific health

issues Better utilization of public health

services Better organization of norms for

health Sensitisation of Panchayats Measurable improvement in child

health (assessed by weight for age)

Funding modality AIPSN does NOT have FCRA

clearance Training

Material Camps

Saathis State-level/Block-level (5) approx

Rs.3000 p.m Equipment/Infrastructure

Saathi Funding Step I

3 to 5 state-Saathis Materials

Step II 5 block-Saathis per block Training camps

Step III Infrastructure building Phase out Saathis (Decommissioning)

Is only AIPSN a part of HBP ?

NO Any NGO satisfying broad goals can

participate

AIPSN Understanding of HBP Known as block-level development

intervention programmes BGVS areas of work

Contacts for AID Initially with a BGVS sub-

committee Then with State Saathis/district

committee Actual outcomes per block v/s

intended outcomes need to be kept clear

AID-AIPSN relationship We “work together”, are

“partners” and we “collaborate” NOT a funding agency relationship

Possibilities for non-financial support/relationship Thematic Study Groups

To support advocacy To develop new action possibilities To develop internal understanding

Project Study Groups To document programmes and draw lessons To provide technical support

Advocacy Group

Thematic Study Groups: Examples I School Science Education, Q.I.S.S.E Primary Schools – Cross-country studies Shaping IT for Indian needs: Policy +

GIS/ Modeling and simulations/ software development

Enron/Power policy study group Pharmaceuticals/ Medical Equipment

Policy watch group Credit cooperatives study group

Thematic Study Groups: Examples II Water Management Systems

Public Water Supply Decision Support for Irrigation Alternatives in Irrigation

Large Dams, Tribal Rights Environment Impact Assessment, Dumping of

Hazardous technologies Health Systems – cross-country studies Creating a market for Handicrafts Agrochemicals production and marketing

feasibility studies Technology development and Professional Studies

Project Visit Report of Bihar Gyan Vigyan Samiti (BGVS), Jahanabad

under the HBP

27th and 28th December 2001

By

Priya Ranjan (AID, Maryland)

Karunesh Pandey (AID, Austin)

Outline

Organizational structure of BGVS Work done by BGVS, Jehanabad Problems faced by BGVS in initiating the program Sustainability of the program Problems faced by women Observations Village trips Some after thoughts (Questions for AIDers)

Jahanabad: Some Statistics

50-60 kms south of Patna. Area =1569 sq. km. Demography.

Population. Total:1174900. Rural:1100430. Urban:74470.

S.C.Population. Total:216083. Rural:205047. Urban:11036.

Literacy.

Males (%) Females (%)Rural 62.44 25.69Urban 72.51 43.59

Organizational Structure and Work of BGVS

Covers 47 districts in Bihar and Jharkhand

Buniyaadi Sabha formed in villages with at least

10 members Democratically elected every

two years Work

Health Primary education Samta (for female health and

awareness)

What does BGVS do?

Health

Maintaining records for births, weight of kids, immunization

Reproductive and child health Recording the incidents in the community Encouraging the pregnant women to go to

hospital Bringing the the govt. (and other bodies)

institutions to the neediest and helping them interact with villagers

Providing regular training to the village workers

MOTIVATING the people to take up community work!! Very much along the idea of AID

An activist Babie with a healthy child

Work of BGVS: Health: Examples

Work of BGVS: Health: Examples

First page of an Activist’s register for Unta Community

Records of pregnancy, birth, marriage, death etc.

Work of BGVS: Health: Examples

Incidental report register: It makes sure that any odd event in the village gets recorded

Work of BGVS: Health: Examples

Records of Vaccination and weights of kids

Work of BGVS: Health: Examples

Malnutrition chart for the kids 0-5 years

Work of BGVS: Health: Examples

Objective Women health Awareness about panchayati raj Elimination of blind faiths

Run entirely by women office bearers Women chosen from those volunteering in

meetings Provided extensive training Selection not based on educational

qualifications

Extremely dedicated and enthusiastic coordinator of Samta Sarita Kumari

Work of BGVS: Women’s issues

Activities Swasthya Kala Jattha (1994) Samta Jattha (1991, 1994,

1997) Samta Vigyan Utsav (health

training to women at the village level)

Training Spread over 20 days Identification, reason and

prevention of diseases No training about treatment

A woman (in the perspective) telling us about the post-operational problems that they face

Work of BGVS: Women’s issues: Activities

Gyan Vigyan Jattha (1991)

Joy of Learning (1994-95) 42 govt. schools Bal melas

Jan Vaachan Andolan (1998) Books read in meetings Helps to eliminate blind faiths and

misconceptions

Gyan Vigyan Vidyalaya ( Jan 3rd 2002)

Work of BGVS: Primary Education

Is there a hope?

Distrust from existing people who were supposed to do the work BGVS was doing

Registered Medical Practitioners (RMPs)

Integrated Children Development Scheme (ICDS) (AanganVaadi)

Village doctors who make tons of money every rainy season

Initial Problems Faced by the BGVS Activists

AanganVaadi workers

Trip to the Villages: Chakiya

25 muslim & 10 SC houses Volunteer- Arshadi Khatoon 3 years with BGVS 8 days of training Used to earn living by

stitching clothes Motivated by recognition and

desire for her kid to get better life

Some questions Small savings? How to tackle problems of

highly specific nature? Theft at Volunteer’s house Hole in heart of a kid

You gotta see Arshadi Khatoon in action, Most familiar and friendly face in the whole village

Trip to the Villages: Larsa

Very outspoken and vocal about rural issues: Chandra Tara Devi

Shanti Devi

200 SC houses Volunteers: Chandra Tara

Devi & Shanti Devi Working since 1993

Organized weighing of babies Camps for vitamin A, Night

blindness,polio Adult Education

Dissatisfied with intermittent working of the program

Ideas Sewing machines Teachers Micro credit groups

Aangan Vaadi

Trip to the Villages: Rangu Bigha

Diesel mechanic: Mishri Lal

Will do anything for literacy: Madan Mohan

70 families Volunteers: Mishri Lal & Madan

Mohan Teach kids Women not very involved with the

program in this village Ideas

Wants to teach people to repair diesel engines

Wants to teach all the villagers including the women

Interested in expanding the scope of BGVS

Final destination: Gaurapur

138 families Volunteer: Santosh Kumar 7 years with BGVS Secretary of Block Exec. Com. Does work for social recognition

and did contest elections for village panchayat. He has very original idea about governance, like govt. should be for people both in representation and in work.

Fought with electricity department for getting the connection

Very progressive and techno savy!!

Need the govt to work for us: Santosh Kumar

Developing a referral system (Rs. 10 per 6 month per family)

Gyan Vigyan School BGVS, Jehanabad Full timers with BGVS to

be absorbed Inaugurated on Jan 3rd

2002

Integration of the program with village panchayats

House is again provided by Saritajee for almost free

Sustainability of the BGVS Jahanabad

Gyan Vigyan School already running

Some Afterthoughts

Cash Crunch Initiation of BIRDS (Bihar Integrated Rural Development Society) Provisions for small expenses in proposals Inability to help specific cases

Sustainability is a MYTH? Supporting a volunteer from BGVS Main Issues

Drinking problem Lethargy amongst women Some data in the charts Mistrust amongst women

The main issue is how much we want to get involved?The main issue is how much we want to get involved?The main issue is how much we want to get involved?The main issue is how much we want to get involved?

List of 12 Bihar +2 Jharkhand Districts selected for HBP

District-Block

1. Gaya -Manpur

2. Nawadah-Rajouli

3. Darbhanga- Kusheshwar Sthan

4. Supoul-Raghopur

5. Saharsa-Nauhatta

6. Rohtas-Dehri On Sone (My home town/block)

7. Begusarai-Dendari

8. Madhepura-Shankarpur

9. Purnia-Tikapati

10. Bhabhuan-Chand

11. Jahanabad-Jahanabad

12. MakhdoomPur-Jahanabad

Jharkhand blocks:

12. Kodarama - Jainagar

13. Dhanbad - Gomoh

H

HH

H

H

H

H

H

HH

H

H H

H: HBP District

1. Go visit the places, Bihar is not as bad as its reputation

2. Call BGVS people in Patna (011-91-612-368 087)

3. Need help in setting up creating ways to inspire people to take advantage of govt. services

4. Villages don’t bite: Take the rural message to your friends in urban areas. Middle class support is vital for success of any developmental effot

5. Come lets work together!!

How can you join the effort?

Health Training Camp in Bihar

Jan Swasthya Abhiyan (People’s Health Campaign) State level workshop at the Madhyamik Shikshak Sangha

Bhawan, Jahanabad from June 20th 2002 –June 23rd 2002 Attended by state level resource persons, district level

resource persons and block coordinators, 60% women Resource persons included Dr. T. SunderRaman, Balaji

Sampath, Mr. Ghalib, Dinesh Prasad, Ms. Usha, Ms. Pushpa (Group Savings), Mr. Jitendra (Education), Mr. KashiNath (Globalization aspects) and members of Panchayat.

Karunesh from Lucknow also attended the camp and wrote the report

Health Training Camp in Bihar

Develop a feel for various problems affecting the blocks under consideration

Impart hands on health training to the field volunteers

Identify state level full timers for the program

Formulate an action plan for the program

Training Camp: 06-20-02

Started in the afternoon Familiarization with local problems

faced by blocks Effect of globalization in general and on

health in particular

Training Camp: 06-21-02

Started with movement songs Preliminary information about malnutrition and

Diarrhea Group reading and discussion Helped by Dr. Sundarraman with Technical

questions Three causes of Malnutrition: Poverty, Illiteracy

and Superstitions Information regarding malnutrition Age/weight, Breast-feeding, Disease History,

Economic/Social Status of the family and current efforts for the child.

Training Camp: 06-21-02

Started with movement songs

Do not advise to Give a nutritious diet to the child

Keep the child and your surroundings clean, General and unthoughtful advice does not impress people.

The second session on the second day saw the groups reading books on cough, cold and immunization.

Training Camp: 06-21-02

Started with movement songs A talk by Dr. Sundarraman on Poverty and

Malnutrition Effects of malnutrition needs to be stressed Can severely harm the child or even can be fatal Much more severe problem in Bihar compared to

TN. As much as 60% kids may be lower categories malnourished

Also talked about Diarrhea, breathing problems, pneumonia and other water-born diseases.

There was a field visit to Poorvi Uta block.

Training Camp: 06-21-02 Dr. SunderRaman, Balaji, Dinesh Prasad, Ghalib,

Sarita Kumari, Pushpa sat together to setup the guidelines for the plan of action.

Rs. 10,000/pm Dinesh Prasad, Sarita Kumari, Pushpa, Usha and

Kundan as block full-timers 7 books on health issues, “Margdarshika”(guide-

book)->Bacchon ke Liye Swasthya”->“ Mahilaaon ke Liye Swasthya”->“ Hamari Swasthya Sewayein aur Hamara Adhikaar”-> “Village Mdeical Kit” and “Bimaariyan”.

Tricky issue of Sustainability

Training Camp: 06-22-02 Dr. Sundarraman talking about the aim of health

programs Increase in awareness of the people and

providing information to the people Make the government health facilities available

to the people and the people start using them People take their health issues in their own

hands The women get more organized Panchayats get involved with the health

program How to achieve these goals? Need to reach to every household and explain

the need for their participation

Training Camp: 06-22-02 Dr. Balaji Sampath talk about the utility of

village health register Give us (the volunteers) information about the

village Help in quantification of work Indicate the changes occurring during the course

of the program The register could also be used as a planning

tool by the panchayat Information about the location of Primary Health

Centre (PHC), Health sub-centre, community health centre (referral).

Train the midwives

Training Camp: 06-22-02 Data regarding ANM: Prepare a list of the ANM’s Find out whether they stay at the centre or not Whether the place is safe or not Whether there is electricity or not, etc Find out her timetable as to when she is going to

be in a village  Nurses has their own problem in working in a

male-dominated society and also lack of family support

Village worker/panchayat may want to discuss the safety of nurses/medical workers

Training Camp: 06-22-02 Facilities available to a villager are: Aanganwadi-Very important for babies health School-Important for vaccination Village nurse-For the medical needs of adults These are the various vaccines:BCG (at birth), DPT

(three vaccines) (1st upto 3 months, 2nd 3-4 months, 3rd 4-5 months), Polio (three drops) (1st upto 3 months, 2nd 3-4 months, 3rd 4-5 months), Measles (Vaccine) (upto 9 months), Vitamin A (9 months) (2ml), DPT Booster dose (18months), Vitamin A and dose for worms every 6 months

Problems of pregnant women and DDK (Disposable delivery kits)

Finally, another field trip led by Sarita Kumari

Training Camp: 06-23-02 Quality monitoring/evaluation of health program and

feedback The indicators for monitoring and evaluation are Input Indicators (Training +material) Process Indicators (quality + what is to be done) Impact indicators

Directly trainedInput

Village traineesProcess

Overall Change in the village

Feedback

Training Camp: 06-23-02 Phased out execution Preparatory Phase, Jul-Sept. 2002 Formation of block committees Identification of full timers Identification of village activists Simultaneous formation of small savings groups Block training

Directly trainedInput

Village traineesProcess

Overall Change in the village

Feedback

Training Camp: 06-23-02 Phase 1, Oct-Dec 2002 Zonal retraining of block activists and full timers Opening of health registers Reaching each and every household Compilation of data regarding “Dais (midwives)” Block level training A report is to be generated for villages, which have

communication and transport problems with the PHC’s and the state level activists are to initiate meeting district administration to address the problems.

Training Camp: 06-23-02 Similar Plans for Phase 2 and Phase 3 Panel discussion on “Role and Cooperation of

Panchayati Raj Institutions in Public Health” Active Participation from local Panchayat People Usha (member of Zila Parishad) rightly commented

that most of the members went on to use the funds allotted by government to build community centers, roads, etc., these works though important are to be given second priority to works like developing education system for the kids.

Point again is that what do we do from here?