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Location

Mayurbhanj district Odisha
Thematic Intervention: Health, Nutrition, Participation


Background

The organisation was formed on 2nd October 1996 by a group of likeminded persons, from rehabilitation and social work background, for working with children and adults with disability with a vision of creating inclusive communities where every citizen irrespective of their abilities can live with dignity and get opportunity to realize their inherent potential. In due course, a community based rehabilitation (CBR) approach was adopted, aiming at improving the quality of life of children and adults with disability. The organisation’s basic philosophy is to work with willing persons and organisations to create inclusive villages where every person, children irrespective of their ability will get opportunities to grow and be nurtured to become responsible citizens. Its focus is on a twin-track approach – empowerment of people to play a meaningful role as partners in development and strengthening of good governance which can play an effective role as duty bearer to respect, protect and fulfil the rights of each and every citizen.
At present, SADHANA is working in the whole of Baripada Block and 6 GPs of Suliapada Block. The founder, Mr. Ranjit Kumar Mahapatra, through his work, has developed extensive experience in both disability and development sector and tries to mould all the programmes of the organization to a right based approach.

Situation

Health: The incidence of child rights issue is quite prevalent in the area. In general the health condition of children is poor and most of the children are malnourished. The children suffer from common diseases like diarrhoea, malaria, scabies, TB, pneumonia, seizure disorder, mental illness, etc which contributes to their poor health condition in the area. The status of institutional deliveries in the district is about 70% through initiatives under the National Rural Health Mission (NRHM) as per the records. Home deliveries are conducted by traditional village birth attendants or quacks that do not have the requisite training, leading to unhygienic conditions, which creates complications for both the mother and the child.

Nutrition: Data collected from the ICDS centers shows a high incidence of malnutrition among under fives. The incidence of malnutrition is around 30% to 40% according to data collected from Anganwadi Centres and from direct intervention during the last four years. This remains in the same range and appears to be stagnant. This forces us to look beyond the existing intervention dimensions of our project aspects. Only about 30 % of the children are exclusively breast fed. About half of lactating mothers are working mothers and they have to leave their children with other siblings or grandparents who feed the children with sweetened water. Malnutrition of lactating mothers is prevalent and therefore the baby does not get enough nutrition.

Participation: The gap remains largely at the community level, which has been sensitized of children’s rights over the years through several processes but has failed to capture the voices of the children and provide space in decision making. Over the years, children have always been at the receivers end and have been vulnerable to exploitation based on the in ability to demand or voice out their opinion in the public forum in the past. The children do not find space to voice their opinion in the decision making processes even where the children have been a representative directly i.e. like in School Management Committee.

Objectives

  • To enhance the access of people to free and quality primary health care services in our intervention areas
  • To improve health service provision in the communities (through VHND), at the sub-centers, PHCs and district headquarters hospital.
  • To encourage and facilitate participation of children in a multicultural society.

Achievements & Impact in the Review Period


SADHANA has been involved in Bankisole, Betna and Laxmiposi gram panchayats and working with children since last 4 years. It has established a good relationship with the community as the presence of SADHANA is long and was implementing community based rehabilitation programme. As an organisation the focus is on health, nutrition which is critical in the intervention area.

  • Community awareness on health services particularly for ante-natal care and institutional delivery etc. was conducted in all the 20 villages.
  • Cluster level meetings of lactating mothers of children in age group of 0-6 years to discuss importance of exclusive breast feeding and identify local practises was conducted.
  • The community mobilization process initiated in the previous years had strengthened the Matrumandal committees, which was observed through the regularity of the meetings held.
  • 14 meetings were facilitated through the community level workers, where they have mainly emphasised their role of Matrumandals members and to ensure that all pregnant lactating mothers attend Village Health and Nutrition Day (VHND) and immunisation and take care of their nutrition.
  • The organization taking a lead shared the health status of their respective villages and mobilized the Gaon Kalyan Samiti (GKS) to participate and support on the issue of health.


  • Facilitated quarterly children’s groups meeting and the children took up 3 key areas during the year (1. Health and hygienic daily routine, 2. village sanitation).
  • The child groups planned and organised the events themselves through “child to child 6th step approach”. They planned that they will implement this in Village Health and Nutrition Day (VHND), school and hamlet with a role play.
  • Community in villages, are aware about the health status of their children and understand the impact of health and well being on the overall development of the children, by understanding the provisions of government schemes, use of mother and child protection (MCP) card and supporting families to access available services in their villages/ primary health centers/ district hospital.
  • Community volunteers are enabled to analyse the gaps, and support the PRI leaders in the project Gram Panchayat (GPs) to approach appropriate authorities and demand for quality primary health care services as per provisions of government.
  • The health workers are strengthened on the process of VHND along with the project staff to collaboratively function for effective VHND process in the villages.

Plans


Focus 1: Access to free, primary health care in the intervention area

  • Coordinate with ICDS workers for early registration, distribution of Mother and Child Protection (MCP) Card and Institutional Delivery.
  • Closely monitor the Mother and Child Protection (MCP) card get filled up during Village Health and Nutrition Day (VHND)
  • Home visit of mother who have not attended the Village Health and Nutrition Day for Anti natal / Post natal Care.
  • Pregnant mothers and families to be facilitated to have deliveries in the institutions of health for better care.
  • School Management Committee (SMC) and parents training and planning on facilitating school health card and health checkups in 15 schools in the villages including follow ups.
  • Analysis of the health information of the 600 children.
  • Facilitate the entire adolescent group for the supplementary food and nutrition through peer to peer mobilization.


Focus 2: Reduction of child malnutrition in operational areas for children from 0 to 6 years

  • Training on treatment and designing a feasible and compatible community based management of Severely Acute Malnourished (SAM) children.
  • Tracking growth chart and facilitating for referral.
  • The concerned District Nutrition Council headed by the District Magistrate/Collector will be shared with the findings at the field level.
  • Space as a proactive NGO on Health and Nutrition will be created at the District Nutrition Council.
  • Preparation of presentation for schools and VHND for sensitization on anaemia.
  • Kitchen garden by two children groups and two adolescent groups, involving the local nutrient yielding vegetables and food materials.


Focus 3: Improved understanding of children on their age appropriate growth & development

  • Support for 6 groups to facilitate the child to child approach.
  • Interaction camp (3 days) among the leaders of children groups to develop relationship and exchange ideas later

ANNUAL FINANCIAL SUMMARY

  • Right to Survival
    $1,124
  • Right to Participation
    $330
  • Administration
    $13,521
  • Total Grant Approved
    $14,975