A report on the IEC Mela on RMNCH+A organised by the ... Aug 25.pdf · A report on the IEC Mela on...

A report on the IEC Mela on RMNCH+A organised by the Government of Uttar Pradesh

July 24, 2014

Submitted by

Urban Health Initiative

Submitted to

Department of Health and Family Welfare,Government of Uttar Pradesh

BACKGROUND 7

ABOUT THE EVENT 8Objectives 8Key stakeholder groups 8Developing an inventory of IEC materials 9Pre-publicity efforts 9Proceedings 9The inaugural ceremony 9Overwhelming participation 11IEC materials on display 13Games and entertainment-education activities 14

KEY OUTCOMES OF THE IEC MELA 15

VOICES OF CHANGE 16

GLIMPSES OF THE EVENT 17

ANNEXURE 18

Contents

Background

Reducing maternal and child mortality are among the most important goals of the National Health Mission. The Reproductive Maternal Newborn Child and Adolescent Health approach (RMNCH+A) essentially looks at addressing the major causes of mortality among women and children as well as the delays in accessing and utilising health care and services. It allows for an integrated approach to providing a “continuum of care” i.e. giving equal focus to health at various life stages.

In Uttar Pradesh, the state government and several development agencies are working closely to enhance public awareness of key health behaviours and to promote utilization of government schemes and services related to RMNCH+A. A wide range of communication tools and innovative job aids are being used by both public and private sectors to engage more effectively with rural as well as urban audiences. Recently the Department of Health and Family Welfare, with support from the Urban Health Initiative, put together an electronic inventory of all available IEC materials related to RMNCH+A in the state. Following this, the state government organized an IEC Mela with the objective of showcasing all available IEC materials, enhancing public and media awareness on RMNCH+A related issues and providing an interactive platform to frontline providers and community leaders working on these issues at community level.

The IEC mela also marked the culmination of the Population Stabilization Fortnight (refer box item below) observed annually by the state government. The mela saw unprecedented participation by all development agencies working on RMNCH+A in the state along with several government departments like Women and Child Development, State Urban Development Authority, UP State AIDS Control Society, Departments of Basic and Secondary Education etc. Since the IEC Mela addressed the health care issues required at each stage across the entire cycle of life, the theme of the Mela was ‘Jeevan Chakra’ (the cycle of life), denoting different stages of the health lifecycle. The event was inaugurated by the Chief Guest, Shri Ahmad Hasan, Hon’ble Minister, Health and Family Welfare, Government of UP.

Population Stabilization Fortnight (July 11 – 24, 2014)

World Population Day (WPD) is an annual event, observed each year on July 11, which seeks to raise awareness of global population and health issues. The fortnight that follows this date is marked by events, campaigns and activities that draw attention to health priorities and call for collective action by a wide range of stakeholders. In government of Uttar Pradesh leverages this as an opportunity to mobilize the community, government staff and non-governmental organizations to intensify their efforts in the area of public health.

The 2014 theme for WPD shared by Government of India was “Niyojit Parivar, Khushiyan Aapar” i.e. A planned family gives immense happiness. Building on this theme, the Population Fortnight was flagged off in Uttar Pradesh with a Marathon organized on June 11 at the state level. This was followed by activities and health camps on family planning and reproductive health issues across all districts of UP finally culminating into the IEC Mela on RMNCH+A titled Jeevan Chakra at Lucknow on July 24, 2014.


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Lucknow saw a prolific display of IEC materials on health and healthcare, focusing particularly on reproductive health, maternal health, neonatal health, child and adolescent health (RMNCH+A). Organized on the theme ‘Jeevan Chakra’ (literally meaning ‘life cycle’), the IEC Mela was organized by the Department of Health and Family Welfare (GoUP), with the Urban Health

Initiative providing technical support with all the creatives and design-related aspects, facilitating the logistics, coordinating participants and conducting the event.

The Mela saw participation of more than 25 government and non-government organisations (Refer Annexure 1 for list of participating organisations) working in RMNCH+A as well as the presence of a host of key policy makers from the Department of Health and Family Welfare, GoUP as well as the National Health Mission, Uttar Pradesh. Counsellors from the Urban Health Initiative (UHI) and UP AIDS Control Society offered advice to couples and general public and several participants presented attractive educational games that drew throngs of youngsters and crowds of viewers.

Objectives

The key objectives of the Mela were to generate public and media awareness on issues related to RMNCH+A and to promote involvement of all public sector departments and non-governmental agencies towards addressing the health needs of the community.

Key stakeholder groups

The chief target audience for this advocacy event were residents of urban slums particularly married women in reproductive age group, , in - school and out – of - school adolescents, print and electronic media , frontline workers from different departments and the general public.

Since the Mela was a joint effort by government as well as NGOs, participants also comprised the Health Directorate, officials from National Health Mission, the Technical Support Unit (TSU) , State Innovations in Family Planning Project Agency (SIFPSA) , other related government departments and all key NGOs working at scale in UP on RMNCH+A.

Developing an inventory of IEC materials

One of the key activities preceding the Mela was to develop an IEC inventory comprising print materials, training toolkits, job aids, audio-visuals, Radio/Television spots and drama series in short /long format etc covering the gamut of RMNCH+A. The process

About the Event


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involved establishing a website (http//www.iecrmncha.in), uploading all materials from partners using minimum qualifying criteria to ensure technical correctness and also collecting a set of each in hard copy – resulting in a first time ever comprehensive IEC inventory by the State Health Department. Close to 120 different print materials and 85 audio visuals were on display at the Mela.

Pre-publicity efforts

The week before the Mela was preceded by pre-publicity efforts. These included: • Radio announcements on AIR and FM,• Newspaper advertisements in all leading English and Hindi dailies • Word-of-mouth publicity by all frontline workers in urban slums • Advocacy with media and curtain raisers

PROCEEDINGS

The first half of the day was dedicated to the inaugural session following which the Mela was made open to the general public. Various events like magic shows, games, street plays, song and drama were organized by the health partners to engage the public and spread key messages related to RMNCH+A. .

The inaugural ceremony

The inaugural ceremony began with a song performance by Vatsalya – with messages on health by a group of adolescent girls, women and urban ASHAs (Accredited Social Health Activist). The dignitaries who were present during the inaugural ceremony included the Chief Guest, Shri Ahmad Hasan - Hon’ble Minister, Health and Family Welfare, Government of UP; Shri Sanjay Prasad, Secretary, Department of Health and Family Welfare, Government of UP; Shri Amit Kumar Ghosh - Mission Director, National Health Mission, Government of UP; Dr Lakshmidhar Shukla - Director General, Family Welfare, Government of UP; Ms. Niloufar Pourzand - Chief of Field Office, UNICEF Uttar Pradesh; Dr Jyoti Bajpai from the Bill and Melinda Gates Foundation, Ms. Gita Pillai – Project Director, Urban Health Initiative.

Women from Mahila Arogya Samiti – an SHG group from Agra supported by the Urban Health Initiative, presented a musical performance with mesmerizing table beats serving as a background to a call on men and women to adopt family planning.


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This was followed by the welcome address by Shri Amit Kumar Ghosh, the Mission Director, National Health Mission-UP, who began by congratulating the non governmental organizations and the Health Department for their pooled efforts in organising the IEC mela.

Focusing on the impact of population growth on development parameters and especially on health parameters, Mr Ghosh said that it is important to step up efforts at ‘family planning’ – for spacing and limiting births. “Otherwise, if we continue at the current rate of growth, given that UP’s population today is 19 crore [190 million], by 2050 we will have a population of 45 crore …” he remarked, adding that, “we have to curtail population growth if we are to develop”.

Mr Ghosh also emphasized that a gap of at least two-and-a-half years between consecutive births is very important for health of mother and child. He shared that about 40 per cent of women in UP have chil dren with a gap of a year or less, especially in case of the first two births. The good news, he commented, is that the reduction in infant and maternal mortality rates in UP has been highest among all states in recent years.

He pointed out, however, that much still needs to be done and strongly highlighted the urgency of addressing the problem of an increasingly skewed gender ratio, saying that “it is especially alarming that the sex ratio in the under-six age-group is turning adverse”. Mr Ghosh also highlighted the need to address health issues among adolescent girls, especially the high incidence of anaemia.

Secretary Health and Family Welfare, Mr Sanjay Prasad also addressed the audience and encouraged people to avail their entitlements offered by different health schemes of the government. He also emphasized the role of grass root level health workers in enhancing public awareness of government schemes and facilities.

UNICEF State Chief, Ms. Niloufar Pourzand spoke briefly to congratulate the organizers and highlight the links between family planning and development.

This was followed by a felicitation of service providers who had performed exceptionally well in providing family planning services in their respective districts. This included surgeons performing No Scalpel Vasectomy (NSV), Minilaproscopy, Laproscopic Ligations and Post Partum IUCD Insertions (PPIUCD). Prizes were also distributed to college students who had won debating competitions


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focused on health issues in a campaign that preceded the IEC Mela. Prizes were also given to school children who had participated in and won debates on health issues conducted in the following schools – Bal Nikunj Inter College at Aliganj, Shia Inter College at Kadra and Karamat Hussain Inter College.

The chief guest, Shri Ahmad Hasan opened his inaugural address with the remark that “family planning helps people; and programmes such as the present IEC Mela, which inform and educate, help people to understand the issues related to family planning”.

In his inaugural address, the Health Minister Shri Ahmad Hasan lauded the work of healthcare workers such as the ASHAs and ANMs (Auxiliary Nurse Midwives) and that of the NGOs in spreading awareness about government schemes at the grassroots level. Their efforts, as well as that of the young generation of doctors, he observed, is one of the principal reasons for the improved performance of the health department. Routine immunization coverage has increased from 41 per cent to 66 per cent in the state, and child and maternal mortality rates have fallen significantly.

The minister said that the Department for Health and Family Planning currently provides healthcare services to about one crore (ten million) people annually, adding that “our goal is that whatever is allocated for the services must reach the people.” Shri Hasan said that the government is committed to expanding healthcare facilities throughout the state and would promptly clear proposals for making healthcare services accessible to all. The minister highlighted the need for continuous improvement in the quality of healthcare services. He concluded by saying that “our goal is to make Uttar Pradesh the healthiest state in India and its healthcare infrastructure the best in the country”.

Overwhelming participation

The Mela saw footfalls from about 200 women from Lucknow slums, more than 80 Anganwadi Workers (AWWs), 100 Peer Educators (PEs), 50 SUDA/DUDA workers, over 350 nursing students and 300 school-going adolescent girls and boys. In addition, the

Performance based recognition to government surgeons and gynaecologists

The state government, with support from the TSU and SIFPSA, distributed cash prizes to twelve doctors for outstanding performance in NSV, Lap Ligation, Minilap and PPIUCD. First, second and third prizes were given in each of these four categories with Rs 20,000/- as first prize, Rs 10,000/- as second prize and Rs 5,000/- as third prize. The list of awardees is placed at Annexure 2.


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Mela was attended by Health Education and Information Officers (HEIOs) from all 75 districts, the entire Health Directorate, State Program Management Unit of National Health Mission and all key Development Partners working at scale in Uttar Pradesh

Students from TGN Inter College attended the event with their teacher Nikhat Jamal,

who exclaimed - “Young people today know so much about health and reproductive health and hygiene issues! And it’s because of events like this and the work done by organizations such as Population Foundation of India, which held a debating competition at our college, as well as TV and other mass media, that they are so aware. This is good!”

While development workers said that the Mela gave them an opportunity to showcase their work and seek opportunities for new alliances and initiatives, visitors said that it offered scope for learning and getting information that could impact their lives.

Santosh from Bharatiya Mahila Vikas Sangh (one of the SHGs from Agra) and a colleague from Chetna Mahila Vikas Sangh said: “Coming to such events is an opportunity to learn. We get to see what others are doing and also how we can expand our reach”

Sudha Tiwari, a counsellor with the Family Planning Association of India (FPAI), asserted that the Mela is an opportunity to showcase what the organization is doing and the services it offers. This was echoed by Sonia Khanna and Manish of the NGO Janani, which works closely with UHI and runs the Surya chain of clinics at the 11 cities where UHI is active.

Ratna Khare of Population Foundation of India (PFI) had a more strategic take on the value of participating in the Mela. She said: “We can reach doctors, other NGOs, government people and other decision-makers and activists through such Melas. It helps to expand our services and also to learn about opportunities”.

Rekha Choudhury and Mamta from World Vision India, accompanying student performers from six different colleges presenting a musical drama advocating institutional childbirth – said that the Mela gave them “a chance to showcase their good work”.

Young people had an uproarious time playing a floor-board game of snakes


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and ladders organized by WaterAid based on hygiene-centric messages and directions. Other games played by the radio jockey as well as in the stalls by UHI representatives drew a lot of crowd and served as an education-entertainment factor for the general public. Participants also enjoyed the many performances put up by the health partners (songs, skits, magic shows etc.) on key RMNCH+A messages.

At the counselling centre set up in a room off the main exhibition hall, a group of counsellors – from NRHM and UHI – young couples and older women sought advice on various reproductive health issues. “We had about 40 sessions” said Vidhi Mirza of UHI, with Sarita Shukla of NHM explaining that a number of young couples visited seeking advice on contraception.

IEC materials on display

The IEC materials at the stalls not only drew attention to the issues of family planning, these offered practical information on the types of contraception for spacing births as well as information about centres where such services are available.

Throughout the venue, prominently displayed were posters and banners with key messages displayed. Some of the IEC materials highlighted information on helplines and government schemes in order to increase uptake of these services by people.

At the CARE India stall was a poster saying: ‘Share Responsibility’. A CARE worker said “We focus on sensitizing male family members about their role in the household and in creating an environment where others can open up about their needs”.

Mr. Atalulla, secretary at Grameen Vikas Sansthan, a CARE partner based at Rae Bareilly, said: “The main need is to create awareness … to generate demand. Once that is there, people will look to accessing the services”. The Sansthan has an adoption rate of about 75 per cent, he said.

The Hindustan Latex Family Planning Promotion Trust (HLFPPT) stall had

Innovations in spreading health messages

The IEC Mela also saw various innovative methods of spreading health-related messages. These included magic shows, game stalls, use of models, demonstration of nutritious recipes, a counselling cell, posters carrying information on helplines and entitlements.


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information about the Merrygold hospitals that provide a full range of reproductive healthcare services. Working as franchises of HLFPPT, there are Merrygold hospitals in 45 districts across UP. Aditya Prakash Srivastava of HLFPPT said: “Such Melas help in information dissemination and promotion”.

The Dr. Govind Ballabh Pant Institute of Studies in Rural Development, which works in close alliance with World Vision India, offered information on various contraceptive methods provided by government clinics.

The PATH stall had displays that drew a lot of attention – videos made by the community using hand-held devices working in three blocks of Rae Bareilly since October 2012, PATH has recorded more than 50 such videos – in the blocks of Basrawan, Saroni and Hiru. The stall drew crowds from activists and visitors alike as well as government officials.

At the Jhpiego stall was information of a different kind – in addition to educational material on safe childbirth and ante-natal practices, there was also information about oxytocin and its role in childbirth.

There were also materials on display on hygiene, maintaining clean water sources, good diet, breastfeeding, polio, AIDS as well as practical information such as information about free ambulance services - “Phone 102 for Free Ambulance for Institutional Delivery”.

Large-screen LCD TVs were placed strategically at various locations on the Mela venue screening the performances on stage as well as a series of pre-recorded videos and films made by the Government of UP, NHM and other health partners.

Games and entertainment-education activities

Following the inaugural session, there were a number of performances by community volunteers, health workers and folk media troupes. Some of these included:• Role play by Vatsalya on Hygiene and Sanitation Street play on HIV by Mamta,• Role play on Male Involvement in Family Planning by Urban Health Initiative • Performance on the issue of maternal mortality by World Vision, and • Magic show with family planning messages by HLFPPT

Many interesting games were played with school children. “Fill in the blanks” was a game in which a list of incomplete messages were provided to children and they were


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asked to complete the message by going around the stalls and making a note of the stall number and the development partner. Another game which was immensely enjoyed by the adolescent girls and boys was in which the participants used toy cars on chart papers with key messages provided on them.

Another game played by the event RJ was where students were made to develop slogans and jingles around key messages related RMNCH+A. Prizes were then handed over to the winners.

KEY OUTCOMES OF THE IEC MELA

The IEC mela was attended by over 1500 participants. The success of the Mela could be gauged from the enthusiastic participation in games with health messages, the rapt attention to stage performances, the youth lining up at the counselling cell and the public rush to access information at different stalls.

The comprehensive media coverage following the event (Annexure 3) was indicative of the success of the event. The media hailed the event as one of a kind and laid emphasis on the various initiatives that Shri Ahmad Hasan spoke about during his address. Coverage also included the overwhelming response of the public towards the games and activities in the event.

However, the most noteworthy and lasting outcome of this initiative is the web based IEC inventory carrying technically sound and field tested print materials, job aids, audio-visual materials by the state government and NGOs working at scale in UP. This on-line inventory established with support from the Urban Health Initiative will henceforth be maintained and kept updated by the Health Department and will serve as a valuable resource for RMNCH+A related program efforts.

Overwhelming response from the public

A young female student who attended the event exclaimed that - “Young girls like me today want to have an understanding of sanitation, health and hygiene issues! And this Mela has given a solution to many such queries. This is good!”

A mother of two school going children enjoyed the games and activities especially the game with the toy cars. She said “Games like these can be used even in the schools to teach the children. Teachers can use these methods too to make the students understand key aspects of health.”

Shri Ahmad Hasan “Our goal is to make Uttar Pradesh the healthiest state in India and its healthcare infrastructure the best in the country.”

Students from TGN Inter College “Young people today know so much about health and reproductive health and hygiene issues! And it’s because of events like this.”

Shri Amit Kumar Gosh, “We have to curtail population growth if we are to develop.”

A CARE Worker,“Such Melas help to expand our services and also to learn about opportunities”.

Shri Ahmad Hasan “Family planning helps people; and programmes such as the present IEC Mela, which inform and educate, help people to understand the issues of family planning.”

Abt Associates worker, “These melas serve the need to create awareness”.

Voices of change


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Information on various contraceptive methods in the PISRD stall.

Adolescent girls seeking health-related information at the UPSACS stall during the IEC Mela.

Shri Ahmad Hasan interacting with health counselors in the Counseling Room.

Shri Ahmad Hasan discussing Surya Clinics at the Janani Stall.

Spreading awareness on RMNCH+A through magic performances during the mela.

Innovative games being played at the mela to promote RMNCH+A related messages.

Glimpses of the Event


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Annexure 1

Key departments and health partners at the IEC Mela

1. Department of Health and Family Welfare, Govt. of Uttar Pradesh2. National Health Mission, Govt. of Uttar Pradesh3. ICDS, Department of Women and Child development , Government of Uttar Pradesh 4. Department of Basic Education, Government of Uttar Pradesh 5. Department of Secondary Education, Government of Uttar Pradesh6. Uttar Pradesh State AIDS Control Society (UPSACS) 7. State Urban Development Authority (DUDA) 8. BBC Media Action9. Better Education Through Innovation (Beti)10. CARE India 11. Catholic Relief Services 12. Clinton Foundation13. Family Planning Association of India 14. Govind Ballabh Pant Institute of Studies in Rural Development15. HLFPPT16. Jhpiego17. Mamta Health Institute for Mother & Child18. PATH19. Population Foundation of India 20. Population Services International21. Save the Children22. SIFPSA 23. UNICEF24. UPSACS 25. Urban Health Initiative26. Abt Associates24. Vatsalya 28. WaterAid 29. World Vision

Annexure


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Annexure 2

List of government doctors rewarded for good performance in family planning

Details of Reward to service providers- WPD 2014-15

S.No RewardeeLaproscope Sterlization

1st Prize 2nd Prize 3rd Prize

1

Name Dr Ram Naval Dr A.H Khan Dr Surendra Sahi

Designation Surgeon Surgeon Surgeon

Posting Place DCH CHC - Tamkohi

District Maharajganj Kushinagar Sitapur

No. of cases 8383 5409 4074

2

RewardeeMinilap Sterlization


Name Dr Pushpa Lata Verma Dr Devendra Bhitauriya

Dr Sanjay Singh

Designation LMO CMS MO

Posting Place PPC Jhansi CHC Jalaun PHC Niyamtabad

District Jhansi Jalaun Chandauli

No. of cases 2776 2256 1789

3

RewardeeNSV


Name Dr RP Singh Dr Ram Bihari Dr G.P Mathaurya

Designation Surgeon Surgeon Surgeon

Posting Place DH Agra DH CHC Mooradnagar

District Agra Aligarh Ghaziabad

No. of cases 824 515 321

4

RewardeePPIUCD


Name Dr Manju Agrawal Dr Alka Singh Dr Shailly Singh

Designation CMS LMO Surgeon

Posting Place DWH DWH DWH

District Hathras Barabanki Agra

No. of cases 274 247 183


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Annexure 3:

Newspaper clippings of the event

Rashtriya Sahara

Dainik Jagran


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Navbharat Times

Kalptaru Hindustan


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Roznama Sahara

Instant Khabar


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Kanwhizz Times

Kanwhizz Times


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