Background

Considerable experience and knowledge had been built up over a long period, working on other projects for the poor i.e. distribution of lands to the landless, adult and basic education, provision of water supply for drinking and irrigation, services to self-help groups and training of rural and tribal women for self-employment, in Lesliganj and Panki blocks in Palamu district, Jharkhand and from this came the project that started in October 2000.

The community leaders, women groups and grassroots organisations raised the issue of poor reproductive health and high rate of death arising out of lack of access to reproductive health services as reported at village and organisation meetings.  Government service providers also were concerned that urgent action was required.

When attending an AID workshop meeting the stakeholders (registered with AID) jointly proposed and pledged their support to this project.

Activities

The major issues quantified were :

• Lack of access to reproductive health services (92%)

• Lack of awareness and skills among the existing community organisations to articulate and demand services as a matter of right from the government to deal with reproductive track infection (63%)

• Child and early marriages (82% of all marriages)

• Teenage pregnancies (79% of teenage pregnancies)

• Maternal (1050 in 100000) and child mortality (113 in 1000) rates.

• Very low use of family planning methods (14% of population)

The main purposes of the project are to :

• Promote and train the community in their planning and action programmes and encourage their networking with people from other organisations.

• Provide participatory learning and action among the beneficiaries.

• Give information support services.

• Campaign on all reproductive health matters with communities and their organisations providing health services.

• Training of village panchayat leaders, women groups and volunteers in the village

• Promotion of village planning, re-sourcing, operation and self-evaluation.

• Information support through publicity materials and video shows.

• Promotion of family planning and prevention of sexually transmitted infections.

• Provide participatory learning and action among the beneficiaries

• Promoting community action for reproductive health.

• Advocacy and networking for reproductive and sexual health.

Some of the important achievements accomplished by the project and grouped into areas of activity, were :

Empowering the community to obtain reproductive health services.

Right to information on health

Community action for family planning, STI and maternal and child care services

Improved local governance

Objectives

The ultimate target over the four years from October 2000, is to considerably increase the number of people being reached by government and private health services channeled through the village community organisations. 

• Through 90 village communities to improve the reproductive status of 11,000 adolescents and 18,000 eligible couples by demanding and utilising the government and private health services.

• To raise the capacities of community organisations and to encourage and enable them to accept full ownership to deal with their problems through co-operation and collaborative action for :

  • 30% reduction in maternal and infant mortality

  • 10% reduction in early marriage and teenage pregnancies

  • 20% increase in contraceptive preference

• The training and other targets are to :

  • Train 180 village panchayat leaders, women organisation representatives, teachers and private service providers to identify and demand reproductive health services from the government.

  • Set up 60 participatory learning, planning and action groups to be formed with continuous learners initiatives for improving their reproductive health.

  • Engage in campaigns, multimedia and information presentations, monthly meetings with community organisations and networking and links with community organisations and service providers in respect of all reproductive health issues, services and creating general awareness.

The project has completed three and half years of service with another 6 months left until completion. In this phase, the project is gearing up the community to take increasing responsibility to manage and maintain the project by themselves.