Centre for Health & Resource Management (CHARM)

Project Theme

Health

Target Group

Women

Project Period

01 Apr 2014 - 31 Mar 2015

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Introduction

Bihar is one of the poorest states of India. With an unfavourable Human Development Index, the health infrastructure in the state is in shambles. Gross deficiency of physical and human resources only adds to the people’s woes. Large number of posts of Medical Officers, Specialists and front line health workers has been vacant for last several years. Poverty, migration, illiteracy, poor health delivery system makes people vulnerable to illness. There are 8,858 Health Sub centres (HSCs) in the state instead of the sanctioned 14,959 HSCs.

Impact by partner
  • 67% eligible women receive benefits under JSY. 
  • 76% deliveries are institutionalised. 
  • 90% of children between 12 to 23 months are fully immunised. 
  • 60% of households use government health facilities. 
  • Reduction in malnutrition of children 0-2 years by 45%. 
  • 100% eligible and lactating women receiving supplementary nutrition from AWC. 
  • 25% increased access to ANC services & 10% increased access to PNC services. 
  • Community-based monitoring has improved; 40% increase in better functioning of VHSC; 100% RKS functioning improved; a Public dialogue on health services was held in both PHCs. 
  • A meeting with legislators from all political parties was held and citizen’s charter on health shared; legislators promised to support implementation of health rights. 
  • The utilisation of untied fund through VHSNCs has shown a remarkable improvement. The PRI members and members of the communities with support from project staffs are involved in the process. 
  • The project has been able to engage with service providers meaningfully to enhance the coverage of underserved area. 
  • CHARM has been associated with other networks as well. They are part of Right to Food Campaign in Bihar. They also made a visit to Saharsa after a hunger death and successfully exposed the false claim of the government that it was an illness related death. CHARM was also instrumental in suggesting the government through Governor of Bihar that a SOP should be developed for Mid Day Meal at schools after the tragic death of students in a school of Saran district. 
  • On the PIL filed by CHARM in Patna High Court on improving maternal health in Munger district, the bench has ordered District Judge to visit the health facilities in the area and report to the High court on the status of maternal health services. 
  • CHARM is on the core committees on preventive health and integrated health policy of Government of Bihar.

Case Study

“Baaji, Sonu has been bleeding from nose for last few days. I have taken her to doctor sahib, but there is no improvement. He has become serious” informed Shabnam to Anjum and Mona. “What should I do” adjusting her dopatta (head scarf) over her head she asked?

Shabnam is a 30 year old thin built woman of short height. Looking at her one may pass her as a school going girl due to her physical contours. Sonu is her twelfth child, although she had been pregnant thirteen times with one adverse pregnancy outcome. She lives at Bhusaula nahar per in Phulwarisharif block of Patna district. She was married at the age of 12 years to Aftab who works as a construction labour. Sonu is little over one year old but weighs around three kilograms only. Shabnam is a member of Khatoon Majlis. Khatoon Majlis is a group of women of pregnant mothers and women with children. The formation of Khatoon Majlis has been facilitated under the project area to make them aware of their health rights and entitlements; their capacity building on maternal and child health is done by the project staffs with the help of flip book on a regular basis. The formation of Khatoon Majlis has increased their bargaining capacity with service providers.

Anjum and Mona are project staffs of CHARM. Shabnam is a recent entrant to Khatoon Majlis. Anjum and Mona had been motivating Shabnam for some time to take her son Sonu to Nutrition Rehabilitation Centre (NRC) which is about 40 Km away from her home. They had explained her that Sonu is a Severely Acute Malnourished (SAM) child. The project staffs use Mid Upper Arm Circumference (MUAC) measuring tape to ascertain the nutritional status of child.

Shabnam has come to Khatoon Majlis meeting for the first time. Other members of Khatoon Majlis joined project staffs in motivating her to take Sonu to NRC. Finally Shabnam agreed to take Sonu to NRC, but with a rider that Anjum will accompany her to NRC as it is far away and she is not aware how to get her child admitted in NRC. Much improved Sonu was discharged after 21 days stay in NRC. He has gained 560 gm in weight during his three weeks stay at NRC. The project staffs continue to monitor Sonu, so that he doesn’t slip back to poor nutritional status.

Now Shabnam having understood the importance of Khatoom Majlis and NRC is active in motivating other members to participate and take advantage of the facilities provided by the government.