IHMP (Ashish Gram Rachna Trust Pachod)

Project Theme

Health

Target Group

Women

Project Period

01 Oct 2014 - 31 Mar 2015

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Introduction

Health is a cross cutting issue in poverty alleviation and sustainable development as the health status of the urban poor is an integral part of the vicious cycle of poverty to which they are subjected. National Family Health Survey 3 reveals that the health needs of the urban poor in Maharashtra are not being adequately addressed. The health of the urban poor has been neglected by policy makers. The Government initiative on National Urban Health Mission (NUHM) got stalled for a while as the Planning commission decided to initiate discussions on the NUHM proposal with several advisory groups where a decision was taken to implement the NUHM proposal only in the 12th five year plan. IHMP designed and pre-tested 6 distinct interventions that can be introduced as a Public Private Partnership Model in the primary urban health care centres proposed to be established in future under NUHM by the Government. The Six innovations in the context of urban slums are as follows:

  • Monthly surveillance of health needs
  • Monthly Micro-planning
  • Need specific BCC and counselling
  • Outreach services and active linkage of beneficiaries with health providers
  • Provision of Obstetric and Gynaecological services by a specialist attached to PUHC on per clinic payment basis (based on the Chiranjeevi model from Gujarat)
  • Slum Health and Development Committees for demand generation and community based monitoring
Impact by partner

IHMP is a training Institute and has trained over 5000 NGO functionaries in the country and more than 250 NGOs in RCH, in Maharashtra. IHMP has experience in partnering for the scaling up of several initiatives:

  • Life Skills Education through 5 NGO partners of Bhavishya Alliance.
  • Adolescent Reproductive and Sexual Health with the MacArthur Foundation.
  • Maternal and Neonatal Health of Urban Poor with 7 NGOs supported by PATH.
  • Adolescent Reproductive and Sexual Health with 5 NGOs, supported by SDTT.
  • Partnering with Government of Maharashtra for Innovative NRHM project through 7 PHCs in one block
  • IHMP has trained 300 NGOs in Maharashtra and can partner with several of them In the last one and half year the achievement of the project :
  • Meetings with PMC officials resulted in the successful provision of laboratory services and installation of Mother and Child Tracking System (MCTS) software at the PUHC.
  • PMC officials gave permission to upgrade services at the PUHC. Following tasks were completed by IHMP at PUHC;
    • One sterilizer for sterilization of instruments and gloves were purchased by IHMP and handed over to the PUHC.
    • One of the rooms in the PUHC was converted into a laboratory for performing routine laboratory tests. A platform and wash basin for the laboratory was provided by IHMP.
    • A small cubicle has been constructed and a computer has been donated to the PUHC by IHMP to utilize the software for the mother and child tracking system (MCTS) in the project area.

As a result of this small investment by IHMP, laboratory facilities have been started at the PUHC by the municipal corporation. A laboratory technician and lab equipment and reagents have been provided by the municipal corporation

  • Surveillance and Monitoring System: Protocols for the surveillance and monitoring system for urban slum areas were designed and printed. These protocols were pre-tested in the slums during the period April and May 2012 by the community health workers (CHWs). Needs assessment through monthly surveillance was carried out by 12 CHWs from June 2012.
  • Capacity building of CHWs – Seven days induction training programme for CHWs was organized at IHMP Pune centre. The detailed curriculum for training was prepared. Cognitive and practical skills were provided during the training to the CHWs.
  • Group Behavior Change Communication (BCC) by project staff at community level – Group BCC sessions were conducted for women at community level. Services to be provided through the urban health programme were discussed during the sessions.
  • Capacity building of SHDC – Orientation meetings & participatory training sessions were organized at the slum level for SHDC members. Cognitive and practical skills regarding community based monitoring (CBM) were imparted to them. After the orientation, a skills development session was arranged for all the SHDCs at the slum level.
  • Formation of “Arogya Vikas Samanvaya Samiti” – A coordination committee for all SHDCs known as the “Arogya Vikas Samanvaya Samiti” was established. The Arogya Vikas Samanvaya Samiti offers a common platform for all SHDCs to discuss their health and development issues and take collective action.
  • Clinics for emergency obstetric and gynecological services were conducted at the Galande Patil dispensary. 24 obstetrics /gynecology clinics were conducted by the PUHC and IHMP project staff.

Case Study

Case study – Shalan Jadhav – Out of pocket expenditure

My name is Shalan and I am from Suryaprakash Nagar. I am living in a joint family where my mother-in-law is head of the household. I am a housewife. My husband works as a labourer. We belong to the Wadar caste. Our average monthly expenditure is around Rs 8000.00.

When I was two months pregnant I had severe lower abdominal pain and vaginal bleeding. I visited a private hospital for treatment; the doctor examined me and advised hospitalization. He told me the treatment will cost Rs 10,000.00 and asked me to pay an advance fee of Rs 5000.00. At that time I was not in position to pay such a big amount hence I didn’t take the treatment for my ailment from the private hospital.

Dipali, the CHW in our slum, trained by Institute of Health Management, Pachod visits our house every month. Since I was pregnant I was worried that I may have an abortion or some other severe complication so I went to Dipali and discussed my problem with her. She gave me counseling on where to go for treatment for this ailment. She referred me to the Rajiv Gandhi Hospital (MCH clinic) that is run by the Pune Municipal Corporation.

Dipali offered to come with me to the hospital so I decided to go and get treatment at this hospital. At the hospital the doctors examined me and asked me to get admitted for treatment. I was admitted at the MCH clinic for three days in a general ward and was given treatment. I am completely cured now.

The expenditure incurred for the treatment was Rs 690/-. It includes doctor’s fee, ward fee, fees for diagnostic tests and cost of medicines.

My husband lost his wages for three days and we had to spend money on food and transportation which totaled to Rs 1560.00.

I paid the amount of expenditure incurred for the treatment by taking a loan of Rs 1000.00 from my relatives and spent Rs 1250.00 from household income.

I am really grateful to Dipali, our CHW, for her advice and support. Because of her I could get treatment at the PMC hospital at a cost that I and my husband could afford.