Child in Need Institute (CINI)

Project Theme

Health

Target Group

Others

Project Period

01 Apr 2015 - 30 Mar 2016

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Introduction

Jharkhand has an extensive network of Government health institutions. There are 4462 sub centres, 368 additional PHCs, 193 block PHCs, 37 referral hospitals, 10 sub divisional hospitals, 22 Sadar hospitals, and 3 medical colleges and hospitals. However, despite these numbers, they still fall short of what is necessary and access to quality health services is a major issue.   Furthermore, the sheer remoteness of several populations makes it difficult to access the health provisions that do exist. 

About 12.5% of the population fails to get 2 square meals a day (NSSO, 55th Round). Only 75.4% of householders have safe drinking water and 16.8% have toilet facilities. Infant Mortality Rate is 504 per 100000 deliveries. Anemia among women is high at 72.9%.  As per the NFHS data in Jharkhand the number of infant deaths per 1000 live births in the last five years was 69 as compare to national average 57, similarly percentage of children under age 3 who were underweight was 59 as compared to the national average 46, the percentage of institutional deliveries was only 19 as compared to the national average 41, percentage of children 12-23 months who have received all recommended vaccines is 35 as compared to national average 44. However, the status was worse in rural areas. 

As far as the status of education is concerned, Jharkhand stands 2nd from the bottom in over all literacy (53.6%, Census, 2001) surpassed only by Bihar. Sarva Shiksha Abhiyan (Government of India’s flagship education program) was launched in partnership with the State Government and the local Self Governance to ensure the elementary education to all children in the 6-10 years age group by 2010 leading to some gradual improvement. However, the status of education remains poor. Roughly 14 lakhs children are out of school- of which roughly 80% are tribals.  Only 58.4% of children enrolled in grades I-V attend school regularly. The primary completion rate is around 56% as per the NSS 55th round estimates. 

These figures of high numbers of children out of school are a reflection of the poor infrastructure in schools. The State has the highest Pupil Teacher Ratio and school infrastructure. It is significant to note in this regard that the newly enforced norms of the RTE Act make the prevalence of such infrastructure a justiciable violation of the rights of children. Furthermore, it is essential to recognize that children from the Adivasi community belong to a particular cultural background that requires recognition in the curriculum and requires adaptation of the modalities of teaching. This is usually not done, leading to high dropout rates among dalits. 

Thus we see that the access to essential services in the State is a major issue of concern. The necessity of strengthening the universal mechanisms for free and public health and education is based on simultaneously the need to ensure entitlements reach the population in need, while at the same time providing a tool for empowerment and a model for democratization of government functioning.

 

The Project  

The project aims to strengthen capacity of civil society organizations to monitor implementation of public health and Right to Education in selected villages of Jharkhand. The project plans to: 

•To establish grievance redressal mechanism for implementation of RTE in five regions in Jharkhand.

•To provide handholding to various stakeholders like SMCs, VHSNCs to monitor and effective implementation of provisions under RTE and Health entitlements. 

•To strengthen networks of civil society organization and linked with other state and national level networks and advocacy on implementation and policy issues.

 

The Impact:

Oxfam India along with its partner initiated the process of strengthening the civil society movement towards realizing the entitlements on health and education. We have so far - 

•Community got sensitized on RTE and School Development plan.

•SMC Meeting regularized in 23 villages .

•23 SMC taking active participation in preparing School Development Plan.

•SMC doing regular school visits to ensure its proper functioning.

•School dropout rate has decreased marginally.

•School enrollment has been increased marginally.

•Regular MDM has been ensured through the SMC.

•20 VHSNC has regularized their monthly meeting.

•20 VHSNC is preparing the village health plan to ensure effective utilization of untied fund.

•20 VHSNC showing active participation during VHND.

•PRI is showing active participation in ensuring the rights and entitlements of the community.

•CSNCR acting as a pressure group to raise voice of the community on the health and education issues.

•CBM is held on regular basis by the community on health and education.

•Draft has been prepared and submitted for the formation of Grievance redressal Cell in Jharkhand and has been submitted to SCPCR.

•State level Advocacy has been done for availability of free and generic medicine under Jan Swastha Abhiyaan.

•SCPCR, Oxfam India and CINI conducted public hearing on the report card prepared through CBM in 5 blocks of Jharkhand with the government department.

 

Quotes of Beneficiaries:  

“Hum to shaadi jaldi kar liye, isiliye hum pad nahin paye, lekin ab sab jagruk ho gaye hein” Sahiya,Village Paalu, Ormanjhi 

 

Case Studies/Human stories:

Phulmani Khacchap, a 50 year old is a motivation for others.  She is working as ANM in HSC, (Health Sub Center) located in Jidu village. Being a resident of Ranchi, Phulmani covers more than 35 km everyday to reach Jidu village.  She has been working from last 4 years with a sense of care & commitment for the wellbeing of people and catering to the needs of community.    

Health of community is shared responsibility of every one including public, private health delivery system, doctors, nurse, service providers and the community as a whole. Phulmani is among the one, who is serving the deprived section of society living in rural pockets.

The small sub center of Jidu village is really eye catching and inspirational in itself, the way it has been decorated with IEC materials and posters. Necessary equipments, essential medicines, family planning methods, IFA tablets, sanitary napkins etc are available at the center. Apart from that there is availability of separate table for abdominal and other checkups. 

During village health and nutrition day ample of services provided to infant, pregnant, lactating women and adolescent girls. Phulmani Khacchap is committed towards discharging her duties on village health and nutrition day.  Apart  from that home visit to pregnant, lactating women is also carried out by her wherein she counsel women on maternity care during pregnancy, importance of ANC & PNC checkups, motivating pregnant women for institutional deliveries, counseling on health & nutrition, intake of IFA tablets etc. Lactating mothers are counseled on neo natal care, family planning methods, safe abortion etc. The way Phulmani is catering to the needs of community is really a motivation for other. It shows her commitment and willingness to work for the betterment of community and serving deprived section of society leaving in hard to reach areas, where there are lack of health amenities.

Phulmani Khacchap is really a motivation for others. And it will not be wrong to say that nothing is impossible if there is willingness and determination to work. The health sub center of Jidu village has all essentials medicine, equipments which are required at the center. The small room is well decorated with IEC materials, posters so, that community can be sensitized on various government schemes and can avail health related services.