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Studies Completed Year 2015-2016

Financial Resource Flows for Family Planning (FP Project-2014)

Agency: UNFPA and NIDI

Team: Anoop Khanna, Ajay Sharma

The ‘Financial Resource Flows for Family Planning’ (FP) is being executed by NIDI in collaboration with the United Nations Population Fund (UNFPA). IIHMR plays the role of outsourcing partner for data collection, processing, analysis and providing technical support to data collectors.

The backbone of the “FP project” is Family Planning 2020 (FP 2020) initiative, which is a global partnership that supports the rights of women and girls to decide freely, and for themselves, whether, when and how many children they want to have. The goal of FP 2020 is to enable 120 million more women and girls to use contraceptives by 2020. To estimate the additional resources needed for reaching this goal, there is need to know how much money is being currently spent on family planning and the allocation of such resources. The “FP project” aims to estimate expenditures on family planning within a country, and targets public and private sectors as well as NGOs.

Under the Family Planning Project 2014, financial information for 2014 has been collected during the financial year 2015-2016. Sample of 81 countries from four regions were covered in this survey. The UNFPA country offices were responsible for collecting data for each country covering relevant government organizations, NGOs, Insurance Companies and Corporations. The UNFPA country offices were provided with specially designed survey instruments. A database has been designed for the purpose of feeding and analysis of the information collected on family planning activities. IIHMR process the data submitted by the country offices through family planning database in the cloud. This database be accessed globally by all the authorized users. IIHMR also provided technical support to data collectors during the survey.

National Family Health Survey (NFHS)-4 Uttarakhand

Agency     :   International Institute for Population Sciences (IIPS) Mumbai, Ministry of Health & Family Welfare, Go

Team:   Neetu Purohit, JP Singh, Preetha GS, Rashmi Nair, Satish Singh, Suresh Siwal, Lalchand Sharma, Rohit Jain, Paras Kumar, Danish Ahmad

Ministry of Health & Family Welfare, Government of India (MoHFW-GoI) is conducting CAPI based National Family Health Survey-4 (NFHS-4) in all 35 States and Union territories of India. NFHS is being undertaken with the main objective of strengthening India’s demographic and health database by providing information that is both valid and reliable.

MoHFW-GoI has entrusted IIHMR with the task of conducting field work for NFHS-4 in Uttarakhand. IIHMR has conducted district wise household survey in all the 13 districts of Uttarakhand from January to June 2015. As per the estimate, 14620 households from 731 PSUs of Uttarakhand were covered under this survey.

The sample spreads in all 13 districts. Each district had 40-70 Primary Sampling Units (PSUs) covering rural and urban representation as per the percentage of rural and urban population of the state. From each PSU pre-determined 22 households were surveyed.

One of the components of the household survey was Clinical Anthropometry Biochemical Testing (CAB). The CAB component included measurements of height, weight, blood pressure, hemoglobin and random blood sugar for men, women and children in the selected households. In the subsection of the households, dried blood spots (DBS) have also been taken from men and women for HIV testing.

National Family Health Survey (NFHS)-4 Madhya Pradesh (East)

Agency    :   International Institute for Population Sciences (IIPS), Mumbai, Ministry of Health & Family Welfare, GoI

Team        :   Santosh Kumar, Arindam Das, BS Singh, Amlan Dutta, Rohit Jain, SP Chattopadhyay, Laxman Sharma, Tukaram, Praful Barla, Shirish Harse, Kailash Prajapati, Ravi Tulayat

Ministry of Health & Family Welfare, Government of India is conducting CAPI based National Family Health Survey-4 (NFHS-4) in all 35 States and Union territories of India. NFHS-4 is being undertaken with the main objective of strengthening India’s demographic and health database by providing information that is both valid and reliable.

MoHFW, GoI has entrusted IIHMR, Jaipur with the task of conducting household interviews in 22 districts of Madhya Pradesh-East for NFHS-4. As per the estimate, 19,780 households from 989 PSUs of MP-East were covered under this survey. Each district had 43-86 Primary Sampling Units (PSUs) covering rural and urban representation as per the percentage of rural and urban population of the state.

Apart from household interviews, Clinical Anthropometry Biochemical Testing (CAB) tests were also done on selected respondents. The CAB component included measurements of height, weight, blood pressure, haemoglobin and random blood sugar for men, women and children in the selected households. In a subsection of the households, blood samples (using Dried Blood Spots techniques) were taken from men and women for HIV testing.

Integrated Programme Strategy For Food Fortification – Fortification of Wheat Flour with Iron, and Milk and Edible Oils with Vitamin-A and Vitamin-D

Agency   :     Global Alliance for Improved Nutrition (GAIN), India

Team       :     Suresh Joshi, Sudeep Sharma, Ranjeeta Rani, RS Rathore, Rajeev Baghel, Rajkapoor Raghav, Rahul Sharma

Food Fortification Project aimed at reducing the prevalence of micronutrient deficiencies in the state of Rajasthan by making available fortified wheat flour, oil, milk and soya dal analogue through open markets, government distribution channels and also through the other public funded programs such as Mid-Day Meal and Integrated Child Development Services. The core project components were: Production and Distribution, Legislation and Quality Control, Social Marketing and Communication and Monitoring and Evaluation. A Project Management Unit was set up at IIHMR for the execution of the project with the support of Global Alliance for Improved Nutrition (GAIN). Since its inception, the project succeeded in making large scale flour mills to produce fortified wheat flour, major milk dairies in Rajasthan including all 23 milk dairies of Rajasthan Cooperative Dairy Federation and private dairies to fortify toned and double toned milk. Major oil refineries like Ruchi Soya Industries Ltd., Bunge India Pvt. Ltd., Mahesh Edible Oil Industries and Ajanta Soya Ltd. were made associated with the project to produce fortified refined soyabean oil, mustard oil and palmolein oil for open market. Project supplied Soydal Analogue to various centralized kitchens of Akshaya Patra Foundation, Naandi Foundation and Adamya Chetna Foundation in several districts used for Mid-Day Meal preparation covering over a million school children in Rajasthan. Various social marketing and communication approaches were implemented to create the awareness to use fortified food in the community. Special efforts were also made to involve print and electronic media to promote the consumption of fortified food.

The project achieved great success in Rajasthan. Around one lakh metric tons of fortified wheat flour was produced and sold annually by the associated roller flour mills benefitting more than 1 million individuals. More than 5 lakhs metric tons of fortified milk was processed annually benefitting around 8 million individuals in the state. Around 3 lakhs metric tons of fortified edible oil was produced on annual basis benefitting around 42 million individuals. Above all, one million school children received fortified meals through the Mid-Day Meal program. Though the project has come to an end in the month of September, 2015, GAIN and IIHMR are actively engaged in providing technical support to the Department of Food and Civil Supplies, Government of Rajasthan and the Rajasthan State Food and Civil Supplies Corporation to mainstreaming supply of fortified food items through Public Distribution System as a compliance of the budget announcement of 2015-16 by the Hon’ble Chief Minister for supplying fortified wheat flour, fortified edible oil and double fortified salt through PDS with an objective to reducing the prevalence of malnutrition in the state.

Technical Assistance for IDA assisted ICDS Systems Strengthening and Nutrition Improvement Project (ISSNIP)

Agency    :     Ministry of Women and Child Development, Government of India

Team         :      SD Gupta, Anoop Khanna, Vinod Kumar SV, Pradeep Singh Kachhawa, Vivek Shukla, Shiv Kumar Acharya, Kanaram Saran

The Ministry of Women and Child Development (MWCD) initiated several measures to direct a strong focus on child nutrition and development. Conceptualizing the International Development Association (IDA) supported Integrated Child Development Services (ICDS), Strengthening Nutrition Improvement Project (ISSNIP) was one of its unique initiatives that complements the Government of India’s larger efforts and is aligned with the key decisions made by the Council support 200 high burden districts in the country. Of these, ISSNIP was supposed to be implemented in 162 high burden districts in eight states. IIHMR was a consortium partner with

PricewaterhouseCoopers Private Ltd (PwC) and Child in Need Institute (CINI) to work as the Technical Agency (TA) for ISSNIP. The TA has a structure comprised of the Central TA team, consisting of the Project Director, Team Leader, Deputy Team Leader, Advisors and the five Technical Programme Coordinators (TPCs) leading each of the technical task areas. At the State level, State Team Leaders (STLs) were engaged in leading the state level activities. There were a team of four Regional Managers (RMs) in the state to assist the STL in the implementation of TA activities. The Technical Assistance Agency has provided support, guidance and assistance in achieving the key objectives of Phase 1 of the ISSNIP with interventions designed across the four key components:

  • Component 1: Institutional and Systems Strengthening
  • Component 2: Community Mobilization and Behaviour Change Communication (BCC)
  • Component 3: Piloting Convergent Nutrition Actions
  • Component 4: Project Management, Technical Assistance, Monitoring & Evaluation.

The TA Agency provided a specialized and focused technical expertise to the ICDS programme considering the need for techno- managerial support required for strengthening the policy framework, systems and capacities at the national and state levels. The project also entailed design and conduct of a range of specific pilots in limited areas to generate concrete evidence for approaches that are likely to work at a scale to improve programme outcomes.

Asian Regional Capacity Development for Research on Social Determinants of Health

Agency     :   Karolinska Institute, Sweden

Team        :   Barun Kanjilal, Neetu Purohit, Manu Gupta

The project was coordinated by Karolinska Institute in Sweden, involving twelve partners across Europe, Asia and Africa including IIHMR. These four-year projects (2011-2015) were funded by the European Commission’s 7th Framework Program. The ARCADE project used innovative educational technologies to strengthen health research across Asia. Focusing on post-graduate, doctoral and post- doctoral training, partner institutions that are developing cutting-edge online courses, blended with learning modules and joint programs that will enable training of researchers in low- and middle-income countries who might not otherwise have access to such material. Under this project, IIHMR has produced a self-learning module on “Climate, Society and Health” for prospective PhD students in developing countries. Two modules on “Health and Development” and “Behaviour Change and Communication for Health Researchers” developed are also being used as a resource material for the PhD students of IIHMR University.

Rapid Training Needs Assessment (TNA) for Staff Development and Learning for WHO Staff in SEAR Region

Agency     :   WHO-SEARO

Team        :   Nutan Jain, SD Gupta, DK Mangal, Vidya Bhushan Tripathi

The World Health Organization (WHO) introduced a Global Competency Model composed of 13 competencies that included Core, Management and Leadership competencies and skills (WHO 2004). The Rapid Survey aimed at assessing development and learning needs of the staff of SEA Regional and Country Offices in the region at all levels in the organization based on the competencies required for these positions. The specific objectives were to: (i) review WHO global competency model (core, management and leadership competencies) and job responsibilities of all the managerial, supervisory, technical, administrative and secretarial staff of the Regional Office and SEAR

Country Offices; (ii) conduct a rapid learning needs assessment of the WHO-SEARO staff in relation to 13 core competencies; and (iii) recommend areas for future staff development and learning plan. The rapid e-survey was conducted in WHO-SEAR Office and the country offices in member countries (Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, DPR Korea and Timor-Leste.The staff development and learning needs have been identified for the WHO staff at various in the SEARO and with the stakeholder.

Technical Support for Improved Delivery of Comprehensive Package of Health Services to Urban Poor

Agency:   USAID India, Delhi

Team:   Dhirendra Kumar, Goutam Sadhu, Ambey Srivastava, BL Tailor and Madhur Mathur (Rajasthan); Rakesh Kumar, Hemant Kumar Mishra and Yagyesh Srivastava (Chhattisgarh)

Health of the Urban Poor Program (HUP) was implemented in eight different states by a Consortium consisting Population Foundation of India (Prime Recipient), Plan India, Institute of Health Management Research, Jaipur, Bhorukha Charitable Trust, Jaipur (Sub-Prime Recipient and Implementing Partners), International Institute for Population Sciences (IIPS), Micro Insurance Academy (MIA) Delhi, Centre for Development and Population Activities (CEPDA) – (Technical Partners).

The program aimed at improving the health status of the urban poor by adopting effective, efficient and sustainable strategic intervention approaches, adopting the principle of convergence of the various development programs. The program was supported by the Government of India and funded by United States Agency for International Development (USAID), India. The objectives of the program were: (i) to provide quality technical assistance to the Government of India, to the states and the cities for effective implementation of the National Urban Health Mission (NUHM); (ii) to expand partnerships in urban health engaging the commercial sector in public private partnership activities; (iii) to promote the convergence of different Government of India urban health and development efforts; and (iii) to strengthen urban planning initiatives by the state through evidence-based city-level demonstration and learning efforts. A Technical Advisory Group (TAG) at the national level provided technical guidance to the TA Team.

IIHMR implemented the Health of the Urban Poor (HUP) program in two Empowered Action Group (EAG) states, i.e. Rajasthan and Chhattisgarh. As an implementation partner, IIHMR managed these two states with overall technical assistance for training and capacity building as well as managing the city development model. The program was initially designed for 2009 to 2013, but due to its good impact, the USAID India extended the program up to September 2015.

Study of Global Ageing and Adult Health (SAGE) India Wave-2 Project Survey in Rajasthan

Agency           :   International Institute for Population Sciences (IIPS), Mumbai and World Health Organization

Team            :   Santosh Kumar, ND Sharma, Deepanshu Srivastava, Akhil Agarwal, Rohit Jain, Rakesh Sharma

The Study on Global Ageing and Adult Health (SAGE) India Wave – 1 initiated by the World Health Organization was conducted by the International Institute for Population Sciences (IIPS), Mumbai, as a part of multi-country in six of the seventy countries that participated in the World Health survey, 2003. SAGE is a longitudinal, cross-sequential household face-to-face survey. IIHMR was also selected as field agency for conducting SAGE Wave-1 in Rajasthan in the year 2007. IIHMR has been retained to conduct WHO-SAGE Wave- 2 in Rajasthan this year. The objectives of the survey are (i) to obtain reliable, valid and comparable data on levels of health on a range of key

domains for older adult population (50 years and above); (ii) to examine patterns and dynamics of age-related changes in health and well- being using longitudinal follow-up of survey respondents as they age, and to investigate socio-economic consequences of these health changes; (iii) to supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures through measured performance tests for selected health domains; (iv) to collect data on health examinations and biomarkers to improve reliability of data on morbidity, risk factors and monitor the effect of interventions; and (v) to obtain data on contraceptive use and its continuation, morbidity conditions during various stages of reproduction and responsiveness of health system towards these conditions for adult population in age 18-49. The Survey targeted 1800 individual interviews in the state of Rajasthan.

Assessment of Alcohol Situation in Urban Sphere: In Context of Violence against Women in Private and Public Spaces

Agency     :   Family Health International 360

Team        :   Nutan Jain, Arindam Das, Vidya Bhushan Tripathi, Priyanka Sharma, Kailash Prajapati

IIHMR has been subcontracted by Family Health International - FHI360 for conducting DFID supported research study entitled Assessment of Alcohol Situation in Urban Sphere: in the Context of Violence against Women in Private and Public spaces in the state of Madhya Pradesh. The purpose of the study was to examine the linkage between alcohol and violence against women and also to understand the existing scenario of alcohol use and violence against women for preparing guidelines for making policy to prevent violence against women. The objectives of the study were:

  • To better understand the relationship between alcohol consumption and violence against women;
  • To understand the patterns of sale, purchase and consumption of alcohol at the community level; and
  • To review the existing state of alcohol policies and regulatory mechanisms to make recommendations.

The study was conducted in two urban cities of Madhya Pradesh, Bhopal and Jabalpur. The target population for gathering evidence consisted of married men and women who are 18 years or above including government officials, NGO workers, and staff of alcohol outlets, doctors, drivers and others.

Project Implementation Plan for Bali Block in Pali District Focus: Maternal and Child Health and Nutrition Imbedded with Transformation Initiative

Agency       :   Centre for Microfinance (CmF), Rajasthan

Team  :   Suresh Joshi, Gowthamghosh B

The IIHMR University prepared a project implementation plan for the Centre for Microfinance (CmF), Rajasthan for expanding their area of functioning to cover the Maternal and Child Health, Nutrition issues along with the Transformation Initiative. The objectives of the project were to understand the situation of child malnutrition and maternal and child health issues in Bali block and the feasibility of layering a health project onto the existing Transformation Initiative SHG platforms in the block Bali of Pali district and also to provide resource support to CmF through developing a project design that would enable CmF to implement a nutrition-centric maternal and child health programme in Bali for a period of five years (2015-2020).

As a part of the study, a block level situational assessment was carried out at Bali. During the assessment, selected health facilities, Anganwadi Centres were visited and numbers of key Health and Integrated Child Development Services (ICDS) personnel were interviewed. Focus group discussions were conducted to gather information on current situation of MCHN services coverage and other related information. On the basis of the rapid assessment, a draft plan of action has been developed for implementation.

Assessment of Appropriate use of Mobility Fund for Supportive Supervision in Madhya Pradesh

Agency     :   Madhya Pradesh Technical Assistance Support Team (MPTAST)

Team          :   DK Mangal, Alok Mathur, Arindam Das, JP Singh, Manasee Mishra. Jitendra Soni, Mohammed Shahnawaz, Ashish Bandhu, Rajeev Singh Dhakad, Pradeep Singh Rathore

FHI 360 as part of the Madhya Pradesh Health Sector Reforms Program (MPHSRP) subcontracted IIHMR to conduct an independent assessment of appropriate use of mobility fund for supportive supervision of health facilities in Madhya Pradesh for the financial year 2014-15. The objectives of the study were to assess and validate the status of implementation and adherence to financial management and procurement guidelines issued by NHM for use of the mobility support; to understand the type and extend of the supportive supervision provided at different levels of facilities particularly at GAK level; and to provide recommendations to improve implementation of mobility support and supportive supervision.

Supportive supervision is an essential function for effective and functional primary health care system. The Health Department, Government of Madhya Pradesh has placed high priority on strengthening supportive supervision through providing mobility support, established “Gram Arogya Kendras” at village levels and creating “Gram Swasth Prahri Dal” for each sector at PHC level. The assessment study reveals that though the interventions has been institutionalized in the state, there are bottlenecks at the implementation level towards utilization of mobility support funds at different levels of health facilities as well as organizing supportive supervision visits effectively.

Conducting Polling Booth Survey among Currently Married Women in Selected Districts of Eastern Uttar Pradesh and Odisha, India

Agency     :   Public Health Foundation of India (PHFI)

Team        :   Shilpi Mishra, Neetu Purohit, Nivedita Roy, Abhishek Kumar

Polling Booth Survey (PBS) was conceptualized to understand the knowledge and the behavioral patterns related to HIV among migrants and their spouses. The objectives of the study were (i) to assess the current level of knowledge, attitude and risk behaviour of currently married women at the identified high out migrant districts of Uttar Pradesh and Odisha and (ii) to assess the exposure to the health related interventions, i.e., current level and type of HIV related health services availed by currently married women in MSDS and Non-MSDS study districts of Uttar Prades and Odisha.

Assuming that the knowledge, attitude and behavior vary significantly by sex, age and marital status, the polling booth surveys were carried out on spouses of migrants and non-migrants in the age group of 15-49 years. Altogether, 120 PBS sessions, with 60 sessions in each state were conducted covering 1235 participants. The respondents for the PBS were selected using a three-stage cluster sampling method which included, (i) selection of blocks; (ii) selection of villages/selection of segments and (iii) selection of respondents. The analysis was done from two aspects, migration status of spouse of the respondents and MSDS implementation status of the selected area. Not much difference was found between the migrant and non- migrant groups on most knowledge and awareness related indicators especially in case of Uttar Pradesh and is indicative of need for renewed efforts for intervention among migrants. The women in the intervention areas (MSDS implemented area, Gorakhpur) in Uttar Pradesh had poor awareness and reported to be indulging in higher risk behaviour than the same group of women in Odisha. This implied that while efforts are needed in both states, more focused and targeted interventions are required in Uttar Pradesh.

Child Sex Ratio in Rajasthan: Tehsil Level Trends

Agency     :   UNFPA Rajasthan

Team        :   DK Mangal, Priyanka Sharma, Abhishek Kumar, Lalitha Swathi Vadrevu, Rajeev Singh Dhakad, Rohit Jain

Child Sex Ratio in Rajasthan was analyzed and graphically represented through GIS maps. The census data for 1991, 2001 and 2011 was used to prepare the tehsil-wise maps of CSR trends. The trends were mapped to emphasize upon the point of declining trends within the district and also identify potential geographical areas where trends were disturbing. Analysis of Child Sex Ratio trends at tehsil level indicates the disparities within the districts. A declining trend was noted in almost all the tehsils over the period 1991-2011. Among these tehsils with substantial decline of more than 50 points and there are tehsils with a sharp decline of 30-50 points in census 2011 compared to census year 1991. Some tehsils reported with moderate drop of less than 30 points. To correct this persistence in adverse child sex ratio, there is a great need for policy and programmatic action on several fronts. We believe that these tehsil level maps showing/depicting the trends over time on child sex ratio would be used as effective advocacy tool to energize local community level action for reversing the declining child sex ratio in the state.

Study of Village Level Wheat Flour Fortification in Relation to Knowledge, Attitude and Practice among Chakki Owners and Community in Udaipur District of Rajasthan

Agency       :   Project Management Unit, Food Fortification Project

Team          :    Tanjul Saxena, Divya Vyas, Nivedita Roy

The study was commissioned to assess the pilot project by Global Alliance for Improved Nutrition (GAIN) for “Use of Fortified Aata by Community using Small Chakki for Flour Fortification in tribal Blocks of Udaipur District”. The objective of the study was to assess the present knowledge among rural families (including general population, pregnant and lactating women and adolescents) on food fortification and their attitude and behavior towards regular use of fortified aata.

The study also purported to compare the changes in knowledge, attitude and practices from the baseline study before the intervention and with a control block that is homogenous to the intervention blocks in terms of socio economic profile. The study also aimed to assess the knowledge, attitudes and practices of fortification of aata done at small chakkis in the villages of the flour produced from wheat brought by families for grinding.

The survey used structured questionnaires to interview two category of respondents i.e. community (general population, pregnant and lactating women and adolescents) and chakki owners. Focus Group Discussions and interviews were also conducted to capture the qualitative results of the pilot project.

End-line Evaluation for Diabetes Prevention and Control in Jodhpur District, Rajasthan

Agency       :   Humana People to People in India (HPPI)

Team          :     Sunita Nigam, Gowthamghosh B

The end-line evaluation for Diabetes prevention and control was carried out with the objectives (i) to evaluate the status of the target population under the project areas, (ii) to measure the degree of changes on KAP on Diabetes Community Care and Support project among the target community before and after the implementation of the project and (iii) to document good practices and success stories of the project for up scaling the project activities in other areas in near future.

The End-line evaluation study was adopted both the quantitative as well as qualitative techniques to develop the measurable indicators to verify the changes under the project. The sample frame for the evaluation survey was developed based on the number of village covered under the project. The structured questionnaires were used for household level survey and checklist for In-depth interview. For qualitative aspects, Focus Group Discussions (FGDs) at community level were organized separately for men and women. In depth interviews were carried out for the frontline health workers (ANM& ASHA), knowledgeable/PRI members of the community, project staff/field workers of HPPI and NPCDCS staff (specially looking after the Diabetes) along with District level health officials, MoIC of Mandor block of Jodhpur District.

The survey showed an increase in awareness of diabetes as compared to the base line data. At the time of base line 24 percent people were aware which has increased to 96 percent. It showed excellent contribution of the project to create awareness among the community about the disease. The knowledge of risk factors of diabetes also showed a change from 13 percent to 59 percent. This change could be associated to the severe awareness campaign in schools, in the community and use of wall writings, nukad nataks, which was one of the most efficient strategies adopted by the organization, and IPC through task force going door to door spreading awareness about the disease. Almost three fourth of the community members were influenced by the organization’s efforts as revealed by the study. Nearly 87 percent people went for blood test after the intervention under the project. The major contribution by the organization can be seen in the fact large number of persons having blood sugar more than normal value (hyperglycemia) had stopped taking anti diabetic oral medicines and have controlled it with exercise and dietary measures promoted under the project.

Consultancy for Training Frontline Workers on Water, Sanitation and Hygiene by MPTAST in Madhya Pradesh

Agency     :   MPTAST, India

Team        :   DK Mangal, SP Chattopadhyay, Laxman Sharma, Mohammed Sharif, Melvin John Baxla, NK Sharma, Sunita Nigam

The WASH component of MPTAST led by WaterAid and contributes to MPTAST objective on WASH by promoting skills, systems and sustainable services with attention on safe, equitable, inclusive and sustainable access to water supply, sanitation services and improved hygiene behaviors.WaterAid works to identify problem areas and provide technical assistance to the departments concerned of GoMP, i.e. PHED and Rural Development Department to improve WASH planning, budget utilization and strengthen WASH delivery at state and in priority districts.

One of the important components of the MPWASH program was to develop capacity at community level for greater community awareness and action on WASH. The program involved training of Frontline workers FLWs (ASHA, ANM, AWW, Teachers, MATE NREGA and Village Motivator Saakshar Bharat), who played an important role to assist communities in raising their awareness and motivation in order to help integrate WASH in their core activities. The goals of the training were build capacities of Frontline workers to support implementation of WASH programme in the districts; Improve knowledge, increase demand and access for WASH services through community mobilisation processes; Strengthen linkages with government service providers to ensure access to quality WASH services etc.

IIHMR has been identified by the WaterAid for conducting training of about 15000 FLWs mainly ASHA and certain number of AWWs in 7 districts in Madhya Pradesh, namely Jabalpur, Mandla, Rewa, Satna, Sidhi, Chhatarpur and Damoh. The IIHMR team is implementing the FLWs training program and it is expected that by the end of June, 2015 the team will reach the target.

Client Exit Survey for Client Satisfaction

Agency       :   Marie Stopes India

Team          :   Laxman Sharma

Marie Stopes India (MS India) assigned IIHMR to carry out a client exit survey in selected districts of Rajasthan, UP, MP and Bihar. The exit survey involved interviewing the clients who avail family planning/safe abortion services from Marie Stopes India service delivery channels– outreach camps, (both Marie Stopes India and government managed outreach) clinics, and social franchises.

The major objectives of the survey were to assess the profile of clients visiting different service delivery channels of Marie Stopes India; assess the satisfaction of clients with the services of Marie Stopes India; and also cleanliness at the facility, waiting time, privacy, staff behavior and counseling provided at the camp, assess how well our marketing/BCC activities work and assess the method of choice of the clients and reason of their preference.

The Survey was conducted in 10 selected districts of Rajasthan, 19 districts of Madhya Pradesh, 8 districts of Bihar and 3 selected districts of Uttar Pradesh namely Bareilly, Barabanki and Sitapur.

Assessment of the Status of Education, Health and Protection of Vulnerable Children Engaged in the Brick Kilns of West Bengal, India: An End-Term Evaluation of the Brick Kiln Project conducted in Malda and North 24 Parganas Districts of West Bengal

Agency     :   Save the Children, West Bengal

Team        :   Veena Nair Sarkar, Saheli Manish Kumar

The broad objectives of the evaluation study were: assess the extent to which the project has achieved its expected outcomes; review and evaluate overall performance of the project in terms of its objectives, strategies, processes and achievement of the key result areas; and to identify good practices and the learnings from project implementation and provide recommendations for future programming.

The study adopted a mixed methods approach. The methodology followed the five internationally used assessment criteria viz., Relevance, Efficiency, Effectiveness, Outcome and Sustainability. The study found that all brick kilns had been covered through the project and all Bridge Course Centres were functioning. The centers were the most visible component of the project. Certain issues with regard to project implementation were identified.

Situational Analysis of Lymphatic Filariasis Cases in Three Endemic Districts of Madhya Pradesh

Agency     :   Lepra Society, Secunderabad

Team        :   Amlan Datta, Veena Nair, Saheli Manish Kumar

The study was undertaken to understand the important factors enabling and hindering the elimination of Lymphatic Filariasis activities in the three highest endemic districts of Panna, Rewa and Chattarpur in Madhya Pradesh. Two blocks were chosen from each study district.

A line list of cases was analyzed. Lymhoedema cases with elephantiasis and/or hydrocoele were examined and interviewed. Based on the study findings, the recommended interventions included regular updation of line list of Lymphatic Filariasis cases, refresher training to staff, increased IEC and BCC activities amongst community members in endemic areas, night blood sample surveys at community level hot spots, integrated vector management and strengthening of Morbidity Management and Disability Prevention (MMDP) of chronic cases.

Uncertainty from Below: Study on Climate Change and People’s Narratives in the Sundarbans

Agency     :   Institute of Development Studies, Sussex, UK

Team        :   Upasona Ghosh, Shibaji Bose (Consultant), Rittika Brahmachari, Sujan Sarkar (Research Assistant)

The study sought to explore perceptions of different stakeholders regarding climate change in the Sundarbans in West Bengal. Qualitative methodology (ethnography) was used. The study enabled an understanding of the knowledge uncertainty of the different stakeholders regarding changing climate in the Sundarbans in West Bengal. The coping and adaptation processes of the local people of Sundarbans facing climatic threats were also understood.

Study on Identification of Barriers in Accessing Services in RSBY

Agency       :   CARITAS India - Poorest Areas Civil Society Programme (PACS), New Delhi

Team         :   Manasee Mishra, Arnab Mandal, Saheli Manish Kumar

The study ‘Utilization Patterns and Reasons in Disadvantaged Communities: A Study of Rashtriya Swasthya Bima Yojana (RSBY) in West Bengal’ seeks to understand the major barriers in the utilization of RSBY scheme and reasons thereof. The study is located in the five PACS intervention districts of West Bengal. It systematically looks at patterns in the utilization of RSBY scheme among beneficiaries, and differing uptake of the mandated services among various socio-economically backward communities in the five study districts. Behaviour changes in the beneficiaries due to the introduction and active advancement of RSBY scheme are captured.

The study suggests specific inputs for advancement of the advocacy agenda of PACS with special reference to facilitation, coordination, the use of various communication channels and the quality of messaging therein.

KAP Study of Water, Sanitation and Hygiene (both Personal & Menstrual) among School Students of Chinsurah - Mogra Block (Tribeni area) of Hooghly District

Agency       :   Water for People India Trust

Team         :   Veena Nair Sarkar

The objectives of the study were to assess the gaps in knowledge, attitude, practices and influences on the behaviour of school children. The study adopted a mixed methods approach to comprehensively address the questions of relevance, efficiency, effectiveness and practicality of the project. Primary and secondary data was used for the purpose. A quantitative sample survey was supplemented by qualitative fieldwork with all the key stakeholders such as school representatives, community representatives, health workers, ICDS officials, community based support groups and beneficiaries. The study findings will inform programme communication approaches for bringing about behaviour change. The study revealed soaring level of change in hygiene practices since project inception. The project activities are highly acknowledged by all the key stakeholders of the project. Two key behaviours sought to be improved through the project are: use of toilets, and washing hands using soap/hand-wash. These behaviours score high on knowledge, attitude and practice among school children. Perceptions about menstrual taboos need to be changed.