PROJECT:

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Mother NGO for Adolcsent Reproductive & Sexual Health “ARSH Udaan”

Mother NGO for Adolcsent Reproductive & Sexual Health “ARSH Udaan” (Department of Health & Family Welfare, Government of Uttarakhand and National Rural Health Mission “NRHM”) (2012 – 2015)

It is a matter of pride that IMPART has been selected both mother and field NGO for Adolescents Reproductive & Sexual Health (ARSH) program. In the year 2008, the ARSH intervention was initiated through a pilot project in the state of Uttarakhand with the external support of USAID under Innovations in Family Planning Services (IFPS) grant. The branding of the ARSH program in the state was done as “UDAAN – Understanding, Delivering and Addressing Adolescent Needs”. However, prior to this pilot few other intervention programs like KISHORI UTTHAN PARIYOJANA and others were also implemented in the state. In the year 2008 UKHFWS decided to initiate the pilot project, through USAID’s IFPS mechanism, in eight blocks of the four districts namely Dehradun, Haridwar, Udham Singh Nagar and Nainital. A midline assessment of the impact of UDAAN services in these pilot blocks was undertaken by UKHFWS through IFPS funds in the year 2010—11. Some of the key findings are being listed here:

  • Awareness of services was 51.2 % in males and 48.8 % in females.
  • Awareness of health camps was relatively higher compared to other activities. Being highest in Dehradun ( 41.9%) in males and in Nainital(40.6 %) was highest in females.
  • Awareness and utilization of Udaan services was found higher among school going adolescent as compared to non-school going adolescent.
  • Over Four –Fifths reported satisfaction with services, who utilized at least one service by UDAAN program.
  • Regarding Location of Health Services for adolescents, 44% male adolescents stated that it should be within village and 27% female adolescents stated that sub-centres would be convenient.
  • A higher proportion of users 21.5% reported having ever heard of RTI, compared to non-users 10.2% of Udaan services.
  • A higher proportion of users (76.6%) reported having ever heard of HIV/AIDS, compared to non-users (61%) of Udaan services.
  • A much higher proportion of users (94.1%) perceived ideal number of children as one or two, compared to non-users (10.4%) of Udaan services.
  • A higher proportion of users (76.2%) perceive problems arising from early pregnancy, compared to non-users (63.7%) of Udaan services.
  • Awareness about minimum legal age at marriage for girls being 18 yrs, was observed among a higher proportion of users (90.1%) compared to non-users (84.5%) of Udaan services.
  • Awareness about minimum legal age at marriage for boys being 21 years, was observed among a higher proportion of users(77.2%), compared to non-users(71.4%) of Udaan services.
  • Parents reported their satisfaction by stating that ,the adolescent are engaged gainfully due to program initiatives, participation in the program made adolescent more aware and adolescents also tend to learn on a variety of new and useful life aspects.

In the subsequent year, UKHFWS expanded the ARSH – UDAAN project which is now running in 27 blocks of the state. A State Nodal Agency, CSHCS &SAMARPAN was also selected to provide the technical assistance to the UKHFWS on ARSH issues in terms of undertaking all the activities as envisaged in the concept note of ARSH – UDAAN project under the guidance of Programme officer RCH and state has decided to continue with the same agency as SNA in the year 2012-13.

Coverage of UDAAN (ARSH) Program in Uttarakhand

Presently, the ARSH – UDAAN program is implemented in 27 blocks of 4 districts of Uttarakhand with the help of 12 Field NGOs at the block level and a State Nodal Agency for providing technical assistance to the SPMU within UKHFWS.

S. No. District Blocks Population Adolescents Sex Ratio Literacy Rate (M) Literacy Rate (F)
1 Dehradun 6 1698560 373683 902 90.32 79.61
2 Haridwar 6 1927029 423946 879 82.26 65.96
3 U S Nagar 7 1648367 362641 919 82.48 65.73
4 Nainital 8 955128 210128 933 91.09 78.21
Total Averages 27 6229084 1370398.48 908 86.53 72.37

Objectives of Program:

  • To make health care services more accessible and acceptable to adolescents.
  • To build the capacity of health providers to improve service performance for the delivery of adolescent-friendly services.
  • To establish convergence of various stakeholders in providing a comprehensive package of services for the adolescents based on their needs.

Services under UDAAN

The comprehensive package of services was designed to respond to the diverse needs of different adolescents and includes promotive, preventive and curative services. The package also include services which may be beyond the purview of health per se, but are indirect determinants of the physical, social and mental well-being of adolescents.

  • Promotive Services like counselling for unmet need of contraception, information on RTI/STI , menstruation and other sexual concerns.
  • Preventive Services like nutritional counselling, supplement for nutritional anaemia , T.T. Immunization and focused antenatal care.
  • Curative Services viz; treatment for RTI/STI, Anaemia, acne, cornice infection etc.
  • Miscellaneous Services like life skills education, career counselling and co-curricular activities.

The state proposes to expand the program in 15 blocks of remaining 9 districts of the state, the remaining 53 blocks in 9 districts will be covered in FY 2013-14 as second phase of expansion. In this way the state will ensure the 100% coverage of all the block by the FY 2013-14.

Expansion of ARSH- UDAAN :

The ARSH-UDAAN program is proposed to be expanded in some blocks, 1 in 3 small districts ( Rudraprayag ,Bageshwar and Champawat) and 2 blocks in remaining 6 districts namely Uttarkashi, Chamoli, Tehri, Pauri Garwal, Pitthoragarh and Almora. There are 95 blocks in the state and 27 are already covered through the block level FNGOs and 68 are remaining in 9 districts, where no such program is undertaken. Hence, in addition to the existing 27 blocks, additional 15 blocks will be covered during next FY 2013-14 while the remaining will be propose in the next PIP for the FY 2014-15 to cover all the 95 blocks of the state.

 

S. No. District Total Blocks To Be selected Pop Adol. Pop Sex Ratio Literacy Rate (M) Literacy Rate (F)
1 Uttarkashi 6 2 329686 72531 959 89.26 62.23
2 Chamoli 9 2 391114 86045 1021 94.18 73.2
3 Tehri 9 2 616409 135610 1078 89.91 61.77
4 Garhwal 15 2 686527 151036 1103 93.18 73.26
5 Rudraprayag 3 1 236857 52109 1120 94.97 70.94
6 Champawat 4 1 259315 57049 981 92.65 68.81
7 Pithoragarh 8 2 485993 106918 1021 93.45 72.97
8 Bageshwar 3 1 259840 57165 1093 93.2 69.59
9 Almora 11 2 621927 136824 1142 93.57 70.44
Total/Average 68 15 3887668 855287 1057.56 92.71 69.25

Indicator for FNGOS 2014-15

 Quarterly Indicators: 1st Quarter    

  • Procurem
  • ent of Adol. Kits from UKHFWS (PGE Kits)   — Yes
  • Project Staff to be stationed at block level AFCC of the Intervention Block. — Yes
  • Selection/Continuation of 50 priority villages in the intervention block in consultation with Block MO I/c — Yes
  • Advocacy Meetings at village level with parents & VHSC members and Adolescents for selection of PGE’s in 50 priority villages. — Yes
  • 50 percent of existing PGEs (who are inactive and completed the age of 19 years) will be replaced by selecting new PGEs. — Yes
  • Training of 50 male and 50 female PGEs — Yes
  • Opening of individual saving bank account of all the selected PGEs. — Yes
  • Identifying/Continuation 15 AFC and coordinate with UKHWS for IEC material for AFC. — Yes
  • Distribution of News paper and magazines at the AFC from the 3rd month. — Yes
  • Organization of 2 Health Camp — Yes
  • 1st Exposure Visit . — Yes
  • 3 School Based workshop on Adolescent Issues. — Yes
  • 10 Advocacy Meetings (5 in each month) on Menstrual Hygiene to Adol. girls with ANM. Should be in the group of minimum 15 Adol. girls. — Yes

Quarterly Indicators: 2nd Quarter   Nov 2013 to Jan 2014

  • Monthly scholarships for 100 PGEs into their individual bank account only. — Yes
  • Organization of monthly 45 cluster meetings (15 in each month) — Yes
  • Incentivize ASHA’s to support Cluster meetings — Yes
  • 15 Advocacy Meetings (5 in each month) on Menstrual Hygiene to Adol. girls with ANM. — Yes Should be in the group of minimum 15 Adol. girls. — Yes
  • 4 School Based Workshops on Adolescent issues— Yes
  • 3 Health Camps — Yes
  • Sponsorship for the enrollment of 10 (5 Male/5 Female) Out of School Adol. for livelihood Training programs. — Yes
  • Distribution of News paper and magazines at the AFC on monthly basis. — Yes
  • 2nd exposure visit — Yes

Quarterly Indicators: 3rd Quarter   Feb 2014 to April 2014

  • Monthly Scholarships for 100 PGEs into their individual bank account only. No
  • Organization of monthly 45 cluster meetings 15 in each month. — Yes
  • Incentivize ASHA’s to support Cluster meetings — Yes
  • 15 Advocacy Meetings on Menstrual Hygiene to Adol. girls with ANM. Should be in the group of minimum 15 Adol. girls. — Yes
  • 4 School Based Workshops on Adolescent issues — Yes
  • 3 Health Camps, 1 in each month. — Yes
  • 7 School Based Poster/Drawing Competitions — Yes
  • Sponsorship for the enrollment of 10 (5 male and 5 female) Out of School Adolescent for livelihood Training programs — Yes
  • Distribution of News paper and magazines at the 15 AFCs on monthly basis. — Yes
  • 3rd exposure visit – Yes

 

 

 

ARSH Program in US Nagar, Uttarakhand:

As per the given targets, IMPART and its field NGOs has conducted following activities during the specified time span.

 

Sl Formation of Adolescent Groups TOTAL
Activity     Organized per Block JASPUR     KASHIPUR     BAJPUR   GADARPUR   RUDRAPUR   SITARGANG   KHATIMA  
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i Total number of groups formed 100 100 100 100 100 100 100 700
ii No. of Active Groups 100 100 100 100 100 100 100 700
iii Total Enrolled School- going Adolescents 1610 1575 1575 1544 1490 1594 1478 10866
iv Total Enrolled Non School- going Adolescents 90 199 199 203 41 181 22 935
v Total Enrolled Adolescents 1700 1774 1776 1747 1531 1775 1500 11803
Training Sessions Organised and Monitored
Sl Activity     Organize in per Block JASPUR     KASHI PUR     BAJPUR   GADARPUR   RUDRAPUR   SITARGANG   KHATIMA   TOTAL
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i Total no. of ARSH Mobilizers 2 2 2 2 2 2 2 14
ii Training Sessions delivered by ARSH Mobilizes to PGEs 213 127 135 15 170 135 321 1116
iii Training Sessions monitored by ARSH Mobilizers 211 140 175 164 258 161 384 1493
iv Sessions organized by PGE in fields 3414 2979 2211 2815 3278 2733 2430 19860

 

 

BCC Activity TOTAL
Activity     Organize in per Block JASPUR     KASHIPUR     BAJPUR   GADARPUR   RUDRAPUR   SITARGANG   KHATIMA  
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i Total No. of villages identified/ covered 50 50 50 50 50 100 50 400
ii Total No. of Adolescent Friendly Clubs formed 15 15 30 15 15 30 15 135
iii No. of Cluster Meetings organized 135 135 135 15 150 135 153 858
iv Participation of PGE in Cluster Meetings 791 818 863 705 938 665 844 5624
V No. of Community Meeting organized 52 50 125 50 50 52 50 429

 

Sl No. of School Based Activities Total
School Workshops 15 14 16 15 13 15 13 101
( No. of Adolescents participated ) 987 327 526 497 386 624 368 3715

 

Sl Facilitation of AFHS TOTAL
Activity     Organize in per Block JASPUR     KASHI PUR     BAJPUR   GADARPUR   RUDRAPUR   SITAR GANG   KHATIMA  
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i Health Camps organized by ARSH Mobilizer 10 11 11 10 5 9 5 61
a Health Camps organized With School Health Team 4 4 5 4 5 4 0 26
ii Adolescents received Health Services in Health Camps 554 569 574 578 263 446 200 3184
iii Adolescents facilitated to receive Health Services at AFCCs 311 224 592 104 11 281 14 1537
iv Adolescents referral to higher health facility 29 47 8 105 0 20 0 209
V School going Adolescents Counseled 409 109 217 272 263 47 200 1517
Vi Non School going Adolescent Counseled 31 12 75 306 19 0 0 443
Vii Adolescents who received AFHS after Counseling 74 13 265 226 0 0 0 578

 

 

No. of Adolescents who received following
Sno Activity     Organize in per Block JASPUR     KASHI PUR     BAJPUR   GADARPUR   RUDRAPUR   SITAR GANG   KHATIMA   TOTAL
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i T.T 486 252 341 245 55 0 0 1379
ii IFA 246 176 345 408 13 319 0 1507
iii Height 554 518 581 578 161 419 108 2919
iv Weight 554 518 583 578 161 529 108 3031
v D- Worming 195 176 519 230 10 485 73 1688
vi Others- Calcium 122 97 285 318 21 225 0 1068
No. Of Adolescent who Complained of
Sno Activity     Organize in per Block JASPUR     KASHI PUR     BAJPUR   GADAR PUR   RUDRA PUR   SITAR GANG   KHATIMA   TOTAL
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i Anemia 209 77 93 167 0 93 0 639
ii Worm Infestation 178 26 27 255 0 33 0 519
iii Irregular Menses 77 47 84 30 0 96 0 334
iv Pain in Lower Abdomen 987 36 26 34 0 69 0 1152
v Back Ache 97 28 9 67 0 24 15 240
vi Burning in Urine 66 9 10 20 0 14 0 119
vii Itching 112 77 99 62 0 38 0 388
viii White Discharge 80 57 79 50 0 28 0 294
ix Dental Carries 126 30 67 62 0 34 7 326
x Skin Diseases 117 64 65 120 0 54 8 428
xi other – headache etc 91 62 64 83 0 119 0 419
Networking and Liasoning
Sno Activity     Organize in per Block JASPUR     KASHI PUR     BAJPUR   GADARPUR   RUDRAPUR   SITAR GANG   KHATIMA   TOTAL
Name of   FNGO GCVWS IMPART IMPART GCVWS KAGAS IMPART KAGAS
i Health Center (SC/PHC/CHC/DH) 130 77 90 145 63 99 78 682
ii School teachers 92 30 32 60 14 26 23 277
iii PRI (Pradhan,VHSC,Sarpanch, Panchayat, local leader) 124 57 227 120 115 165 47 855
Iv Block (Block pramukh, VDO, MOIC and other) 70 24 20 72 44 107 24 361
District   13 14 16 10 14 15 6 88
vi  Others (ICDS, ASHA etc.) 192 139 208 195 333 250 245 1562
Other Activities
i PGE’s Training (Number of Participants Boys/Girls) 100 100 100 100 100 100 100 700
ii Exposure Visits for Adolescents 4 4 4 4 4 4 3 27
  ( No. of Adolescents participated ) 100 88 94 100 75 85 88 630
iii Livelihood Training 2 2 2 2 2 2 2 14
  ( No. of Adolescents participated ) 20 44 44 20 20 44 20 212
i v Advocay for mestrual Hygiene with ANM 50 58 61 51 60 55 53 388
  ( No. of Adolescents Girls participated ) 790 752 867 707 1,193 694 711 5714