Mother NGO for Reproductive Child Healthcare

Mother NGO for Reproductive Child Healthcare (Department of Health & Family Welfare, Government of Uttarakhand and National Rural Health Mission “NRHM”) (2008 – 2012)

 Introduction:

Within the framework of WHO’s definition of health as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity; reproductive health addresses the reproductive processes, functions and systems at all stages of life. Reproductive health therefore implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide, if when, and how often to do so.

This definition focus on right of men and women to be informed of and to have access to safe, effective, affordable, and acceptable methods of fertility regulation of their choice, and the right to access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.

Essential Components of RCH Programme

1. Prevention and management of unwanted pregnancy.
2. Maternal care that includes antenatal, delivery and postpartum services.
3. Child survival services for newborns and infants.
4. Management of Reproductive Tract Infection (TRIs) and Sexually Transmitted Infections (STIs).

Major Elements of RCH Programme

1. Reproductive Health Elements

• Responsible and healthy sexual behavior
• Interventions to Promote Safe Motherhood
• Essential Obstetric Care for All
• Prevention of Unwanted Pregnancies: Increase Access to Contraceptives
• Emergency Contraceptives
• Safe Abortion
• Pregnancy and Delivery Services
• First Referral Units (FRUs) for Emergency Obstetric Care
• Management of RTIs/STDs
• Infertility & Gynecological Disorders
• Referral facilities by Government /Private Sector for Pregnant Woman at Risk
• Reproductive Health Services for Adolescent Health
• Global Reproductive Health Strategy

1. Child Survival Element

• Essential New Born Care
• Prevention and Management of Vaccine Preventable Disease
• Urban Measles Campaign
• Elimination of Neonatal Tetanus
• Cold Chain System
• Polio Eradication: Pulse Polio Programme
• Hepatitis B Vaccine
• MMR Vaccine
• Global Alliance for Vaccine and Immunization (GAVI)
• Diarrhea Control Programme and ORS Programme
• Prevention and Control of Vitamin A deficiency among children

Strategy:

1. Bottom-up Planning
   2. Decentralized Participatory Planning & Implementation
   3. Strengthening Infrastructure
   4. Integrated Training Package
   5. Improved Management

 Under the Reproductive and Child Health Program the Mother NGO scheme was introduced by the Department of Family Welfare in the Ninth Five Year Plan (1997-2002). Under this scheme, the Department of FW identified and sanctioned grants to selected NGOs called Mother NGOs (MNGOs) in allocated district/s. These MNGOs, in turn, issued grants to smaller NGOs, called Field NGOs (FNGOs), in the allocated district/s. The grants were to be used for promoting the goals/objective as outlined in the Reproductive and Child Health Programme of the union government.

The major thrust of the MNGOs and FNGOs is in the area of advocacy and awareness generation in respect of the RCH programme, with due emphasis on gender, while aiming to augment institutional capacity at the field levels. They also play a crucial role in addressing the gaps in information and counseling. IMPART identified as a mother NGO for district Udham Singh Nagar by the aforesaid department.

Activities:

The scheme is in its implementation phase. Representatives of IMPART participated in various training programs, workshops and meetings etc organized by state Govt. and regional resource center (VHAI, New Delhi). IMPART invited application as per guideline of MNGO scheme from NGOs working in the field of reproductive child health and social sector for working as a field NGO in the mother NGO scheme. Screening of applicant NGOs were carried out by IMPART and district health system. After field appraisal 4 NGOs selected i.e. Institute of Social Development, Grameen Vikas Evam Sodh Sansthan (GVESS), Kumaon Agriculture and Greenery Advancement Society (KAGAs) and Paryavaran Evam Jan Kalyan Samiti.

Health Goal:

Improved Quality of Reproductive and Child Health Care Services in unserved & underserved villages of Kiccha, Khatima, Rudrapur and Sitarganj blocks of Udhamsingh-nagar District in Uttarakhand from 2009 to 2011.

FNGO’s Objectives:

For MCH services:

To increase the percentage of women receiving complete ANC during pregnancy from 11% to 100%, accessibility of institutional delivery from 27% to 50%, deliveries by SBAs from 19% to 40% and complete immunization against VPDs from 42% to 100%

 For FP services:

To increase the male sterilization (NSVs) from 1% to 10%, Cu-T insertion from 2% to 20%, OCP usage from 6% to 30% and condom usage from 37% to 40% and maintain the Tubectomy level at 42%

For prevention & treatment of RTI:

To decrease prevalence of RTI among women from 64% to 20% and among men from 27% to 0%

For ARH

To reduce the no. of girls marrying before attaining 18 yrs from 61% to 20% and adolescent pregnancies from 41% to 10% 

For Sex Ratio:

To address and improve the declining Sex Ratio from 916 to more than 933.

MNGOs Objectives:

• To enhance the managerial skills of FNGOs for better implementation of MNGO Scheme in the above mentioned unserved & underserved blocks of U.S. Nagar district.
• To facilitate the provision of RCH Services (Complete ANC Check up, Institutional Deliveries, Family Planning services, Complete immunization etc) at the grass root level through networking and liaisoning with District Health Society (CMO and RCHO) as well as State.
• To resolve the FNGO’s problems/challenges through advocacy during District / State Health Society meetings.
• Development of IEC material for distribution at the grass root level through FNGO’s volunteers to create awareness in the above areas.
• To ensure better implementation of the project at the grass root level through Supportive Supervision, Monitoring & Evaluation.

 Strategies: proposed by FNGOs to achieve its objective

• Community mobilization for demand generation and increased community participation & involvement in the programme.
• Facilitation of service delivery.
• Sensitization of Village Health & Sanitation Committee members about RCH services and its significance in controlling maternal & child mortality and morbidity and ownership transfer.
• Behaviour Change Communication approach to enhance knowledge and male participation through IEC activities.
• Capacity Building of ASHA, AWWs, ANM, PRIs and other stakeholders to enhance service utilization & improve the quality of RCH care.
• Liaisoning & networking with district, block and subcentre health functionaries to provide quality health care services.
• Advocacy for strengthening the infrastructure and improved supplies.
• Monitoring and evaluation.

Strategies proposed by MNGO:

• Capacity building of FNGO workers to increase the managerial capabilities.
• Liaisoning and Networking with the district/state health functionaries.
• Advocacy with the District / State Health Societies.
• Developing appropriate need based IEC material for BCC and community sensitization.
• Procurement of IEC material already available at the state and district level for distribution among FNGOs.
• Orientation of Block/Subcentre/PRI and other stakeholders about the NGO activities to improve RCH services.
• Monitoring and evaluation.
• Documentation, reporting and auditing.

Monitoring Plan:

• Development of formats and registers for record keeping and community based monitoring.
• Updating of Baselines data collected by FNGO through formats developed to track the progress for mid course correction
• Identification of gaps by analyzing the data, monitoring, visits reports, formats and other related documents.
• Fortnightly meetings with various stakeholders in the first 3 months and then monthly visits and meetings with stakeholders for mid course correction.
• Village health committees will have feedback register/record register for community based monitoring.
• Monthly progress reports (MPR) from FNGOs, Quarterly Progress reports (QPRs) to State NGO coordinator and RRC and Annual Progress Report (APR) to Distt Health Society, RRC and State NGO Coordinator, and State RCH Society.

Evaluation:

Following steps will be taken by the MNGO for smooth external evaluation by the Govt. / State agency.

• Complied reports of MNGOs
• Complied & consolidated reports of the FNGOs
• Field registers and formats
• Meetings registers of stake holders
• Meetings with Village Health & Sanitation Committee
• Monitoring visit reports and action taken reports by MNGO
• Quarterly progress reports & SOEs, UCs, Vouchers & bills and annual audited accounts