action to improve public scheme access and...

Contract Number:DCI-NSAPVD/2013/311-986

Action to Improve Public Scheme

Access and Delivery

Action to Improve Public Scheme

Access and Delivery

January-December, 2017January-December, 2017

Interim Narrative ReportInterim Narrative Report

Submitted by:

THE NAND AND JEET KHEMKA FOUNDATION

nidan

Supported by:Local Partner:Training Partner:

THE NABHA FOUNDATION

INDEX1. Project Description 1

2. Assessment of Implementation of Action Activities 2

3. Partners and other Co- operation 106

4. Visibility 117

2.1 Executive Summary 2

2.2 Activities and Results 5

2.3 List of Activities that were planned but could not

be implemented 93

2.4 Assessment of the results of the Action so far 94

2.5 Action Plan 99

3.1 Assessment of the relationship between the formal

Partners 106

3.2 Assessment of the relationship between organization and

State authorities in the action area 114

3.3 Description of the relationship with any other organizations

implementing the action 115

3.4 Development of any links and synergies with any other

actions 115

3.5 Receiving of any previous EU grants in view of strengthening

the same target group 116

4.1 Online Newsletter 117

4.2 Media Coverage 118

4.3 Jan Soochna: My Information, My Right 118

4.4 NJKF Website 119

4.5 AIPAD Annual calendar 119

4.6 AIPAD Facebook Page 120

4.7 Wall Writings 120

Acronyms and Abbreviations

AIPAD Action to Improve Public Health Scheme Access and Delivery

ANM Auxiliary Nurse Midwifery

ASHA Accredited Social Health Activist

AWW Agan Wadi Worker

BEO Block Education Officer

BHM Block Health Centre

BRCC Block Resource Centre Coordinator

CBO Community Based Organization

CDPO Child Development Project Officer

CSCC Civil Surgeon Cum Chief

DEO District Education Officer

DM District Magistrate

DOBO Data Operator Block Office

DS Deputy Superintendent

FLW Field Level Worker

FPA Family Planning advisor

MO Medical Officer

MOIC Medical Officer In Charge

MOPHC Medical officer, primary health centre

MVW Male Village Worker

NJKF The Nand Jeet & khemka Foundation

PC Project Coordinator

PHC Primary Health Centre

PM Project Manager

PRI Panchayat Raj Institutions

PSM Panchayatt Samiti Member

SDM Sub Divisional Magistrate

VP Vice Pramukh

Annual Report : January-December, 2017 Page 1

1 Project Description

1.1 Name of beneficiary of grant contract: The Nand & Jeet Khemka Foundation

1.2 Name and title of the Contact person: Ms. Shubhra Singh

1.3 Name of partners in the Action: Nidan, The Nabha Foundation

1.4 Title of the Action: AIPAD – ACTION TO IMPROVE PUBLIC SCHEME ACCESS AND DELIVERY, BIHAR, INDIA

1.5 Contract number: DCI‐NSAPVD/2013/311‐986

1.6 Start date and end date of the reporting period: 1st January – 31st December, 2017.

1.7 Target country (ies) or region(s): Bihar, India. District – Bhagalpur, Blocks – Kahalgaon, Pirpainti, Sanhoulla, Shahkund, Jagdishpur

1.8 Final beneficiaries &/or target groups:

Target groups: Rural communities in multiple blocks in the district of Bhagalpur (especially women, girl children and unorganized workers, SC/ST, Muslims & other disadvantaged communities), Panchayati Raj Institution members, government

1.9 Country (ies) in which the activities take place (if different from 1.7): Not Applicable


2 Assessment of Implementation of Action Activities

2.1 Executive Summary

Action to Improve Public Schemes Access and Delivery (AIPAD) is a project initiated in the Bhagalpur of Bihar, covering 5 blocks namely Kahalgaon, Pirpainti, Sanhoulla, Shahkund and Jagdishpur. The overarching objective of the action is to improve access to public schemes and services and enhance the wellbeing of citizens in Bhagalpur by using a participatory community based advocacy, monitoring and accountability model, with special emphasis on disadvantaged groups. The action focusses on increasing awareness of public schemes, with special focus on women, girl children, scheduled castes and scheduled tribes. These groups have limited or no knowledge of existing public schemes that could aid their socio‐economic development as a result of poverty and marginalization. Through community and household level interventions, the action has specifically made people aware of their rights and entitlements, and by working closely with government functionaries, supported the efforts of the people to secure their rights.

Therefore, the results that the project aims to achieve are:

Result Area 1: Improved access to and increased uptake of public schemes

Result Area 2: Increased accountability towards beneficiaries of schemes

Result Area 3: Use of technology to collect, track and disseminate information

Result Area 4: Identification of best practices for replication

This report represents the AIPAD project progress and uptake of work in the period from January to December 2017. The report outlines the project activities and achievements in the fourth year, challenges and constraints faced; lessons learned and planned project activities for the next year. AIPAD has been aggressively working towards enhancing access to and uptake of various schemes and creating awareness among communities about their rights and entitlements. Moving towards the broader objective of reaching out to people, project in its fourth year adopted and improvised strategies and approaches along with replication of some of the best practices in other areas/domains. Entering the fourth year, project focused on creating sustainability beyond the stipulated time by empowering and strengthening village level ownership and local institutions. AIPAD organized activities with a specific focus on


strengthening the communities so that they are empowered and independent. For achieving this, AIPAD this year aggressively organized youth group and citizen leader’s trainings and involved them in our community’s work and awareness campaigns. Observing the tremendous results of the Swasthya slate device and the strong recommendations from ROM, the district magistrate and other government officials, Swasthya slate/Health Cube was up scaled and launched in the Annual State Consultation and replicated in complete blocks of Pirpainti and Kahalgaon. AIPAD adopted a comprehensive approach towards addressing the sanitation and hygiene issues in the various bocks. Apart from toilet construction, AIPAD this year focused on Information, Education and Communication (IEC) and Behavior Change Communication (BCC) in creating awareness about good sanitation practices. AIPAD team organized large scale sanitation campaigns and rallies addressing the issues of bad sanitation practices. A team of local masons and PRI members in all the blocks were trained on low cost affordable toilet construction so that community can easily afford to pay and be encouraged to use toilets. AIPAD team worked aggressively on enrollment of students through its Shikha Rallies so that no child is left behind from the goal of universal education. AIPAD team also worked aggressively on opening student bank accounts in massive numbers so that the benefits of the schemes for the students should be received directly in their accounts thereby combating pilferage. Social security camps were organized in large numbers and efforts were made to reach the last mile population. A series of Protsahan Divas were celebrated in all the blocks on achieving universalization of villages. Kshteriyay Samitis were formed and federated in all the blocks and efforts were made to strengthen the advocacy groups and make them more functional. Mass awareness was created through our Jan samvad raths, cycle pe soochna, campaigns and rallies and through these approaches, we have reached out to the entire population of 10 lakh people.

AIPAD through its rigorous camps and community meetings has reached out to roughly two lakh beneficiaries directly this year under all the schemes


Table No 1 Total Population of targeted blocks in Bhagalpur District

No. Block Gram Panchayats

Total Population SC ST Minority

Population Others

1 Jagdishpur 15 1,76,180 18,590 24 62,980 94,586

2 Shahkund 19 2,22,769 35,381 12 30,500 1,56,876

3 Pirpainti 29 3,18,831 44,980 43,516 45,531 1,84,804

4 Kahalgaon 28 4,23,769 56,442 22786 53,489 2,91,052

5 Sanhaula 18 2,19,181 39,873 9,520 51,782 1,18,006

* Source – Health Management Information System (HMIS)


2.2 Activities and Results

2.2.1 Health and Sanitation

Janani Surkasha Yojna (JSY)

JSY is a safe motherhood intervention scheme under NRHM (National Rural Health Mission) that aims at reducing maternal mortality rate and neo-natal mortality among pregnant women by encouraging them to conduct institutional deliveries in government health facilities. The aim of the JSY scheme is to encourage poor pregnant women to give birth in registered health institutions where medical staffs are on-hand. Launched in April 2005, the JSY scheme is being implemented in all States and union territories of India. However, there is a special focus on Low Performing States (LPS) – those where less than 25% of women give birth in a health institution, Bihar being one of them. Assistance in the form of an account payee cheque of Rupees 6000 is being given to women delivering in a public health institution. The Yojna has identified ASHA, the accredited social health activist as an effective link between the Government and the poor pregnant women. Each beneficiary registered under this Yojna should have a JSY card along with a MCH card. ASHA/AWW/ any other identified link worker under the overall supervision of the ANM and the MO, PHC should mandatorily prepare a micro-birth plan. This will effectively help in monitoring Antenatal Check-up, and the post-delivery care. Besides the cash assistance, help in the form of Referral Transport is also being provided under the Yojna.

Understanding the fact that Bihar is home to millions of people living on or below poverty line, since the start of the project AIPAD has been focussing on making women aware about their health rights and reducing MDR and CDR rates. Bihar’s MMR and IMR are still much higher than national average where 2 mothers die out of every 1000 in child birth and 4 children die out of every 100 born. AIPAD team through its regular meetings with the communities, ASHAs, ANMs and PRI members has tried to eradicate the existing barriers towards women’s health and created awareness about JSY and its benefits. Information regarding institutional deliveries, ANC check ups, nutrition and food intakes, how to avail the JSY money etc has regularly been provided by our team members. AIPAD this year aggressively worked on creating awareness about institutional deliveries and ANC check ups and thus made a step towards the goal of reducing MMR and IMR. For achieving that, AIPAD took an initiative of facilitating regular health meetings with pregnant and lactating mothers in villages/panchayats in all the blocks twice a month. Therefore apart from conducting community meetings, this year AIPAD facilitated and mobilised meetings exclusively focussing on pregnant women and their rights and entitlements. Our FLW or PC would inform about this meeting either in the community meetings or pass on the information to the ASHAs and ANMs about the place and time of these meetings so that they can pursued women to participate. The objective behind these meetings was to motivate and generate


awareness among women about their health rights and encourage them for regular ANC checkups, immunization and institutional deliveries, thereby impacting maternal and child morbidity. Through these meetings, AIPAD made sure that each pregnant and lactating woman is completely aware about her health and necessary precautions required to have healthier and safer pregnancies. Importance of immunization for the kids was also explained in these meetings so that these women are motivated to get their children immunized on VHSNDs and routine immunization days. Issues like regular ANC check ups, follow up with the ASHAs and ANMs, food and nutrition intakes, benefits of institutional deliveries and procedure of availing the JSY money were thoroughly discussed in these meetings and solutions were provided. Roles and responsibilities of ASHAs and ANMs were also made clear to the women so that in case of any difficulty or any problem, they are not hesitant to ask these health practitioners. Observing the rigorous involvement of our team members and the impact of these meetings on women’s health, even government functionaries and officials have been participating in these meetings and supporting our team for this larger cause.

Following were some of the points that were discussed in the meetings:

• Regular health check ups. • Consulting ANMs and ASHAs in case of any medical emergencies • Regular visits to PHCs during PMSMA • Regular intake of iron, folate and calcium supplements. • Awareness about Janani Suraksha Yojna and other public schemes. • Encouragement for institution delivery and its benefits • Encouragement for immunization of their kids • Awareness on heath & hygiene in general

Results

Given below is the table showing total number of meetings conducted by our team members. A total of 55 meetings were conducted in all the five blocks and around 831 women participated in these meetings. AIPAD plans to conduct more and more of these meetings so that the goal of reducing MMR and IMR can be achieved and we are able to provide safe pregnancies and motherhood to our women.

Table No 2 Total number of meetings with Pregnant and Lactating mothers

(January –December 2017)

Sl. No Name of Block No. of Meetings held

No. of women participated

1 Jagdishpur 16 2172 Shahkund 12 1323 Sanhaula 08 121


4 Pirpainti 10 1905 Kahalgaon 09 171 Total 55 831

Source: AIPAD MIS data

Table no 3 given below shows the number of beneficiaries for JSY, total women receiving 4 ANC check-ups and number of institutional deliveries. A total of 10760 registered for first ANC check up and around 9986 women went for their complete ANC check up and the same got their JSY benefits. We can see that approximately 7 percent of women did not go for their complete ANC check-ups even after registering for it. AIPAD through its awareness campaigns, regular meetings and follow up is aggressively addressing this issue so that every pregnant woman undergoes her complete ANC check up thereby combating high risk pregnancies and mortality rates. Approximately 22517 women went for institutional deliveries from all the five blocks.

Table No 3 Total number of JSY beneficiaries (January-December 2017)

Sl. No Name of Block Registration for

ANC in First trimester

4th ANC Total women Receiving JSY

No. of Institutional Delivery

1 Jagdishpur 1259 1373 1373 3565

2 Shahkund 1249 2077 2077 3422

3 Pirpainti 2400 2029 2029 6904

4 Kahalgaon 3890 2727 2727 4498

5 Sanhaula 1962 1780 1780 3768

Total 10760 9986 9986 22517

Source : Data collected from HMIS

Pregnant women, especially from economically weaker sections and rural areas, tend to be malnourished and lacking in vital nutrients during pregnancy. This often results in children being born with abnormalities and suffering from undernourishment. To combat the issues of maternal mortality and malnourishment, central government has launched Pradhan Mantri Surakshit Matrieva Yojana (PMSMA). Under this initiative, all government hospitals and health centres shall offer free health check up on 9th and 21st of every month to all pregnant women. The check-up will include haemoglobin test, blood test, sugar level test, blood pressure, weight and general screening. This is an effort to combat the increasing rates of women and child mortality rates. AIPAD team created awareness about this new development through its awareness campaigns and community meetings and ensured that every pregnant woman should get her routine check-up done. A total of 6208 women


participated in the PMSMA days that were motivated and pursued by AIPAD team which is reflected in the table given below:

Table no 4 Total number of women who participated in Pradhan Mantri Surakshit Matrieva

Yojna (January –December 2017)

Sl No Name of the block Total no of pregnant women mobilized by AIPAD to participate in PMSMA

1. Jagdishpur 12632. Shahkund 14183. Sanhaula 13374. Kahalgaon 10625. Pirpainti 1128 Total 6208

Source: PHC of concern Block

Village Health Sanitation and Nutrition Day (VHSND)

The Village Health Sanitation and Nutrition Day (VHSND) is a Government initiative to improve access to Maternal New born and Child Health (MNCH), nutrition and sanitation services at the village level in India. These are scheduled to take place in every village, across the country, once a month. Pregnant women and lactating mothers along with children and adolescent girls are provided with need-based integrated health and nutrition solutions on VHSND days. On VHSNDs days, Community Health Workers (CHWs) that include Accredited Social Health Activists (ASHAs) and Anganwadi Workers (AWWs) conduct sessions on health, nutrition and sanitation (mostly hygiene related) for community members they mobilize from their catchment areas. The Auxiliary Nurses Midwives (ANMs) in the meantime provide MNCH services at the chosen locations for the same. This presence of all three cadres of CHWs at the same place every month holds the potential of being developed as a platform for ensuring high quality and effective MNCH service delivery and information dissemination.

VHSNDs are slated to be organised at the village AWC once every month on a designated Wednesdays or Fridays. Though it is an effective initiative to combat the issues around maternal and child health, but in most rural places like Bihar and Bhagalpur, services of VHSNDs are lacking behind. AIPAD this year was aggressively involved in regular monitoring of the functionality of VHSND and its services. AIPAD team on a regular basis motivated the women to bring them and their children at the desired location on VHSNDs days so that information about health and nutrition and regular check-ups can be provided thereby reporting any serious health concerns. Our team counselled the women about the significance of regular check ups and precautions. Our team members made


sure that they are physically present in the whole process so that the women don’t hesitate to interact with the frontline health workers and avail all basic services and information. As VHSNDs are the key platforms for tracking and providing essential vaccines to pregnant women and children, therefore AIPAD team through its community meetings and awareness campaigns made sure that women are aware about the importance of this day and are duly present for their check ups so that maximum immunization and vaccination should take place. Apart from motivating the women, AIPAD team also counselled the front line health workers like ANMs and ASHAs to do household interventions and encourage women to attend VHSNDs and avail services.

Results

Table no 5 given below shows the total number of VHSND visits by the AIPAD team. It can be seen that a total of 1179 visits have been made by our team members across all the five blocks over the period from January –December.

Table No 5 Total number of Village Health Sanitation Nutrition Day visits by AIPAD team

(January-December 2017 )

Sl.no Name of blocks No of VHSND visits

1 Kahalgaon 341 2 Shahkund 172 3 Pirpainti 373 4 Sanhaula 176 5 Jagdishpur 117 Total 1179

Source: AIPAD FLWs daily register

Swasthya Slate Pilot Project

India has made rapid strides in improving reproductive maternal, neonatal, adolescent and child health, but a lot remains to be done .We live in an age where we often hear news, reports or articles, which talk of increasing numbers of women deaths or women delivering in the gallery of hospitals or women dying due to anemia etc. Such occurrences are very disturbing yet common for many places in Rural India especially for states like Bihar. The maternal mortality rate of Bihar is 208 (SRS, 2013-2015) which is quite high as compared to the national average being, 167. Sometimes the unavailability of a doctor or inaccessibility to a nearby hospital or the lack of referral services for high risk pregnancies are the explanations for the rapidly occurring news about women’s morbidity and poor state of rural health services in our country. There is no denying fact that health services, especially Reproductive


Health have improved significantly over the years by additional PHC’s, CHC’s, ASHA workers, ANM’s etc, but still it remains a challenging task to combat the increasing numbers of MMR and IMR.

One of the overarching objectives of AIPAD was to identify gaps in the delivery mechanism and to improve the accessibility of health services for pregnant and young mothers. Going by the increasing numbers of MMR, IMR and lack of access to health for pregnant women specially, RMNCH+A was one of the most needy and sensitive gap area that our project identified. No facility available for early detection of high risk pregnancies leading to more cases of maternal morbidity. Therefore, in the landscaping exercise done by the AIPAD team during the starting of our project, we reviewed a few technologies for mapping the data concerning health in general as well as reproductive health in specific. Swasthya Slate was one of such device which enabled point of care diagnosis at the door steps of women. Therefore after consulting with all the stakeholders in the district and community, Swasthya Slate as a pilot project was launched under AIPAD in the selected health sub centres.

Swasthya Slate (SS) as a Pilot project was launched under AIPAD on 14th July 2015 by the District Magistrate of Bhagalpur in a ceremony held at the Block Hospital, Shahkund. The device was launched to be used in health sub centres, primary health centres and additional primary health centres of 3 panchayats of Shahkund block. With this device being used by ANMs for ANC and PNC checkups for over two years, a paradigm shift has occurred in the delivery mechanism of health care services. Negligible out of pocket expenses, instant results and data sharing, identifying high risk pregnancies and referral cases and combating maternal mortality rates have been achieved.

Results

In order to have a clear understanding of the improvement in the health care practices with the usage of Swasthya Slate, AIPAD also conducted an impact assessment study in which health data of the panchayats implementing Swasthya slate in Shahkund block was compared with a control group. There was a remarkable difference in the numbers of the tests which is represented in table no 6 given below. Data from September 2015 to October 2017 has been used in the table. Apart from this, it was noted that Swasthya slate implementing panchayats have not reported a single maternal morbidity caused due to health risk in the last three years.

A comparison of the VHSND data in the Swasthya Slate implemented panchayats and panchayats not using Swasthya Slate Kit(SSK) from January to December 2016 ,will help to analyse the situation clearly, which is represented by the table given below:


Table No 6 A comparison of VHSND data of Shahkund block (January –December 2017)

Reproductive and Child Health

Panchayats implementing Swasthya Slate

Panchayats not implementing Swasthya Slate

Kasba Kherahi Amba Jagariya Belthu Dindayalpur Saroni

Total population of the Panchayat

10699 9558 10519 8480 7221 7456

Total number of pregnant women registered for ANC

667 587 649 678 415 357

Number of pregnant women received 3 ANC check ups

301 408 359 439 233 168

Number of Urine-Protein tests

547 575 654 0 0 0

Number of BP tests 679 848 886 0 0 0Number of temperature tests

670 817 874 0 0 0

Number of pulse tests

689 849 889 0 0 0

Number of haemoglobin tests

493 556 572 609 497 292

Number of sugar tests

646 777 760 0 0 0

Number of HIV tests

348 358 430 0 0 0

Number of Hepatitis-B tests

352 359 434 0 0 0

Number of pregnancy tests

341 329 384 0 0 0

Number of syphilis tests

364 359 412 0 0 0

Number of malaria tests

384 355 417 0 0 0

Number of blood group tests

400 412 474 0 0 0

Grand total Diagnostic Tests

5913 6594 7186 609 497 292

Source : HMIS of Shahkund and Swasthya Slate kit during VHSND

Table no 6 shows a comparative analysis of all the tests undertaken at AWCs/HSCs in the panchayats implementing Swasthya Slate and those not implementing it. As from the table, AWW/HSC’s not implementing Swasthya Slate have considerable low numbers of registration and most of the tests like malaria tests, syphilis tests, blood group, pregnancy tests, HIV tests etc. have not been administered at all in these respective centres. Complete lack of diagnostic facilities in the above mentioned panchayats illustrates the alarming situation of health prevalent in the selected areas. Despite government‘s efforts to improve


the health situations, inadequate local facilities at the grass root level is one of the many reasons for the disquieting death rates in the rural areas. Late diagnosis leads to higher number of women facing mortality.

We can see all the necessary tests being administered in higher numbers in the SS implementing panchayats, while those not implementing have negligible results. Even the number of woman who registered is higher for panchayats implementing SS pilot. Grand total of the diagnostic tests are 5913, 6594, 7186 respectively for panchayats Kasba Kherahi, Amba and Jagariya while grand total for panchayats for Belthu, Dindayalpur and Saroni are 609, 497 and 292 respectively. Thus, the panchayats having Swasthya Slate have shown significant improvement in spreading awareness about importance of antenatal and post-natal check ups , reflected through higher registration of women. Additionally, the large number of administered tests indicates that ANCs and PNCs are being done regularly. The data reiterates that this intervention is positively contributing towards an improved and holistic health status of pregnant women and infants in the project area.

Figure 1 : Representation of the work of Swasthya Slate /Health Cube Device

Replication and Scaleup of Health Cube(Swasthya Slate) in Pirpainti & Kahalgaon Block

After successful implementation of Swasthya Slate in Shahkund Block and the device being used for over two years in 27 health sub centres(HSCs), 1 PHC and 6 APHCs, women with high risk pregnancies have been regularly identified early in their pregnancies and duly referred for further treatment in the selected panchayats of Shahkund block. Women across


backward villages were able to access improved and efficient health services with much ease. The functioning of VHSND changed after the usage of Swasthya Slate.

One of the key recommendations of the ROM report in 2016 was that this pilot should be replicated and up scaled in other blocks of the project areas as well, since it has been giving excellent results in Shahkund block. Therefore observing tremendous positive results of using Swasthya Slate in Shahkund block, there was a strong push by the District Magistrate and Chief Medical Officer for a wider scale up and to have a proof of concept operationalized on valid sample size. Data from Shahkund Block, where Swasthya Slate was being used, was shared with the DM and he observed the change in MMR and IMR numbers after the usage of this device. Acknowledging the fact that it is a lifesaving initiative, both DM and CMO collaborated with the team to scale it up in Pirpainti & Kahalgaon block too. Understanding the need and addressing the recommendation of the dignitaries, NJKF procured a technologically advanced version of Swasthya Slate, ‘Health Cube’ and planned on scaling up the pilot with District Health Society(DHS) to two complete blocks of Kahalgaon and Pirpainti so that young mothers and women of these remote areas can get maximum benefits from this initiative.

The Health Cube pilot scale up therefore, was inaugurated on 27th July 2017 by the District Magistrate of Bhagalpur in the Annual state consultation1 held at the Town hall, Bhagalpur. The device will be used in all the PHCs/APHCs/HSCs of Kahalgaon and Pirpainti block. The District Magistrate, Mr Adesh T along with Ms Shubhra Singh of Khemka Foundation and other government dignitaries inaugurated the Health cube device by lighting the lamp, unveiling the device and distributing devices to the ANMs.

Figure 2 : Newspaper clippings of our Annual State consultation and Health cube launch

1 Please refer to section 2.2.3 under the subheading Annual State Consultation, AIPAD


ANMs training at Kahalgaon and Pirpainti

The Health Cube Pilot project was successfully launched in Kahalgaon and Pirpainti block with an aim to reach out to every pregnant lady with improved and efficient health care. A training programme was organized under the AIPAD project for the government ANMs of around 57 panchayats, 13 APHCs (Additional primary health centres ), 76 HSCs(Health sub centres) and 1 RH (Referral hospital).A total of 82 ANMs from Kahalgaon and 77 ANMs from Pirpainti participated in the training programme. This training programme was organized for four days from 10th to 13th of august 2017 parallely in both the blocks. The Health Cube devices were handed over to the ANMs at the end of the training programme. The block and district level officials like Block Health Manager (BHM) Ajay Kumar (Kahalgaon) and Pranav Kumar (Pirpainti), MOIC Dr P C Sinha (Kahalgaon) and Dr N K Verma (Pirpainti) etc attended this training. This training was conducted by resource team of trainers Mr Shashank Bhatt, Mr Krishna Rao and Mr Puneet Maan from HealthCubed Pvt Ltd, New Delhi.

The four day training program created a lot of enthusiasm amongst health functionaries and was very well received. Program Manager of AIPAD, Mr. Sanjay Yadav along with technical support officer Mr Ameet Kumar and the entire AIPAD Team participated in the programme. 165 ANMs from both the blocks participated in the training in two batches. The whole process included live demonstration, power point presentation and hands on training.

The first day of the training i-e 10th august, started with the registration of the first group of ANMs followed by a presentation by the resource person about the working of the Health Cube device. ANMs were trained on the operation of the device, registration of the mothers and pregnant women, and filling of the ANC (Antenatal care) forms through the device. They were also explained about the impact this device can bring to the lives of mothers as well as the health practitioners i-e ANMs themselves.

The second day of the training-e 11th august started with explanation about the NHM (National Health Mission) recommended diagnostic tests available on the Health Cube device and how to conduct these tests accurately. ANMs were also informed about the process of uploading the registered data and the information about the diagnostic tests on the health cube web portal. They were explained that this uploaded data is very important as it helps in tracking the high risk pregnancies and reproductive health history of the pregnant women.

ANMs were also requested to fill a post training feedback form and a feedback was taken by the ANMs for further improvement.


Figure 3 : ANMS getting trained about healthcube device

Figure 4 : Newspaper clippings about our ANM training programme

Cluster level ANM capacity training and Follow up

To solve the technical issues related to the health cube device and its functioning, cluster level trainings are being organised for the ANMs of Kahalgaon and Pirpainti blocks. The objective behind these trainings is to address any technical errors related to the functioning of the health cube device and train ANMs for the usage and handling of the device during their VHSNDs days. ANMs are quite new to the working of this device and therefore at times face a bit difficulty in understanding the technicality part of the device. Through organising these cluster level trainings, AIPAD is trying to combat any minor or major issue related to health cube and motivating ANMs to perform their tests effectively.

Cluster level trainings are being organized from time to time for small batch of ANMs (7-8). The reason of having a small group is to ensure an enhanced concentration of the trainer as well as the participants. Along with the AIPAD team, a technical expert from Health Cube Pvt Ltd is present in these meetings to address any technical issues. ANMs are informed


beforehand about the training and the date and time is finalized consulting them. Through these meetings and constant follow up, AIPAD is trying to make these ANMs a skilled professional and motivating them to be confident while using this device.

These types of trainings are being organized on regular basis alternatively in both blocks. During training process, firstly all the issues related to the functionality of the device are addressed and then training is given on diagnosis and conducting tests. In the same process, follow up is done on the overall check up process that is conducted on VHSND days and if any confusion emerges regarding the process, solutions are immediately provided. In total, around 6 trainings have been conducted including both blocks. AIPAD plans to conduct similar kind of trainings on a regular basis so as to have a proper functioning of the health cube device.

Figure 5: ANMs using Health cube during VHSND days

Results

Health Cube has made a major impact on the overall health scenario for pregnant and lactating women and children by combating maternal and infant mortality rates. With the use of Health cube in VHSNDs, women from rural and remote locations can access health services with much ease. Various diagnostic tests available on the device not only are for all age groups but also result in immediate testing and results. With the coming of this device, registration and handling so much of information electronically and quick has led to an overall effective process. High risk pregnancies are now being easily identified and duly referred to higher institutions and the information is easily shared with other block and


district health officials. With usage of Health Cube, the registration, ANC and all the diagnostic tests of pregnant ladies are done simultaneously and the result generated can be instantly sent to the Health cube server, from where different monitoring bodies like PHC can check and get the results. Before the use of Health cube, maintenance of the register and sending the register to head office and then waiting for getting the register from head office took minimum 10-15 days. But after the use of Health cube, 10-15 days are now reduced to maximum 30 minutes only. Patients also get to know about any disease easily and go for immediate treatment leading to early detection and prevention from diseases.

With this device being used by ANMs during ANC and PNC check ups of pregnant women, a paradigm shift has occurred in the delivery mechanism of health care services in the following ways which are mentioned below:

Accessibility and Out of pocket expenses In rural and remote locations, it is extremely difficult to access public health institutions as they are situated very far from the villages. Women therefore find it hard to reach to these hospitals for checkups and or any kind of medical emergencies. And even if they manage to travel, their out of pocket of expenses are so high that they prefer not going for their ANCs and PNCs which further leads to complications and high risk pregnancies. Even if on reaching the institutions, women have to wait in long queues for their turn which becomes a major issue for pregnant ladies. With this device, the prescribed health care services are being delivered to the women at their door steps without them travelling to far off places or waiting in long queues.

Instant Results and Reports Initially, women had to run back and forth to collect their reports of the tests, but with the health cube , results are generated instantly on screen and can be shown directly to the patient. This not only saves a lot of time and money for these women, but always generates transparency among the patients.

Identifying High Risk Pregnancies and Referral cases With the proper conduction of tests happening and accurate reports being generated along with the data being shared on the web portal, high risk pregnancies, which are one of the main reasons of increasing MMR, can be easily identified and therefore can be duly referred. Thus, timely referrals ensure safe motherhood for women and any complications can be further treated by appropriate doctors.

Empowering Health workers and Combating high rates of MMR Health cube is empowering health workers by making them technology and internet friendly. It is making the ANMs confident to do their work effectively and more passionately. Health Cube is thus aiming at delivering safe motherhood and ensuring safe deliveries to the women, thereby combating higher rates of MMR and IMR.

Therefore it aims at addressing the foremost causes of morbidity among women by bridging the major gap between availability of services and accessibility of these services at the local


level by using a technology that will make the hectic and time taking process of check-ups and treatments, quite simple and effective.

It is a powerful device that allows Android Tablets and Phones to conduct 33 diagnostic tests on the mobile device. The Health cube includes specialized applications that help users perform a variety of screenings and health analysis protocols. After the launch of Health cube and this device being used during VHSND in the all panchayats of Kahalgaon, Pirpainti & selected panchayat of Shahkund block, the scenario of VHSND has changed. With usage of Health cube, the registration, ANC and all the diagnostic tests of pregnant ladies are done simultaneously and the result generated can be instantly sent to the Health cube server, from where different monitoring bodies like PHC can check and get the results. Before the use of Health cube, maintenance of the register and sending the register to head office and then waiting for getting the register from head office took minimum 10-15 days. But after the use of Health cube, 10-15 days are now reduced to maximum 30 minutes only. Patients also get to know about any disease easily and go for immediate treatment leading to early detection and prevention from diseases.

Thus, Health cube has created a vast difference in the whole VHSND process. Quick registration of pregnant women, diagnostic tests being carried out instantly and data sharing with the officials at the block and district level have made the whole time taking process quite simple and operative.

Table given below shows the number of tests conducted and number of women benefited by using health cube during their ANC and PNC check ups. As it can be seen a total of 1943 women have registered for their ANC and PNC check ups from September 2015-dec 2017. A total of around of 20106 tests have been conducted using health cube device in 3 panchayats of Shahkund. Similarly, 475 and 560 women have been registered for their ANCs respectively for Kahalgaon and Pirpainti and a total of about 2458 and 2541 tests have been conducted for the same. The data presented in the table for Kahalgaon and Pirpainti block is just for four months as this device was launched in the same year and it took some time for it to be operationalised on the ground.

Table no 7 A comparison of total tests conducted using health cube device among three blocks

Activities Swasthya Slate implementing Block (Sep 2015-Dec 2017)

Health Cube implementing Block (Sept 2017-Dec 2017)

Reproductive & Child Health Shahkund Kahalgaon Pirpainti Total number of pregnant women Registered for ANC

1943 475 560

Number of BP tests 2463 400 475Number of Temperature tests 2401 315 365Number of pulse tests 2427 375 415Number of Hemoglobin tests 1661 155 155


Number of Sugar tests 2223 304 396Number of HIV tests 1176 41 70Number of Hepatitis-B tests 1195 53 55Number of pregnancy tests 1104 76 104Number of Syphilis tests 1175 60 70Number of Malaria tests 1204 64 72Number of blood-group tests 1301 250 295Number of Urine Glucose–Protein tests

1776 61 69

Grand Total Diagnostic Tests 20106 2458 2541

Source : HMIS of Shahkund , Kahalgaon and Pirpainti and Swasthya Slate kit during VHSND

Figure 6 : Women beneficiary of Healthcube device

Health Cube device Impacting life

Mentioned below are some successful stories of women who have been recognised and duly referred with the help of health cube device as well as the experiences of ANMs who are using healthb cube device :

Beneficiary Feedback Kahalgaon

My Name is Raishma Devi and I m from Kahalgaon block. With the Health Cube device in VHNSNDs, the tests are quickly done in front of me and I don’t have to wait in long queues for collecting the reports. I come from a poor family and for any check up , I had to go to the hospital at the block which would cost me a lot of money and there I had to wait in long queues. Therefore many a times, I would just not go for my routine check up. But with health cube, I don’t have to go anywhere and my tests are conducted at

Figure 7 : Beneficiary of Kahalgaon


my doorsteps only without costing me any money. I’m really happy with this device.

ANM Feedback Pirpainti

My name is Anjana Kumari and I m posted as an ANM at PHC Kahalgaon. Before this device being launched, we used to use registers for entering all the data and only two tests like haemoglobin and blood pressure were being conducted for women. Women had to go to various hospitals for conducting other necessary tests. But now with this health cube, all tests are being conducted very efficiently and all the data is being uploaded accurately on the device. We are being trained for using this device and even we are improving day by day with the help of this device.

Beneficiary Feedback Pirpainti

My name is Sunida Khatun. Initially, only two tests used to happen, but with this new device, almost all the necessary tests are being conducted at our foot steps. We used to go to the city to do all the tests which would cost us a lot of money and had to visit the hospital to and fro to collect the reports. But now, we don’t have to go anywhere and all the tests are being conducted right at our village. We are extremely happy with this device as it has solved a lot of our problems and our money is also saved.

Monthly Review meeting with the District Health Society (DHS)

AIPAD has been constantly participating in the review meetings of ANMs and ASHAs at the block level. These meetings are organised every month and issues such as ANC check ups, functionality of VHSNDs, institutional deliveries etc are discussed in these meetings. Our team has been regularly participating in these meetings and ensuring that all existing issues related to maternal and general health are raised and discussed thoroughly. Also, roles and responsibilities of ANMs and ASHAs are also discussed along with their deliverables in the field. Technical problems related to the working of the health cube device are being regularly discussed in these meetings.

Figure 8 : ANM of Pirpainti block

Figure 9 : Beneficiary of Pirpainti block


AIPAD team witnessed a lot of issues/problems existing at the village and block level such irregular opening of VHSNDs, functioning of PHCs, lack of stock of medicines etc while participating in these meetings. Therefore, AIPAD team thought of having a platform where these issues can be escalated and brought into immediate attention of the district health officials for proper solution. Since AIPAD works in close collaboration with the district government, therefore, the team proposed and requested the District Health society for creating a similar platform where all the issues related to maternal and child health can be thoroughly discussed and brought in to the notice of the administration for its immediate action. Understanding the requirement of the situation, DHS took an initiative of creating a platform for discussing matters related to overall scenario of health prevalent at the village and block level. DHS organises monthly review meetings, known as “Task Force Meeting” with all the Block Health Managers (BHM), MOICs, Civil Surgeon , other health functionaries along with civil society organisations including AIPAD team. DHS has recognised AIPAD as a member of the Task Force meeting and the team has received a letter of participation and invitation from the district administration. The district magistrates chairs these meetings and issues such as lack of stock of medicines, regular monitoring of PHCs and CHCs, functionality of VHSNDs, any dip or changes in morbidity rates, status for routine immunization for children etc are discussed in detail and solutions are provided. The idea behind these meetings was to have a common platform for the district government and civil society to address the issues existing at the ground level related to maternal and child health. Apart from this, AIPAD through this platform tried to create a better accountability model which will not only act as a bridge between government and common people but also make the government more responsible and accountable towards its people. Since civil society organisations are also participating in these meetings, therefore the real scenario and the existing gaps at the ground level in the health domain are raised resulting into concrete action .

Results

AIPAD team therefore is regularly participating in the review meetings and using this platform to raise all the issues prevalent on the ground for a quality and effective healthcare for its people. Functioning and problems related to Health cube device are also being discussed in these meetings. A lot of challenges and problems that the team was facing have been solved through these meetings. For example, our team raised the issue of not having internet facility in the PHCs of block Kahalgaon and Pirpainti. Since these PHCs are using Healthcube device, therefore ANMs were facing a lot of problem in uploading the heavy health data through the normal network. Internet facility in these centres would take half the time and the whole process would be very quick and hassle free. Our team pushed this matter in the review meeting and the district administration understood the problem, thereby issuing Wi Fi facility in these centres. Also, our team witnessed that the health cube devices were not handled properly by some of the ANMs and were roughly handling the device and its accessories, resulting in the damage of the device. Our team discussed this


problem in the review meeting and the civil surgeon issued a letter to MOIC of Pirpainti and Kahalgaon for proper handling of the devices and considering them as a government property. We also requested for the consumables for the health cube device and the DHS has released funds for the purchase of the consumables.

Figure 10 ; Letter from District Task force meeting Figure 11 : Letter From AIPAD to the District health society

Rogi Kalyan Samiti Meeting

Rogi Kalyan Samiti (RKS) is a simple yet effective management structure. This committee, which would be a registered society, acts as a group of trustees for the hospitals to manage the affairs of the hospital. It consists of members from local Panchayati Raj Institutions (PRIs), NGOs, local elected representatives and officials from Government sector who are responsible for proper functioning and management of the hospital / Community Health Centre / FRUs. RKS is free to prescribe, generate and use the funds with it as per its best judgement for smooth functioning and maintaining the quality of services.

Rogi Kalyan Samitis (RKS) have been formed at various levels of health facilities under the NRHM to ensure the local community’s participation in the management of these facilities. An untied fund is also provided annually to these samitis to be used for improvement of these facilities. AIPAD observed that though these samitis are formed in facilities in the project area , but their functionality is negligible and are functional only on pen and paper . Their


meetings were not regular at all and even the community members were not aware of how the funds allotted were being spent. AIPAD discussed this matter in the community meetings also so as to have an idea of the status of this committee and functionality. This year AIPAD aggressively worked towards this issue and took efforts towards making these committees functional and monitored the overall functioning of RKSs. AIPAD team in all the blocks interacted with the RKS members and explained them the importance of this samiti for the upliftment of their community people. AIPAD team through its meetings pursued the RKS members to take this seriously and regularly organise meetings. A lot of members were not aware about the roles and responsibilities of this samiti. Through these meetings, roles and responsibilities of being a RKS member was explained and suggestions were made for solving issues through the RKS.

AIPAD has been regularly attending the RKS meetings every month and ensuring maximum participation in these meetings .Apart from that, AIPAD also gives inputs about the issues based on their experience from the field. AIPAD plans to continue the monitoring of RKS in the coming year also so that the issues related to management of the PHCs are not overlooked. Following are some of the points that were discussed in these meetings :

• Problems faced by the patients in Hospital • Arrangement of the equipment, furniture, ambulance for the hospital • Making arrangements for the maintenance of hospital building (including residential

buildings), vehicles and equipment available with the hospital • Improving boarding / lodging arrangements for the patients and their attendants • Entering into partnership arrangement with the private sector for the improvement of

support services such as cleaning services, laundry services, diagnostic facilities and ambulatory services etc.

• Developing out vacant land in the premises of the hospital for commercial purposes with a view to improve financial position of the Society

• Promoting measures for resource conservation through adoption of wards by institutions or individuals.

Results

Table given below shows the total number of RKS meetings attended by our AIPAD team . A total of 48 meetings were held this year in which our team participated across all the five blocks.


Table No 8 Total number of Rogi Kalyan Samiti meetings held (January –December 2017

Sl No Name of Block No. of meetings held

1 Jagdishpur 10

2 Shahkund 12

3 Sanhaula 6

4 Pirpainti 11

5 Kahalgaon 9

Total 48

Source: PHC of concern Block

Integrated Child Development Services

ICDS is an Indian Government programme which provides food, preschool education, and primary healthcare to children less than 6 years of age and their mothers. These services are provided from AWC’s established mainly in rural areas and staffed with frontline workers. It aims to combat the profound problem of malnutrition in India. Apart from fighting malnutrition and ill health, programme is also intended to combat gender inequality by providing girls the same resources as boys. ICDS was launched in 1975 in accordance to the National Policy for Children in India. Over the years it has grown into one of the largest integrated family and community welfare schemes in India. The Integrated Child Development Services (ICDS) scheme is one of the world’s largest programmes dedicated to early childhood development. With the intention of “providing pre-school education on one hand and breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality on the other”, it is the foremost symbol of India’s commitment to its children.

Following services under the ICDS scheme are being utilized by the team members, which

are mentioned below:

1. Immunization

2. Supplementary nutrition

3. Health checkup

4. Referral services

5. Pre-school non formal education

6. Nutrition and Health information.


AIPAD team has been aggressively working on identifying gaps in the facilities provided for the communities and working towards it. AIPAD in the period of four years identified that in spite of ICDS programme being the largest programme in the country introduced for the growth of early childhood, yet there were many obstructions on the ground level as far as the delivery of its services were concerned. Some of the obstacles that AIPAD identified and worked on are mentioned below:

• Awareness To run a program of such large magnitude, support and participation of local people is as important as responsibilities of the department. AIPAD team noticed that communities were not aware of what ICDS is and what programmes and benefits are there for them. The sole concern of the community was the take home ration (THR) that they received on THR day. They did not have much information about other services like pre-school education, health services and nutritional services which are being provided by ICDS. They never bothered to enquire about the food being served or hygiene conditions at AWCs as they were not aware about the importance of hygiene and health for their kids. They were not aware of nutrient quotient of food items. Parents of children attending AWCs were not much informed about in detail about the services and were not very regular in sending their children to these centres resulting in short attendance of their kids. AIPAD team through its community meetings and awareness campaigns have been informing parents and other community members about the services of ICDS and importance of sending their kids to AWC centres. Our team members made sure to effectively utilize the services so that the desired objectives could be achieved under the AIPAD project. With the collective action of the ASHA’s, ANM’s and the community, the team members focused majorly on improving the quality and quantity of these services. Our team visited door to door with proper information in villages and approached community about the importance of mentioned services through community meetings. Though our team members faced a lot of challenges initially because of the traditional beliefs of the communities, but later on with constant effort and time, they were able to bring out some change in the community. Team also had regular meetings with the parents to make them aware about attendance, health and hygiene of their children. Our team made sure that people know the importance of immunization as how severe these diseases can go if not immunized at early stage. Also, AIPAD constantly follows up with the community members about the entitlements of all the schemes and services available under ICDS such as poshak rashi, THR etc .

• Inadequate Supervision Our team identified that in spite of these centres opened in huge numbers, the non serious attitudes and lack of supervision of its staff was one of the obstacles in proper delivery of its services. There was a serious gap in the overall supervision of these centres. This problem was worst in areas that were really remote and were located in the interiors. These reasons led to irregular opening of these centres and poor functionality which resulted in communities not getting their services and entitlements. Many a times, AWWs misuse their position and cause a lot


of disprecancices like fraud attendance registers showing full attendances, below standards food being served or non/less distribution of THR ( take home ration ) etc. AIPAD has been working on removing such barriers by focusing majorly on regular opening of AWCs and Sakivas role and responsibilities, regular disbursement of THR (Take home ration), regular monitoring of the overall process. By involving advocacy group members and CBO members, AIPAD team is trying effectively address these issues in a collaborative way so that even after this project is over, members are empowered and informed enough to claim their rights and face authorities.

Apart from addressing these identified gaps, our team has been regularly organising camps and meetings about the services of ICDS and importance of immunization for the children, especially in minorities and Muslim communities. There are a lot of cultural and religious barriers that Muslim communities in particular have against getting their children immunized and therefore are quite resistant against vaccination. Though it is a deep seated issue , but AIPAD team has been aggressively working on this through meetings and household interventions with the communities trying to break the barriers and achieve the target of full immunization.

Results

Table no 9 given below shows the total number of beneficiaries under the ICDS scheme and children immunization status and the results are quite satisfactory. With the constant effort of our team members, block and district level health officials, there has been significant improvement in all the five blocks. It can be seen that a total of 91800 beneficiaries received the THR , 40380 received the poshak rashi and 40040 children received the swasthya poshan shiksha. Apart from these numbers, to ensure that the community is being provided the services under ICDS, our team facilitates the below mentioned activities in an AWC:

• Register all pregnant women during ANC check-ups and ensure JSY benefits • Identify pregnant women left out from services and help them to avail services • Identify and connect cases of severe anemic and pregnant women with obstetric

emergencies to the respective ANMs • Facilitate full immunization for children below one year and spread awareness on the

same • Identify children left out of immunization services for immunization • Organize group session for health education and counseling for creating awareness • Improve access for vulnerable and hard to reach populations


Table no 9 Total Number of Beneficiaries Under ICDS (January –December 2017)

Block No of AWC

No of children received

Swasthya Poshan Siksha

No of students who received Poshak Rashi

No of beneficiaries who

received Take Home

Rashan(THR) Kahalgaon 301 12040 12040 27090

Shahkund 209 8360 8100 19170

Pirpainti 219 8760 8760 19710

Sanhaula 151 6040 6640 14940

Jagdishpur 121 4840 4840 10890

Total 1,001 40040 40380 91800

Source : ICDS Data Centre

Social Audit of Anganwadi Centres

Social Audit is a grievance redressal mechanism that gives an opportunity to poor to seek justice by reviewing official records and determining whether state reported expenditures reflect the actual money spent on the ground. In Bihar, social audit takes place in Anganwadi centres twice in a year on 20th June and 20th January at all AWCs across Bihar, where all the beneficiaries and PRI members of that particular Anganwadi participate. It is a process in which the details of the resources, financial and non-financial, used by the public schemes for the development initiatives, are shared with the people, often through a public platform. It allows community to enforce transparency and accountability, thereby providing them an opportunity to scrutinize the development initiatives. Social audits have been a way of improving governance and service delivery of AWCs. This is a process by which beneficiaries participate in activities such as planning, implementation, and monitoring and evaluation. Local communities monitor the AWC services on an ongoing basis, thereby helping set up a direct feedback mechanism between the service providers and users. This also helps strengthen community voices. While it has been successfully implemented in some areas, it has been a challenge in others.

Results

The real challenge that AIPAD observed was that social audits were not actually happening i-e not in a functional state in many panchayats/blocks. AIPAD witnessed this real challenge and tried to make communities aware about this process and also made an effort in engaging government officials and PRI members in making the social audits happening. AIPAD team actively participates in the social audit every year and tries to engage the community actively. Apart from addressing corruption and discrepancy in the system, social audits


are a great mechanism to strengthen accountability in government service delivery. Also, it was observed by our team members that in some panchayats, social audits took place with a lot of participation and inputs from both community and government officials like discussion about THR, financial aspects and other social aspects, whereas in some places, it was observed that social audits were below average with negligible participation and inputs.

Therefore, this year AIPAD planned to work on such panchayats and blocks where social audits were not happening properly. Our team actively participated in this exercise and created awareness among the communities by explaining them the significance of social audits. AIPAD team facilitated the social audit in many panchayats/blocks by following the government mandate of conducting social audits as given in the figure given below:

Figure 12 : Government issued guidelines of conducting social audits

Our team members have been motivating the community and PRI members about the relevance of social audit so that people participate in it in large numbers. With the effort of AIPAD team, people understood the core and crux of social audit and are now becoming aware about the benefits and services of ICDS. People’s participation in social audits have given them a lot of confidence to face government proceedings and have become empowered to question about their benefits and entitlements.


Table No -10 Total Number of Beneficiaries Under Social Audit (Jun &December 2017)

Block

Social Audit on 20-Jun-2017 & 20-Dec-2017

Population Total No of AWCs where social audits

were held

Total No of people who participated

Kahalgaon 4,03,271 17 536

Shahkund 2,11,993 20 435

Pirpainti 3,03,409 9 248

Sanhaula 2,08,579 7 221

Jagdishpur 1,67,658 15 482

Total 12,94,910 68 1922

Source : Data collected from all FLWs

Table no 10 clearly reflects the participation of beneficiaries in the social audit. In total, 1922 beneficiaries participated from all the five blocks this year and 68 Anagnwadi centres held social audits . This has been possible by the constant effort and awareness created by all of our team members. With social audit happening, even common people will be able to have ownership over the services that they are entitled to. This activity also creates an atmosphere of trust within the community over the government processes and services since the main aim of this activity is to bring transparency and address important issues which are otherwise buried.

Rashtriya Bal Swasthya Karyakram camps in Jagdishpur

Out of every 100 babies born in India annually, 6 to 7 have a birth defect. This would translate to around 17 lakhs birth defects annually in the country and accounts for 9.6% of all the new-born deaths.i Developmental delays are common in early childhood affecting at least 10 percent of the children. These delays if not intervened timely may lead to permanent disabilities including cognitive, hearing or vision impairment. Early detection and management of diseases including deficiencies bring added value in preventing these conditions to progress to its more severe and debilitating form and thereby reducing hospitalization and improving implementation of Right to Education.

Rashtriya Bal Swasthya Karyakram (RBSK) as an initiative under NRHM aims at early identification and early intervention for children from birth to 18 years to cover 4 ‘D’s viz. Defects at birth, Deficiencies, Diseases, Development delays including disability. The services aim to cover children of 0-6 years of age in rural areas and urban slums in addition to children enrolled in classes 1st to 12th in Government and Government aided Schools.


Understanding the need for early detection of diseases in children and objectives of RBSK, AIPAD team in Jagdishpur organised student health check-up camps throughout the month of May, in 113 schools including primary, middle and high schools. With the help and support of PHC block level doctor in charge, Dr Uday Shankar Sharma, student health check-up camps were organised in all these schools and students were checked against defects at birth, deficiencies of any kind, diseases and development delays. A team of doctors including Dr Sharma, Dr Rahet Nazat and one ANM, Ms Savita Devi were present in all these camps for the check ups. Health cards of all the students were being made in these camps which contained information about their weight, height, body temperature, blood pressure and any other type of abnormality or disease. Students with specific problems were referred for early detection to the PHC. In the same camps, iron and vitamins tablets along with medicines such as OFloxacin, Paracetamol and cough syrups were distributed to the students. AIPAD team created awareness about these camps in their community meetings and through household visits so that no student is left outside the coverage of the services that he/she is entitled to. A total 5634 students have been checked in these camps in about 113 schools. Out of which 2323 students got tablets and were diagnosed with some problem or deficiency.

AIPAD has organised similar camps in all other blocks as well so that mortality in children can be checked and necessary prevention can be taken.

Analysis of Experiences and Learnings in Health in Last four years: Maternal and Child Health Status

According to the Lancet Maternal Health series ( 2016) , ‘Too Little too late care’ is the adage aptly used to describe maternal health care in Bihar. Poverty, ignorance about healthy pregnancy and delivery, lack of proper transport to and fro from facilities characterise maternal health care in the state. In spite of the country’s NRHM and RCH programme , the state still suffers from high maternal mortality rates , unsafe delivers and poor health infrastructure and lack of access to timely emergency obstetric care .

Bhagalpur is one of the least developed districts of Bihar, which is again one of the most densely populated states of the country where 81 percent of the total population is rural. The baseline survey2 conducted by AIPAD in 2014 in the five blocks of Bhagalpur revealed

2 A quantitative cross-sectional approach was adopted for the study. A household survey was thus conducted as part of the study employing a structured interview schedule as the research instrument. In all, 994 households were covered investigating status of the health, education and social security indicators as may be

Figure 13 : Rashtriya Bal Swasthya Karyakaram taking

place in our blocks


that around 70 percent of the women in the study area opted for institutional delivery while around 60 percent of the women had received benefits from the Janani Suraksha Scheme (JSY) scheme. The status of full immunization was around 28 percent across all categories. Access of toilets was found to be low among the respondents, with 78 percent reporting open defecation. Instances of maternal death and infant death were also captured in the five blocks.

Over the period of four years, AIPAD has been aiming at improving the access to entitlements and provisions under government schemes by the aims to improve the access of marginalised communities in the five blocks (Kahalgaon, Sanhaulla, Jagdishpur, Shahkund and Pirpainti) of Bhagalpur. Enhancing access to health service delivery is one of the key focals of the project and AIPAD has been trying to eradicate the deep seated issues concerning maternal and child health through its technology based Health Cube (currently running in 3 blocks), community meetings, advocacy, liasoning with the health department, regular meetings with the ANMs and generating awareness and concerns. The core strategy that AIPAD has been adopting is empowering the frontline health workers and activating the communities and citizens to engage with the public health system. AIPAD has been engaging with the government system at multiple levels (local, district, state, and national) to address the gaps in the public delivery system. Though the project has been successful in addressing the issues as not a single case of maternal mortality has been recorded in the panchayats using health cube device ,health services are being delivered at the remote locations, women are informed about institutional and safe deliveries, and VHSND services are regularly operationalised , yet there is a lot that needs to be done.

AIPAD recently conducted a small study in which the HMIS3 data of all the five blocks from APRIL- July 2017 was studied and the results were analyzed. The objective of this comparative analysis was to understand the health situations in the respective blocks and the reasons therein. The study was conducted so as to serve as a reference for measuring change incidental to the implementation of the project. Apart from that, analysis of the data would provide an understanding and a clearer picture of persistent health concerns in the field area despite of the numerous efforts from the government and civil society Findings of which are mentioned below:

• Percentage of women received 4 ANC checkups Antenatal checkups of pregnant women with the health workers is one of the important determinants of maternal and child health . It is the first step towards healthy pregnancies and reducing maternal mortality. If the ANC checkups are done properly, then the chances of high risk pregnancies are reduced. From the survey it was found out that out of the total

applicable in the sampled household. The overall sample was distributed across the 35 villages randomly selected from the four project blocks. 3 Health Management Information System (HMIS) data was collected by our team from the respective blocks and a comparative graph was made.


population of the blocks, 21 percent of the women received 4 ANC checkups in Pirpainti block, Kahalgaon 31 percent, Sanhaula 19 percent, Jagdishpur 13 percent and Shahkund 16 percent.

• Percentage of Institutional Deliveries conducted : From the study,it was found out that 30 percent of women in pirpainti block had institutional delivery , 24 percent delivered in Kahalgaon , 14 percent in Shahkund, 15 percent in Jagdishpur and 17 percent in Sanhaulla. It can be seen that Pirpainti has the highest percentage of institutional delivery because the Referral Hospital in pirpainti is equipped with all the necessary facilities and is performing very good in terms of providing the health services.

• Percentage of Home Deliveries conducted: Even after NRHM and RCH programmers focusing on institutional deliveries, still a very huge percentage of women still deliver at their homes. It was found out that 55 percent of women in Kahalgaon had home delivery, 22 percent in Sanhaula, 17 percent in Pirpainti and 6 percent in Jagdishpur. It can be seen that Jagdishpur has the lowest percentage of home deliveries and Kahalagon has the highest.

• Percentage of Still births in Public hospital Still births occur at a high number in rural areas due to the cumulative effect of unsafe pregnancies, weak mothers and high risk pregnancies. 35 percent still births had occurred in Pirpainti, 24 percent in Kahalgaon, 13 percent in Shahkund, 19 percent in Sanhaula and 9 percent in Jagdishpur. It can be seen that Jagdishpur having the lowest percentage of home delivery also has the lowest still births. There is a strong linkage between home deliveries and still births as women delivering at home face a lot of challenges and there is a huge risk for the infants as well as the mother.

• Percentage of Full Immunization It was found out that 26 percentage of children had full immunization in Pirpainti , 28 percentage in Kahalgaon, 18 percentage in Sanhaula, 15 percentage in Shahkund and 14 percentage in Jagdishpur.

Results

We can clearly see that Kahalgaon block has the highest ANC check ups recorded while Jagdishpur has the least. In case of institutional deliveries, Pirpainti has the highest and Shahkund as the lowest. Referral Hospital in Pirpainti is equipped with proper infrastructure, specialist doctors and medicines to tackle maternal emergencies and therefore institutional deliveries occur here in large numbers, whereas it is not the same scenario in hospitals of other blocks. In case of home deliveries, Kahalgaon has recorded the highest percentage and Jagdishpur the lowest. Also, in case of still births, Pirpainti has the highest percentage and Jagdishpur the lowest. Sanhaula (18 percent) and Jagdishpur (14 percent) have the lowest percentage in terms of full immunization. The reason for Jagdishpur having the lowest immunization rate is mostly because of the high population of the Muslim community in this block. There are a lot of cultural and religious barriers that Muslim communities in particular have against getting their children immunized and therefore are quite resistant against


vaccination. Though it is a deep seated issue, but AIPAD team has been aggressively working on this through meetings and household interventions with the communities trying to break the barriers.

The findings of the study gives a clear picture that the health situations over the years have improved but there is still a lot to be done. AIPAD is doing it bit in combating the serious issues concerning maternal health, but still we can see high percentage of home deliveries, still births, lack of awareness about ANC checkups and resistance towards immunization. Reasons for persistent issues around maternal health can be explained as follows:

• Home deliveries Due to persistent pressure on increasing the institutional deliveries numbers and the incentives being given to pregnant women under Janani Suraksha Yojana has led to a sharp increase in institutional delivery (from 39% in 2005-06 to 79% in 2015-16)4, yet there is again a huge percentage of women who are delivering at their respective homes like 55 percent in Kahalgaon which is a huge number. The reasons of home deliveries can be many such as lack of health facilities with requisite infrastructure, unhygienic environment, lack of doctors, shortage of trained medical personnel including nurses and midwives, accessibility to the hospitals and high out of pocket expenses for deliveries. Many a times due to poor road connectivity, the community neither had access to health centres nor institutional delivery. Also due to delays in arranging for transport and bad roads lead to home deliveries.

• Poor Infrastructure and Lack of accessibility Women delivering in these public hospitals are often unsatisfied by their experience and even after delivering in the hospitals , they suffer from complications and infections as a study conducted by the Bill and Melinda Gates Foundation, even though 64 per cent of women opted for institutional deliveries in Bihar, half left the public health facility within eight hours of delivery, and one fourth left within four hours, owing to institutional gaps in staffing, equipment and hygienic practices. Even the public health institutions such as the PHCs, CHCs and other health centres still lack basic infrastructure and are mostly in dysfunctional state. Irregular opening of these institutions, absence of doctors and nurses, lack of sufficient beds and inadequate supply of medicines are some of the reasons for existing health scenario in rural areas like Bhagalpur. Also many a times, lack of accessibility to these institutions makes it difficult for women from rural locations to reach out in case of emergencies thereby leading to increased numbers of home deliveries, still births and maternal mortality numbers.

• VHSNDs inefficient services The NRHM conceptualized the Village Health and Sanitation Committee (VHSC) are as responsible for village-level health planning and monitoring and are formed within the overall framework of the Gram Panchayat (village council), in which women, village members from vulnerable groups and minority communities are adequately represented. AIPAD is actively

4 Annual Health Survey 2015


involved in regular monitoring of the functionality of the VHSNDS and its services. But the services under VHSNDs especially in places like Bhagalpur are often lacking behind and in most of the remote locations they are not even functional. There is Important activities such as ANC checkups and immunization services therefore are affected resulting in higher numbers of maternal and child mortality.

“Leaving no woman behind” is the noble mission of our government and the recently launched Sustainable Development Goals (SDGs) that focus on equitable and quality health care. But the chances of achieving this goal remain slim, unless more tangible measures are taken to improve access to complete maternal health services. We are in need of a comprehensive and holistic approach to women’s health focusing on good nutrition, safe contraceptive options, healthy pregnancies and safe deliveries for every adolescent and adult in the state. Strong governance and political are essential to build a robust health system with the capacity to every woman the healthcare she deserves.

Swachh Bharat Abhiyan

To accelerate the efforts to achieve universal sanitation coverage and to put focus on sanitation, the central government launched the Swachh Bharat Mission(SBM) on 2nd October, 2014. The broad objective of Swachh Bharat Abhiyan is improvement in the general quality of life in the rural areas, by promoting cleanliness, hygiene and eliminating open defecation. One of the major objectives of AIPAD project is to encourage good sanitation practices under the Health & Sanitation domain and to eradicate open defecation.

Results

Despite sanitation being on the list of priorities of the state government, the miserable performance of the states like Bihar has been a cause for serious concern for the state government as well as the central government. With the launch of the Swachh Bharat Abhiyan, the sanitation scenario has improved across many of states as more than 4.75 crore toilets have been built and sanitation coverage increased to 68.21%5. But this improvement is not equal across all states as some of them have done well than others and few of them have not been able to make any major stride despite of this programme nearing the three year landmark. As far as Bihar is concerned, it is one of the lowest performing states in spite of government and civil society’s’ major involvement in promoting sanitation and usage of toilets. It has an open defecation rate of 82.4 percent. An article quoting a report of the Department of Drinking Water and Sanitation – DDWS (Ministry of Rural Development, Government of India) had hit the headlines proclaiming that ‘Toilets for all may take 124 years in Bihar’. The article detailed out the present ‘implementation rate’ of the Total Sanitation Campaign (TSC) in different districts of Bihar and projected a time period in which the districts would be termed as ‘fully covered’, stretching from 2014 – 2135. 5 http://www.caravanmagazine.in/reportage/swachh-bharat-mission-heading-failure


According to a report published in the Ndtv times on 2nd October 2017 , ‘out of 6.4 crore households that still require toilets in India, Bihar’s share is a staggering 22 per cent, or roughly 1.4 crore’. This is really a worrying fact for the government that inspite of three years of Swachh Bharat Abhiyan and its rigorous focus on achieving universalization by 2019, , Bihar’s Sanitation’s Toilet Coverage is still At 32.35%6.

Since the starting of our project, AIPAD has been actively involved in promoting and enhancing the goal of Swachh Bharat and is putting efforts towards making its blocks ODF(open defecation free ). AIPAD through its rigorous sanitation campaigns, community meetings , mason trainings and construction of toilets has tried to combat the issues around sanitation and usage of toilets. Owing to the fact that Bihar is still one of the lowest performing states in terms of sanitation and toilet usage, AIPAD has adopted a comprehensive and multi prong approach including behaviour change communication and IEC so that deep seated issues around sanitation can be eradicated. According to government data, Bihar had the lowest proportion of households with toilets in 2017: 30 %, which is an improvement from 25 % in 20167. Reasons for this state performing poor are many. There are gaps both at the ground level in terms of lack of awareness among people as well as the implementation policy in terms of disbursement of money for toilet construction. Despite of huge allocation of funds under Swachh Bharat Abhiyan, there are many gaps in the scheme including a lack of a proper disbursement model.

A lot of families due to financial constraints were not able to arrange for initial capital investment required for constructing toilets in their houses, especially in rural areas where rate of open defecation is quite high. To combat this issue, last year in the state level consultation in Bihar, Principal Secretary PHED announced that under SBA, the sanctioned amount of 12,000 rupees to BPL families which was initially reimbursed after completion of the construction of the toilets will now be reimbursed in two instalments of 8,000 and 4,000. This intends of design change by government of Bihar in the existing SBA was to encourage and facilitate construction of toilets in the poorest households, who otherwise, lacked the initial capital investment. AIPAD created awareness about this new update among the communities through its rallies and campaigns so that maximum people can go for construction of toilets. This new update in SBA helped a lot of people in overcoming their financial constraints faced in construction of toilets and thus moving towards a healthier nation. AIPAD thus facilitated in construction of toilets and created awareness about this new update and a lot of people opted for construction of toilets.

But soon in the same year, there was a sudden change in the scheme which stated that for the disbursement money to reach the beneficiaries, the entire ward or village will have to go for toilet construction. It came as a major set back for people and resulted in people getting

6 http://swachhindia.ndtv.com/three-years-of-swachh-bharat-abhiyan-bihars-sanitation-scenario-in-tatters-as-toilet-coverage-is-at-32-15-despite-3-years-of-swachh-bharat-abhiyan-11962/ 7 https://scroll.in/article/818062/swachh-bharat-the-same-five-states-continue-to-fare-worst-in-sanitation


demotivated with the fear of arranging the initial capital investment and dealing with financial constraints. People faced delay in disbursements of funds which further hampered the process of building of toilets. A lot of communities suddenly withdrawn the construction work knowing that there were be a delay in the overall disbursement process. AIPAD team has been constantly raising this issue that people lack initial capital and there is an urgent requirement of a proper disbursement model under SBA.

Therefore, this year AIPAD faced a major challenge in facilitated construction of toilets and making villages ODF as communities were not eager to put their money at risk and were lacking initial financial investment. Thus, absence of an effective disbursement model is also one of the many reasons for Bihar to be one of the lowest performing states. If we talk about other states such as Punjab, they have a very effective disbursement model in which the sanctioned amount is given in three transactions, on completing each milestone as decided by the government. The final payment is made when the officer himself/herself witnesses the completion of the toilet. This model of payment is linked to completion of the work and has proved to be very efficient and transparent and also is not putting communities under any kind of financial constraints.

Similarly, Namami Gange Project or Namami Ganga Yojna which is an ambitious Union Government Project that integrates the efforts to clean and protect the Ganga River in a comprehensive manner, also has the same issue of not having any proper disbursement model. This scheme is still in operational process. The area of operation of National Mission for Clean Ganga (NMCG) shall be the Ganga River Basin, including the states through which Ganga flows and Bhagalpur as one of those states. Three of our large blocks such as Kahalgaon, Pirpainti and Sanhaula fall under the Ganga basin and are therefore entitled under this scheme. Due to lack of a proper implementation model, panchayat representatives and other stakeholders have no understanding of this scheme and how to implement this on the ground with the communities. Despite of huge allocation of funds, the ambiguity around this scheme still exits at the state level and therefore this scheme had a major set back. AIPAD along with other community based organisations (CBOs) is trying to push these matters to the higher authorities so that the structural gaps in the scheme should be duly addressed and communities can go for toilet construction achieving the goal of ODF. To address this issue, AIPAD team along with other organisations is helping and influencing the state government through meetings and constant follow ups in changing the policy framework for disbursement of the Swachh Bharat Mission (SBM) entitlement amount. Though the Swachh Bharat Mission’s objective to completely eliminate open defecation in India is an enormous goal, and an admirable one, but achieving it still needs strong push and community motivation and involvement.

AIPAD over the period of years has understood the fact that the practice of open defecation in India, especially in rural places, comes from a combination of factors and the most prominent of them being the traditional behavioural pattern and lack of awareness of the


people about the associated health hazards. People do lack information about the schemes (SBM), technical knowhow, ways for cleanliness and maintenance, proper way to use toilets. Caste system prevailing in our society also hinders the use of toilets. AIPAD therefore identified that practice of sanitation and hygiene can only be achieved by behaviour change communication and IEC focussing on people’s sanitation habits and their deep rooted reasons for not accessing toilets. AIPAD through its comprehensive and multipronged approach focussed on collective behavior change as it is a function of empowered communities which help the communities to analyse their behavior and act on their own to effect change. For achieving this, community meetings were organised focussing on sanitation practices where through an interactive process, attempts were made by the team members to break the traditional barriers around sanitation and explaining them the health hazards of defecating in open. Through these meetings, door to door interactions and campaigns, AIPAD identified many such cases where in spite of having toilets in their houses, a lot of families were still defecating in the open. Many believed that defecating in open is a part of their culture and would not want to leave this practice as their ancestors have been doing it for centuries. AIPAD aggressively worked with these communities and made them understand why it is extremely essential to bring a change in their habits. Therefore, apart from focussing on construction of toilets, AIPAD this year focussed on creating awareness about behaviour change and good sanitation practices through its massive sanitation campaigns in schools and communities. Sanitation campaigns were organised on large scale by our team members in the blocks and importance of sanitation and demerits of open defecation were communicated to them. Campaigns and hand wash activities were organised in schools to promote good sanitation habits and create awareness about various health hazards poor hygiene causes to the community and environment. AIPAD also ensured that stakeholders and PRI members understand the importance of hygiene and sanitation so that they can also mobilise and communicate to their people about it. Therefore, AIPAD also involved stakeholders and PRI members in their meetings so that even they are informed about the health hazards of open defecation. Mass awareness to remove the scourge of open defecation and the benefits of having toilets and good sanitation practices was created by moving our Jan Samavd Rath across all our blocks.

On October 11, 2014, the Government of India launched an ambitious scheme for village development – the Saansad Aadarsh Gram Yojana (SAGY) or ‘Model Village’. The proposed “Sansad Adarsh Gram Yojana” of the Central Government aims to involve MPs more directly in the development of model villages. By adopting a village(s) under this initiative, an MP has the opportunity to directly benefit all sections of a village community in an integrated, efficient and participatory fashion. The scheme requires ‘saansads’ or elected MPs to convert villages in their constituency into ‘Adarsh Grams’ or model villages worthy of replication elsewhere in the country. It endorses an integrated approach towards development that includes better and improved physical infrastructure in the villages, along with building community spirit. It aims for better governance (transparency, accountability and integrity), active people’s participation (mutual cooperation, self-help & self-reliance and improved


standard of living & quality of life), and environmental consciousness that can be replicated. It hopes to use the resources from existing schemes for furthering the cause of these villages. In the sanitation sector, it aims at villages becoming ODF, attaining universalization of toilets, betters sanitation practices and waste management strategies.

Figure 14: Components of a model village

Going by that, AIPAD team therefore planned on adopting this model and took an initiative

in which each of our FLW was given a particular village and an attempt was made to make that particular village a ‘Model village’ or ODF free village. Despite of all the measures taken by government, open defecation (OD) still remains in our country one of the major reasons for various health hazards occurring. Therefore, this year each block identified 2 villages each as model village and worked extensively for achieving the goal better sanitation practices and open defecation free. Rigorous camps, community meetings and awareness rallies are being organized in these villages so that the community members are motivated to bring a change in their sanitation habits and practices. Therefore, 10 villages were identified across all the blocks which are mentioned in the table given below:

Model village towards ODF

Sl. No Name of Block Number of village 1 Jagdishpur 2 2 Kahalgaon 2 3 Pirpainti 2 4 Shahkund 2 5 Sanhaula 2 Total 10


Mentioned below are major activities on which AIPAD focussed this year to take a step towards a Swachh Bharat :

Moving towards a Swachh Bharat…

Sanitation and hygiene is critical to health, survival, and development. An estimated 2.5 billion people lack basic sanitation (more than 35% of the world's population) throughout the world, out of which India accounts for nearly 600m of them. Poor sanitation impairs the health leading to high rates of malnutrition and productivity loss as well as leaving people at risk for water, sanitation, and hygiene (WASH)-related diseases. It is a fact that states with the poorest levels of sanitation and highest levels of population density such as Bihar also have the highest levels of child morbidity in the country due to poor sanitation practices.

Apart from construction of toilets and moving towards the goal universalisation of toilets, AIPAD during its course of action identified communication as an issue and therefore adopted a comprehensive approach towards sanitation and hygiene. AIPAD focussed on Information, Education and Communication (IEC) and Behavior Change Communication (BCC) in creating awareness about good sanitation practices and moving towards the broader objective of SBA. A multi prolong approach has been adopted by AIPAD through sanitation and hygiene camps in schools, awareness rallies in various blocks , addressing the issues in community meetings, visiting schools and anganwadi centres , directly talking to the community and encouraging stakeholders to get involved in breaking the social and cultural taboos against toilet usage and hygiene practices. Apart from focusing on physical dimension of sanitation, focus was on understanding and eliminating the social and cultural barriers against good sanitation practices.

Since July and August are the months of heavy rainfall and severe floods in Bhagalpur, therefore AIPAD team aggressively organized camps on sanitation and hygiene and spread of water borne diseases knowing that well-crafted health and sanitation campaigns are very effective in raising awareness and promoting health-enhancing practices in rural areas. Apart from addressing the broader issues of sanitation practices, these campaigns and rallies also focussed on the spread of water borne diseases such as diarrhea, gastroenteritis, jaundice, cholera and typhoid. Water logging on places and hygiene issues after that makes communities vulnerable to various diseases and therefore causes mortality and morbidity. AIPAD strategically planned on involving children in their awareness rallies and campaigns because not only children educate their entire families and their neighbourhood, but also children are affected more than adults as the rampant spread of diseases inhibits children’s ability to absorb nutrients affecting their growth. AIPAD team also involved PRI members, VSS members, and Citizen Leaders, Advocacy & youth groups in addressing the issues around sanitation.


Various strategies adopted by AIPAD through which the issues of diseases and sanitation were addressed are:

• Campaigns and Rallies: Awareness rallies and campaigns were organised on massive scale involving school children, local villagers and PRI members. People moved across the villages and blocks chanting slogans on practicing sanitation and hygiene and spread of water borne diseases. Through these rallies, people in the remote areas and locations were informed about sanitation practices and were made aware about the endemic diseases. Around 1732 people participated in these rallies and around 35 villages were covered.

The following steps were followed by our team in organising these campaigns:

• Our team contacted with the PRI members, citizen leaders, and advocacy group members as well as communicated with the locals CBOs for a fix date and venue for the campaign.

• Our team distributed the roles and responsibilities among its members as well as youth group leaders.

• Sound systems, banners, posters and slogans were organised for the rallies.

• PRI members led the campaign with the help of youth group members and , advocacy groups.

Table No 11 Total number of campaigns held (January-December 2017)

Sl.No Name of the Block Number of villages covered

1 Jagdihspur 12

2 Pirpainti 8

3 Kahalgaon 7

4 Shahkund 4

5 Sanhaula 4

Total 35

Source : AIPAD MIS data

Figure 15 : Students participating in the awareness rallies


Table no 12 given below shows the total number of people participated in the rallies:

Table no 12 Total number of people participated in the awareness rallies (January-December 2017)

Date Block Panchayat School Number of

people/students

25.8.2017 Sanhaula Amdanda Middle School Chandpur 115

26.8.2017 Sanhaula Telwara Middle School Telwara 90

20.9.2017 Sanhaula Tadar Middle School Sonudih 60

28.8.2017 Jagdishpur Sanhauli Middle school Tardiha 235

23.8.2017 Jagdishpur Jagdishpur Middle Angari Tola 235

28.8.2017 Pirpainti Ekchari Middle Dakhili Tola school 142

29.8.2017 Pirpainti Olapur Primary school Bairia Tola 122

28.8.2017 Kahalgaon Banshipur Primary school, Dewari 113

29.8.2017 Kahalgaon Oriyap Primary School Harichak 120

26.8.2017 Shahkund Bhulni Middle School Chada 243

29.8.2017 Shahkund Benlthu Middle School Belthu 492

Total 1732


• Community meetings: Regular community meetings were organised by AIPAD in all the blocks addressing the issues around sanitation and how to take precautions around the spread of water borne diseases .Importance of maintaining their surroundings and environment clean were explained to them.

• Sanitation Campaigns in Schools and Anganwadis ; The national campaign, Swachh Bharat: Swachh Vidyalaya (SBSV), or “Clean India: Clean Schools”, was launched in September 2014, heralding a new era in the Indian government’s focus on WASH in Schools. A key feature of the campaign is to ensure that every school in India has a set of functioning and well maintained water, sanitation and hygiene facilities. SBSV’s goal is to make a visible impact on the health and hygiene of children through improving both their health and hygiene practices, and also those of their families and communities. We have conducted several orientation and awareness programme in schools, AWC, villages for best practices of hygiene such as hand washing, disposal of kitchen waste, use of toilets etc. we encouraged teachers and students for cleaning of school campus. Hygiene in school also supports school nutrition. The simple act of washing hands with soap before eating the school mid-day meal assists to break disease transmission routes. AIPAD has been conducting hand wash campaigns in various schools where children are taught about the five steps of


hand wash and are informed to wash their hands before eating and after defecating. Children are also told to take a sanitation oath pledging to practice safe sanitation and hygiene practices.

• Menstrual hygiene management: Girls are particularly vulnerable to dropping out of school, partly because many are reluctant to continue their education when toilets and washing facilities are not private, not safe or simply not available. When schools have appropriate, gender-separated facilities, an obstacle to attendance is removed. Therefore, AIPAD team also created awareness about menstrual hygiene and assisted the schools in orientating the menstrual hygiene program along with distribution of sanitary pads to adolescent girls. We have conducted training programme on adolescent hygiene and distributed cotton sanitary pad8 among 180 girls of Jadgishpur, Sanhaula, Kahalgaon & Pirpainti blocks.

Figure 16: Orientation on Sanitary pad at Shahjangi Panchayat, Jagdishpur Block.

Apart from above mentioned strategies, AIPAD team celebrated Swachhta Pakhwada on 15th September 2017 in around 16 schools. As a part of central governments Swachhta Pakhwada, cleanliness drive was organised in various schools on 15th September. Various activities such as hand washing, cleaning the school camps and awareness rallies were organised in the schools.

8 Eco Femme is an organization (NGO), located at Saracon campus, near Ganesh bakery, Kottakarai, Auroville, Tamil Nadu, Pin-605111. AIPAD has entered into partnership with Eco Femme and launched the Pad for Pad program in March,2017. In the Pilot project Eco Femme provides reusable cloth pads (cotton sanitary pads) free of cost & educational materials for facilitator. AIPAD conducted campaigns for pad sessions in our project intervention area and reached out the most marginalized sections of the communites. During these sessions we conducted one hour session on menstrual management with a group of 30 adolescent girls. Thereafter these girls are provided cotton sanitary pads for better menstrual experience. These cloths pads are reusable and can be washed and reused upto 75 times. It is biodegradable and environmental friendly. Till now we have reached upto 210 adolescent girls of our project area. These cloth pads are made by women of Self Help Groups from Tamil Nadu.


Table given below shows the total number of schools where Swachhta Pakhwada was celebrated:

Table No 13 Total number of students participated in Swachhta Pakhwada

Block Name of School Number of students participated

Kahalgaon Middle School, Mushahari, Ghogha 178 Kahalgaon Primary school, Jagannathpur 70 Kahalgaon Middle School, Antichak 436 Kahalgaon Primary School, Dalma 113 Shahkund Middle School Mohanpur 92 Shahkund Middle School Maheshletti 164 Shahkund Middle School Chahkchmari 213 Shahkund Middle School Malekpur 85 Pirpainti Middle School Pasahichak 80 Pirpainti Middle School Ammapali 150 Pirpainti Middle School Laxmipur 400 Pirpainti Middle School Khawaspur 60 Sanhaula Middle School Karhariya 165 Sanhaula Middle School Mahadevpur 200 Sanhaula Middle School Khiridar 360 Jagdishpur Middle school Baluachak 83 Jagdishpur Primary School, Salepur 80 Total 2929


Figure 17 : Students cleaning school campus


Mason Training for construction of affordable toilet: The Government of India has recognized that safe water and sanitation are vital to the nation’s survival, mandating that open defecation should be eradicated in India by 2019. Open defecation free is one of the key objectives of Swachha Bharat Mission. It is well documented that OD leads to transmission of diseases and produces adverse health outcomes for nearby populations, especially children. One of the key priorities of Swachh Bharat Abhiyan (SBA) is to end open defecation by 2019. Going by the objectives of SBA and considering the importance of mason in construction of affordable and quality sanitary toilets, this year also training was organized by AIPAD for local masons on the construction of low cost toilet model. The idea behind this training was to identify the local masons in the blocks and train them for constructing low budgeted toilets in their regions. Keeping in mind the entitled amount for toilet construction under SBA which is Rs.10, 000 for APL and Rs.12, 000 for BPL, it was planned by AIPAD to conduct training for the local masons so that community can afford sanitation and hygiene at affordable price. It was an expressed need of the community which led AIPAD to find a community based solution to increase the access and use of toilets. This sustainable community based approach means delivering services at a price that the community can afford and is willingly to pay for. Therefore, by training the local masons at an affordable cost toilet model, the access of toilets and their usage can be increased.

During training, the importance and necessity of having toilets was explained to the communities along with relevant detailed information about the programme (SBM) including construction logistics was also shared with the participants. During the entire phase of training, behaviour change strategy was adopted by trainer Mr. Murali, and various topics such as importance of having toilets at homes and their usage, inconvenience (at night, time wasted to walk to open defecation sites), women safety and privacy, shame, health, loss of school and work days from being sick, cost of treatment for intestinal infections etc were discussed. Also discussions happened about menstruation with men and it was explained to them how their mothers, wives and sisters face difficulties during this time. Such discussions were made to make men understand the terrible situation of their women and are hence motivated to build toilets at their homes. During the same training, about 533 local masons were trained from across all the blocks. The training of these 533 local masons will impact a population of around 100 panchayats taking it approximately to 10 lakh population. Community members were also informed about the low-cost, location specific, acceptable technologies and designs which will be constructed by community members of their own accord and depending on their socio-economic status. AIPAD plans to conduct similar kind of training in the coming year so as to increase the construction of toilets and its usage.

Campaign for ODF at Ranidiyara, Pirpainiti: AIPAD team organized ODF campaign in Ranidiyara in Pirpainti block. The objective of this campaign was to break down the practice of open defecation and to explain the significance of sanitation and hygiene so that people are motivated for making their villages ODF. These campaigns were organized in all the blocks


and apart from community members, PRI members , teachers and youth group leaders participated in these campaigns.

In the Rani Diyara panchayat, under the Nammi Gange programme., approximately 1400 toilets have been constructed. But AIPAD team observed that in spite of these toilets, lot of these families were not using them and were still defecating in open. AIPAD team intervened in this matter and asked them to specify their reasons for not using them. Many said that it’s their habit to go out in the fields and feel uncomfortable in using the toilets. Therefore acknowledging the need, AIPAD team organized a behavior change rally in this particular panchayat on 19th may 2017. Team contacted the ward members and Mukhiya of this panchayat and explained them the importance and objective of this campaign. Team also contacted the Headmaster of the middle school and requested to make sure that even children participated in this rally. Slogans and banners containing information about good sanitation practices and hazards of defecating in open were used in this rally. AIPAD team interacted with villagers in between the rally and explained them the benefits of using toilets and motivated them to use them.

Figure 18 : Students in rallies and Newspaper clippings about our rallies and campaigns

People in Bhagalpur participated with a lot of enthusiasm in the Sanklap

se Siddhi short Film competition organised under the programme

Sanklap se Siddhi to make ‘Filth –Quit India’ and over 100 entries were

successfully made from our project area.


Given below is one of the examples of sanitation campaigns organized by Team AIPAD:

‘Clean India: Clean Schools’: Sanitation campaign in Pirpainti.

Estimates suggest that nearly 65% of India's population still defecate in the open. This practice of open defecation in India comes from a combination of factors and the most prominent of them being the traditional behavioural pattern and lack of awareness of the people about the associated health hazards. The best way to break bad practices is to cultivate good practices and childhood is the best time for that as children are receptive to all influences. Therefore school sanitation and hygiene education have been given prominence in Swachh Bharat Abhiyaan, which recognizes the role of children in absorbing and popularizing new ideas and concepts. This program intends to tap their potential as the most persuasive advocates of good sanitation practices in their own schools, households and community. Government of India has launched this program integrating with broader sanitation program to ensure that all the schools especially rural schools in the nation have basic sanitation and drinking water facilities and good hygiene practices are taught to the children.

Since the beginning, AIPAD has been adopting strategies to fulfil the broader objective of SBA. Construction of toilets, sanitation and awareness campaigns, community meetings about knowing the traditional habits of the people and trying to break the stigma, are some of the strategies that are constantly being organized and supervised by AIPAD team members. Following the same path and keeping in mind the overall objective, team in Pirpanti organized sanitation cum Handwash campaign at Middle school Roshanpur. Group handwashing with soap before the mid-day meal is also an important component of Government of India’s Swachh Bharat Swachh Vidyalaya – ‘Clean India: Clean Schools’ campaign.

Figure 19: Sanitation campaigns being organised by AIPAD in schools and AWCs


Thus, AIPAD this year conducted many more such sanitation campaigns in schools and AWCs so that the future of our country is secured and aware about the normal health practices.

2.2.2 Education

Securing universal and elementary education is a fundamental right and key element of our country’s plans and policies since 1960s and beyond. The previous two decades have seen a massive push by the government to promote literacy with higher spending and new schemes such as the Sarva Shiksha Abhiyan. There have been significant changes in terms of literacy and enrolment rate. But challenges remain. There are still huge numbers of drop outs from the schools especially in rural areas. Enrolment in government schools still suffers because of a lot of cultural and social barriers. Apart from this, there is still a persistent gender gap in access to education. In Bihar, enrolment in primary education is still quite low as compared to other states and national average. Gross enrolment ratio of Bihar for higher education is close to 13 percent while the national average is close to 24 percent.

The 86th Amendment to the constitution of India has made Elementary Education a fundamental right for all children of the age group of 6-14 years. Scheme of Sarva Shiksha Abhiyan is flagships programme of Government of India to achieve the goal of Universalization of Elementary Education (UEE) in partnership with States and Union Territories (UTs) in a fixed timeframe.

The objectives of the Sarva Shiksha Abhiyan (SSA) includes all children in school, education guaranteed centre, alternative schools, back to school camps: All children complete 5 years of primary schooling by 2007: All children complete 8 years of elementary schooling by 2010: focus on elementary education of satisfactory quality with emphasis on education for all: bridge all gender and social category gaps at primary stage by 2007: elementary education levels by 2010 and universal retention by 2010. The basic features of the SSA includes Institutional reforms; Sustainable financing; Community ownership of school through decentralization; Improvement in quality; Effective monitoring with transparency; Planning at habitation level; Mainstreaming gender; Focusing on educational participation of the deprived sections; Making education relevant; Resource development among teachers.

Keeping in view of the objectives and features of the scheme, through our initiative, Enrollment Drive, AIPAD over the years is aiming at reenrolling drop out children back into government schools and Anganwadis. We also have been tackling the drop out problems at the grass root level and probe the reasons that lead children to drop out of schools. AIPAD through its approach has been motivating community members about the importance of education and encouraging the school drop outs to have a progressive attitude towards life. Through the education camps, AIPAD team has been addressing the various social factors surrounding the education of girl child so as to increase the awareness of the education and


role it plays in the betterment of one’s life. Many a times, parents ask their children to drop out of schools so as to help them financially by working as a labourer or some other occupation. Many parents think that instead of investing money in educating their children, it is better to save that money for giving dowry at their daughter’s wedding or constructing their houses. Therefore, AIPAD team specially has addressed such cases and motivated such families to understand the importance of education and urged them to fully participate in the progress of their own children.

Understanding the importance of maximum enrolment towards achieving universalization of education, AIPAD team in Bhagalpur this year aggressively organised enrolment camps and shiksha rallies throughout the five blocks of our project area. During our team interaction with the teachers and head masters of various schools, there was an expressed need to convince and motivate parents and children about their education and schooling. AIPAD team strategically chose months of April to June to organise rallies and camps since these are the months for maximum enrolment.

Shiksha Rallies were carried out with teachers, PRI members, students and other media representatives and they all move from one part of the village/panchayat to the other, covering an area of approximately 2-4 kms in each rally. Around 500-600 people participated in these rallies from each block. Densely populated and remote areas are normally chosen as the location for these rallies. Students move across the community with the banners and chanting slogans containing ‘enrolment and sanitation issues’. These rallies give students a sense of empowerment and generate awareness among parents regarding the importance of education.

Similarly, enrolment camps were also organised on a massive scale across all the blocks during the same time. Before organizing these camps, door to door visits were done by the team members in the panchayats so that both parents and children are fully aware about these camps and are motivated enough to bring their children to the camps. All the relevant information about the admission was given to the parents and children in these camps. For cases where documents were missing, authentication letter was provided by the Mukhiya of that particular panchayat through the help of AIPAD team members so that the admission could take place promptly and without any hassle.

Results

Table no 14 given below shows the total number of people participated in the rallies across all five blocks. A total number of 1966 people participated including both men and women.


Table no 14 Total number of people participated in Shikha Rallies (January –December 2017 )

Sl.No Name of Block Name of school/Panchayat No of people participated (approx)

1 Jagdishpur Jagdishpur, Balua Chak 5002 Pirpainti Kajiwara 1753 Sanhaula Chhoti Naki, Tadar 2504 Shahkund Hajipur, Daspur 5815 Kahalgaon Bansipur, Shyampur 460 Total 1966

Source: AIPAD MIS data

Table no 15 given below shows the total number of students enrolled through our camps across five blocks. Out of 199216 students totally enrolled in 784 schools across all blocks, 85221 girls have been enrolled while 113995 boys have been enrolled. AIPAD is extensively working to ensure maximum girl child enrolment through interacting with the community members, campaigns and enrolment rallies. 11703 students (6113 boys enrolled, 5590 girls enrolled) have been directly reached by AIPADs intervention. Through its camps and Shikha rallies, AIPAD has ensured to have maximum enrolment from hard to reach population (last mile). Similarly table no 16 shows total enrolment of students in Anganwadi centres (AWCs). Out of 5042 students enrolled in AWCs, AIPAD has directly reached out to 1472 hard to reach cases and ensured maximum enrolment. Out of 1472 cases reached out by AIPAD, 746 girls have been enrolled in AWCs and 726 boys have been enrolled. AIPAD is constantly making its efforts to encourage girl child education and ensure maximum enrolment of girls in schools and AWCs.

Table no 15 Enrolment of students in schools (January-December 2017)

Block

Total no of Schools

(only Primary &

Middle School)

Total no of Enrolment in

schools

Enrolment of Schools

Total no of girl child

enrolment

Total no of boy child enrolment

Total no of enrolment through

AIPADs intervention(hard

to reach population)

Kahalgaon 196 60464 27059 33405 572Shahkund 153 21376 9052 12324 3540Pirpainti 178 56454 23690 32764 3692Sanhaula 145 33448 14700 18748 2800Jagdishpur 112 27474 10720 16754 1099

Total 784 199216 85221 113995 11703

Source: BRC data and data collected from FLWs


Table no 16 Enrolment of students in AWCs (January –December 2017)

Block Name

Total no of AWCs

Total no of Enrolment in AWCs

Total no of enrolment

through AIPAD intervention(hard

to reach cases)

Total no of girl child

enrolment( through AIPAD)

Total no of boy child enrolment (through AIPAD)

Jagdishpur 121 323 175 92 83

Kahalgaon 301 2065 755 404 351

Pirpainti 219 2190 142 69 73

Sanhaula 151 380 250 96 154

Shahkund 209 84 150 85 65

Total 1001 5042 1472 746 726

Source : ICDS data centre and data collected from FLWs

Figure 20 : Shiksha Rally being carried out by our AIPAD team

Figure 21 : AIPAD FLW ensuring maximum participation in AWCs

Table no 17 given below depicts the total number of schools and AWCs visited by our FLWs this year. Our team visited 2090 schools visits and 2487 AWCs visits in all the five selected blocks under our project.


Table No 17 AWC and School Visits of FLWs

Block

AWC & SCHOOL Visit of FLW

Total no of AWCs

Total no of AWC Visits by

FLWs

Total no of Schools ( only

Primary School & Middle

School

Total no of School Visits by

FLWs

Kahalgaon 301 549 196 394

Shahkund 209 504 153 440

Pirpainti 219 568 178 483

Sanhaula 151 496 145 426

Jagdishpur 121 370 112 347

Total 1001 2487 784 2090

Source : AIPAD MIS

Opening of Student Bank Accounts

Though Enrolment of children and drop outs has always been AIPADs main agenda, but this year, our team aggressively focussed on opening bank students for students so that they can easily get their scholarship amount directly in their accounts .Under RTE Act, students are entitled to scholarships, uniform, books and certain state level retention schemes. Also, there is a provision of bicycles for 9th grade and 11th grade students as an encouragement to continue studies. AIPAD team directly experienced heavy pilferage due to human interface and cash transactions as specific amounts, so far in cash were distributed by teachers to avail the benefits of these schemes. The usual route of pilferage was either by giving a lesser amount than the mandated amount or by showing utilisation for absentee students. To address such issues, government has taken action to directly transfer the entitlement amount to the beneficiaries’s bank account which also results in saving manpower and paperwork. Therefore, AIPAD welcomed government initiatives of DBT (Direct Benefit Transfer) and actively joined hands with government to facilitate opening of bank accounts for students. Opening of bank accounts not only provides solution to the problem of pilferage, but also gives a sense of security to the beneficiaries for attainment of their allocated amount. The usual route of pilferage was either by giving a lesser amount than the mandated amount or by showing utilisation for absentee students. AIPAD team acted as a facilitator in organising the overall process so that benefits can reach out to maximum population without much hassle.

AIPAD team observed that though the direct benefit transfer has proved to be a very effective approach in combating the pilferage system, but in many cases it still exists. For example, for availing the benefits of the bicycle amount, beneficiaries have to submit a bill for the cycle and hand it over to the Headmaster for issuing the cheque. In this process, the concerned


authority claims some amount from the beneficiary for issuing the cheque and beneficiaries have no choice but to succumb to the system. In case of uniforms and books, this is not possible as the amount is directly transferred to the beneficiaries account.

Results

Table no 18 given below shows the total number of students accounts opened through AIPAD’s awareness campaigns and rallies. A total of 94953 bank accounts have been opened this year across all blocks. Out of which, 39511 accounts have been opened for girls and 55442 boys accounts have been opened. There has been a massive growth in terms of numbers as 20,998 accounts were opened last year through AIPADs intervention and this year close to a lakh. AIPAD is aggressively putting efforts towards opening more and more bank accounts so that the mishandling of beneficiaries entitlements can be stopped.

Table No 18 Total number of student’s bank accounts opened (January –December 2017)

Name of block Number of bank accounts opened

Number of bank accounts

opened(boys)

Number of bank accounts

opened(girls) Pirpainti 23768 12372 11396

Kahalgaon 22345 14305 8040

Sanhaula 14715 8597 6118

Jagdishpur 18150 11223 6927

Shahkund 15975 8945 7030

Total 94953 55442 39511

Source : AIPAD MIS

Bihar Student Credit Cards enabling higher education

One of the seven resolutions taken by the Bihar government, Bihar Student Credit Card (BSCC) was launched on 2nd October 2016 and it promises Rs four lakh interest free loans to 12 th pass students for pursuing higher education. Under the scheme, an allowance of Rs 1,000 per month is also provided to unemployed students in the age group of 20 to 25 for two years to help them search for jobs. Apart from that, students can get free training under Kaushal Yojna as a part of skill development programme. This scheme is an initiative to combat financial hurdles towards higher education. Any student who is not able to pursue higher education because of financial constraints can avail the benefits of this scheme by going through some normal proceedings. This scheme is an attempt to fight against illiteracy and unemployment in Bihar.


AIPAD team in Pirpainti block planned to organize a camp and create awareness about BSCC yojna and help students get benefits of this scheme. Getting the official permission from BDO and with the help of District Resource and Counselling centre (DRCC), a camp was organized on 12th April 2016 at Inter level Boys High School of Mahesh ram panchayat, Pirpainti. AIPAD team created awareness and motivated the students to reach the venue to understand the proceedings for availing the credit card scheme. Mr Mitesh Rai from DRCC and two teachers from the school facilitated the camp and around 78 students filled their application form for availing the benefits of BCC scheme.

AIPAD team conducted such camps on massive scale in all the blocks so that the benefits of BSCC yojna should reach to every struggling student in the region and students can pursue their academic and career goals.

Figure 22 : AIPAD team planning to organise camps on Bihar credit card scheme

Village Seva Samiti (VSS) meetings and Formulation and final submission of School Development Plan

Right of Children to Free and Compulsory Education, 2009 (RTE Act) is a landmark legislation in the area of education. Various provisions have been made in the Act to ensure quality education for all children in the age group of 6-14 years. Specific provisions have been made for democratization of schools and for parents and local communities to play their due roles in shaping and running of the schools in the form of School Management Committees (SMC) (known as Vidayalya Shiksha Samiti (VSS) in Bihar). Seventy five percent of the VSS members are parents of the children attending schools and rest of the members are teachers and PRI representatives.

Every SMC is required to develop an annual School Development Plan (SDP), which is a comprehensive document covering each and every aspect of school related to its proper functioning, physical infrastructure access and coverage. For communities to be able to


effectively play that role, they need to be oriented/ trained and supported. To engage with the school system, members of community need to develop technical skills like collection of relevant information, analysing it and finally designing appropriate interventions, basing on norms set in the RTE Act.

Through interactions and meetings with the VSS members , AIPAD during the initial years of its project identified that though VSS was formed on pen and paper, these members were not aware of their own roles and responsibilities. There were hardly any meetings happening and various relevant issues such monitoring of mid day meals , infrastructural issues, attendance of the students, cleaning of the school toilets etc ,were not been discussed at all. Apart from this, even the community members and parents of the children going to school were not aware of VSS and its roles in impacting quality education. Also, the process of preparation of School Development plan was actually a one sided process as there was a major skill gap existing within the VSS members as well as they were majorly dependent on government school teachers to prepare SDP.

To address these issues and gaps within VSS members, AIPAD organised two back to back training sessions in the second and third year of the project in all the five blocks..The objective of the first training organised by AIPAD was to make the VSS members ware about their own rules and responsibilities and are informed enough to take on their roles in achieving quality education. With the efforts of our AIPAD team, presence and participation of VSS members in their respective schools was made sure. VSS members were made aware about the following responsibilities:

• During monthly meeting necessary actions should be taken for the development of the school.

• Planning of basic infrastructure development of the school and also its monitoring. • Assessment of the attendance of students and also take necessary action for the

improvement of attendance. • Identification of children who are not going to school and motive their parents to send

their children to schools. • Monitoring of mid day meal menu, hygiene in kitchen and cleaning of toilets and

campus

The objective of the second training which happened in 2016 was to train the VSS members about the objectives and formation of School Development Plan. The training was broadly divided into two days in each of the schools. On the first day of the training, a brief introduction on the purpose of SDP was given while on the second day; actual formulation of SDP took place.

Following were the main points discussed in the training programme:


• Various kinds of Grants being allocated to the schools and their effective utilization. • Discussion on various government schemes operating in schools like scholarship,

cycle and uniform yojna. • Discussion on the form of SDP and how to fill it. • Discussion on various issues being incurred in schools. • Discussion on various strategies to solve the issues pertaining to schools.

Thus, the subsequent trainings and meetings actually helped the VSS members to be fully aware of their responsibilities and formulation of their SDPs which resulted in generating a much transparent system. This year also, AIPAD team participated regularly in the VSS meetings across all five blocks and ensured maximum participation of VSS members in these meetings. This year AIPAD constantly followed up with the VSS members and facilitated the formulation of SDPs of their respective schools. AIPAD aggressively worked towards this objective of ensuring maximum formation and submission of SDPs. A total of 377 SDPs have been formulated and finally submitted to the Sarv Shiksha Abhiyan with the constant efforts and follow ups of AIPAD team. The main activities that are monitored and facilitated by the AIPAD in detail are mentioned below :

Action taken by AIPAD team:

• Motivating VSS member to participate in the monthly meeting. • Regular discussions with VSS member for the progress of the school. • Motivate VSS member for regular monitoring of midday meal menu. • Organise Parents teachers meet along with VSS members. • Discussions on financial expenses during VSS meeting. • Engage VSS members, youth & advocacy group members, and teachers in Siksha

rally and enrolment camp. • Identifying drop out students, non school going children and motivate their parents

for re admission. • Formation of Bal sansad & meena manch and regular meetings with this group • Educate students on personal hygiene • Organise health & sanitation awareness campaign with the help of teachers, students,

PRI, youth group leaders. • Time to time orientation of VSS members on their role s & responsibilities. • Training of VSS members for preparation of School Development plan.

Results

Table no 19 given below shows the total number of VSS meetings attended by our team across all blocks this year. A total of 363 meetings happened in which AIPAD team participated and followed up regularly.


Table no 19 Total number of VSS meetings attended by AIPAD (January –December 2017)

Sl.no Name of Block No of VSS Meeting

1 Kahalgaon 82

2 Shahkund 63

3 Pirpainti 73

4 Sanhaula 69

5 Jagdishpur 66

Total 363

Source:- Data taken from Flw’s, daily register

Table no 20 given below shows the total number of SDP formed and submitted this year. A total of 377 SDPs were formed and submitted to the Sarv Shiksha Abhiyan

Table no 20 Total number of SDP submitted through AIPADs intervention

(January-December 2017)

Sl.no Name of Block No of SDP submitted

1 Kahalgaon 77

2 Shahkund 112

3 Sanhaula 94

4 Jagdishpur 94

Total 377

Source: Data collected from BRC

Apart from regular meetings and follow ups with VSS members, AIPAD team this year attended and participated in the Parent Teacher Association meetings (PTA). In these meetings, apart from VSS members, AIPAD team invited ward members, senior citizens, ANMs and ASHAs etc. The objective behind participating in these meetings was to have discussions around all the relevant issues not just pertaining to schools and education, but also health and social security. The goal behind inviting ward members and health functionaries was to have a common platform with all the respective representatives of each domain where various issues of the communities can be discussed, as every social issue is interlinked to each other.


2.2. 3 Social Security

Social Security as a concept is enshrined in Article 22 of the Universal Declaration of Human Rights which states ‘Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality’. Every person is faced with social problems and risks at some time in his life span due to risks associated with sickness, accident, unemployment, disability, maternity and old age. The. Social Security Policies are intended to mitigate or provide cover the costs for these problems and risks faced by persons. any of the measures established by legislation to maintain individual or family income or to provide income when some or all sources of income are disrupted or terminated or when exceptionally heavy expenditures have to be incurred are social security (e.g., in bringing up children or paying for health care)

Social security thereby refers to the programs of the government intended to promote social welfare and protection to its citizens against providential mishaps over which a person has no control. The underlying principal of social security is that the state shall make itself responsible for ensuring a minimum standard of material welfare to its citizens especially women, children and other disadvantaged groups on a basis wide enough to cover all contingencies of life.

The presence of numerous social and welfare schemes for the poor and marginalized sections by the government has not widened the gap between the communities who have to access these schemes and the government. There is a wide gap in the accessibility of the benefits of these schemes by the common people, especially in rural areas. One of the foremost reasons of poor accessibility of these schemes is the lack of awareness and information about these schemes among citizens. Apart from this, even if people are aware, they have no information about the procedure of availing these schemes. There is a long and lengthy documentation process required for availing these schemes which people fail to complete for some reason or the other. Over the years, AIPAD as a team has tried to address these issues and bridge the gap between government and beneficiaries by creating awareness about these schemes and facilitating the overall process by helping beneficiaries in the documentation process.

Social Security Camps

Since the broader objective of AIPAD is to improve the accessibility and uptake of government schemes, AIPAD adopted the strategy of reaching out to people through its large scale social security camps. Social security camps have been used as a tool by AIPAD to help beneficiaries avail the benefits of the various schemes and facilitating the process of documentation since the starting of the project . These camps have proved to be an excellent method of reaching out to the last mile population and facilitate the


communities in availing their rights. Apart from generating awareness about the schemes and identifying eligible beneficiaries, these camps also help people in understanding the documentation process and helping them in case of any missing documents. Camps are normally organised by our FLWs in a particular panchayat and people are informed beforehand to gather at a respective location. Our team through its door to door interventions informs communities about the date and time of these camps and ensures that maximum people participate in these camps. Location of a camp is chosen keeping in mind the accessibility of the people and where whole community can gather easily. In the third year of the project, an initiative was taken by AIPAD in which Aam sabhas and camps were amalgated and social security camps were organized on massive scale through Aam Sabhas. Beneficiaries for various schemes were identified through these camps and Aam sabhas. This model turned out to be an excellent tool for community awareness and uptake of schemes. The objective behind merging Aam sabhas and camps was to provide a common platform for stakeholders and community members to come together and address the issues. Result of such amalgamation was that Mukhiyas themselves started organizing AamSabhas and invited our team to organize camps in those Aam Sabhas. Identification of beneficiaries and the solution to their various issues regarding receiving of benefits are being now addressed jointly in these sabhas and camps. This kind of model is also ensuring sustainability of our project beyond our stipulated time

This year also AIPAD team this year organised camps aggressively in all the five selected panchayats. Observing the achievements of the camps over the years, and their effectiveness in reaching the common people, AIPAD team this year also continued the same process with much dedication and focus. The camps this year were being organised on a campaign mode covering more population and people. This year apart from the identification of the beneficiaries, more focus was given on solving the pending cases of many beneficiaries. AIPAD this year maintained a constant follow up with the beneficiaries whose benefits are waiting due to some reason or the other. Many beneficiaries whose documents were missing or were lost or were not updated were especially given attention this year and were constantly followed up with our team members. Even in many cases, where documents needed to be approved by their respective PRI members, AIPAD team facilitated the entire process. Physical verification of the documents was done by the team members themselves and ensured that all necessary formalities are fulfilled. In spite of the two consecutive elections in 2016 and the code of conduct, AIPAD team managed to take the overall process to another level. FLWs not only assisted the identified beneficiaries in the documentation process, but visited beneficiaries physically so that no stone is left unturned.

Results

This year, camps were being organised with the help of PRI members as well as our youth group leaders, advocacy members and citizen leaders. Observing the dedication and hard work of our team and benefits of these camps, even ward members and PRI


representatives assisted the team in organising these camps and achieving the objective of reaching out to people. Participation and involvement of PRI members and other stakeholders in these camps is not only installing faith of the people in the government representatives, but also adding to the sustainability of our project. Few PRI heads have utilised their own funds in engaging paid volunteers similar like AIPAD’s FLW so as to have maximum outreach to the communities just like our social security camps. Also, this year major focus was given on addressing the last 20 percent of the population i-e the last mile population. AIPAD team specially worked aggressively towards reaching the maximum number of beneficiaries from the last mile population and facilitating them in getting their entitlements.

Achieving Universalisation: Celebrating Protsahan Diwas in all the Blocks

AIPAD has been aggressively involved in universalization of the various social security schemes among the selected five blocks. To make it universalized, AIPAD team has worked effectively with the panchayat heads and ward members and motivated them to reach out to the unreached. AIPAD this year celebrated a series of Protsahan divas in all its five blocks and awarded the PRI representatives of a particular village on reaching universalisation. Protsahan Diwas has been conceptualized by AIPAD as an effort to identify and appreciate those panchayats and their panchayat heads who have achieved 90 percent of coverage under various social security schemes so as to enhance the effectiveness of the elected people’s representative of a good performing panchayat. 90 percent coverage is considered keeping in mind the 10 percent floating population in the form of new beneficiaries being constantly added and identified for schemes like Kabir Antyesthi, JSY and pension schemes etc. To motivate and facilitate the work of panchayats or villages which have been performing well in uptake and accessibility of schemes and services, AIPAD team identified such panchayats and facilitated their representatives by celebrating Protsahan Diwas. Also, other panchayats representatives are inspired and motivated to do a similar kind of good work. Protashan Diwas achieves the following objectives:

• Motivating PRI members and other representatives for achieving the state of ‘universalization

• Moving towards the broader objective of improving access and uptake of social security schemes

• Improving and maintaining supportive relationship with the government officials.

Results

Table no 21 given below shows the total number of villagers and ward members where Protsahan diwas were celebrated this year. A total of 39 villages achieved universalization and 24 PRI members were recognized and appreciated for their outstanding work.


Table no 21 Total number of Protsahan Diwas celebrated after achieving universalization (January-

December 2017 )

Name of Block No of PRI members

No of Target villages

No of villages covered

Jagdishpur 4 10 7

Shahkund 7 10 10

Sanhaula 2 12 6

Pirpainti 7 8 8

Kahalgaon 4 10 8

Total 24 50 39


Liasoning with the Social Welfare Department

AIPAD has been working very closely and in a collaborative way with the government functionaries in all its three domains. This year also AIPAD worked closely with the department of social welfare and organized meetings with the officials so as to discuss various ground level issues and problems faced by the community people. Team through its constant follow up ensured that the problems faced by the common people are not being unnoticed. A lot of beneficiaries were facing serious problems with their BPL status and Aadhar linkage to their accounts. Due to which they were not able to receive their benefits. Moreover there was not a proper channel through the beneficiaries can know about their status and act accordingly. For addressing the problem of BPL list and list of Aadhar linked bank accounts, our team approached the District Social welfare (DSW) department and explained them the problem and asked them where we can find the right information about these lists. Understanding the situation, the officer gave him the link of the website where the BPL list and names of all those who’s Aadhar has been linked is uploaded and hence any one can check their status and then claim their rights. After having this right information, our team made sure to create awareness about this link and even our established Information centres have lists of those beneficiaries who have BPL status and have their Aadhar Linked to their bank accounts so that beneficiaries can come and get the relevant information.

Link:

http://www.nsap.nic.in/nationalleveldashboardNew.do?methodName=subDistrictCente

rLevelData&districtname=BHAGALPUR&districtcode=0527&schemeCategory.

www.elabharthi.bih.nic.in


Mentioned below is an example of the social security camps that are being organised by AIPAD across all the blocks. The following camp was on disability certificate and was organised in Pirpainti

Figure 23 : Disability camps being organised in all the blocks

Disability certification camp, Pirpainti.

According to Census 2011, over 21 million people in India are suffering from one or the other kind of disability and this is equivalent to 2.1% of the population. Out of the 21 million disabled, Bihar alone has around 1.9 million populations as disabled. People with disability live in an atmosphere of poverty, marginalization, isolation and stigma. Their experiences have been exacerbated by the lack of services & facilities and vehement attitudinal barriers in all walks of their life. In spite of a number of schemes established by the Centre and the state for the disabled, a very low percentage of PwDs (Person with Disabilities) in Bihar have been receiving marginal amount of services.

Government of Bihar has implemented various schemes for the disabled through the Directorate of Social Security and Disability, Department of Social Welfare. Disability pension is one of the schemes among various disability schemes. There are two types of schemes that are entitled to the disabled population. Indira Gandhi National Disability Pension Scheme which is implemented by the funds received by the central government and Bihar Pension Disability Scheme which is implemented by the state of Bihar. Despite of these schemes issued exclusively for the disabled population, a large part of population remains unaware of these schemes and those who are aware lack necessary documents for availing the benefits of such schemes and face a lot of hurdles in the official proceedings.

One of the major constraints noticed by the AIPAD team during their awareness campaigns and community meetings was that people were facing a lot of difficulty in getting the disability certificate formed. And because of that, they were not able to avail the schemes. In one of community meetings, Mukhiya of Ekchari panchayat addressed this issue and informed that because Referral hospital (RH) in Pirpanti is located very far away, therefore people are not able to get their certificates done from the hospital. Seeing the seriousness of the issue, our team discussed this with Medical Officer in charge and Health Manager of RH and requested them to organize a camp in Ekchari panchayat.


Therefore, a disability camp was organized with the efforts of AIPAD on 15th February 2017 at Health Sub Centre. AIPAD team facilitated the camp by mobilizing the disabled population to reach the Centre by 11 am. A team of doctors reached at the given location and time and started the process of making disabled certificate. Around nineteen people got the certificate that day and four were referred to Bhagalpur Hospital.

Mukhiya ji and other ward members really appreciated the efforts of AIPAD and people were happy considering the fact that now they can easily avail their pension rights. AIPAD plans to conduct many more such camps for the population that cannot access their hospitals and help them in availing their rights and entitlements.

Figure 24: Our project coordinator facilitating beneficiaries during camps

Details of Social Security Scheme

Widow Pension Scheme

A pension of 300 rupees is being granted to widows between 40-59 years of age belonging to below poverty line (BPL) families are eligible for benefits under this Scheme. . There are two types of pension schemes which are being offered by the Bihar Govt. One is the popular known central provided scheme called as Indira Gandhi Widow Pension scheme and the other is Laxshmi bai pension scheme which is a state govt. run scheme. To avail benefits the beneficiary has to submit two copies of application in a prescribed format along with photographs, BPL certificate, age certificate and proof of residence to the Block Office. The applicant should obtain receipt for the application submitted which would help in availing the information regarding the progress of application. Mukhiya of gram panchayat reviews the list of widows in his/her panchayat and reports in case of any re marriage. After Mukhiya’s confirmation, the Approval Order is sent to the Post Office, where a savings account is opened in the name of the beneficiary for making the payments. The amount of pension is deposited in the post office savings account of the beneficiary. AIPAD team through the camps helped in identification of these beneficiaries and facilitating the documentation process and final submission.


Results

In order to get an idea of the progress made by the AIPAD team in the year 2017, the table represented below depicts the total number of open and selected cases that have been identified and closely followed by the team members along with rejected cases. Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance whereas selected cases are hard to reach cases that have been selected, approved and benefits have been received by the beneficiaries through AIPADs intervention. Open cases being identified are further closely followed up by our team members whereas rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by redressal grievance mechanism and liaoning with advocacy group members and block level officials.

A total of 128 hard to reach beneficiaries have received their benefits of widow pension across all the five blocks through AIPADs intervention whereas 156 cases have been rejected. A total of 1831 cases have been selected by the government. The reasons for rejection are many like lack of proper documents, not having recent photographs; absence of an Aadhar linked bank accounts etc. AIPAD is working on these existing barriers through its camps so that the benefits can reach the beneficiaries. AIPAD through its regular follow up with these beneficiaries is trying to address their issues.

Table no 22 Total number of beneficiaries under Widow Pension (January-December 2017)

Block

Schemes for Widow Pension

Total number of Open 9 cases as per AIPAD MIS

Total number of Rejected10 cases as per AIPAD

MIS

Total number of Selected11 cases as per AIPAD

MIS

Total number of selected cases as per Government

data Kahalgaon 72 17 55 202Shahkund 5 0 5 935Pirpainti 116 97 19 261Sanhaula 41 32 9 190

Source : AIPAD MIS

9 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 10 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials. 11 Selected cases are hard to reach cases who have been selected, approved and benefits have been received by the beneficiaries through AIPADs intervention


Old Age Pension Scheme

The Scheme is designed for older persons who are at the age of 60 years or above. Financial Aid is provided to the old age persons as Pension every month. This scheme was earlier named as National Old Age Pension Scheme. The age of the applicant (male/female) should be 60 or above (revised from 65 in 2009). A pension of 300 per person every month to the age group of 60-79 years and 500 per person every month for age 80 years or more is being entitled under this scheme.

Results

During the team visits to fields and meetings conducted in villages, many people were identified who were not availing the benefits of old age pension scheme. The table given below shows the number of people who have been identified for Old age pension scheme (open cases) along with the number of people who have been benefited (selected cases) through rigorous AIPAD follow up (usually found difficult due to lack of documentation or reach). Out of 2330 cases selected by the government, 932 cases have been identified and 686 hard to reach cases have got benefits through AIPAD intervention. Out of 932 cases, 537 were women and 395 were men. 259 cases have been rejected due to failure in documentation process.

Table no 23 Total number of beneficiaries under Old age pension (January –December 2017)

Block

Schemes for Old Age Pension

Total number of

Open 12 cases as per AIPAD MIS

Total number of Rejected13

cases as per AIPAD

MIS

Total number of open cases (women)

Total number of

open cases(men)

Total number of Selected14 Cases as

per AIPAD MIS

Total number of

selected cases as per Government

data

Kahalgaon 114 58 83 31 56 595

Shahkund 53 0 27 26 53 904

Pirpainti 337 6 183 154 344 446

12 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 13 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials. 14 Selected cases are hard to reach cases that have been selected, approved and benefits have been received by the beneficiaries through AIPADs intervention.


Sanhaula 199 182 120 79 17 182

Jagdishpur 229 13 124 105 216 203

Total 932 259 537 395 686 2330

Source : AIPAD MIS

Disability Pension Scheme

There are two types of Disability Pension Scheme; one is Indira Gandhi National Disability Pension scheme, where a pension of Rs. 300 per month (From fiscal 2012-13) to be granted to physically/mentally handicapped individuals living below poverty-line conditions from the age of 20-79 years and at least 80 % disabled. To avail the benefits under the scheme, the eligible person has to submit two copies of duly filled application form along with documents to the concerned Block Development Officer (BDO). After scrutiny, the application is forwarded by the BDO to the Sub Divisional Officer for approval. Following the approval, the approval letter is dispatched to the Post Office, where a savings account is opened in the name of the beneficiary for making the payments. In case of rejection of application, the applicant is duly informed.

Results

There is a another scheme which is run by the Bihar govt. known as Bihar Disability Scheme under this, the person should be at least 40% disabled, living under poverty line or his/her annual income is less than Rs. 60,000/- and those who are not covered under the Indira Gandhi National Disability Pension Scheme (IGNDPS) .The table given below shows the number of people who were identified as difficult cases and benefited by the help of project team during the field visits. Out of total 208 cases, that were identified, 68 hard to reach cases got selected who received their benefits through AIPADs intervention and around 140 cases got rejected.132 men got identified through AIPAD and 76 women. A total of 1929 cases were selected by the government. AIPAD is constantly following up with the identified and rejected cases so that they can also receive their entitlements.


Table no 24 Total number of beneficiaries under Disabled scheme (January –December 2017)

Block


Total number of

Open 15cases as per

AIPAD MIS


Cases as per AIPAD MIS

Total number of open cases

(men)

Total number of open

cases(women)

Total number of Selected17 cases as per AIPAD MIS

Total number of selected

cases as per government

data

Kahalgaon 39 9 24 15 30 278

Shahkund 13 0 9 4 13 937

Pirpainti 56 55 39 17 1 198

Sanhaula 78 75 45 33 3 205

Jagdishpur 22 1 15 7 21 311

Total 208 140 132 76 68 1929

Source : AIPAD MIS

Table no 24 given above shows clearly the progress in the schemes for disability. Open cases are higher as compared to selected ones. Open cases basically reflects that application and identification process has been completed but benefits have not been received. Reasons for open cases are many like lack of documents, medical certificate or voter id etc. AIPAD team has extensively worked on these issues through the camps to remove such deadlocks so that benefits of these schemes can be availed by those who need it the most.

Mukhiya Mantri Kanya Vivah Yojna

This scheme provides financial assistance to the family of the girl child at the time of her marriage, encouraging registration of marriage and to stop child marriage and to provide financial help to get poor girls married off in Bihar.

This scheme is applicable to those girls belonging to below poverty line (BPL) families whose family income is below Rs 60,000 per annum. An amount of Rs 10,000 is given at the time of marriage. This scheme supports the marriage of girls at right age and also prevents dowry.

15 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 16 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials. 17 Selected cases are hard to reach cases who have been selected, approved and benefits have been received by the beneficiaries through AIPADs intervention


Results

Table no 25 given below shows the progress done by AIPAD in this scheme. Out of 249 open cases, 91 hard to cases have been selected and received benefits through AIPADs intervention.158 cases got rejected. 2241 cases have been selected by the government.

Table no 25 Total number of beneficiaries under Kanya Vivah Yojna (January-December 2017)

Block

Schemes for Mukhya Mantri Kanya Vivah Yojna

Population

Total number of

Open18 cases as per

AIPAD MIS


cases as per AIPAD MIS

Total number of

Selected20cases as per AIPAD

MIS

Total number of Selected cases as per Government

Data Kahalgaon 4,23,769 1 1 0 455Shahkund 2,22,769 50 0 50 505Pirpainti 3,18,831 95 68 27 568Sanhaula 2,19,181 98 89 9 301Jagdishpur 1,76,180 5 0 5 412

Total 13,60,729 249 158 91 2241

Source : AIPAD MIS

Parvarish Yojna

The objective of this Scheme is to provide allowances as grant for upbringing/foster care of orphans and children of widows and disabled child (of selected categories) of the economically weaker sections of society. The benefits of the Scheme can be availed by such orphans upto the age of 18 years who are being maintained by their kins, children upto 18 years of age of the widows covered under Laxmibai Pension Scheme and physically disabled children upto the age of 10 years belonging to BPL family or those families whose income is less then Rs. 30,000. The grant allowance is Rs. 3000 bi-annually to be paid though Post Office account in the name of the child and operated by the widow or the applicant family head.

18 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 19 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials 20 Selected cases are hard to reach cases who have been selected, approved and benefits have been received by the beneficiaries through AIPAD intervention


Results

Table no 26 given below reflects the number of cases of parvarish yojna. Open cases are much higher as compared to selected ones. We can see that the uptake of this scheme is very low as only 4 cases have got benefits and 6 have been identified. The reasons for the low uptake are many. One of the foremost reasons is that the criteria for availing this scheme is very difficult as children under the age of 10 years and belonging to the BPL families are eligible for this scheme and their numbers are quite less. Also, the fund allocation for this scheme is quite low. Moreover there is major lack of information about this scheme, not only among community members, but also government functionaries have no awareness about this scheme to identify beneficiaries from their areas. AIPAD has been extensively worked on such issues through the organisation of camps to increase and improve the uptakes.

Table no 26 Total number of beneficiaries under Parvarish Yojna (January-December 2017)

Block

Schemes for Parivarish Yojna

Total number of Open cases21 as per AIPAD MIS


MIS

Total number of Selected23 cases as per AIPAD

MIS


Data Kahalgaon 1 1 0 0Shahkund 0 0 0 0Pirpainti 1 1 0 0Sanhaula 0 0 0 0Jagdishpur 4 0 4 4

Total 6 2 4 4

Source : AIPAD MIS

Kabir Antyesthi Yojna

Kabir Antyesthi Yojna is a unique social security scheme under Govt. of Bihar where an amount of Rs 3000 will be given to the family members of any person who is below poverty line, for cremation purpose, after he/she dies. The best part of this scheme is that there is no age limit for getting benefit. The only condition to avail this scheme is that the person should 21 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 22 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials 23 Selected cases are hard to reach cases that have been selected, approved and benefits have been received by the beneficiaries through AIPAD intervention


be a domicile of Bihar or living in Bihar from last 10 years. This scheme has been running from 2007-08. Mukhiya and Ward members have the power to approve money for Kabir Antyesthi to the needy family who don’t have enough money for cremation purpose. This scheme runs under the Social Welfare Department, Government of Bihar.

Results

Table no 27 given below shows the number of beneficiaries of this scheme. 79 hard to reach cases have got benefits through AIPAD while 121 cases have been identified and are still pending and follow up is maintained. Out of 121 cases, 79 men were identified and 42 women. A total of 1870 cases have been selected by the government while, 42 cases got rejected due to documentation failure.

Table no 27 Total number of beneficiaries under Kabir Antyeshti Yojna (January –December 2017)

Block


Total number of Open cases24 as per AIPAD

MIS


cases as per AIPAD MIS


(men)


(women)

Total number of Selected

cases as per AIPAD

MIS

Total number of Selected26 cases As per Government

Data

Kahalgaon 25 7 10 15 18 436Shahkund 27 0 18 9 27 494Pirpainti 21 20 13 8 1 502Sanhaula 29 7 28 1 22 217Jagdishpur 19 8 10 9 11 221

Total 121 42 79 42 79 1870

Source : AIPAD MIS

Rashtriya Parivarik Labh Yojna

Under this scheme, a financial assistance of Rs. 20000 to the bereaved household in case of death of the primary bread winner irrespective of the cause of death. This scheme is applicable to all the eligible persons in the age group of 18-64. 24 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 25 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials 26 Selected cases are hard to reach cases who have been selected, approved and benefits have been received by the beneficiaries through AIPADs intervention.


Results

Table no 28 given below reflects the beneficiaries of Rashtriya Pariwarik Labh Yojna. Total 21 cases have been identified & 17 cases selected and got benefits under this scheme directly through AIPAD. A total of 255 cases have been selected by government.

Table no 28 Total number of beneficiaries under Parivarik Labh Yojna (January –December 2017)

Block

Schemes for Rastriya Pariwarik Labh Yojna

Total number of Open cases27 as per AIPAD MIS


MIS

Total number of Selected 29cases as per AIPAD

MIS


data

Kahalgaon 9 3 6 107

Shahkund 0 0 0 54

Pirpainti 10 0 10 35

Sanhaula 1 1 0 22

Jagdishpur 1 0 1 37

Total 21 4 17 255

Source : AIPAD MIS

Ujjwala Gas Yojna

Pradhan Mantri Ujjwala Yojana is an ambitious social welfare scheme of Narendra Modi Government launched on 1st May 2016 from Ballia in Uttar Pradesh. Under the PM Ujjwala Yojana, the government aims to provide LPG connections to BPL households in the country. The scheme is aimed at replacing the unclean cooking fuels mostly used in the rural India with the clean and more efficient LPG (Liquefied Petroleum Gas).

India with its vast rural area has a huge population that is dependant on cooking fuel which is Ujjwala Yojana is aimed at providing 5 Crore LPG connections in the name of women in

27 Open cases are those beneficiaries who have been identified for the scheme and their application has been processed but is in the process of pending acceptance 28 Rejected cases are those where there is lack of documentation work or missing documents or wrong photograph etc and these cases are closely followed up by our team members and by redressal grievance mechanism and Liaoning with advocacy group members and block level officials 29 Selected cases are those who are hard to reach last mile population have been selected, approved and benefits have been received by the beneficiaries.


BPL (Below Poverty Line) households across the country. The government has set a target of 5 Crore LPG connections to be distributed to the BPL households across the country under the scheme. Some of the objectives of the scheme are

1. Empowering women and protecting their health.

2. Reducing the serious health hazards associated with cooking based on fossil fuel.

3. Reducing the number of deaths in India due to unclean cooking fuel.

4. Preventing young children from significant number of acute respiratory illnesses

caused due to indoor air pollution by burning the fossil fuel.

The eligible women candidates from BPL families can apply for the scheme by filling up the Ujjwala Yojana KYC application form (in prescribed format). The interested candidates require filling the 2 page application form and attaching required documents along with the form. The basic details such as Name, Contact details, Jan Dhan / Bank account number, Aadhar card number etc are required to fill in the application form. The applicants also need to mention their requirement of cylinder type i.e. 14.2KG or 5KG.

Results

In the current financial budget 2018, the government has provided an additional allocation of Rs 4,800 crore the Pradhan Mantri Ujjwala Yojana (PMUY) and the enhanced the target of beneficiaries under scheme to eight crore from five crore. The government has also expanded the scope of the scheme to cover all the eligible beneficiaries across the country. While earlier the Ujjwala beneficiaries were being chosen from the Socio Economic Caste Survey (SECC) 2011 list, this left out those poor households which were not part of the Survey.In addition to SECC identified households, the government has approved to expand the Scheme to cover all SC/ST households, beneficiaries of Pradhan Mantri Awas Yojana (Gramin), Antyoday Anna Yojana, forest dwellers, most backward classes, Tea and Ex-Tea Garden Tribes, people residing in Islands and rivers.

Table no 29 given below reflects the total number of beneficiaries of Ujjwala gas yojna. Out of 28375 women registered under this scheme, 19191 women have received benefits of this scheme. There has been a sharp growth in the uptake of this scheme where 4318 women were benefited last year and 5456 got their benefits.

Table no 29 Total Number of Beneficiaries Under Ujjwala Gas Yojna(January –December 2017)

Block Schemes for Ujjwala Gas Yojna

Total number of women benefitted

Total number of women registered

Kahalgaon 5336 7112


Shahkund 415 1204

Pirpainti 7204 9323

Sanhaula 2000 3231

Jagdishpur 4236 7505

Total 19191 28375

Source : AIPAD MIS

Rashtriya Swasthya Bima Yojna

RSBY is one of the government schemes to provide financial assistance protection against catastrophic health costs by reducing out and to improve access to quality health care for below poverty line households of pocket expenditure for hospitalization and other vulnerable groups in the unorganized sector. However, this scheme is not functional for now and is in process of functioning again. One of the biggest reasons for non-functionality of this scheme was the medical malpractices carried out by the doctors and the middle men using the benefits of this scheme. As a part of this scheme, government outsourced health facilities to private insurance company for disbursement of the medical expenses to the beneficiaries and that resulted in misusing of the government funds by these private companies and doctors. Therefore, to stop this practice, this scheme was made non-functional temporarily.

Shatabdi Yojana

Under this scheme, state government provides financial assistance to the deceased family belonging to below poverty line. Financial assistance in the form of Rs 30,000 is provided in case of death due to medical reasons and 1,00,000 in case of death due to accidents.

Currently this scheme is not functional and has been discontinued from the government side.

Mukhiya Mantri Kanya Suraksha Yojna

Under this scheme, the Bihar government donates Rs 2,000 each on the birth of the first two baby girls in BPL families. Rs. 2000/- is given to girl child after producing Birth registration certificate and the birth has to be registered within a year of the birth. Assistance is given to only for two girls per family. Under this scheme, an amount of Rs 2,000 is invested in Child Carrier Balanced Plan of UTI Mutual Fund in the name of girl.

Currently this scheme is not functional and has been discontinued from the government side.


2.2.4 Mass Awareness Campaigns

Community Meetings in all the five blocks:

Community meetings are been used as a tool by AIPAD to create awareness about different schemes in domains of health, sanitation, education and social security among the community, especially marginalized and deprived sections of the society. Community meetings have proved to be very efficient tool and have helped AIPAD immensely in reaching the overarching objective of improving access to various schemes. Through these community meetings, not only AIPAD is able to create awareness and provide right information, but is also immensely reaching out to the last mile population. These community meetings provide a common platform wherein people engage and participate in addressing their issues as well as getting the relevant information. Community meeting is a process where people gather together from different sections of the community to exchange their ideas, viewpoints, opinions and information for the betterment of their own society. Community meetings also provide an opportunity for identification of the eligible beneficiaries for a particular scheme thus helping in the follow up process of AIPAD.

Community meetings have proved to be beneficial in all stages of AIPAD’s work. For example, during the initial phase of our work, FLWs used community meetings to explain about our work and about AIPAD and tried to build rapport with the community. These meetings have also proved to be an efficient platform for identifying PRI members and stakeholders. Community meetings also play an important in bringing out various issues that are being faced by the communities and provide their relevant solutions. Normally, our FLW informs each and every person of a village/panchayat through door to door interventions or informing ASHas/ANMs , PRI members/representatives about the meeting and asks them to gather a particular place and time. Topic of the discussion normally comes out from the communities itself or is decided based on the existing important issue that needs utmost attention. Through these community meetings, AIPAD is not only achieving the objective of reaching out to people, but also creating faith in people about government and its schemes.

Results

Table given below shows the number of community meetings conducted by AIPAD as a team in the selected five blocks. In total, 1338 meetings have been conducted across five blocks in which around 12000 people participated. AIPAD plans to continue conducting more and more meetings that the schemes and their benefits can reach out to more and more people.


Table no 30 Total number of community meetings (January- December 2017)

Name of Blocks No of Community meetings

No of people who participated

Kahalgaon 318 2544

Shahkund 95 855

Pirpainti 306 2448

Sanhaula 349 3141

Jagdishpur 270 2430

Total 1338 11418

Source : AIPAD MIS

Youth Group Training: Leadership Development among Rural Youth

AIPAD has been working aggressively for four years on improving the accessibility of the schemes and information access. During its course of work, AIPAD team found out the major issues or barriers that rural people were facing in availing their entitlements were lack of proper information, incomplete or vague knowledge of process, lengthy documentation procedures and vague idea about the role and responsibilities of the concerned government officers/bodies. Addressing the need and existing issues, AIPAD team planned to establish and create a very strong village level ownership so that the villagers are equipped to deal with panchayat and government officials and can claim for their rights and entitlements. To make it happen, it is essential that young generation is involved passionately in the betterment and development of their community and are motivated to become active agents of change. AIPAD decided to involve the youth in the community work and create leadership within the younger generation as there is no better stakeholder to carry forward this work. AIPAD has always believed in the power of youth as most of the field staff of our project consists of local young people who have been trained and motivated to work for the larger good of the community.

Therefore, AIPAD initiated group trainings on government schemes and information access for the youth of the selected blocks of Bhagalpur. The objective behind such trainings was to make the young generation well equipped and informed about the various schemes and services provided by the government so that they are confident and trained enough to face the panchayat and government and claim for their and their community’s rights. Through these youth leaders and their training , AIPADs sustainability goal will also achieved in the sense that they are trained enough to take the ownership of the work and impact lives beyond the specific period of our project.


AIPAD planned to train more than 1000 youths from 18 to 35 years from all the five blocks of Bhagalpur phase wise and 132 youths including girls and boys have been trained in the first round of training across all five blocks. AIPAD will continue to engage the youth in the same format. These young leaders have been actively participating in the community work along with AIPAD . Social security camps, community meetings, various awareness campaigns and ground level advocacy work are being addressed by these youth leaders jointly with our AIPAD team.

Given below is the schedule of the youth group training that was circulated by the team AIPAD:

Training module of Youth group members

Time Subject Objective Methodology

10:00 to 10:30 Management to know the participants Descriptove writing FLW/ CO

10:30 to 10:45 Welcome address

To formally welcome the participants

Oral narrative P C

10:45 to 11:00 Introduction To know each other better Oral exercise Krishna Murari

11:00 to 11:30 Brief about the project

To understand AIPAD oral narration PC

11:30 to12:00 Local self governance structure

प To understand the framework of local self governance

oral narration Krishna Murari

12:00 to 12:30 various schemes

Better understanding of state and central schemes

participative discussion

Krishna Murari

12 :30 to 1:00 Role of youth in a democracy

Understanding the role of youth in democractic discourse

participative discussion

Sanjay Kumar / Team

1:00 to 1:30 Refreshment break

1:30 to 2:30 Social security scheme

detailed information sharing on social security schemes

group discussion

PC

2 :30 to 3:00 Work plan To prepare a work plan for the project period

Brainstorming Krishna Murari

3:00 to 3:15 Thank you vote of thanks Oral narration PC


Figure 25 : Young leaders being trained at youth group training

Results

Table no 31 given below shows the total number of youth leaders that were trained by AIPAD this year. Various handouts like the articles containing qualities of a leader as well as the content on leadership were also circulated among the participants. A total of 164 across all the five blocks people were trained and motivated on the roles of a youth group leaders. Out of 164, 44 females have been trained and 144 male leaders have been trained. AIPAD is extensively working to train more and more female leaders and make them empowered and independent.

Table no 31 Total number of participants in Youth group training (January-December 2017)

Block Name Youth Group Training

Male Female Total Participants Kahalgaon 32 05 37 Shahkund 21 12 33 Pirpainti 22 10 32 Sanhoula 26 06 32 Jagdishpur 19 11 30

Total 120 44 164

Source : AIPAD MIS


Citizen Leader Training

Citizen Leaders or Nagrik Neta are certain enthusiastic persons among the community itself who actively engage in addressing the needs and aspirations of their fellow villagers absolutely voluntarily and solely driven by their own zest and passion for the development of their community. Citizen leaders (CL) are those who would take initiative within the community, having leadership skills and have an in depth understanding of issues of their community. They basically work at the ground level with the community and are identified from the community itself. The Citizen leader is mainly responsible for identifying beneficiaries as well as in information dissemination to the community. Citizen leader as a concept not only makes the community self-sufficient, but also adds on to sustainability aspect of the project.

AIPAD team therefore studied and learnt the concept of Citizen Leaders during the exposure trip at Unnati Jodhpur and planned to replicate the same practice within our project too. Identification of such people and then mobilizing them to become citizen leaders is a very important and crucial process. Mobilization includes preparing such members of the community who are willing to take responsibility and accountability for their village’s development goals. Thus, AIPAD discussed the concept within the team and decided to identify people within our blocks with the zest and zeal to work for the community and train them about the roles and responsibilities of CL.

Following that, an identification exercise took place in all the five blocks for the citizen leaders. The team kept the following points in mind for identifying eligible citizen leaders:

• Having an eye to identify people who are self-motivated and passionate enough to work for the development of their community voluntarily and facing challenges and resolving them simultaneously.

• Capacity building of these potential citizen leaders through various training programs, exposure visits so that they are well versed with their roles and responsibilities.

• Guiding and providing them a platform where they are self-empowered and become agents of change for their own community

FLWs identified such people from their respective panchayats who have already been helping them in working for the community and also those who are willingly to work passionately and voluntarily for improving their lives. Such enthusiastic people were identified across all the five blocks and trained around the concept of ‘citizen leaders ‘and their various roles and responsibilities. The various roles of citizen leaders that were explained to them were:

Citizen Leader helps as:

• He / She is a local villager, who stays in that particular village only


• Citizen leader helps in bringing Sustainability angle to the project • It helps in mobilizing people for community meetings • To do follow up with the people • Brings agendas/issues for community meetings

Such trainings were conducted across all the five blocks under our project. Our project coordinators addressed the identified leaders and explained them about our work as well as their roles and responsibilities. Brief introductions were made about the project work and its objective of reaching out to people. Demonstrations were given by our program manager on the qualities of a leader and how to maintain leadership skills among by using power point presentations and live games with the participations. It was made clear to the participants about the nature of their role and subsequent expectations that this role will have. Case studies of various citizen leaders were also shared and discussed with them to have an understanding of how they have contributed in resolving their communities’ issues. Their action plan was also discussed in brief during the training program which is mentioned below:

Plan of action

• Monthly meeting at Block level • Form an institution at block level & district level • Team will discuss with government officials for resolving the issue of Panchayats

(health, Education & social security) • Time to time discussion with district level authority

AIPAD conduced the exercise this year and a cadre of enthusiastic and self-motivated ‘citizen leaders’ were established and trained by the AIPAD. The main purpose of training and identifying such people is to make these potential leaders self-empowered and self-aware and are willingly to work for their community’s good. These newly generated leaders are trained on AIPADs work also and are working in collaboration at the ground level with the FLWs and are helping in assisting the team in recognizing the ongoing agenda and issues of a village/panchayat. Communities can easily relate to them as they are one of them and even these leaders can understand the issues present at the ground level as they have also faced the same problems. Apart from providing the communities with a leader who is willingly to work for their rights and entitlements, the concept of citizen leaders is adding to the sustainability of our project as these leaders will continue to work as they are being trained by AIPAD, even after our project will get over.

Results

Table no 32 given below shows the total number of citizen leaders identified and trained by AIPAD across five blocks this year .A total of 51 leaders were trained out of which 45 were


male and 6 were females. AIPAD plans to continue such trainings more in the coming year so that these leaders get more confident and empowered enough to face the authorities and fight for their rights and entitlements. Also, more focus will be given to train more and more female young leaders to make them empowered and fight for their own rights.

Table no 32 Total number of citizen leaders trained (January –December 2017)

Citizen Leaders Training

Male Female Total

45 06 51

Source : Data collected from AIPAD FLWs

Figure 26 : Roles and responsibilities of citizen leaders shared by our team

Advocacy group

The idea of forming Advocacy Groups is to strengthen the community ownership and empowering the communities especially the disadvantaged sections to fight and claim for their rights and entitlements. The primary role of Advocacy Groups is to advocate for


systemic reforms, regulations, distribution of resources or other decisions that affect people’s lives and to ensure that such decisions lead to effective implementation. Rural people face systemic barriers in accessing information and entitlements and lack of “voice” of disadvantaged groups is an impediment to community’s development. Therefore advocacy groups are formed in the selected panchayats of all the five blocks to empower the communities and make them self independent to stand up for their rights. The members of the advocacy group are mainly the ward members, ANMs, ASHA, AWW, school teachers and including community members etc. The group has different names and they gather once in a month and a meeting is conducted and the minutes of the meetings are maintained in a register, the discussions over the meeting are mainly related with Government Services being provided and on how to improve the overall status of Panchayats in Health, Education and Social Security.

In pursuit of empowerment of local communities using sustainable strategies, AIPAD team during the period of four years, has been able to form 22 Advocacy Groups across all the five blocks. Regular monthly meetings are organized by these Advocacy Groups to deliberate on issues concerning their respective panchayats. Steps which need to be taken to resolve the issues are also discussed in the meeting, in a participatory manner and consensus is built. Registers are maintained to record the proceedings of Advocacy Groups. The process of formation of advocacy groups is quite simple. AIPAD team identifies people who have been helping our team directly or indirectly in reaching out to the people and facilitating them in getting their rights. People who are aligned with the objective of being the agents of social change and standing up and fighting for their rights are identified by our team. Subsequently, PRI members and stakeholders from all the domains are also identified and a common platform is created by the team wherein community members and ward members gather and participate . Team explains them the purpose of coming together of this group and how this group will be contributing in impacting their lives and their communities. Roles and responsibilities of each and every member of the group are thoroughly discussed. The group members themselves decide a name for the group and a president, vice president and a secretary is selected from within the members. Our team facilities the process and motivates them to start with a fix agenda in every meeting and try to solve the issue themselves. Through this, not only the members will be empowered, but also will be responsible for their own actions.

Results

Advocacy groups have proved to be an effective way of strengthening the community and empowering them for their rights and entitlements. Advocacy groups are not only helpful in empowering the community, but enabling them to take self-initiative to resolve their problems, thereby making them self-independent. AIPAD, this year facilitated formation and functioning of such groups in the selected panchayats. In total, 19 groups were formed under AIPAD project in the selected panchayats this year. Thus, so far the


project has formed 41 functional groups across all the five blocks. ANM, ASHA and AWWs are also members of the groups. Inclusion of ASHA, AWW and PRI members in the group ensures that important issues of the panchayat are raised in a comprehensive manner and resolved following a participatory approach. Advocacy Groups are also critical keeping in sustainability of AIPAD project, where in future, people are empowered enough to fight for their rights.

Table no 33 Total number of advocacy groups formed (January –December 2017)

Sl.No. Name of Block No. of Groups formed 1 Shahkund 11 2 Jagdishpur 07 3 Shanhaula 06 4 Kahalgaon 09 5 Pirpainti 08 Total 41

Source ; AIPAD MIS

Apart from formation of advocacy groups this year, AIPAD specially focussed and worked on the functionality of these groups. AIPAD team through its regular meetings with the group members ensured that the team members are motivated and passionate enough to organise regular meetings and are addressing the issues within their groups. AIPAD faced a lot of challenge in pursuing the members to maintain a constant interest in the activities of the group. Many a times, a lot of members during the meeting deviate from their core objective of the group and start discussions about irrelevant issues. Also, it becomes really difficult at times to gather each and every member of the group at a particular time and place. To overcome these issues, AIPAD team aggressively worked with the group members and explained them the significance of these groups and how these groups are established for the betterment of their own lives. Our team members ensured to be in constant touch with the group leaders and gave them the responsibility of motivating their team members. Also, the group members of some groups decided to eliminate few members who were not fulfilling their roles and were distracting the overall objective of the group. AIPAD team also helped in solving the issues which were not solved by the group itself.

With the constant efforts of AIPAD as well as the group members , advocacy groups in all the panchayats have been able to address many issues such as pension schemes, organising camps and sanitation rallies etc . These group members are now aware about their rights and entitlements and are not sacred to claim them. They are confident and empowered to face the authorities with a lot of conviction as they have the right information with them and are informed about the plan of action. With the efforts of AIPAD, there has been a paradigm shift in the overall ground level scenario, where initially, people were not having right information and were scared to face the authorities. But now these youth group leaders,


citizen leaders and advocacy group members are working in a collaborative way to address various existing issues themselves as they have the right information and are extremely confident and empowered to face any challenge or authority. They have finally broken their culture of silence and are voicing out for claiming their rights , thereby rising above the barriers of oppression and domination. AIPAD team also liasoned with the print media to publish the encouraging work of these upcoming leaders so that the common people can draw inspiration from them and are motivated to stand up for their rights. Similarly, in the Harnath panchayat, there were many issues regarding to the disbursement of the pension money. Common people were having a lot of problems as they were not getting their entitlements. They were visiting the RTPS counter back and forth and each time some excuse or the other was given. They were not given the complete information and their request and problems were being completely ignored. Seeing the ongoing troubles of the common people, Mukhiya of Harnath Panchayat, who happen to be completely involved with AIPADs work and is a member of advocacy group, wrote a letter to the BDO Shahkund stating the behaviour of the RTPS officials and asking the reasons for the delay in disbursement. This was an extremely courageous action taken by the Mukhiya for the benefit of its people and it was even published in one of the local newspapers.

Given below are some news articles which have published the actions taken by our leaders:

Figure 27 : Articles in the newspapers depicting the actions taken by our Citizen leaders &

Youth group Member

Figure 26 : Letter of BDO Shahkund published in the local newspaper


Advocacy Group Members of Baluchak Panchayat

Mentioned below is the outstanding work of the advocacy group members of Baluchak Panchayat and how they contributed in solves the issues of mid day meal .

We would like to share an inspiring work of advocacy group members of Jagdishpur block of Baluchak panchayat who independently addressed the issues of mid-day meal and were successful in solving the issues.

Members of the advocacy group observed that in Baluchak middle school, mid-day meal was not being prepared according to the government issued menu. They visited the school couple of times and witnessed the issue. After that, they directly spoke to the Headmaster of the school and brought this issue to his notice. The Head master assured them to look into the matter. Members rigorously followed up with the Headmaster and made sure that this issue is being given utmost importance. After few days, these members again visited the same school and found out that good quality food was being served as per the menu.

Figure 28: Advocacy group members addressing local issues

Block Level Federation of Advocacy groups: Kshetriyay Samiti

To strengthen the community and empower them for their entitlements and rights, AIPAD facilitates the formation of Advocacy Groups in the selected panchayats of the five blocks. The members of these groups consists of ANMs, AWWs, ASHAs, school teachers etc and the meetings of these groups happen once in a month where issues related to health, education and social security at the panchayat levels are discussed. The objective of these meetings is to advocate problems, and challenges faced by the communities at the panchayat level, get feedback on public scheme delivery mechanisms, and engender better flow of information. Advocacy Groups basically operate at the panchayat level. There are many issues or problems which needs to be brought into the notice of the block level officials and


need to be accelerated at the block level for proper solution. Therefore a platform is needed where unresolved panchayat level issues can be discussed and brought into attention for immediate action. Kshetriyay Samitis are formed to address such issues only. Kshetriyay Samiti is a way for community members to gain knowledge about various government schemes related to education, health and social security and also to raise their grievances and queries about any other problem in their panchayats. The members of the Samiti consist of members from the Advocacy Groups that have been federated at the block level along with different heads at block e.g BDO, Pramukh, CDPO, BEO and MOIC etc. This Samiti normally meets once on a quarterly basis and addresses the following issues :

In order to have a timely solution of the problems, the issues should be reported immediately to the concerned official , in order to avoid any kind of delay

Seriousness of the issue should be understood by the members and solution should be provided.

Members of the Kshetriyay Samiti will be elected from the advocacy group members of the various panchayats only.

BDO, CDPO, MOIC, BEO will also be a part of the Samiti

Results

Following the same path, this year AIPAD facilitated and completed the formation of all Kshetriyay Samitis across the five blocks. AIPAD helped in the formation of these groups and explained them the significance of these Samitis. AIPAD team explained the role of the Samiti to the group members and encouraged them to actively participate in the meetings and to become a sustainable platform to resolve their issues themselves. Table given below shows the name of the Samitis in the respective blocks.

Table no 34 Total number of Kshetriyay Samiti formed (January –December 2017 )

Name of Block Group Name Jagdishpur Sathi Hath Badhana Shahkund Kshetriya Jan kalian Samiti, Shahkund Pirpainti Samajik Sahyog Kshetriya Samiti, Pipainti Kahalgaon Samajik Vikas Samiti, Kahalgaon Sanhaula Samadhan Kshetriya Samiti, Sanhaula

Source : AIPAD MIS


Programme Steering Committee

The program steering committee functioned as the apex review, monitoring and planning body engaging AIPAD partners as well as the government officials. The steering committee was chaired by the District Magistrate of Bhagalpur and co convened by Ms Shubhra Singh as the project lead AIPAD along with state programme manager Nidan Mr Ratnish Verma. Since the third year of the project , this committee has been meeting quarterly to discuss and deliberate on the progress of the project and to also plan for incremental activities and new strategies. These meetings are attended by the Chief Medical Officer, District Planning Officer, District Development Commissioner and other relevant government officers.

Results

This year we conceptualised that one single platform was difficult to address the issues of all the three domains. If we talk about practically considering the ground level, each domain has its own problems and has a wide range of issues to be solved. Therefore, AIPAD team discussed with the District magistrate and his office administration about having a separate platforms for each of the domains so that each domain can get sufficient attention. For health, the platform has been formalised where the team regularly participates in the District Health Society meetings and is a member of the ‘Task Force Meeting’. These meetings are chaired by District Magistrate, MOICs, BHMs and BCMs. Social security and Education platform are still in formulation stage. Social security aspects at the district level will be led by District Development Commissioner (DDC). Education platform will be led by District Education officer (DEO) and District Programme Officer (DPO).

Jan Samvad Rath moving across all five blocks: Moving Vehicle disseminating information among communities

AIPAD intends to work towards improving the socio-economy condition of vulnerable communities through collective demands. In advocacy front there is a need of creating awareness. This year again Jan Samvad Rath was used as a tool to create mass awareness, where mobile vehicle was equipped with all information (innovative IEC materials) related to Education, Health, Sanitation and Social Security Schemes were moved in all the five blocks of Bhagalpur.

Figure 29 : People gathered to see Jan Samvad Rath


Results

The Rath visits in schools, villages and conducts community meetings. Relevant IEC material is disseminated and information regarding various public schemes on health, education and social security is shared with the community. The community meetings organized with the help of Jan Samvad Rath tend to be more effective, as the Rath itself attracts the community and audio recordings of schemes details helps to gather the community and raise their concerns with it. Table given below shows the total number of panchayats covered this year through this rath. A total of 79 panchayats have been covered. This year focus was more on reaching out to the last mile population (hard to reach communities). Rath moved across those panchayats where significant population was last mile, as compared to last year, where Rath covered the entire 109 panchayats.

Table no 35 Total number of hard to reach areas covered by Jan samvad rath

(January-December 2017 )

Name of Block Number of panchayats covered Jagdishpur 15 Kahalgaon 21 Pirpainti 15 Shahkund 14 Sanhuala 14

Total 79

Source : AIPAD MIS

Wall Writings

Wall writings in the selected blocks of Bhagalpur depicting the details of the government schemes also forms a part of our visibility activities. Simple descriptions of the schemes make people aware about the schemes. We have complied with EU visibility guidelines. EU logo including publications, web presence of any kind and banners have been included in all of our reports and newsletters.

Figure 30 : Wall writings depicting government policies


Cycle Pe Soochna: Bicycle moving across backward places disseminating information

There are numerous welfare schemes of Central and State government established for the poor especially marginalised and disadvantaged communities, but rural people are not able to access these schemes because of lack of awareness and right information. To address this issue , AIPAD has been using ‘Cycle Pe soochna’ as one of the tools that has proved to be an excellent approach in information dissemination. Cycle pe Soochna is a new visibility and mass awareness tool introduced by AIPAD. Information about various schemes is shared in the form of recorded voice messages on a moving cycle. Our FLWs also moves along with the cycle. It is serving as a visibility tool as well as a mass awareness tool. It is proving to be one of the best mass awareness tools as it moves and covers intensively dense and remote locations where Jan Samvad Rath cannot reach. These cycles are being flagged off by the Mukhiyas and the ward members of the respective panchayats. There is a huge demand from various panchayats and Mukhiyas to provide them cycle pe soochna tool. It is an excellent visibility tool for project physical display of logos of partners.

Results

Table given below shows the total number of panchayats being covered by our cycle pe soochna. A total of 29 panchayats were covered this year through this mass awareness tool. This year focus was more on reaching out to the last mile population (hard to reach communities). Cycle was moved across those panchayats where significant population was last mile and to the remotest of areas where Jan samvad rath cannot reach, as compared to last year, where Rath covered the entire 109 panchayats.

Table no 36 Total number of remote areas covered by Cycle pe soochna (January –December 2017 )

Name of Block Number of panchayat

Covered

Jagdishpur 8

Kahalgaon 7

Pirpainti 3

Shahkund 8

Sanhuala 3

Total 29


Figure 31: Cycle Pe soochna moving across backward areas.

Information Centres: Soochna Kendras

Rural people face a lot of barriers in availing their entitlements and have to run back and forth to the government departments even for minute information. Even after having the right information, beneficiaries face serious issues in terms of finding the right document or reissuing a missed document or even getting approvals on their documents from their respective PRI members. Since the boarder objective of AIPAD is to act as a bridge between government and beneficiaries and thereby help in improving the accessibility of government schemes, AIPAD has established information centres, ‘Soochna Kendras’, in the five blocks of Bhagalpur that will help in removing the existing barriers to information access and reaching out to the last mile population. This is an attempt to make the process of information access and gathering very easy and quick. The objective of the Soochna Kendra is to bring all public service schemes under one roof and make the process of applying for schemes simple and hassle free. These centres will furnish all the necessary information about the various government schemes and forms, required documents, their eligibility criteria and the procedure of availing them. All necessary information can be obtained by just walking in to these centres. This is an attempt by AIPAD to address the issues of the last mile population and make the process of information access and gathering very easy and quick.

Such centers will not only act as a source of providing the right information but also act as a platform where rural people can go and enquire about any of their queries or problems. These centres will be equipped with all the facilities such as computers, printers, photocopy


machines, application forms etc. These centres are established in government or community spaces keeping in mind the sustainability goal of these centres. Soochna Kendras are not only achieving the broader objective of reaching out to people, but also achieving the sustainability goal of our project. These centres are well established in all the five blocks and are very appreciated by the community members as well as the ward members.

Such Soochna Kendras are established across all the five blocks of Bhagalpur and are providing the following functions:

• Generating awareness about all social security schemes • Providing right and complete information about documentation work for the

schemes • Providing assistance in availing and filling application forms • Providing printed and photocopies of the required documents in minimal charges • Identifying eligible beneficiaries and providing IEC materials on various schemes • Kendra will have lists of voter and BPL beneficiaries of that region so that they can

easily be identified and beneficiaries don’t have to rush to the government departments for availing their copies

• Kendra will also be having list of people whose Aadhar card has been linked with their bank accounts so that they are aware about their current status and therefore can claim their benefits.

• Kendra will be registering complaints of the beneficiaries in hard as well as soft copy along with their names and telephone numbers so that a regular follow up can be maintained with the beneficiaries.

Figure 32 : Soochna Kendra being inaugurated at our block


Results

Table no 37 given below shows the total number of beneficiaries identified and benefitted this year with the help of information centres. A total of 456 cases were identified out of which 171 have benefitted, 903 benefitted by visiting the kendras and getting the right information and the those which are pending are constantly being followed up by our team. It has been only few months30 since these kendras have been opened in all the blocks and still these kendras have reached out ton approximately 1000 beneficiaries. AIPAD in the coming year plans to reach out to the entire population through these centres.

Table No 37 Total number of beneficiaries through Soochna Kendras (January-December2017)

Block Cases identified People who

applied through soochna kendra

People who visited soochna kendras for

information Jagdishpur 72 31 147

Shahkund 10 06 98

Kahalgaon 146 68 249

pirpainti 112 31 211

Sanhaula 116 35 198

Total 456 171 903

Source : Data collected from AIPAD FLWs

Panchayat-Ekchari, Kahalgaon Panchayat-Baluachak, Jagdishpur Sanhaula Block, Campus

Figure 33: AIPAD Information centres opened across all blocks

Annual State Consultation, AIPAD : Replication and Launch of Health cube (Swasthya Slate) in Kahalgaon and Pirpainti.

The Annual State Consultation was held on 27th July 2017 at the Town hall, Bhagalpur. The Annual State consultation ceremony was attended by various government officials from all 30 Information centres in Kahalgaon, Pirpainti and Sanhaula were opened in June 2017, Jagdishpur in May 2017 and Shahkund in November 2017.


the departments such as civil surgeon Dr. Vijay Kumar, Additional District Magistrate Mr. Vaibhav Chaudhary, Additional Chief Medical Officer Dr. Ramchandra Prasad, AACMO Dr. Anjani Kumar, along with PRI members, representatives and advocacy group members. The idea behind organizing this event was to have a platform for all stakeholders to meet and reflect on the impacts achieved and exchange ideas for better community outreach. The AIPAD team was led by Chief operating officer, Ms. Shubhra Singh, Programme officer Ms. Vimmi Lekhi, Programme assistant Ms. Anuja Tripathi , State Manager, Nidan Mr. Ratnish Verma, Project Manager, Mr. Sanjay Yadav and Mr. Prashant Arukia from Health Cubed Pvt. Ltd. Around 650 people participated in the ceremony out of which 150 were ANMs from Kahalgaon and Pirpainti block along with community members.

The Health Cube pilot scale up was inaugurated on the same day i-e 27th July 2017 by the District Magistrate of Bhagalpur in the Annual state consultation held at the Town hall, Bhagalpur. The device will be used in all the PHCs/APHCs/HSCs of Kahalgaon and Pirpainti block. The District Magistrate, Mr Adesh T along with Ms Shubhra Singh of Khemka Foundation and other government dignitaries inaugurated the Health cube device by lighting the lamp, unveiling the device and distributing devices to the ANMs.

Ms Shubhra Singh opened the ceremony by delivering the welcome speech in which she explained the objective of AIPAD and health cube device and how this device has proved to be a lifesaving initiative for rural women. She expressed her gratitude towards the government for the effective collaboration in bringing up this initiative. She specially thanked the District Magistrate, Mr Adesh T for continuous support and enthusiasm for this scale up. She also stated that with the coming of this device, health services will be delivered at the door steps of women of remote areas and hoped that with the constant efforts of ANMs and our team, we would be able to combat maternal and child mortality effectively.

District Magistrate, Mr Adesh T addressed the gathering by acknowledging the paradigm shift that Swasthya slate has brought in Shahkund block in two years. He said that after comparing the results from the Shahkund block, he suggested our team to upscale this device to two complete blocks of Kahalgaon and Pirpainiti, since maximum child and mother deaths are reported from these areas.. He specially appreciated the efforts of Khemka Foundation, Nidan and European Union for making Bhagalpur the first district in Bihar with such high-tech health facility for rural women. He ended the speech by making a promise of scaling this device in the entire district so that every pregnant mother can get her ANC check up done effectively and her entire pregnancy is duly tracked thereby combating the issues of maternal and child mortality.


Sanjay Yadav also shared some of the experiences and challenges while working with the community. He specially thanked the government for constantly supporting our project and motivating us for continuing our good work. A film based on AIPAD reflecting AIPADs work in all the blocks was shown so that people can have an idea of AIPAD project and its goals and outreach. The working of the Health cube device was explained by Mr Prashant Aurkia and the challenges faced were shared by technical expert Mr Ankit Kumar. A vote of thanks was given by Mr Ratnish Verma wherein he specially thanked our chief guest and other eminent dignitaries along with panchayat representatives, ANMs and our community members.

Figure 35 : Health Cube being launched by the DM in the Annual State consultation

Figure 36 : DM addressing the crowd during Annual State consultation

Figure 34 : Newspaper clippings showing the Annual State consultation, Bhagalpur


2.3 List of Activities that were planned but could not be implemented

All activities have been completed as per as the activity plan 2017.

2.4 Assessment of the results of the Action so far

Reaching out to the unreached:

This year being the fourth year of the project gave us sufficient time to tap all the Panchayats of respective Blocks and vice a versa. This year gave us the time to learn and unlearn our experiences of the three years and harness last three year’s work experience /learning’s and relationship building. Apart from reaching out to the last mile population, this year the team focussed on making the project sustainable beyond our stipulated time frame by organising trainings, empowering local bodies and institutions, strengthening established systems and organising activities that would empower the communities .Also this year some of the best practices were replicated in various blocks and activities organized or conducted involved all the panchayats in that particular block. Increase in visibility through wall writings, Jan Samvad Rath, IEC material and media coverage in local news helped a lot in making people more aware and informed about our collaborative approach.

Table given below reflects last year’s progress of AIPAD in terms of total number of beneficiaries reached out in the various government schemes across five intervention blocks. Out of 10 lakh population , AIPAD has reached out to roughly two lakh eligible beneficiaries directly this year. Indirectly through our mass awareness campaigns, community meetings, jan samvad rath , cycle pe soochna and social security camps, we have nearly impacted the whole of the population which is close to 10 lakh.

Table No 38 Total number of beneficiaries reached directly through AIPAD

(January-December 2017)

Schemes Jagdishpur Shahkund Sanhaula Pirpainti Kahalgaon Total Janani Suraksha Yojna 21 52 17 11 10 111Kabir Antyeshti Yojna 240 521 29 21 25 836Kanya Suraksha Yojna 0 0 8 1 0 9Mukhya Mantri Kanya Vivah Yojna

417 555 399 663 456 2490

Old Age Pension 229 53 199 337 114 932Parwarish Yojna 4 0 0 1 1 6


Rastrya Pariwarik Labh Yojna

1 0 1 10 9 21

Schemes for Disabled 22 13 78 56 39 208 Swachhya Bharat Abhiyan (Universalization of Toilets Benefits Received)

242 350 105 342 372 1411

Widow Pension 50 5 41 116 72 284Ujjwala Gas Yojna 4236 415 2000 7204 7112 20967Enrolment of Drop out from AWCs

121 209 151 291 301 2001

Enrolment of Drop out from School

112 153 145 178 196 784

Students Bank Accounts

18150 15975 14715 23768 22345 94953

No of Students covered under Sanitation Campaign in AWCs

1270 1120 1190 1670 1786 7036

No of Students covered under Sanitation Campaign in Schools

1063 1235 1008 1575 1435 6316

Fully Immunized Children Under (9-12 )months

4079 3078 5053 6867 5917 24994

Full Immunized Children More than 16 month

4137 3078 4907 6426 6514 25062

Total Number of Women Received JSY Benefits

3091 2978 3279 6528 3619 19495

Total 37542 29790 32761 55684 50323 206100

Source : AIPAD MIS

Table No 39 Population reached out through mass awareness campaigns and social security camps

Block Total Population Gram Panchayat

Jagdishpur 130690 15

Shahkund 153407 19

Pirpainti 219559 29

Kahalagon 269774 28

Sanhaula 150936 18

Total 924366

Source : AIPAD MIS


Table no 39 shows the total number of population that has been indirectly reached out through our mass awareness campaigns like community meetings, social security camps, Jan samavd rath, cycle pe soochna etc. Around nine lakh eligible beneficiaries have been made aware and informed about various government schemes using the above mentioned strategies.

Some Key achievements of 2017 are

• Replication and Scale up of Health Cube (Swasthya Slate ) in Pirpainti and Kahalgaon :With the Swasthya Slate device being used for over two years in 27 health sub centres(HSCs), 1 PHC and 6 APHCs, women with high risk pregnancies have been regularly identified early in their pregnancies and duly referred for further treatment in the selected panchayats of Shahkund block. Women across backward villages were able to access improved and efficient health services with much ease. The functioning of VHSND changed after the usage of Swasthya Slate. One of the key recommendations of the ROM report in 2016 was that this pilot should be replicated and up scaled in other blocks of the project areas as well, since it has been giving excellent results in Shahkund block. Therefore observing tremendous positive results of using Swasthya Slate in Shahkund block, there was a strong push by the District Magistrate and Chief Medical Officer for a wider scale up and to have a proof concept as a valid and sizeable sample. Acknowledging the fact that it is a lifesaving initiative, both DM and CMO collaborated with the team to scale it up in Pirpainti & Kahalgaon block too. Understanding the need and addressing the recommendation of the dignitaries and the ROM report , NJKF procured a technologically advanced version of Swasthya Slate , ‘Health Cube’ and planned on scaling up the pilot with DHS to two complete blocks of Kahalgaon and Pirpainti so that young mothers and women of these remote areas can get maximum benefits from this initiative.

• Information centres; ‘Soochna Kendras’ in five blocks : Since the boarder objective of AIPAD is to act as a bridge between government and beneficiaries and thereby help in improving the accessibility of government schemes, AIPAD has established information centres, ‘Soochna Kendras’, in all the five blocks of Bhagalpur that will help in removing the existing barriers to information access and reaching out to the last mile population. This is an attempt to make the process of information access and gathering very easy and quick. The objective of the Soochna Kendra is to bring all public service schemes under one roof and make the process of applying for schemes simple and hassle free. These centres are furnishing all the necessary information about the various government schemes and forms, their eligibility criteria and the procedure of availing them. These centres are established either on government spaces or community places . All relevant information can be obtained by just walking in to these centres.

• Youth Group Training One of the various objectives that AIPAD entails to achieve is to make community self-empowered and self-sustainable so that even after the


project gets over, community can perform and take decisions on its own. . AIPAD decided to involve the youth in the community work and create leadership within the younger generation as there is no better stakeholder to carry forward this work.

Therefore, AIPAD initiated group trainings on government schemes and information access for the youth of the selected blocks of Bhagalpur. The objective behind such trainings was to make the young generation well equipped and informed about the various schemes and services provided by the government so that they are confident and trained enough to face the panchayat and government and claim for their and their community’s rights. Through these youth leaders and their training , AIPADs sustainability goal will also be achieved in the sense that they are trained enough to take the ownership of the work and impact lives beyond the specific period of our project.

AIPAD planned to train more than 1000 youths from 18 to 35 years from all the five blocks of Bhagalpur phase wise and in this process 132 youths including girls and boys have been trained in the five blocks until now.

• Citizen leaders Training Citizen Leaders or Nagrik Neta are identified enthusiastic persons among the community itself who actively engage in addressing the needs and aspirations of their fellow villagers absolutely voluntarily and solely driven by their own zest and passion for the development of their community. Citizen leaders (CL) are those who would take initiative within the community, having leadership skills and have an in depth understanding of issues of their community. AIPAD team therefore studied and learnt the concept of Citizen Leaders and planned to replicate the same practice within our project too. Thus, AIPAD discussed the concept within the team and decided to identify people within our blocks with the zest and zeal to work for the community and train them about the roles and responsibilities of CL. In total 51 citizen leaders have been trained by the team. AIPAD plans to continue this process in the next year also.

• Mason Training: Going by the objectives of SBA and considering the importance of mason in construction of affordable and quality sanitary toilets, this year also training was organized by AIPAD for local masons on the construction of low cost toilet model. The idea behind this training was to identify the local masons in the blocks and train them for constructing low budgeted toilets in their regions. AIPAD planned to conduct training for the local masons of all the five blocks on low cost toilet module. The objective behind this training would be to achieve the objective of universalization of toilets at much affordable prices. During the same training, about 533 local masons were trained from across all the blocks. The training of these 533 local masons will impact a population of around 109 panchayats making it approximately to 10 lakh population .

• Federation of Kshteriyay Samiti : This year AIPAD facilitated and completed the formation of all Kshetriyay Samitis across the five blocks. AIPAD helped in the


formation of these groups and explained them the significance of these Samitis. AIPAD team explained the role of the Samiti to the group members and encouraged them to actively participate in the meetings and to become a sustainable platform to resolve their issues themselves and further escalate the matters to higher authorities.

• Sanitation Campaigns and Rallies: Sanitation campaigns and rallies were organised on large scale by our team members in the blocks and importance of sanitation and demerits of open defecation were communicated to them. Campaigns and hand wash activities were organised in schools to promote good sanitation habits and create awareness about various health hazards poor hygiene causes to the community and environment. AIPAD team aggressively organized camps on sanitation and hygiene and spread of water borne diseases knowing that well-crafted health and sanitation campaigns are very effective in raising awareness and promoting health-enhancing practices in rural areas. Apart from addressing the broader issues of sanitation practices, these campaigns and rallies also focussed on the spread of water borne diseases such as diarrhea, gastroenteritis, jaundice, cholera and typhoid. AIPAD strategically planned on involving children in their awareness rallies and campaigns because not only children educate their entire families and their neighbourhood, but also children are affected more than adults as the rampant spread of diseases inhibits children’s ability to absorb nutrients affecting their growth. AIPAD team also involved PRI members, VSS members, and Citizen Leaders, Advocacy & youth groups in addressing the issues around sanitation.

• Strengthening the Advocacy Groups : . AIPAD specially focussed and worked on the functionality of the advocacy groups. AIPAD team through its regular meetings with the group members ensured that the team members are motivated and passionate enough to organise regular meetings and are addressing the issues within their groups AIPAD faced a lot of challenge in pursuing the members to maintain a constant interest in the activities of the group. It becomes really difficult at times to gather each and every member of the group at a particular time and place. To overcome these issues, AIPAD team aggressively worked with the group members and explained them the significance of these groups and how these groups are established for the betterment of their own lives. Our team members ensured to be in constant touch with the group leaders and gave them the responsibility of motivating their team members. Also, the group members of some groups decided to eliminate few members who were not fulfilling their roles and were distracting the overall objective of the group. AIPAD team also helped in solving the issues which were not solved by the group itself.

• Replication of social security camps : Social security camps have been used as a tool by AIPAD to help beneficiaries avail the benefits of the various schemes and facilitating the process of documentation. Since the broad objective of AIPAD is serving as a connecting link between government and its schemes and common people, therefore social security camps have proven to be an effective initiative. AIPAD have been aggressively conducting camps in all the five panchayats. This year


, camps were being organised with the help of PRI members as well as our youth group leaders, advocacy members and citizen leaders. Observing the dedication and hard work of our team and benefits of these camps, even ward members and PRI representatives assisted the team in organising these camps and achieving the objective of reaching out to people. Participation and involvement of PRI members and other stakeholders in these camps is not only installing faith of the people in the government representatives, but also adding to the sustainability of our project. Also, this year major focus was given on addressing the last 20 percent of the population i-e the last mile population. AIPAD team specially worked aggressively towards reaching the maximum number of beneficiaries from the last mile population and facilitating them in getting their entitlements.

• Protsahan Diwas : AIPAD this year celebrated a series of Protsahan divas in all its five blocks and awarded the PRI representatives of a particular village on reaching universalization. Protsahan Diwas has been conceptualized by AIPAD as an effort to identify and appreciate those panchayats and their panchayat heads that have achieved 90 percent of coverage under various social security schemes so as to enhance the effectiveness of the elected people’s representative of a good performing panchayat. 90 percent coverage is considered keeping in mind the 10 percent floating population in the form of new beneficiaries being constantly added and identified for schemes like Kabir Antyesthi, JSY and pension schemes etc.

Key Challenges of 2017 are :

• Few government schemes still lack a proper implementation and disbursement model which makes it difficult for people to access the benefits. Swachh Bharat Mission is one of such schemes where lack of having a proper disbursement model is severely affecting the implementation rate of this scheme among people. Communities do not have initial capital to invest in the construction of toilets which is leading to low uptake of this scheme. AIPAD has been constantly raising this issue among the concerned authorities that people lack initial investment and efforts should be taken to combat this issue for achieving the goal of a ’Swachh Bharat’.

• Few convergence schemes such as Nammi Gange which is an ambitious Union Government Project that integrates the efforts to clean and protect the Ganga river in a comprehensive manner, also has the same issue of not having any proper disbursement model . This scheme is still in operational process. Three of our large blocks such as Kahalgaon, Pirpainti and Sanhaula fall under the Ganga basin and are therefore entitled under this scheme. Due to lack of a proper implementation model, panchayat representatives and other stakeholders have no understanding of this scheme and how to implement this on the ground with the communities. Despite of huge allocation of funds, the ambiguity around this scheme still exits at the state level and therefore this scheme had a major set back. AIPAD , like many others, is trying to push these matters to the higher authorities so that the structural gaps in the scheme


should be duly addressed and communities can go for toilet construction achieving the goal of ODF.

• There is an urgent requirement for rigorous training of the cadre of officials handling the social security schemes from the government side. A lot of rejection of the schemes happen due to spelling errors, misprinted voter ids/Aadhar cards, loss of documents etc . Due to these human errors, turn around time gets delayed resulting in difficulty for both government and beneficiaries. Therefore it is crucial to have trained and competent government employees so that the number of rejected cases can go down and people can easily avail their benefits.

• Since we work in close collaboration with the government officials, our team faces a big challenge, every time, there is a change or a shift at the state level. This year the change of the state level government led change in the secretaries along with the ministers which resulted in issues that our team had to face in terms of delay of processing of applications and other related official work.

• It is extremely difficult to find replacement at the Project/Block coordinators level for the project. Because of the remoteness of the region, it becomes extremely challenging to find recruitment at the block level. Though we try our best to explore locally within our district, but the team faces a big challenge where time whenever a replacement is required.

2.5 Action plan

Q1 Q2 Q3 Q4Domain /

sectorObjective Activity Sub Activity Outcome Person

ResponsibleIndicators

Health R1-To increase the accessbility and uptake of public schemes under NRHM

PHC/APHC/HSC/AWC/RKS/JSY Beneficiary/Swasthya Slate

JSY Beneficiaries-tracking & felicitating VHSND :Mobilising beneficiaries Tracking due listAwareness generation

Banners & IEC Material

Number of Meetings Facilitated

R2-To improve the health services in 5 blocks of Bhagalpur by creating awarness among the targeted communities

Participation & facilitation,following up on routine immunisation

Banners & IEC Material

Number of Meetings Facilitated

R2-To build the capacity and strengthen CBOs

Capacity Building Monthly Block Level Health Workers Review Planning Meeting. Monthly District Level Health Workers Review Planning Meeting

Share the content/minutes. Use it as a platform to raise issues/concerns/gaps. Common observation of the block to be shared during the AIPAD Meeting.

Banners & IEC Material, sound systems

Number of Rallies, Pre & post Analysis

Staff training on prepartion of due list & survey lsit

Staff skilled on tracking due list & survey list

update of due list & survey list

Follow up monthly RKS by the CO and Capacity Building supportWiFi facility at PHC level

ICDS Follow up of 6 services. VHSND : beneficiaries, Awareness generation, complete immunisation, nutrition & THR.

Number of Children benefited

Organising hygiene awareness education at AWCs

R1-Improved sanitaton through better toilet usage & sanitation practices (bcc)

Swacch Bharat Abhiyaan

40 Model Villages to move towards ODF goal

R4-Replicating sanitation campaigns

BCC & Awareness Large scale sanitation campaign to cover schools/AWCs & communities

Annual Work Plan 2018

Annual Report : January-December, 2017 100

Q1 Q2 Q3 Q4Domain /




R3 & R4-Improvement in health services delivery mechanism

Heathcube / Swasthya Slate

Core pilot to continue in three panchayats of Shahkund BlockANM training at Cluster level

Sharing the Impact with State Health Society & Department of Health

Education R1 & R2-To improve Education services & create awareness on RTE

School/BRC/CRC/VSS Orientation/liasoning IEC Material Number of SDP prepared fullfilling RTE

R1 & R2-To increase the accessbility and uptake of public schemes for Education

Siksha Mela & Rally for enrollement

Enrollement-children from AWC & school dropout, never enrolled

Number of plans facilitated

R4-Replicating preparation of SDP inremaining 423 schools by 2018

Facilitate development of SDP in 523 schools by 2018

Training of VSS members at cluster level in 5 blocks

Banners & IEC Material, sound systems

Number of Rallies, Pre & post Analysis

R1-Increase in uptake of Education Schemes

Process tracking & follow up in 800 schools by 2018

Cycle Yojna, Poshak Yojna, Scholarships, implementation of RTE

Banners IEC Material, sound systems, logistic arrangments

Number of Melas organised, Pre & post Analysis

Village wise campaign for regularity in attendance led by VSS

Sensitising VSS members on tracking of irregular children

Social Security To improve the Social security services in 5 blocks of Bhagalpur by creating awarness among the targeted communities

RSBY Enrollement, Shatabdi Yojna, Widow Pension, Old Age Pension, Schemes for Disabled, Kanya Suraksha Yojna, Mukyamantri Kanya Vivah Yojna, Kabir Antyeshti Yojna, Atal Pension Yojna, Parwarish Yojna, Sukanya Yojna, PMJDY

Social Security Camps in collaboration with Panchayats to facilitate access to scheme benefits

IEC Material Number of SMART cards made

Universalisation of social security schemes

60 villages by 2018


Q1 Q2 Q3 Q4Domain /




Capacity building of PRI representatives

Panchayat wise resource mapping exercise in collaboration with PRI members and Panchayat secretary

Engage ward members and community leaders and train them for resource mapping

Jan Samvad: Mass Awarness Campaigns

Spread Awarness about Public Schemes on Health, Education, Sanitation & Social Security

Wall writing/flexis/banners

Block Levels/Focus Panchayats Number of Gram / Aam sabhas conducted

Replication of Cycle pe soochna

100 villages in 2018

Poster printing on health & hyigine

Panchayat appraisal to be conducted by advocacy groups culminating into celebration of Protsahan Diwas of selcted Panchayats

60 villages in 2018

Block information Centres align and collaboration with block development office.

Provide assistance and information to eligible beneficiaries

Identification of 2-3 volunteers for functioning of information centres

Community Monitoring and accountability

To strenghthen existing advocacy groups for accountability & transparency

Capacity building and consolidation of advocacy groups

Regularise monthly meetings and follow up

IEC Material Number of Meetings

Federating Kshetriyay Samitis in all 5 blocks

Capacity building and consolidation of Kshetriyay Samiti

Formation & Meeting of Kshetriyay Samitis in5 blocks. Regular meetings of Kshetriyay Samitis in all 5 blocks


Q1 Q2 Q3 Q4Domain /




Program Steering Committee

Strenghthening and consolidation of District Program Steering Committee

Advocacy State Level Advocacy Liasioning & Advocacy with departments of health, education & social welfare

Issue papers to be presented to the concerned department. Round table with stakeholders.

Public consultation

Others To monitor progress and document good practises and success stories and gaps & challenges

MIS Collection of Individual Case studies of all the domains

Number of case studies

Process tracking - Tracking the process from filing of an application to final receipt of benefits. This would include cases of rejections, denials and grievance redressals.

Training To train project staff on project strategies, goals & objectives

Staff training on strenthening of Advocacy

Capacity building of Community Organisers

Visibilty and Information Sharing

To ensure stake holder communication and adequate visibility for the project

AIPAD Newsletter Documentation of Best practises, sharing them in the FB webpage 'AIPAD page' to keep all the partners updated about the project work and facilitate knowledge transfer. The online Newsletter Jan Samvad which is published every 2 months also mentions the project work and provides insights into the realities from the field.

Newsletter, FB Page

Newsletter Issues, FB updates.


Q1 Q2 Q3 Q4Domain /




Social Media & Website- updating information on common portal for all patners " Jansoochna"

Blockwise Media Consultation

Documentation

Progress Reporting Quarterly Reports

Quarterly Financial Reports

Annual ReportEndline Impact ReportAnnual Financial Reports

Planning & Review

Effective planning and review to ensure timely strategy revision or course correction

Planning & Review Meetings

Weekly Program Team Meeting (PTM)

Monthly CWG MeetingWeekly Block Review & Planning Meeting

Final Impact Evaluation Study



List of all the contracts for the implementation of the action (January-December 2017)

Name of the Contractor

Total contract Value

Total paid amount in 2017 Process of selection

Public Health Technologies’ Trust

and

Healthcubed India Pvt Ltd

The relationship letter between the above entities is already submitted to EU. We are attaching again for your convenience

As per the contract signed in 2017

INR 4,821,117/ EUR 72.48 =

EUR 66516.51

Total –INR 4426874/EUR 55321.19

The selection process was conducted in 2015 when the contractor was selected through a rigorous process of open RFP inviting technology solutions to improve Government delivery mechanisms in the domain of health, education or social security. A sub-committee was formed to compare and analyze the received proposals along with the quotations and the final selection was done based on the recommendations of the sub committee using rating mechanism based on a set of selection criteria. In 2017, the swasthya Slate pilot project was scaled up to a wider geography as per the work-plan submitted and recommendations of the EU ROM. Therefore the purchase of new devices and consumables was done in 2017 as per the new contract signed with Health cubed India Pvt Ltd as no other agency provides this technology and between technology comparisons were already done in 2015 as per the exercise mentioned above.


3 Partners and other co-operation

3.1 Assessment of the relationship between the formal partners

The Nand and Jeet Khemka Foundation (NJKF) is the lead partner for this Action primarily responsible for overall Action management as well as advocacy, visibility of the Action and impact assessment - both internal and external. In order to do this, NJKF has been using an appropriate MIS system for regular monitoring of the Action, and training the implementation team staff (Nidan) to objectively collect data. NJKF is an active partner in understanding the issues/challenges and concerns on the ground and engaged intensively and regularly with the Nidan team and complimented their efforts by providing necessary support as and when required. NJKF also ensured empanelling of experts to conduct external assessments as per the Activity Plan. NJKF ensured timely completion of all reports such as mid- term assessment as well as end-line report and organised regular de-briefings for all three partners. Therefore NJKF worked in close coordination with both partners to understand any such needs as when they arise, by means of its strong monitoring and governance structure, and respond appropriately to such situations. NJKF followed the following procedure for providing proper follow up and monitoring :

Project Planning : All aspects of planning like including stakeholder engagement, benefits mapping, risk assessment, as well as the actual plan (schedule) itself are included in effective project planning. It encompasses designing project goals, project tasks and development of a realistic project schedule, as these three aspects contribute heavily to the success of a project.

We made sure that the project planning process was participatory, thereby involving most of the project stakeholders in the planning process. Annual review and planning exercise was a two stage process this time. First stage was detailed discussion and review of the project by the field team in Bhagalpur. Team conduced this two day exercise to review the last year’s shortcomings and achievements and also formulated a rough work plan for the coming year. This exercise was immensely helpful in designing the project goals and activities. Finally, The second stage was culmination of this exercise into an intense discussion between NJKF and entire AIPAD team in Bodh Gaya, Bihar in the annual training of the team31 . The second day of this programme was dedicated to the review of our project’s impacts and achievements and the formulation of the workplan for 2018. Each of the project coordinators presented their work and challenges and achievements were thoroughly discussed.

31 Please refer to section under the subheading Annual training for team AIPAD for more information


Project Monitoring: We continued to follow the project monitoring structure set up in the first, second and third year of our project. Review has helped us understand how we were performing, whether we were reaching our goals, and decide on the next steps. In fact the monitoring and review exercise was not done in isolation, but was integrated with planning and implementation.

Keeping this design in mind we followed the following review and planning process:

A Core Working Group (CWG) which consisted of the entire team involving members from NJKF, Nidan and TNF. This CWG had regular monthly meetings or monthly calls so that the project activities can be efficiently monitored and evaluated, and in the case of any discrepancies in project deliverables or problems, timely decisions and course corrections could be initiated. This had helped immensely in the successful completion of the project activities mandated for the fourth year of the project period.

Project team meetings (Local) : The local project team in Bhagalpur i.e. the Project Manager, Project Coordinators and the Field Level Workers held regular weekly meetings wherein they discussed about the work done in the past week, the issues/challenges faced and reported to the project manager about whether they achieved their targets or not. This activity had been done regularly every week since the project initiation and had instilled a sense of discipline amongst the field team, along with timely achievement of project goals and deliverables. Meetings of the team at the district level also takes place on fortnightly basis so as to have a discussion on the progress of the work and any achievements that are to be brought into notice.

Organizational review: Another set of review and evaluation of the project work was done on a monthly basis in the form of monthly calls of the core working group including the local team lead by the project lead. In these monthly calls, reports in the form of Monthly Progress Report (MPR) that are send to the core working group by the project coordinators are thoroughly discussed and progress of the work is analysed. These reports are first individually sent by the FLWs to their respective project coordinators and then they finally send it to the entire CWG.

District Review : Regular review meetings with the district team including the chief Medical Officer, District Planning Manager (DHS), Sarv Shiksha Abhiyaan (SSA) officials, District Development Commissioner (DDS), Block Development Officers of five intervention blocks, Sanhaula, Jagdishpur, Kahalgaon, Shahkund and Pirpanti. Apart from this, detailed review, planning and coordination meeting with District Magistrate Bhagalpur and other officials have been happening on quarterly basis. Our team is a member of the task force meeting and is regularly participating in these meetings. Our team members


regularly participate in the review meetings of the ANMs as well. Our team constantly engages with all the three departments ensuring better accountability.

Monitoring Visits : Apart from the monthly and weekly meetings, there were bi-monthly monitoring visits done by the Project Lead (NJKF), at times accompanied by the State Lead (Nidan). The main idea behind such monitoring visits had been to get a first-hand insight into the issues/challenges faced during project implementation and find out appropriate solutions. These monitoring visits had also been very successful in keeping a timely check on the work done by the field team, making sure that the project work is completed in a smooth and undeterred manner. During these monitoring visits, the Project Lead and the State Lead also handled most of the advocacy work at the state, district and block level. It has been found that these monitoring visits has been extremely helpful and fruitful in successful implementation of the project during the fourth year of the project.

Annual Training for Team AIPAD

A two day exposure cum training programme was organized by NJKF for the AIPAD team from 13th December to 15th December 2017. The training programme was organised in Bodhgaya. The training programme aimed at bringing together the entire team of AIPAD and providing them a platform for learning new strategies and approaches from the eminent resource persons, understanding and comprehending grassroots and community based leadership skills so as to implement the same to refine our own work. The overarching objective of this programme was to further motivate and strengthen the leadership qualities of the team members, especially the local youth. The training programme broadly focussed on the self-development of the team members and providing them guidance to enhance their strengths and use them to be an efficient community person. The idea behind this training was to strengthen and encourage leadership skills of the local youth so that there are motivated and empowered enough to further help and support their communities, even after the project is over. The whole team of AIPAD including project lead Shubhra Singh, Programme, Programme Assistant Anuja Tripathi of NJKF, State Programme Manager Ratnish Verma and Project Manager Sanjay Yadav from Nidan office Patna, along with MIS officer, project coordinators, technical engineer and frontline workers were present in the training programme.

The two day training programme created a lot of enthusiasm and motivation among the team members. Day one of the programme i-e 13th December, started with a session on impactful communication and its effectiveness by communication expert from Unicef, Mr. Amitabh Pandey. Mr. Amitabh Pandey addressed the team and opened the session by explaining the importance of communication and how it forms an integral part of any social action. He explained the process and steps of an effective communication and ways of using it while in the fields addressing the communities or taking any awareness campaigns. He elaborated that communication is basically communication change and this change is essential for making


impact in all fields of social change, like health, education, or social security. By drawing on the insights from our own work, he further explained that the key of good communication is active listening and one must understand the difference between listening and hearing. Group games and pictorial representation were used in the whole process which helped the team members to stay enthusiastic throughout the session. The whole session was collaborative in nature wherein the team members equally participated and could immediately connect with the learnings. Towards the end of the session, the team learned that it is important to understand and adopt the effective process of communication and behaviour change that will further enhance their community leadership skills and help them reach the desired impact. .Session one ended with a vote of thanks by Mr. Ratnish Verma to Mr. Amitabh Pandey for sharing such an extensive knowledge on communication. Mentioned below are some of the essential components of an effective communication process, as discussed in the session:

• Introducing oneself • Eagerness to know the issue • Ability to build interest and maintain it • To connect from both sides • Learnings through examples • Repeating to know whether right information has been communicated • Helping • Audibility to the audience • Exchange of ideas • Using graphics and pictures • Active Listening • Story Telling • Comfortable environment • Motivating the new members • Eye contact

Second session of day one was held by Reliance Jio head Patna, Mr. Pravir Kumar. Mr. Pravir kumar has more than 20 years of experience in business operations. He spoke to the team about strategic planning on how to reach out to the last mile population and make maximum impact on people’s lives. By drawing on insights from his own life and his career, he explained to the team that nothing is impossible if one is hard working and has a clear focus to reach one’s goal and passion. He took his own example where he and his team have reached the maximum consumers of reliance jio through consistent hard work and believing in themselves and their goal. He further motivated the team to be innovative and unique in their strategies and approaches so that they are able to reach to the maximum people and communities. The whole session was very enriching and left the team highly motivated and enthusiastic. The day ended with presenting a memento and a vote of thanks to Mr. Pravir Kumar.


Figure 37 : State head Nidan addressing the team

Day two i-e 14th December, opened with Ms. Shubhra Singh addressing the team. She talked about developing professional and leadership skills within one self. She explained to the team that it is very essential to enhance one’s skills and capabilities for development of the individual as well as the work. She further elaborated that it is important to observe any situation or problem and then analyse it properly before moving towards its solution. After this session, Project coordinators started with their block wise presentations on their work and challenges if any. Each PC presented their work properly along with the data and figures and a lot of issues such as maintenance of PC registers, flow of information among the team members, tracking MIS data etc. were discussed.

Session two of day two started with the discussion of the previous year’s achievements and targets as against last year’s work plan. The whole team discussed last year’s progress in terms of impact reached and collaborated in the formatting of 2018’s work plan. Activities and targets of 2018 were thoroughly discussed and the work plan of 2018 was formulated in a participative way.

Thus, the two day of training left the team members with a lot of enthusiasm for the coming year and they were motivated to make an impact in the lives of the people by their work.

Figure 38: Ms Shubhra Singh interacting with FLW Figure 39 :Group photo of team AIPAD


Nidan is the local partner for this action and is responsible for all the activities and results in the Action area. Nidan has more than a decade long experience of collaborating with various Ministries and local bodies in Bihar to advocate in the areas of education, health and livelihoods. Nidan worked with the communities on activities such as awareness generation, influencing beneficiaries and engaging with them for regular follow up to increase the uptake of schemes amongst targeted beneficiaries. Apart from this ,Nidan also worked with local Community based organizations on formation, functionalization as well as capacity building to ensure ownership and sustainability of the action. Nidan on one hand, worked very closely with the local self- government structures at all the three tiers - Zilla Parashad, Panchayat Samiti and Gram Panchayat and, on the other hand also worked in close coordination with the district and block administration and all other relevant departments such as Health, Education, Labour and Social welfare etc.

The Nabha Foundation (TNF) has shouldered the responsibility of the capacity building needs of the intervention. TNF's has an extensive experience in health, education, women empowerment, youth employability, livelihood and heritage programs of which an important component is capacity building of the different stakeholders and therefore TNF supports in addressing the training needs. TNF has helped in developing training modules for specific training needs and collaborated with its partners to deliver the required trainings.

European Union has been a huge support in motivating and guiding us to achieve our desired results and objectives more efficiently. NJKF along with the entire team attended EU annual review workshop , details of which are mentioned below :

EU ANNUAL WORKSHOP

The annual review workshop with all the 14 partners of EU was organized in Ranchi from 25th to 27th April , 2017. The host organisers of the workshop were Pradan, Welthungerhilife and Digital Empowerment Foundation (DEF). Participants of the workshop were Welthungerhilife, Pradan, NJKF, DEF, CESVI, ACTED, SAATHI, FYF, AGRAGAMEE, Action Aid, DSC,GLRA, AKRSP and Unnati. The workshop was organised to reflect and review the project activities, deliberate on the impacts reached so far and plan the collaborative action points for future. EU representative Ms Ansuya Gupta led the workshop.

The three days of the workshop were broadly divided into one day of exposure trip and two days of review workshop and presentation. Day 1 was assigned for the exposure trip of the partners to field sites/offices of Digital Empowerment Foundation at Panchayat Jaria and Welthungerhilife at Panchayat Diyankel. The main idea behind the exposure trip was to give an opportunity to the partners to interact with the community members/DPO’s/beneficiaries/panchayats, depending upon their thrust areas. Day 2 and Day 3 were assigned for the presentations of all the 14 partners and discussions on the future


collaborative plans and any other financial issues or queries. The trip has been divided into two main subheadings which are mentioned below:

Exposure Trip:

First day of the workshop started with the early morning exposure trip to the locations mentioned above. Many interesting ideas and concepts were observed during the trip. The entire team of 14 partners were divided into groups of 2. Group one visited the village Tirla in Jaria Panchayat, where DEF has been working to empower the communities and improving their standard of living. Many useful insights came from this village. Partners visited the Government school, Tirla and interacted with the School management committee members (SMC). These members shared their in depth experience on formulation of School Development plan (SDP) and the impacts it has made on the overall school governance. The team had a fruitful discussion with the members and understood how SDP formulation and its functioning is a collaborative and participatory process including not only SMC members but also community members. The team also witnessed the impact of community radio, an initiative by DEF, which plays the entire guidelines of RTE act 2009 within villages and panchayats so that people are informed and aware about the rights and entitlements of their children. Group one also visited Itki village and witnessed the effective functioning of the DEFs information centre established in the village. The purpose of this information centre is to improve the access and uptake of the public schemes and help the community members to avail their entitlements and rights. This centre is equipped with all the basic necessities such as computers, printers, internet, application forms as well as list of eligible beneficiaries for various public schemes. Beneficiaries can just walk into these centres for any kind of information regarding filling up pf application forms, required documents for availing any scheme, eligibility criteria etc. DEF team with the help of these centres are listing the eligible candidates and filling up the application forms after properly checking the documents. After completing the documentation process, the filled forms are sent to the Gram Sabha for their approval. These forms thereafter are sent to the concerned department. Apart from this, DEF team is using tools such as village level camps, involving volunteers, rallies etc as awareness generation methods to increase awareness and combat the issues of low uptake of schemes.

Group two visited the village Paraiya in Diyankhel panchayat, where Welthungerhilife has been working and impacting communities and people and helping them to access their entitlements and rights. The team visited the Anagnwadi centre of the village and interacted with women Group on using Participatory Learning and Action (PLA) as one of the tools for monitoring issues related to maternal and child health. These women are bringing the issues prevalent to maternal and child health in a participative order by using the PLA tool. Apart from this, the team visited one of the health sub centre which has pictorial description in the form of a list of the services available under these Anganwadi centres so that community people are completely aware and can refer to this list for any kind of confusion. This pictorial assessment tool is one of the excellent methods of community monitoring for better service


delivery Thus, the exposure trip generated a gamut of new ideas and findings that could be learned and used by the partners in future for effective implementation and delivery of services.

Review Workshop:

Review of the workshop started with EU representative Ms. Ansuya addressing the partners and explaining the objectives of the workshop. Partners presented their work and achievements along with future goals and objectives. Many rich ideas and concepts emerged during the presentations which led to healthy discussions among the partners. This time, Organisations were informed before to organise exhibitions around their project in the form of posters reflecting project work, newsletters, and other relevant project materials. NJKF presented an exhibition showing our posters, newsletters, reports etc. Ms. Shubhra Singh from NJKF presented an annual update of our project. A short film on the work and impacts reached by AIPAD was also shown in the presentation was really appreciated.

Collaborative Action :

After the presentations, a fruitful and thorough discussion happened between partners which led to many new ideas and insights. Areas of community concerns and work were discussed and partners presented their thoughts and ideas on it. One of the issues that were given the utmost importance was that as projects are entering the last year of its duration so the learnings and impacts should be consolidated in the form of publications. Consensus was reached about organising a platform where post project period discussions can happen. It was agreed that this platform will be a large body of collaborations. As all this would need a lot of time, therefore most of the organisations were of the opinion that the efficient work that each partner is doing should not suffer and efforts should be taken to take it forward, for the larger good of the people.

Figure 40: Our team organising exhibition of our

project documents at the EU workshop Figure 41: Different EU partners participating in the

workshop


Figure 42 : Our team witnessing participative learning and action (PLA) tool in Diyankhel panchayat

3.2 Assessment of the relationship between NJKF and State authorities in the action area

The team has been constantly working in close collaboration with government officials and department representatives. Regular meetings have been organised in order to sensitize the government officials on the state of healthcare services, education and social security issues, public scheme uptake and effectiveness of delivery system in the 5 blocks of Bhagalpur. We made that the problems and issues existing within various policies and the gaps therein are further escalated and understood by the state administration. We are constantly raising the issues in the implementation policy of Swachh Bharat Mission and influencing the government to recognise the structural gaps in the policy and disbursement model. Even the School Development plan (SDP) format formed and designed by us last year is being used across all the schools in the District of Bhagalpur and other Districts.

We have an excellent working relationship at the district level and with all departments. This year AIPAD proposed DHS to create a platform for escalating and discussing issues prevalent at the ground level related to overall health scenario. District Health society is now organising monthly review meetings to monitor all health related problems including functioning of Health Cube device. AIPAD has been invited to participate in these meetings and is now a member of ‘task force meetings’. Upscaling and replication of Health Cube pilot has happened in close collaboration with the District Health Society (DHS) and the entire health department. District Health society has been extremely supportive and appreciative of the pilot and is playing a proactive role in making it a successful initiative.


We have achieved a good dialogical platform with the district officials where we engage and share information with them. Through our regular follow ups and review meetings, any issue faced whether in implementation of any scheme or policy or grievance redressal or any other issue existing is escalated by our team for its immediate action. And we have always received full encouragement and support from the authorities wherever possible.

3.3 Description of the relationship with any other organizations implementing the action

Associate :

Not applicable

Sub contractors :

Not applicable

Final Beneficiaries and Target groups:

Rural communities in multiple blocks in the district of Bhagalpur (especially women, girl children and unorganized workers, SC/ST, Muslims & other disadvantaged communities), Panchayati Raj Institution members, government. AIPAD has reached out to approximately 10 lakh of the population through its mass awareness campaigns and social security camps.

Other third parties involved : Public Health Technologies Trust PHTT(Health Cube Private Ltd) is involved with the project in providing the devices for technology based pilot ‘Swasthya Slate’(Health Cube).

3.4 Development of links and synergies with any other actions

Project Lead, Ms Shubhra Singh attended the consultation on strategies for Improving access to Public schemes organized by Unnati-Ahmedabad . Ms Singh presented a paper on ‘Swasthya Slate’ under the technological domain of the consultation which was highly appreciated.

DEF (Digital Empowerment Foundation) in association with The Friedrich Naumann Stiftung für die Freiheit (FNF) organised the second Digital Citizen Summit (DCS) 2017 at India Habitat Centre, in which our team participated as a working group member.


3.5 Receiving of any previous EU grants in view of strengthening the same target group

Not applicable


4 Visibility Visibility forms a very essential component of any project. It is about sharing information between all the stakeholders involved in the project. It is going beyond just working together to make sure that everyone is on the same page. In order to ensure appropriate visibility to the project and EU contribution, we had undertaken several activities, details about the activities are mentioned below:

4.1 Online Newsletter

A major activity that have initiated since the start of this project was bringing out the AIPAD online newsletter titled ‘ Jan Samvad : Developing Perspectives’. It is an online newsletter available at the NJKF website which we bring out once in every 2 months. The idea behind the online newsletter is to ensure transparency among various stakeholders and the larger public. It also helps to keep the team updated about the various activities that the project has accomplished over the period of time. Through the newsletter, we have tried to create awareness about the work of AIPAD and also intended to contact regular contact with the various stakeholders. Through the beginning of the newsletter, we have ensured that appropriate visibility would be provided to the EU contribution to the project.

In the March edition of our newsletter, we have talked about the sanitation camps organized by our team in schools of Pirpainti , followed by disability camps organized in Pirpainti and citizen leaders leading the front. May edition talked about Bihar credit cards and our teams effort in creating awareness about it , Rashtriyay Bal Swasthyakaram camps organized in Jagdishpur and chasing the goal of universal education through our camps and rallies. July edition of newsletter talked about upscaling of Health cube in complete blocks of Kahalgaon and Pirpainti , Soochna Kendras impacting the last mile population and Leadership development among rural youth. September edition of newsletter talked about training of ANMs of both Kahalgaon and Pirpainti block and Sanitation campaigns organized by AIPAD along with beneficiaries of Health cube device. January edition talked about Baijutola becoming the ODF village, Protsahan Divas celebrating the universalization of villages as well as masons being trained on low cost affordable toilets.

Each edition of the newsletter has a separate column mentioned ‘Stakeholder’s speak’, where various stakeholders such as BDO’s, FLW’s, Mukhiya etc talk about their experience and their understanding of the AIPAD work and how it is benefitting their own people. Also, we added a new column to the newsletter known as ‘News Feed’ where news related to any recent development in the government schemes or any new scheme launched by the government is mentioned. Apart from that, a table showing beneficiaries of a particular is also a new addition to the newsletter so that the reach out of our project can be easily traced.


Thus, newsletter provides a platform for stakeholders to participate and express their views on the various activities being undertaken under the AIPAD team. Also, mentioning of the success case stories in every newsletter keeps the stakeholders and general public updated about the work of AIPAD.

4.2 Media Coverage

Our project keeps a record of all the newspaper clippings related to our work and our project are well recorded. Local media coverage from block to district level is all available with our team. News about any new development in the government schemes, our work at the various blocks, training of VSS and teachers, PRI training etc. are constantly covered under the local media coverage.

Figure 43 : News clippings showing activities of AIPAD

4.3. Jan Soochna: My information, My right

It is an online portal of EU created for all of its partners to share information and their work. This web portal is an initiative of the Digital Empowerment Foundation to collate and share the learnings of all the partners of EU across India. AIPAD has shared all information about the project, its working, the team, annual and weekly reports and newsletters on the site. Any stakeholder can easily have access to all the updated information about the work of AIPAD.


4.4. NJKF website

NJKF website ensures visibility through its website by putting all the relevant information about the project. Latest information about the project, its progress, updates from the field, newsletters etc. are all mentioned on the website.

In short, we have tried to maintain visibility predominantly through the above mentioned mediums.

4.5 AIPAD Annual Calendar

With briefs from the project and impact photos, AIPAD calendars were widely distributed among various stakeholders, district officials, PRI representatives and community members. These calendars were well marked with EU and other partners logos to ensure visibility.

Figure 44 : AIPAD calendar 2018


4.6 AIPAD Facebook Page

We have created a facebook page for our project AIPAD. This page is accessible to everyone and every little activity or achievement made or done by the project is being uploaded on the page. Pictures and videos of the event are being regularly uploaded on the site for people to further like them and share with other people. It is providing complete visibility and information sharing.

https://www.facebook.com/Project-Khemka-Rameshwar-Lal-AIPAD-

760475584027062/?ref=aymt_homepage_panel

4.7 Wall Writings

Please refer to section 2.2.3 under the subheading Wall writings.

Figure 45 : Wall writings depicting government policies


Name of the contact person for the Action :

Signature:

Date report due :

Date report sent :

action to improve public scheme access and...

Documents