popp 2nd year final report in interim narrative rep 01 march 2010 28 february 2011

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The European Union’s Programme For Bangladesh Interim Narrative report for the period of March 2010 to February 2011 ---------------------------------------------------------------- Promoting Older Peoples participation in Development in Rural Bangladesh This project is funded by The European Union A project, implemented by HelpAge International (HAI)

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Page 1: Popp 2nd year final report in interim narrative rep 01 march 2010 28 february 2011

HAI POPP yearend report Page 1 of 31 -------------------------------------------------------------------------------------------------------------------------------------------------------------------------

“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

This report must be completed and signed by the Contact person

The European Union’s Programme

For Bangladesh

Interim Narrative report for the period of

March 2010 to February 2011 ----------------------------------------------------------------

Promoting Older Peoples participation in Development in Rural Bangladesh

This project is funded by

The European Union

A project, implemented by

HelpAge International (HAI)

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

The information provided below must correspond to the financial information that appears in the financial report.

Please complete the report using a typewriter or computer (you can find this form at the following address <Specify>).

Please expand the paragraphs as necessary.

Please refer to the Special Conditions of your grant contract and send one copy of the report to each address mentioned

The Contracting Authority will reject any incomplete or badly completed reports.

The answer to all questions must cover the reporting period as specified in point 1.6

1. Description

1.1. Name of beneficiary of grant contract: HelpAge International

1.2. Name and title of the Contact person: Nirjharinee Hasan, Country Director,

1.3. Name of partner in the Action: HelpAge International (HAI)

1.4. Title of the Action: ‘Promoting Older People’s Participation in Development in Rural Bangladesh’ (hereby referred to as ‘POPP in Bangladesh’)

1.5. Contract number: DCI-NSAPVD/2008/156-800

1.6. Start date and end date of the reporting period: March 01, 2010 and February 28, 2011

1.7. Target country(ies) or region(s): Bangladesh

1.8. Final beneficiaries: 17,000 older people and 294 Union Parishad (Local Authority) members.

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

Executive Summary This annual report reflects the progress of the actions carried out during March 2010 to February 2011. In the report, description of activities follows the result sequence, not the time sequence of activities undertaken. Accordingly in the 2nd year action plan, the partner has implemented most of the activities during the reporting period. With the support of project staff, the Union monitoring team have facilitated 59 orientation sessions with OPA leaders of the Ward monitoring team and the Union Parishad (UP)1 representatives. A total of 1,401 people (226 Women and 1,175 men) participated in these sessions. Women participation was remarkable in these sessions. These activities have contributed to improved access to government services e.g. social safety nets and health care for vulnerable older people and ensured their inclusion in different local decision making bodies. Involvement of the Union Parishad is one of the important aspects of the project and has become an integral part of the project. In the reporting period, Ward and Union level monitoring teams have undertaken quarterly monitoring visits at least once in each ward and tried to influence the Union Parishad members to ensure their participation during visits. Gradually Union Parishad members were involved in this work and drew the attention of local service providers. Most of the visits were related to understanding the actual situation of service delivery e.g. Old Age Allowance (OAA), Widow Allowance (WO) and also health for vulnerable older women and men. Due to UP member’s participation, these actions have created scope for proper selection and delivery of services among community people.

During the reporting period, a total of 2,031 bi-monthly meetings were arranged at village level, 338 OPAs in the project areas of Moheshkhali, Gongachara and Gazipur sub-districts. On an average 12 OPA members were present at each meeting, where five were older women (source: meeting resolutions). It was observed that participation of older women is gradually increasing at these meetings. The meeting minutes and resolutions have been kept properly. These meetings were mostly focused on project activities and progress, problems and solutions, link with local authorities and service delivery, self initiatives e.g. fundraising, medical support, warm cloth distribution and decision making for strengthening of older people organisations.

Throughout the reporting period, the Union committee organised 107 quarterly meetings (84 regular and 23 additional meetings) among 21 Union level OPAs at the project Union office. Average participation was 17 members from the Union committee. Through these meetings, the

1 The lowest tier of local government comprise of elected representatives from the Union.

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

committee members have developed skills in local level lobbying and advocacy for improved access to government & non government services for vulnerable older people. Also, 175 Ward monitoring teams have conducted 942 quarterly meetings in 21 Unions. Approximately 3,583 men and 1,145 women were present at those meetings. Gradually these Committees became able to conduct meetings individually with proper documentation. They have developed a plan for local advocacy, taken initiatives for resource mobilisation and prepared a database i.e. status of health treatment, no. of bedridden older people, listed eligible older people for Government safety nets programme.

During this period, two regional committees were formed at Gangachara and Moheshkhali sub-districts under Rangpur and Cox’s Bazaar districts on 25 September and 6 October 2010 respectively. The regional committee consisted of 17 members in each committee. These regional committees have started to expand their advocacy activities and strengthen organisational capacity to reach the national level audience. On November 2010, the National Federation of Older People was formed through an annual meeting where representatives from OPAs were present. A total of 45 leaders from different districts participated in this meeting. The executive committee of the national federation consisted of 25 members (2 female, 23 male).

Apart from these, the project has arranged several ‘capacity building’ training sessions and refreshers i.e. leadership development, savings and local resource mobilisation, monitoring, replication methodology to name a few, for the respective OPA leaders and members in the project areas. A total of 2,117 older women and men were trained. These interventions have increased their understanding, skills and confidence to lead on the process of accessing their rights and entitlements from state and non state sources as well as community resources. Throughout the reporting period, several advocacy events were organised. A series of activities has been carried out to achieve targeted actions such as a national level workshop for OPA based advocacy, a fair and cultural show, observation of the International Day of Older Persons (IDOP), human chain etc. The OPA based advocacy workshop was an effort to formulate a national advocacy strategy for the inclusion of older people’s interest and stake in the policy process. This workshop was held in Dhaka at the BRAC centre INN and facilitated by an external resource person. This workshop was considered as a capacity building event mainly for the OP leaders and non state actors like RIC, BWHC etc. OPA leaders from different areas, national activists, academicians, representatives of HelpAge International, Bangladesh and the project staff participated in the workshop.

With the help of HelpAge International Bangladesh, project implementing partner RIC has organised a colourful observation of the International Day of Older Persons (IDOP) 2010 at national and sub-district level. The event was implemented through different activities like the fair and cultural show national level consultation etc. Different IEC materials (posters, T-shirts and booklets) were prepared and distributed during the event. These activities have created a platform for mainstreaming the ageing issues and concerns. Various stakeholders i.e. policy makers, academics, researchers, government & non-government officials, electronic & print media, local authorities including older people at national and sub-districts levels jointly participated.

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

Publications on ageing issues are the most significant strategy to promote and disseminate the discourse of older people’s participation in development. Three newsletters, one booklet and one brochure were published during the reporting period. One web page was also designed during the reporting period.

Successful consultations with the Union Parishad and relevant sub-district administrators were done during the reporting period to better target older people for social safety net services and delivery. The project aims to bring some positive changes in the health seeking behaviour of older people along with change in attitude and service standards of health professionals. PRA exercises, workshops with local service providers and ground work for homecare piloting paved the way for improved health care for older people. Disaster risks of older people in both Moheshkhali and Gangachara sub-districts are being identified and addressed through union level training.

During the reporting period, the partner RIC has organized report dissemination of baseline survey among local elected bodies and local government administration and OPAs at Sub district level. In this period, two staff positions has changed, one was Project Coordinator in central office and another Upazila (Sub district) Coordinator in Moheshkhali Sub district. As per advertisement in a national newspaper ‘The Daily Prothom Alo’ on October 25, 2010, PC has recruited and joined on 16th January 2011. Beside that Upazila (Sub district) Coordinator has internally replaced on 1st January 2011. One of the significant events of the project in the 2nd year was the EU results oriented Monitoring Mission (ROM) visit in the project area in Cox’s Bazar district.

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

Introduction

This report primarily demonstrates the activities carried out during the project period of March 2010 to February 2011. It comprises activities performed based on results and action plan, partner and other cooperation and visibility. The project could not undertake all activities planned for the second year, so those activities are proposed to be done in the second year.

Updated action plan

Year 2

Activity 1 Mar

2 Apr

3 May

4 June

5 Jul

6 Aug

7 Sep

8 Oct

9 Nov

10 Dec

11 Jan

12 Feb

Impl. body

Result 1: 338 strong community based organisations give older people a more participatory voice.

1.1 Project orientation, consultations and advisory meetings with local authorities HAI, RIC

1.1.1.Union Parishad Orientation meeting

1.1.2. Participation by Union Parishad in Monitoring Visit

1.3 Establish 287 new OPAs and monitoring teams and strengthen 51 existing OPAs RIC

1.3.1.By Monthly meeting at Village level OPA’s

1.3.1.1.Querterly meeting at Union level OPA’s

1.3.1.2. Quarterly Ward monitoring team meetings

1.3.3.Strengthen 38 (*51 budget head) existing OPA’s orientation meeting

1.3.3.1. Planning meeting-Develop plan of action to poverty alleviation, Health access and DRR.

1.3.4 Federation formation and Annual meeting-Gazipur

1.4 OPA Leadership training RIC

1.4.1.OPA Leadership Training-3 Days

1.4.2.OPA Leadership Training refreshers (Existing 2 Union) *

1.5 Institutional sustainability RIC

1.5.2 Savings and local resource mobilisation training for OPA at sub district level

1.5.3 Discuss meeting with Union committee to select replication

1.6.Union and Upazila Level Monitoring Training RIC

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

1.6.1 Union Monitoring Training refreshers 19 new unions

1.7 Information collection and sharing among monitoring teams to prepare findings RIC

1.7.1 Regular monitoring collect information from village regarding OAA,WA and Health etc

1.8 OPA to OPA replication of the project approach in 10 village RIC

1.8.1 Visit to organise OP and orient to form committee

1.8.2 Training of the Replication methodology to orient newly formed OPA

Result 2: National NSA partner increasingly capable to develop sustainable community based organisations that can advocate for older people.

2.3 Partner workshop to develop strategy for OPA based advocacy workshop HAI, RIC

2.3.1 OPA based advocacy workshop at central level

2.4 Awareness raising events HAI, RIC

2.4.1 Fairs and cultural shows

2.4.2 Observation of International days for Op

2.4.3 Organising human chain events

2.5 Publication and dissemination of information on ageing issues and policies to NSA and LA RIC

2.5.1 Publication of Newsletter

2.5.2 Publication of Booklet

2.5.2.1 Publication Brochure

2.5.3 Website development

2.5.7 Midterm participatory review

Result 3: More effective, transparent, and inclusive local support to address the poverty of the most vulnerable.

3.2 Consultation with Local authorities for better targeting of poverty allowances for older people RIC

3.2.1 Consultation with Local authorities for better targeting of poverty alleviation for older people

3.2.2 OP union committee meeting with Upazila administration 15 members team /total participants 60/3 Upazila

3.4.Skill training for local authorities on delivery of allowances RIC

3.4.1 Skill training for local authorities

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

3.5 .Explore coping strategies among ultra poor older women (Listing and interview for ultra poor ) RIC

3.5.1 Workshop at the union level

3.5.2 Report compilation and documentation to be use as advocacy tools

3.5.3 Sharing of findings and Action planning workshop at the Upazila level

3.5.4 Lobbying with Union parishad and local donors parishad and local donors

3.6 Documented pilot of OPA sponsorship approach for 100 poorest older women RIC

3.6.1 Case studies collection

3.6.2 Case study review, Editing and preparation of document for circulation to Sponsor

3.6.3 Appeal through print media, Website, poster

RIC

Result 4: More responsive and appropriate local health care and expanded health seeking behaviour for older people.

4.1 Community level health priority setting RIC

4.4.1 Union level PRA exercise

4.3 Workshop with local authorities and service providers to identify barriers to Access and quality health treatment RIC

4.3.1 Workshop to identify barriers to accesses quality health care

RIC

4.4 Skills training for local authorities on health care for older people RIC

4.4.1 Training with local authorities on health care for OP

4.5 Awareness raising sessions for older people on self care and standard of care to expect from service providers (3 days)

4.6 Pilot of community based home care approach in 20 villages RIC

4.6.1: Identification of home care organisers and assistants

4.6.2 : Module development and printing

4.6.2 Training of home care assistants and family caregivers

4.6.3 Deployment of home care assistants and follow up

Result 5: Older people in 19 Unions better prepared for natural disaster.

5.1 Training on disaster risk reduction RIC

5.1.1 Workshop with monitoring team on DRR

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

5.2 Develop and implement community based older people’s DRR action plan in 19 disaster prone union RIC

5.2.1 Community Action Plan exercise at the union level

5.2.2 Implementation of CAP (1 plan each union)

5.3 Documentation and dissemination of older people’s issue in disaster HAI,RIC

5.3.1 Documentation and printing OP issue in disaster

5.4 National workshop to sensitize key DRR actors to the needs of older people HAI,RIC

5.4.1 Workshop to sensitize key DRR actors to the needs of older people.

2. Assessment of implementation of Action activities

2.1. Activities and results

Activities performed are listed below based on result and action plan:

Result 1: 338 strong community based organisations give older people a more participatory voice.

Activities undertaken:

1.1 Project orientation, consultations and advisory meetings with local authorities

1.1.1 Union Parishad orientation

The objective of the orientation was to build rapport with the Union Parishad to ensure better services for vulnerable older people at Union level. At the initial stage the orientation focused on introducing the project as well as sensitization of Union Parishad members on ageing issues. During the reporting period, 59 orientation meetings were organised in 21 Union Parishads. A total of 1,401 participants (Women: 226, Men: 1,175) were present. The orientation meetings were formally initiated by the Older People Committee at Union level. In these orientations, the committee members discussed and shared different issues e.g. monitoring team findings which related to older people’s access to health care and safety nets program, updated progress and constraints regarding the support services for the vulnerable older people in the Union. In the reporting period, 14 OPA leaders were included in 3 UP standing committees2 i.e. Vulnerable Group Development (VGD) committee, Old Age Allowance (OAA) committee and Disaster Risk Reduction committee in the Gangachara sub-district. Also, 185 eligible older people (72 women and 113 Men) had the opportunity to participate in the “100 days Cash for Work” program and 15 OP leaders were selected for the next national population census program of Bangladesh. As a result of

2 As per Union Parishad constitution, there should have 13 Standing Committees on different issues

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

the orientations, older people could contribute to the development as well as raise the voice for vulnerable older people.

1.1.2 Participation by Union Parishad in monitoring visits

Generally, the monitoring teams visited offices, service delivery points and houses of the relevant older people to collect information and to observe the situation. Members of the monitoring team planned and implemented these visits. Presence and participation of Union Parisad members have increased the value of the visit and drew attention to the service providers, so the OP monitoring team members often pursued the UP members to join the visit. Specifically in the Gangachara sub-district, UP members participated more in the monitoring visits. Monitoring visits involved meeting the poor and destitute older people at their houses and enquiring about their wellbeing, checking whether they

are listed in the old age allowance and widow allowance register and whether they experience discrimination and face inconveniences in accessing health services nearby. According to the information collected by the monitoring teams, old age allowance recipients increased by 25 % from the baseline report.

During the reporting period it was ensured that UP members participated in at least one monitoring visit in a

quarter with OP committee members. 182 UP representatives have joined the monitoring visits more

than twice. Most of the visits were related to selection and delivery of old allowance. But in some cases OP members accompanied the monitoring team during the visit to FWC and sub-district health complex. 1.3 Establish 287 new OPAs and monitoring teams and strengthen 51 existing OPAs A total of 338 OPAs were functional during the reporting year, there was a slight change in the OPA formation, a total of 290 new OPAs were formed during 1st year of project implementation (280 through direct intervention and 10 through replication by OPA). Whereas, 48 OPAs out of targeted 51 existing OPAs could be reached through capacity building and strengthening support.

1.3.1. Bi-monthly meetings at Village level OPA’s

Holding bi-monthly meetings at the village level OPA’s is the most regular and routine work of the project. In the first year the bi-monthly meetings focused on developing a mechanism of sharing and decision making for the OPAs at the village and community level. In the second year, emphasis was placed on consolidating the OPA process at village level. During reporting period, a total of 2,031 bi-monthly meetings were organised in 338 OPAs at village level in the Moheshkhali, Gongachara and Gazipur sub-districts. Average participation at each meeting was more than twelve. It is notable that the village committee constitutes of 11 members, so most of

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

Good Practice In the Moheshkhali sub-district, the Regional Older People’s committee influenced and continued negotiation with sub-district administration for a sitting / resting place for older people when they visit the sub-district administration office. The Upazilla Nirbahi Officer (UNO), the highest administrative officer at sub-district level, has allocated a room in the office compound for the older people committee for their exclusive use. The handover took place on November 12, 2010.

the members participated in the bi-monthly meetings. Additional participants were the general OPA members who were interested to join and participate in these meetings. Another significant outcome of the bi-monthly meetings was increased participation of older women in these meetings. The meeting minutes and resolution showed that the discussions were initially more on project activities but later turned into discussions regarding livelihoods constraints of older people in the community. In the second year discussions were also linked with monitoring of Old Age Allowance (OAA) and lobbying with health service providers.

At one of the bi-monthly meetings, village level OPA members realized the benefit of raising their own funds for enhancing their economic protection and empowerment. Therefore the majority of members have taken an initiative to deposit savings in 100 OPAs at village level in the Moheshkhali and Gangachara sub-districts. In the reporting period, they have deposited total of 2, 59,168 BDT in Bank.

1.3.1.1 Quarterly meeting at Union level OPAs A total of 107 Union level meetings took place during the second year in the Moheshkhali, Gongachara sub-districts and the Gazipur district. All the Union level meetings were organised at the project Union office. This office performs as a centre of all OPA activities in each Union. The older people have got easy access to share and exchange information, problems & solutions. There were discussions on different issues like findings of the village committee and ward monitoring team, upcoming events such training, consultations and local level advocacy for getting better services from local authorities. Union level OPAs kept meeting resolutions and relevant information. Average participation at each meeting was seventeen (source: meeting resolution). It is mentioned that Union level OPAs comprise of 15 to 18 members. The average number of participants showed that most of the members of the Union level OPAs have regularly participated in the quarterly meeting. 1.3.1.2 Quarterly Ward monitoring team meetings The ward monitoring team met quarterly during the second year and they organised a total of 700 meetings at which 3,488 team members participated. Gradually committee members were able to develop a plan on collecting information on older people’s vulnerability, health care, list of bedridden older people, list of eligible older people for different a safety net opportunity from government service providers. Additional to this, there were also 242 special meetings in response to the situations and priorities identified by the team members. A total of 1,240 monitoring team members participated in 242 special monitoring meetings. Special situations and priorities related to emergencies (fire, high cold

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

wave, river erosion), health related vulnerabilities and also inclusions of support provided in emergencies by the government and local NGOs. 1.3.3. Strengthen 51 existing OPA’s orientation meeting As stated earlier Project could reach 48 Existing OPAs instead of 51 . Special activities were planned to orient and strengthen the existing OPAs in Choto Moheshkhali Union and Maheshkhali Pauroshava in the Moheshkhali sub-district and Gazipur District . The project planned a strategy to organise and consolidate the spontaneous existing OPA’s learning and initiatives on poverty alleviation, health care access and Disaster Risk Reduction (DRR). During the reporting period, 2 meetings were conducted by the committees at Union and village level in both Unions. A total of 60 OPA leaders (19 women and 41 men) participated at the meetings.

1.3.3.1 Planning meeting - develop a plan of action for poverty alleviation, health care access and

DRR. The activities were undertaken to develop a participatory plan on three critical themes; poverty, health and DRR. It was a step by step process and event based. A central project team developed guidelines to implement activities in order to develop a participatory action plan with a bottom up approach in two selected Unions of the Moheshkhali sub-district. The guidelines were shared with the project staff of the Moheshkahli sub-district and assigned them to initiate the process. Two Union facilitators conducted six planning workshops at ward level for sharing the problems, learning and practical actions on the above mentioned themes. These workshops were organised at the regional project office of Moheshkhali sub-district. On average 25 leaders from village level OPAs participated in each ward level workshop, among them 40% were older women. These planning workshops created an understanding about how the ward level findings feed into the Union level integrated planning on poverty, health access and DRR for older people’s wellbeing. Annex 1- guideline and schedule 1.3.4 Federation formation and Annual meeting The objective of the National Federation is to strengthen organisational capacity for national level advocacy. On November 1, 2010 the ‘National Older People’s Federation’ was formed through an annual meeting. 45 leaders from different districts like Cox’s Bazar, Rangpur, Gazipur, Munshigonj, Narshingdi and Pirojpur participated in the meeting. The executive committee of the National Federation consisted of 25

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members (2 female, 23 male) and reviewed the draft constitution. This meeting created a strategic scope for successful advocacy at national policy level for older people’s rights. On the other hand two regional committees were formed on September 25, 2010 and October 6, 2010 in the respective two sub-districts Gangachara and Moheshkhali. Each committee comprised of 17 members. 200 OP leaders participated in the formation process of the regional committee in both areas.

Annex 2 -committee list

1.4 OPA Leadership training 1.4.1 OPA leadership training - 3 days A 3-day long leadership training was arranged in 19 unions in the sub-districts of Moheshkhali, Gangachora and Gazipur. Leadership training in Gazipur was different from the other two areas. The leadership training in Gazipur focused on the OPA to OPA replication in the selected villages. A total of 630 older people participated in this training. At least 40% of the participants were older women. The training module prepared was based on the field needs and current context. Contents of leadership training included problem analysis, communication and other skills and factors of developing successful OP leadership. The module also emphasized participatory training methods like group work, group presentations and structured experience sharing. We could cite an example of a comment by an OPA leader, “this training helped us to understand our problems and roles on how to solve them.” One woman leader also said, “This training helped us to come out from our homes and now we are confident that we could go to the Chairman and Upazilla (sub-district) Parishad and even to the Upazilla Nirbahi Officer (UNO).” Annex 3 - Training schedule of Leadership training

1.4.2. OPA Leadership Training refreshers (Existing 2 Unions) Similarly, 2 (3-day long) refresher leadership training sessions were arranged for the OPAs in the existing two Unions i.e. Choto Moheshkhali and Pourashava, as they received similar leadership training in the previous project. To avoid the duplication of the training, refreshers were planned only for these areas. A total of 60 OPA leaders attended the training. The participants of the refreshers in existing Unions were experienced OP leaders and they could easily grasp and review the key contents of current leadership training. They also related the learning from such refreshers training sessions with the focus on the new project. It is notable that the previous project was more focused on the realization of rights and the current project is to promote participation in development activities. 1.5 Institutional sustainability Institutional sustainability of the project was mainly defined in terms of capacity building, linking to resources and scaling up from own resources. Specific activities were: i) training, ii) initiating process of

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savings and local resource mobilisation, iii) expanding the organisation through OPA to OPA. All the project training on Leadership, Monitoring and DRR included directly or indirectly some content which could be linked to the practices of sustainability but savings and resource mobilisation training considered to be directly related with the sustainability of the OPA.

1.5.2 Savings and local resource mobilisation training for OPA at sub-district level Savings and local resource mobilisation training needs were articulated by the OPA leaders. This training actually addressed the problem of resource shortage of OPAs for their organisational continuity. Two training sessions on these issues took place in both sub-districts, Moheshkahli and Gangachara. The module of the training was developed on fundraising and mobilising local resources. Contents included scope of older people’s savings management and protection of these savings. The local resource mobilisation training focused on possible local resources and practical strategy to mobilise and use these resources for the interest of OPAs. The methodology of the training was mainly brainstorming, participatory group exercise and group presentations. A total of 180 older people (55 female and 125 male) have received such training in the sub-districts of Gangachara and Moheshkhali. Outcome of the training clearly led to better management of savings collection by the OP committee. Now most of the committees have maintained recording the saving transactions. Initially 25 OPAs opened bank accounts for institutionalizing member’s savings. Some of OPA leaders planned to get “Khas land” (government property) allocation through local advocacy for their office. Annex 4- Training Schedule

1.5.3. Discuss meeting with Union committee to select replication

Two very experienced OPA union committees of the Pubail and Nagori Union of Gazipur district have been selected to facilitate the replication process. Project staff had two discussion meetings with these two Union committees and oriented them in regards to the objectives of replication and reached an agreement for replication. 1.6 Union and Upazila level monitoring Training 1.6.1 Monitoring Training refreshers Two batches of refresher training sessions were conducted in each Union. A total of 38 batches were completed this year. There were 25 participants on an average in each batch. Total participants in the Moheshkhali sub-district were 538 and 464 were from the Gangachara sub-district where 23% and 15% respectively were older women. The training content was information identification, data collection, record keeping and findings and sharing and dissemination.

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

Good practice Haider Ali, age 65, in Maliper Bazar under the Barabeel Union in the Gangachara sub-district in Rangpur district was seriously injured by a road accident a few days back. The monitoring team in Barabeel Union was visiting near the hospital and quickly arranged an urgent meeting for proper treatment. They were trying to raise funds from team members and other affluent people at local and sub-district level. After the treatment, Haider Ali was recovering which was beyond his imagination. The committee members are regularly keeping in contact with him and observing progress. This initiative created inspiration among OPAs.

Annex 5 - Training Schedule Monitoring Training refresher 1.7 Information collection and sharing among monitoring teams to prepare findings 1.7.1 Regular information collection from village regarding OAA, WA and Health etc In the Moheshkhali and Gangachora sub-districts, Union and ward level monitoring teams were regularly updating information on old age allowance and widow allowance and health condition of older people at the village level. Basically the ward level monitoring teams monitored access to and delivery process for vulnerable older people. The monitoring teams also shared their findings with social welfare field staff for correcting the lists and selections. There are 196 monitoring teams at the union and ward level and 3 visits were conducted in the second year of the project. Training initiated more systematic monitoring which produced the following outcomes:

Monitoring teams have initiated financial support from local sources for medical treatment

Laxmitari Union in the Moheshkhali sub-district is furthest from the sub-district head quarter and also lacks health care facilities for local people. The older people are more vulnerable there and deprived of treatments. In that situation, the monitoring team has been negotiating with the local authority as well as the sub-district health office to ensuring health care support especially for older people in this area. As result the local authority’s main health department has organised a satellite clinic for older people in this area

1.8 OPA to OPA replication of the project approach in 10 villages As a result of the replication process, ten new OPAs were formed in ten villages of the Timulia and Raria union in Gazipur district with the support from two very experienced OPA union committees of the Pubail and Nagori Union in Gazipur district. In this case, the OPA representatives of Pubail and Nagori Union act as the facilitator of the OPA formation process. This effort demonstrates a positive step towards the OPA-OPA linkage and forecast a possible strategy for organisational sustainability of OPAs and their federation. The following activities were undertaken for replication. Annex 6– List of Replicated areas 1.8.1. Visit to organise OP and orient to form a committee

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Leaders from two Union committees of Pubail and Nagari undertook systematic visits to streamline the replication process in the target Unions and selected villages. The visits covered several purposes. Firstly they collected information on the community and specifically older people from Union Parishad office and other formal sources. Secondly they mobilised older people to build their own organisation. Thirdly they supported and oriented selected older people on the process of committee formation, operation and its initiates. 1.8. 2.Training of the replication methodology to orient newly formed OPA

Orientation training was organised for the newly formed OP groups. A total of ten batch training sessions were conducted among ten OPAs; an average of 30 older people attended each batch. About 45% OP participants were older women. A training module on orientation was developed and clearly listed the contents of replication concept, methods and activities. The methodology was very interactive among the participants. OP resource people from old Unions shared their experiences on organisation building and actions. As a result, the new committees understood the building process and got the road map of developing a self sustainable OPA. Result 2 National NSA partner increasingly capable to develop sustainable community based organisations that can advocate for older people 2.2 Participation in capacity building events arranged by HelpAge International This event was not planned during the reporting year , though two capacity building event took place which does not have any budget implications. During December 2010 one Emergency working group has been established which includes HelpAge and RIC staff with a view to share experience and learn together. During February 2011 HelpAge arranged training on Protection policy for Vulnerable Children and adults. This helped both partners to understand the protection issues for elderly people in Bangladesh. A regional Partners meeting will be arrange during May 2011, which will create a scope to lean from regional experience from HelpAge International partners from south Asia region. 2.3 Partner workshop to develop strategy for OPA based advocacy workshop 2.3.1 OPA based advocacy workshop at central level OPA based advocacy workshop at central level was an endeavour to formulate national advocacy strategy for inclusion of older people’s interest and stake in the policy process. It was not a workshop to disseminate and share the message with the policy makers. Actually it was a capacity building workshop mainly for the OP leaders and non state actors like RIC, BWHC etc. This workshop was organised by an external resource person at the BRAC centre INN in Dhaka. Forty six representatives like OPA leaders from different working areas, national activists, academics and the project staff attended this workshop.

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Objectives of the workshop were: i) To create an understanding among OPA leaders and other facilitating organisations of issues

relating to national level advocacy strategy development for the well-being of older people in

Bangladesh

ii) To identify the policy context of national level advocacy strategy development on ageing

iii) To identify the factors of successful advocacy strategy for OPA

iv) To generate an outline and action plan for implementing the national level advocacy for the OPA

Major advocacy issues came up from group works are:

Mass awareness on older people’s problem and inclusions

Collaboration/Alliance building to promote the participation of older people in all levels of national

lives

Effective campaigning using all the media to disseminate the message relating to older people’s

problems and potential

Training for both orientation and capacity building of OPAs

Dialogue, discussion and lobbying at the policy level

Annex 7 – Group work & schedule of National Workshop

2.4 Ageing awareness rising event 2.4.1 Fair and cultural shows A fair and cultural show was arranged as part of the International Day of Older People (IDOP) observation. The event was attended by a folk singer to disseminate a message on ageing and older people in a musical way. This cultural show was organ ised along with older people’s rallies and mobilisations. Rallies and the cultural show went together. (Details on IDOP observation in 2.4.2)

2.4.2 Observation of International Day of Older Persons: For older people IDOP is a day of celebration, interaction and to raise their voice together for their rights. IDOP observation was planned at local and central level simultaneously. At the sub-district level, the project has supported the rallies and cultural show took place under International Day of Older People (IDOP). The procession of older people from the villages and Unions reached the sub-district headquarters. It was a very festive mood of older people; 600 older people gathered in the open field at sub-district level. They were very vocal and chanted slogans in the gathering. Almost all officials from the Upazilla administration, including the sub-district administrator (Upazilla Nirbahi Officer) joined the gathering; the main procession started and was attended by all including the Upazilla (sub-district) chairmen and Parliament member’s representatives. At the end of

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the procession a short public meeting was held in the Sub-district compound. During speeches all the government and public representative made commitments. The commitments were:

The Upazilla (sub-district) chairmen and Parliament member’s representatives promised older people to provide land for their own office.

The sub-district Health Officer offered older people to provide older people’s friendly health treatment.

At the National Level three activities were implemented under the observation of IDOP in 2010. These activities were a mobile cultural show, national level consultation, preparation and distribution of campaign materials (poster, T-shirts and booklet). Mobile cultural show: The central cultural program was a mobile folk (baul) music team who performed on a mobile stage which moved and was stationed in different public places for singing about older people’s issues and the theme of IDOP. National level consultation A national level consultation was held in Dhaka at the CIRDAP auditorium. Mr. Mahamudur Rahman Manna, a political leader and media personality, has graced the occasion as chief guest. Several academic researchers, national OPA leaders and other NGO and development organisation representatives participated in the national level consultation and mainly discussed the national situation of older people in terms of policy and actions. Civil society participants were very enthusiastic about implementing action points in the interests of the majority of vulnerable older people. Journalists from both electronic and print media were present there. Finally four media items were broadcasted through electronic news. Some national and local newspaper covered the events in the news also.

Prepared and distribution of campaign materials (poster, T-shirts and booklet) Poster, T-shirts and booklets were prepared to display and disseminate the messages of IDOP 2010. The message was “Older Person’s and Achievement of the Millennium Development Goals”. It indicates focus should be on older people’s poverty, health and older women’s vulnerability in a wider campaign on MDG. This spirit was added to posters, T-shirts, and also in booklets. All the campaign materials were distributed in the project areas to make information and knowledge available for the growing number of interested groups i.e. students, NGO workers, social and demographic researchers for promoting the awareness of older people’s participation in development.

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RIC found a document which listed websites and held information and knowledge relating to promote older people participation in development. Therefore, RIC planned to translate this document into Bengali and prepared a booklet for current and potential users of digital knowledge on ageing and development. Annex 08 - Observation of IDOP , Photos and and paper clippings 2.4.3 Organising human chain events Organising human chain was an innovative demonstration of people’s power and will. Human chain is a peaceful technique to raise the voice for rights. OPA leaders have organised two human chains during observation of the International Day of Older Person (IDOP) 2010 in Moheshkhali and Gangachara sub-districts. Both events were very colourful and disciplined which drew attention of the general mass of sub-district headquarters. It was a subsequent event of gathering in the Upazilla (sub-district) complex. A total of 1,300 older people (353 female, 947 male) participated in the human chain events in Moheshkhali and Gangachara sub-districts. 600 older people were in Gangachara and 700 were in Moheshkhali. More than 100 participants stood along the human chain holding placards with written slogans relating the spirit of the IDOP.

2.5 Publication and dissemination of information on ageing issues and policies to NSA and LA: 2.5.1 Publication of Newsletter:

Three quarterly newsletters named “Probin Kontho” were published during the reporting period. Newsletters represented analytical theme based articles on ageing issues. A brief description about the newsletters is as follows: First issue of Quarterly Newsletter: First newsletter of this project was essentially based on the project themes, perspective and other information which had relevance to the project implementations. The main objective of this issue was to introduce the project and it proved effective to let the people know about this project. Second issue of Quarterly Newsletter: The second quarterly newsletter focused on “local institution and the older people of Bangladesh”. The newsletter mainly analysed older people’s positions in terms of local institution’s relations and responses. The issue included comments and assessments of older people’s issues by the head of the local administration along with analysis of relations. Third issue of Quarterly Publication: The theme of third quarterly newsletter was Older People’s Organisations (OPA). The Older People’s Organisation is very critical to promote social protection for vulnerable older people and also mainstreaming the ageing issues. At the time information and knowledge relating to OPA was not very organised and systematic. It is a very emerging paradigm so at this moment needs more patients, more debates, more questions and discussions. So this issue of the newsletter was planned to focus on OPAs. Mainly this issue covered minimum contents relating to older people organisations. The contents were broadly, “What it means by Older People’s Organisation and why, RIC’s experience with the development of older people’s organisation, Organisational

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Experience Sharing (Interviews), another article on “older people’s organisations: Organisational initiatives and facilitations” indicated older people’s activities, initiatives and successes. Target group of newsletters: Generally all stakeholders of this project are the target group of these newsletters. OPA leaders and members are the first target group, and then come the union parishad members and chairmen, other service providers, political personalities, general community people and other stakeholders. Distribution of newsletter at different levels of community was intended to influence and engage wider tiers of people whose understanding and views matter for promoting older people participation in local development activities. 2.5.2 Publication Booklet: One booklet was published titled “Concept, context and direction of older people’s participation in development”. This booklet was planned to present information, analysis and knowledge relating to the concept of older people participation in development. The contents of the booklet mainly tried to link the concept of development, participation and analysis of older people’s context. It is a tool of promoting project ideas among knowledge workers like students, teachers, and development workers/activists. 2.5.2.1 Brochure: A brochure was published on “Introduction to the process of building a national OPA federation in Bangladesh.” This brochure actually introduced the OPA structure and processes. The aim of the brochure was to make the identity of the older people organisations strong so that they could independently run their organisations and it is consistent with the project spirit of strengthening the non-state group organisations or institutions.

2.5.3 Website development: The substance and information on this site is very relevant to older people’s participation in national and local level development activities. Through the site; interested groups, educated OP leaders, workers from non state agencies, organisations, students, professionals, and decision makers could get a scenario on ageing issues as well as some news, related publications and writings. The website will also be used in emergency appeals for assistance of vulnerable older people and the situation of older people is also uploaded. In addition to that, this site will contain contact information and helps network building. The website will also maintain links with all the relevant national and international sites focusing older people and development. The website development process is ongoing and will be completed after approval of the design and content from the EU delegation Bangladesh in its visibility context. 2.6 project monitoring

In the second year, Project monitoring was strengthened from head office and sub –district. Project

coordinators stayed long in the field and monitor the quality of project activities. Apart from the PC, training Coordinator frequently visited field and directly joined training to monitor the training and gave regular feedback of training to sub-district level project trainers to improve the training. Both

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Regional Project coordinator and Trainer Cum Mobiliser had regular monitoring responsibilities in two levels, first they jointed the training and consultations at Union level and helped in reporting writing and collecting relevant information related to the progress and outcomes of the event. Second, they also checked register, resolution and work plan and staff time use. It helped them to improve the project implementation decision making.

Furthermore, there was an extensive monitoring from and field presence HelpAge Bangladesh country Office 2.7 Midterm Participatory Project review and final External Project Evaluation 2.7.1 Midterm participatory review This activity could not be completed during the reporting period, however all the preparatory activities have been completed and it is expected to be completed by the end of April 2011. The objectives of the midterm evaluation are as follows: i) To generate data and information on the current progress of the implementation activities ii) To evaluate the quality of implementation of the activities iii) To assess the planned results of the project so far generated

Annex 09 – Guideline of midterm review 2.7.2 External Final review: This activity is planned at the end of the project

2.8 Audit One Internal audit has been done during 1st year of the project, another is planned by June 2011

Result 3: More effective, transparent, and inclusive local support to address the poverty of the most vulnerable 3.2 Consultation with local authorities for better targeting of poverty allowance for older people Consultation with local authorities for better targeting of poverty allowance for older people indicated a process based action to make the existing poverty alleviations more effective for the vulnerable older people at the village level. Union Parishad (UP) as a local government body and social welfare department was actually involved in selecting the eligible group for poverty allowances. The appropriate and just selection is a challenge of local authority to improve the safety-net programme in the Bangladesh. Targeting and selections are closely related. Information, lists, understanding of the criteria reaching the appropriate group all are part of targeting. In this project targeting the vulnerable older people for old age allowance (OAA) is the main responsibility of UP members. One of the issues in correct targeting and correct selection is information of the target group. The project also designed consultation with local authorities to share information for removing the gap of understanding between providers and recipients. This gap is actually more than just information; it also is a gap of authority and power. Consultations and interactions are supposed to help sensitize the provider side

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to use their authority ensuring the selection of the most vulnerable eligible individuals and groups for poverty allowances. Here, poverty allowances are old age allowance and widow allowance. 3.2.1 Consultation with local authorities for better targeting of poverty allowances for older people

After one year of the project the older people monitoring team successfully listed the vulnerable groups and ranked the individuals in the groups. So these lists became a tool of informing local groups about the problem of selections. In the consultations older people presented the lists and demonstrated how many deserving older people are deprived of support from old age allowances. 213 such consultations took place in three areas; Gongachara, Moheshkhali and Gazipur sub-district. A total of 418 participants (76 female, 342 male) attended.

OPA leaders were the key stakeholder of the consultations. They presented problems, proposed solutions and pursued the UP members to undertake some positive actions (a wide verity of actions from including the OP in VGD, relief list etc. to make requests to health service provider to give free medicine and treatment). They also clearly pointed out that the positive selection and delivery of old age

allowance could be a source of quality support for older people. The outcomes of the consultations were a new partnership between OPA leaders and Union Parishad demanding to work out a sustainable solution of old age allowance. This partnership is still working to change the attitude and behaviour of UP member and chairmen towards the older people community as a whole. Another outcome was that some UP leadership became proactive to include older people into VGD, VGF, 100 days work. 3.2.2 OP union committee meeting with the Upazila (sub-district) administration 15 members team / total participants 60 / 3 Upazila These meetings were planned for the first year of the project. However, considering the local context after reviewing it, it was decided that these meetings would be organised after building adequate rapport with local administration, which would be more effective. Therefore these shifted to the second year. Subsequently in the second year, three meetings were organised in Gongachara, Moheshkhali and Gazipur Sadar sub-districts. On average 20 leaders participated these meetings. Upazilla Nirbahi Officer (UNO) as sub-district administrator was present in every meeting and was a patient listener to older people’s oral presentations. The meetings were held in the Upazilla (sub-district) conference room, so they drew attention from other government officers and gradually they became aware of the older people organisation and their strength.

3 10 consultations in Gangachara, 9 in Moheshkhali and 2 in Gazipur

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3.4. Skill training for local authorities on delivery of allowances 3.4.1 Skill training for local authorities Skill training for local authorities were linked to the Union level findings and consultation on old age allowance, widow allowance and other relevant allowances. Experience and findings from Unions constituted the presentation for training workshops with local authorities. The participants were from the department of social welfare, Union Parishad, District Relief and Rehabilitation Office, representative of local parliament member, journalist and OP leaders. Training sessions were conducted at Upazilla (sub-district) hall room in Gangachara and Moheshkhali sub-districts. A total of 115 participants (32 female, 83 male) attended these training sessions. Training focused on findings of old age allowance and widow allowance from all Unions at sub-district level. After the presentation, mainly social welfare officers responded to problems of old age allowance and agreed to take steps of improving the selection. As a result of the training all the government staff generally agreed that the entire poverty alleviation program should have focused more on vulnerable older people. They also promised to pursue UP chairmen and members to be helpful to the causes of older people. 3.5. Explore coping strategies among ultra poor older women (Listing and interview for ultra poor)

Older women could be identified as the most invisible and unreachable group among the marginalized vulnerable people. They are the poorest of the poor and mostly missing out on state and family support. The project correctly decided to explore coping strategies of these groups and track down the support available for them. Generally it is difficult to document their story but under this project there is great scope of meeting them and documenting their stories with the help of OP committees. Each Union facilitator was assigned to interview 7 older women and documented their stories. 3.5.1 Workshop at the Union level Ten workshops were organised successfully in ten Unions at Gongachara sub-district. The participants were OPA leaders, UP elected bodies and local philanthropists. A total of 218 (39 female and 178 male) participants attended. Due to the local unrest in Moheshkhali sub-district the workshop was

postponed and shifted to next year. During the workshop three results were obtained:

The older people’s vulnerabilities touched the audience. The stories presented were an eye opener for community leaders and participants.

The local donor lists were prepared and identified a course of action, translating promises into real support for vulnerable older women in every union.

At the end of the program service providers’ lists were prepared for lobbying with OP committees initiatives.

Through the workshop, participants got a scenario of vulnerable older women’s struggle. All participants felt solidarity with the vulnerable older women.

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3.5.2 Report compilation and documentation to be used as advocacy tools

The project proposal specifically mentioned older women’s cases related reporting, compilation, documentation and using them as an advocacy tool. Collected case studies from each Upazilla (sub-district) was categorised and compiled on the basis of the principal coping strategy. Findings from the analysis of these case studies were shared with OPA leaders and other stakeholders. Output of this exercise will be used as a tool for future advocacy for older women’s rights. 3.5.3 Sharing of findings and action planning workshop at Upazilla (sub-district) level. In the Gangachara sub-district, a shared meeting was held with the participation of OPA leaders, government health officer, political leaders, Upazilla (sub-district) vice-chairmen, journalists and identified philanthropists. A total of 30 participants attended the program. A power point presentation displayed the extent of older women’s isolation, exclusion, destitution, and their coping strategies. These findings gave a direction of developing a program for older women. Due to the local unrest in Moheshkhali sub-district relating to the pourashava election the workshop was postponed and shifted to the next year. 3.5.4 Lobbying with Union Parishad and local donors Ten lobbying meetings were held in ten Unions of Gangachara sub-district. Enlisted local donors, service providers, OPA leaders were present at the event. A total of 260 people participated in ten meetings of ten unions.

Seven union Parishad members and chairmen promised to provide support from VGD, VGDUP and emergency relief in Gangachhra

Five unions of Gangachara prepared a plan for generating special funds to provide support to older women.

Follow up action was undertaken after the lobbying meeting.

3.6. Documented pilot of OPA sponsorship approach for 100 poorest older women Older women in Bangladesh are destitute and vulnerable in many ways. Discrimination by the family, community and development system makes vulnerable older women’s access to properties, development facilities, health services difficult. Social safety net benefits for older women are highly limited and constricted. The present social protection mechanism fails to ensure older women’s inclusion and participation. The project designed an innovative approach to document older women’s cases and seek sponsorship from philanthropists, institutions and people. The document is not yet published but is at the editing stage. Annex 10 – Guideline for documentation 3.6.1 Case Study Collection

Case study collection is one of the main areas of the project to address the older women problems of exclusion. The program officer developed a guideline, then the training coordinator oriented field staff on how interviews of case studies should be written, analysed and disseminated. According to the

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guidelines, the union facilitator would be responsible for collecting case studies under supervision of senior project staff. From each Union project staff first prepared a complete list of vulnerable older women and then he/she selected from the list of case study process. Finally, 100 case studies would be the inventory of older women’s cases. 3.6.2 Case study review, editing and preparation of documents for circulation to Sponsor A resource person was hired for developing case studies in a more refined language to circulate to sponsors. According to the plan the draft report will be available by 15 April, 2011. 3.6.3 Appeal through print media, website and poster A poster was printed and circulated, demonstrating an appeal to the community for supporting destitute older women. The slogan of the poster was “Destitute older women are our nearest ones, come stand by them in social commitment”; an appeal that targeted all community people. This poster draws attention from the general public and attempts to open their sympathetic eyes for these poor older women. On the ‘RIC’ website, especially on the very recently added page, there is a focus on the appeal for supporting destitute older women. After completing the trial of the project website, these case studies will be uploaded. After taking a draft case study, we have had a successful discussion with three print media journalists. Ideas were shared with them and they have suggested some effective plans to circulate appeals through print media advertising and writings. Result 4: More responsive and appropriate local health care and expanded health seeking behaviour for older people

4.1 Community level health priority setting Older people’s health is another important focus of the project. It is a neglected issue at the community level and this negligence is reflected in the older people’s comparatively low use of government health care services. PRA exercise generated data on older people’s diseases profile, health care seeking behaviour and quality of provider response. 4.1.1 Union level PRA exercise The first year of the project, the Union level PRA exercise ‘Body Mapping’ started in each Union of the Gangachara and Moheshkhali sub-districts. Body Mapping took place with a group of older people at community level. Through body mapping existing disease profiles of older people were identified and the disease profile became a primary tool for exploring other unidentified elements of older people care. Identified diseases were ranked according to the intensity and number of older people affected by the diseases. The findings of the PRA

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Good Practice The Union Health Complex of Lakshitari union is situated in ward # 4. The health complex has not been in service as there is no doctor to attend the patients there. The ward monitoring team and the concerned village committee made an effort to make the complex operational. The members of these two committees frequently met with the concerned official of the upazila administration and made repeated demands for making arrangements to open the complex. They even met a doctor who is supposed to be posted there. The hospital authority agreed to take appropriate measures so that people could have treatment from the health centre.

exercise showed older people are gradually affected by non communicable like diab etics, blood pressure, heart disease etc. In the second year there was a FGD with older people groups to generate data on older people’s health care seeking behaviour and use and access to the local health services. 20 group discussion sessions were conducted. A total of 280 older people (141 women and 139 men) were present. The group discussions also documented older people’s priorities in different aspects of health care services.

4.3 Workshops with local authorities and service providers to identify barriers to access and quality health treatment 4.3 .1: Workshops with local authorities on barriers to Access and quality health Workshops with local authorities on barriers to access and quality health care was planned as a follow

up event of the Union level PRA exercise and group discussions focusing older people barriers to access health services. Workshops with local authorities included Union Parishad members, government and non government health service providers. 19 batches of workshops were held with 391 participants (52 women and 338 men). The members of Union and Ward monitoring teams were found to be actively participating in the

workshops. Workshops were conducted through participatory discussion, question & answer session and a presentation. The final session of workshops focused on specific barriersto quality health services. There were a lot of sharp comments from the participants. One pessimistic participant commented “there is no quality health care service in rural areas which older people would get ac cess to” So the first barrier was the absence of quality services however the participants identified the real barrier of older people to get access to quality services. These real barriers were divided into different components. Firstly, older people’s self confidence to get services, as older people in general have low confidence to negotiate with providers. Secondly, inclusion of older people’s primary health care and their status in terms of water and sanitation is very low. Thus the barrier analysis became a trigger point of local health advocacy. 4.4: Skills training for local authorities on health care for older people

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“This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of HelpAge international Bangladesh and can under no circumstances be regarded as reflecting the position of the European Union.”

4.4.1 Training with local authorities on health care for OP Training for local authorities on health care for OP was organised in two Gongachara and Gazipur sadar. 60 local health staff attended the sessions. Actually the sharing between older people and the health service provider was the main component of the training. In these sessions health providers made their comments in response to the OPA leader’s presentation of their health problem. They (providers) also presented their observation saying “Many older people in our area don’t even have the opportunity to check their blood pressure or monitor diabetes and this is a very unfortunate situation for the older people, we need to work together”. One of the local doctors said, “Without joining this workshop I would not have realized that the older people’s health problem is so intense. This workshop helps me to respond to older people’s problem within my abilities”. In the concluding discussion most of the participants agreed to follow up action for improving the health service provided for older people in this sub-district.

4.5 Awareness raising sessions for older people on self care and standard of care to be expected from service providers Awareness raising training was organised in 19 Unions of Moheshkhali and Gongachara sub-districts and 2 Unions of Gazipur district. A total of 471 participants (130 women and 341 men) were present during the sessions. This training was designed with two components: i) older people demand standard care from providers. ii) Self care. During the first day of training monitoring teams visited the government health facilities and identified the possible causes of older people’s low expectation from government providers. They also observed the quality of services provided in general, behaviour and attitude of providers, level of barriers in using facilities by the older people. Their observation was later presented in the training session with older people. Through observation it was found that older people visits were much lower than other groups. Sharing the findings in the training sessions, older people said low visit was due to the ineffectiveness. So reluctance and frustration to visit union level government facilities were developed in older people. The conclusion of the session pointed out that if the standard of services is not being improved then older people would not be willing to visit the facilities. The second session was conducted on self care of older people. Self care was defining older people’s ability to maintain mental and physical strength to care for ones self. So this session included multiple issues of geriatric care. Food intake and nutrition was first then the possible health risk and taking preventative actions. Then came the community plans and group planning to improve self care of older people. A resource person from both Union and sub-district level conducted the session on self care. In the session the resource person followed the lecture method and sometimes they used the question-answer method. Finally most of the participants agreed about the importance of a scale up of all the unions of Bangladesh through government support. Annex 11 - training Schedule of awareness raising training

4.6 Pilot of community based home care approach in 20 villages 4.6.1: Identification of home care organisers and assistants The first task in this project was the home care selection of villages, and then came the selection of the volunteers. 20 villages (10 in Gangachara and 10 in Maheshkhali) were selected for home care piloting considering the level of distance from the health service centre. Three of the remotest villages were

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identified in Dhalghat Union, two villages under the Huanak Union and five Unions from the nearest sub-district headquarter. In the Gangachara sub-district, villages were selected from most of the Unions considering the geographical connectivity with Upazila Headquarter. 4.6.2 Module development and printing Selected home care assistants and members of the family who provide care to frail older people would receive three days training on all aspects of home care using an external resource person with experience in implementing home care. The training would give an overview of how the home care system would run. It would also review topics such as how to identify and assess the needs of older people, skills required for initiating home care, examples and limits of home care and monitoring and referral. An external resource consultant has been assigned to develop a module considering the context and perspective of the specific POPP project. Training will be held before the last week of May, 2011. Annex 12 – Guideline for Community based training module development Result 5: Older people in 19 Unions better prepared for natural disaster 5.1 Training on disaster risk reduction

Disaster risk reduction training was provided to the Union and Ward level monitoring teams and they would disseminate the training messages to older people living at the village level. There are different natural contexts between Gangachara and Moheshkhali sub-districts. Food crises (Monga) during a specific time of a year and draught and river erosion are the main disaster issues at Gongachara sub-district. On the other side Moheshkhali sub-district generally faces disasters risk relating to cyclones, tornados, tidal storms etc. Older people and disaster is an emerging issue in both sub-districts of

Moheshkahli and Gangachara. This programme involves reducing the disaster risk of all community people. Inclusiveness of the DRR depends on how much they are able to include the vulnerable groups. In this context, older people are one of the vulnerable groups during disaster. So this project specifically designed training on DRR for older people.

5.1.1 Workshop with monitoring team on DRR

This was a two day workshop with monitoring teams on DRR. In the workshop process, the presidents and the secretary of the Union monitoring teams took an important role by providing the Union level information relating to disaster history of the union and variation of risk levels among the villages. The workshop was conducted in each Union of the Moheshkahli and Gangachara sub-districts. 571 wards and union monitoring team members participated in two sub-districts, out of which 118 were older women. The training coordinator and external

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resource person moderated these workshops. The workshop moderated with specific objectives and methodology. The objectives were to increase the awareness about the DRR action and programme among the participants of the monitoring teams. The practical purpose was that the monitoring team member could monitor the access to DRR resources, canalized by government, NGO and humanitarian organisation. The workshop also identified some agenda items of advocacy to include the older people representatives in the DRR committees formed by UP and municipalities. Annex 13 – Workshop schedule The following activities were supposed to be carried out in the first year according to the ‘Budget Line’. They could not be undertaken due to shortened time resulting from delay at the start. We are proposing that these activities be allowed to take place in the 3rd year. 3.4 Skill training for local authorities on health care for OP (Moheshkhali) 3.5 Report compilation and Documentation to be used as advocacy tools 4.6.2 Training of home care assistants and family caregivers 4.6.3 Deployment of home care assistants and follow up 5.2.1 Community Action Plan exercise at the union level 5.2.2 Implementation of CAP (1 plan each union) 5.3.1 Documentation and printing OP issue in disaster 5.4.1 Workshop to sensitize key DRR actors to the needs of older people. Annex 14 – Case study Annex 15 - 3rd year Action Plan

3. Partners and other Co-operation

3.1. How do you assess the relationship between the formal partners of this Action (i.e. those partners which have signed a partnership statement)? Please specify for each partner organisation

RIC is an NGO based in Bangladesh working for the empowerment of rural communities of Bangladesh. RIC has been working in Maheshkhali sub-strict since 1991. Older people are an important population group for RIC interventions; especially as RIC is the only NGO who have a dedicated ageing team in Bangladesh. In the current project, RIC is playing the role of the implementing partner in the working sub-districts. It has appointed a full-time project team and has set up three project offices. It organises field-based activities in consultation with the OPAs, local government and technical experts. It also conducts ongoing monitoring of all project interventions. RIC and HelpAge International communicate

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regularly on the project’s progress, future plans and financial aspects. HelpAge representatives visit the project villages as and when necessary and meet with both beneficiaries and the RIC team. For larger level advocacy efforts, RIC and HelpAge make joint efforts focusing on ageing related issues at state and national levels. RIC representatives participate in the regional conference of HelpAge, where they meet not only the HelpAge team but also other network partners working on the issues of ageing in the region of Asia-Pacific. 1.2 How would you assess the relationship between your organisation and State authorities in the Action countries? How has this relationship affected the Action?

RIC has developed very mutual and productive relations with the local state departments for smooth implementation of the project and for the overall benefits of older people. Local Government representatives regularly visit project sites and provide technical suggestions. OPA members have also started visiting government offices with their issues and demands.

1.3 Where applicable, describe your relationship with any other organisations involved in implementing the Action: Not applicable

Associate(s) (if any) Not applicable

Sub-contractor(s) (if any) Not Applicable

Final Beneficiaries and Target groups: RIC, at the field-level, has developed very strong bonds with the final beneficiaries and target groups. The community is very well represented in the project, in the processes of planning, implementation and monitoring, in the form of OPAs. The participation of the community in the project has been very active and productive. All the suggestions and guidance coming from the community are given adequate respect and attention. The members of the community join the project team in supervising implementation and in organisation of events such as training and awareness camps. The contents of these events are always discussed with community representatives beforehand. The RIC team and the community meet quite often through various forums such as OPA meetings, workshops, federation meetings etc.

Other third parties involved. Not applicable

1.4 Where applicable, outline any links you have developed with other actions

1.5 If your organisation has received previous EC grants in view of strengthening the same target group, in how far has this Action been able to build upon/complement the previous one(s)? (List all previous relevant EC grants).

Not applicable

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2. Visibility

How is the visibility of the EU contribution being ensured in the Action? The visibility aspect is being followed very carefully. We respect and truly appreciate the EC contribution to the project and towards the empowerment of older people in this area. In all training, workshops, dissemination events, rallies, human chain and cultural shows, EC support is clearly mentioned along with the EC logo. All materials and equipment purchased through the project display the EC logo. All project related boards (on offices, project villages) have the EC logo. On project publications, banners and invitation letters of project related events, the EC contribution is mentioned and the logo is displayed.

The European Commission may wish to publicise the results of Actions. Do you have any objection to this report being published on Europe Aid Co-operation Office website? If so, please state your objections here. No objections Name of the contact person for the Action: Nirjharinee Hasan Signature: Location: Dhaka Date report due: 01 April 2011 Date report sent: 07 April 2011