Transcript Community Managed Health and Nutrition program

SERP
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SOCIETY FOR ELIMINATION OF RURAL POVERTY
DEPARTMENT OF RURAL DEVELOPMENT
GOVT. OF ANDHRAPRADESH
Srinivas Baba
Director
SERP
Poverty Eradication
Core Beliefs
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Poor have a strong desire and innate ability to come
out of poverty; a strong sense of self-help and
volunteerism
Social mobilization to unleash their innate energies
Poor can come out of poverty only through their own
institutions
Sensitive support institutions for poor to induce and
nurture social mobilization and their capabilities.
Building Institutions of Poor
Key Interventions
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Social mobilization of poor and building institutions of poor
>1.4 crore poor women organized into 10 LAKH Self Help Groups
(SHGs)
40,000 Village Organizations
1100 Mandal Samakhyas (sub- block federations), and, 22 District
Federations
Community managed financial systems
SHGs and their federations manage a own corpus of Rs.4650 crores
The Three-tiered financial intermediation involving MS-VO-SHG
Initial seed capital support from project
Product innovations to finance ultra-poor, food security, agri-marketing,
health, education
Microfinance - SHG-Bank Linkages
Cumulative bank finance of Rs 45,000 Crores raised by S.H.Gs – 2004/05
– 12 /13.
Andhra Pradesh: Self-help Groups Federation Model
22 zilla samakhyas
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Mandal
Samakhya
Village
Organization
SHG
SHG
SHG
District
Federation
1100 MSs
40 thousand VOs
1 million SHGs and 1.4 crore members
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Features
Self
Help Groups
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First tier and Building Block
Organised by Poor
Comprising 10-20 individuals
Self Help and mutual aid
Unregistered/ Association of
Persons
Monthly twice meetings on prefixed dates
Decisions on consensus
Transactions in meetings
Savings and credit core activity
Micro Credit Plan, Livelihoods
promotion and Social Priorities
SB account in name of Group
Two Elected Leaders – Rotation
Minutes Book and Mobile
accounts
GBK / VBK/CA
Borrowings from VO and Bank
Transactions in Cash
Audit by Vos
Data base of Individuals and
Groups computerised
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Community Investment Fund
POP Fund
Health Risk Fund
Group Savings and Shares
Bulk Finance
Internal lending
SHG Mobile Bookkeeping
SHG Grading
Organising leftover poor into SHGs
Identifying eligible groups and
individuals for schemes
Identifying Community resource persons
Facilitating Bank linkage
Facilitating Insurance
Facilitating Marketing of produce.
Facilitating grant programmes
Facilitating SHG meetings
Monitoring SHG activities
Nutrition and Day care centres
Gender fund management
Programmes
Village
Organisations
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Capacity Building of Social Capital
Formation and development of VOs
Systems and best practices development
Legal compliance by VOs
AWFP facilitation
Corpus funds and capital grants
channelisation
Programme grants channelisation
Supervision of VOs
CRPs strategy
VO Savings and Shares
Internal lending
Mandal level social priorities
Vos grading
Approving eligible groups and
individuals for schemes
Facilitating Bank linkage
Facilitating Insurance
Trading and Marketing
Facilitating grant programmes
Facilitating VO meetings
Monitoring VO activities
Programmes
Mandal
Samakhyas
 Capacity Building of Social Capital
 Development of MS and VOs
 Systems and best practices
development
 Legal compliance by MSs
 AWFP facilitation
 Corpus funds and capital grants
channelisation
 Programme grants channelisation
 Loan insurance, general insurance,
and pensions
 Supervision of MSs
 CRPs strategy
 MS grading
 Approving eligible groups and
individuals for schemes
 Facilitating Bank linkage
 Facilitating Insurance
 Trading and Marketing
 Facilitating grant programmes
 Facilitating MS meetings
 Monitoring MS activities
Programmes
Zilla
Samakhyas
Interventions
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Health and nutrition initiative
 healthy mothers and babies – ‘zero’ low birth weight babies
Education
 Pre-school centres managed by V.Os
Gender initiative – intra family equity, ‘no to domestic violence’,
family counselling centres
Insurance and contributory pension: Life,health,assets&loans
Livelihoods: supporting new and existing micro enterptises inboth
forward and backward linkages and producer organisations
through KRuSHE Project. BMCUs , procurement with MSP
etc.
Why health in poverty reduction
program
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 56% of the SHG members spent their income on health
related issues
 Strong link between poor health and nutrition indicators
 No special nutritional care for vulnerable groups
 Lack of awareness about Govt schemes & low Utilisation
 Mismatch between the design & implementation of Govt
schemes
 Community level interventions are needed to increase
community participation and reduce gaps in service
delivery
Community Managed Nutrition cum Day
Care Center (NDCC)
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 Beneficiaries: Pregnant and Lactating women and Children up to the age of
2 from the poor and marginalized communities (POP/Poor)
 Physical center i.e., building with Kitchen, Dining and Garden (for
growing vegetables)
 THREE MEALS a day prepared and served to pregnant and lactating
mothers and children <2 years
 Cook (Para nutritionist) is an SHG member trained in preparation of
nutritious, traditional diet (with focus on use of millets & green leafy
Vegetables)
 Health activist (Community nutritionist) provides NHED while doing the
CIG activities
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End-to End Community Managed
Model
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 Universal Health interventions as a starting point, such as Health
Savings , Fixed NH Days, Trainings - to set a strong Health and
Nutrition foundation
 Intensive Interventions after 6 months through Community Resource
Persons- CRPs (SHG women) who are the backbone for NDCC
establishment and scale up.
 One-time grant to cover all establishment expenses procured through
the VO
 Identification of active and interested VO members to function as
Health Subcommittee members by CRPs
 Health Subcommittee members are trained once a month on
procurement of materials needed for preparation of a balanced diet,
monitoring of NDCC activities and community mobilization
 Cook (SHG member) is trained once a month on preparation of
balanced diet and maintaining a hygienic environment
 Monitoring and supervision by VO OB
Key
elements
of NDCC
Daily use of
millets
Daily use of sprouts
Balanced diet (3 meals)
NDCC
Fixed
NH
Days
Growth
monitoring
NHED
Common Interest Group
(CIG) activities
Complementary
food
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Capacity building
Community kitchen Garden
NDCC Expansion Graph
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Current status
S.No
Particulars
1
NDCCs established
2
Total beneficiaries enrolled
a
Pregnant
b
Lactating
c
Children < 2Yrs
DPMUs
TPMUs
3138
1089
4227
72168
21855
94023
21574
6439
28013
23392
8397
31789
27202
7019
34221
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Total
%
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Total No of deliveries (2007-2012)
19449
6221
25670
4
No of Safe deliveries
19000
5955
24955
97
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Total no of girl children
11400
2517
13917
54
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No of Children with < 2.5 Kgs
825
600
1425
6
7
No of Children with >2.5 to 3.00 Kgs
11388
3976
15364
60
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No of Children with >3.0 Kgs
No of NDCCs with regular member
contribution
No of NDCCs identified with land
for vegetable gardens under NREGS
No of NDCCs with financial
sustainability
7496
1071
8567
33
2362
503
2865
68
1189
493
1682
40
1408
196
1604
38
9
10
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Note: Approval under NREGS is given on 15th Aug’12 which will enables the NDCC
to become self sufficient.
Reasons for success
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 Community managed through CBOs
 Prioritisation by community for finance.
 End to end monitoring by community.
 Responsibility and ownership.
Education- Interventions by CBO’s
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 Some Vos are arranging common tuitions for their
children from their surplus (profit)
 ECE center’s (play school)are being run by the CBOs
 Vos are financing the education loans to their
members.
 Some CBOs are running Neighborhood centre’s for
PHC children.
Proposed model-MDM
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 End to end control and monitoring by CBOs.
 The MDM to be financed through CBOs where they
can monitor the Quality and Hygiene.
 CBOs can prioritise and finance the related
investments in both backward and forward linkages
in MDM.
 The Responsibility, Monitoring and ownership rests
with the community for their own good.
Why not MDM through CBOs
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PILOT IN 3 MANDALS IN DIFFERENT DISTRICTS ?
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THANK YOU