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PROJECTS

PROJECTS

BACKGROUND

  • With support from the Government of the Netherlands, FPA India implemented the Choices and Opportunities Project which focused on young people, particularly the very young between 10-14 years. It was initiated in 3 Branch locations- Agra, Ahmedabad and Bangalore, was scaled up later to include Madurai, Panchkula and Srinagar Branches.
  • The programme provided an opportunity to promote young people’s sexual and reproductive health and rights (SRHR), to identify and scale-up good practices in adolescent-friendly service provision, comprehensive sexuality education (CSE) and also to identify new strategies to reach young people and underserved groups.

INTERVENTION

  • A comprehensive, gender-sensitive, rights-based sexuality education curriculum ‘Growing Up is Fun’ was developed. The themes that were most relevant to young adolescents were focussed upon while working with them.
  • Parents were also encouraged to communicate with their adolescents on SRH issues and about gender, abuse, pubertal changes.
  • During the Project duration a total of 11,10,551 services were accessed by 33,905 young people. The experience of the Project has been integrated in all FPA India Branches, who are strategising and working with young adolescents

CHALLENGES FACED

  • Communities initially resist SRHR programs for young people as many adults associate a sense of discomfort with talking about sexual and reproductive health. This impacts the willingness of schools to grant permissions for conducting programs.
  • For some topics girls and boys need to be educated separately to maintain comfort levels. Besides, young adolescents are not able to actively contribute project planning.

Total services provided by FPA India (All Branches)

KEY LEARNINGS

  • Programs need to be holistic including opportunities for self-development. They also need to be interactive along with informative.
  • Involvement of parents and teachers is critical equipping them with skills to communicate on SRH issues.
  • Before providing SRH services it is important to touch upon general health services.
  • SRH needs for information or services is not uniform with those living on the streets having different needs as compared to those living in protective environment of families.
  • Capacity building of service providers is imperative, particularly skills in counselling. They should also assuring confidentiality to the young adolescent
  • Capacity building of government frontline workers is important.

BACKGROUND

  • SETU (Services, Education, & Training Unit) project was envisaged to increase awareness and access to family planning services by poor, underserved and vulnerable groupsof the community, while utilising and revitalising the existing service delivery channels.
  • The project was implemented in 26 districts of India from 2012 to 2015
  • Focus of SETU model was on doorstep delivery of Contraceptives commodities and FP services through trained Community Based Provider (CBPs) who also mobilised communities.
  • Targeted IEC activities including interpersonal communication and multi-media activities were carried out leading to behaviour and social change.

INTERVENTION

  • A cadre of 2500 CBPs were the ‘Peer’ with-in the community, providing doorstep service delivery and mobilising the community.
  • About 2000 ASHAs trained to reach out to the community.
  • In far-flung, hard to reach, remote areas poor and underserved population were provided the access to basic essential FP, MCH services through mobile medical vans.
  • Special outreach service sessions were arranged near to community.
  • Social marketing of RH commodities for sustainability of CBPs.
  • A satellite clinic was placed in the community to provide basic, non-invasive FP, SRH and MCH services at minimal/free cost.

CHALLENGES FACED

  • More than 55 lakhs FP and RMCH services delivered to about 20 lakhs beneficiaries through SETU project.
  • About 12000 female sterilisations, 1000 male sterilisations done under the project.
  • Expanded coverage of newer contraceptive – about 15,000 Injectable DMPA doses provided through project.
  • Capacity building of 5000 community health workers in FP and RMCH issues.

KEY LEARNINGS

  • Upgradation of CBDs to CBP (i.e. Depot – Providers) suited the outreach design of less HR and max output.
  • Data verification is needed to keep the project staff updated about the timely change in definition and M&E practices.
  • Commodity Security System of the satellite clinic and RHFPC need to be strengthened.
  • Mobile Medical Van approach was important to increase the accessibility and acceptability of services by community.
  • Introduction of user fees in SETU satellite clinic and social marketing of contraceptive and other commodities helped in the cost recovery and sustainability.
  • Financial transition with outreach team like CBD/CBP, link workers were made through bank only. This helped CBD/CBP open the bank account leading to their empowerment.

BACKGROUND


IPPF received a grant from the David and Lucile Packard Foundation to harness the political priority and evidence to ensure that SRHR is represented in the final intergovernmental negotiations on the post 2015 development framework.


In India, the project was implemented by FPA India (Family Planning Association of India) from July 2012 to June 2014, through IPPF, with the following objectives to get SRHR prioritized in national as well as local level policy, budgets, regulatory documents or legislation.


  • To assess linkages between SRHR and poverty alleviation in key national development policies and programmes currently implemented at the national/state level.
  • To develop strategic alliances to raise awareness about linkages between SRHR and poverty alleviation zamong key stakeholders at the national level
  • To develop evidence-based messages which resonate with key stakeholders from the civil society and relevant government department.

  • PROJECT INTERVENTION


    Project activities were designed to collate evidence at the policy level as well as from the community perspective to work towards the objectives.Policy and programme documents and papers developed by the Ministries of Women and Child Development, Health and Family Welfare, Rural Development, Urban Development and Poverty Alleviation, Statistics and Programme Implementation and the Planning Commission, were scanned. Structured interviews were conducted with government officials from some of these ministries. This review revealed that SRHR and poverty alleviation measures were not adequately linked in the government programmes and policies.


    Three non-SRH civil society organizations (CSOs) were partnered with and oriented on the relevance of SRHR to poverty alleviation. These NGOs also conducted community-based activities to bring about awareness of the link between SRHR and poverty alleviation.In order to influence programmatic and policy changes with regard to carrying out integrated SRHR and poverty alleviation programmes, a two–day workshop for staff belonging to the partner NGOs in Barwani was conducted, to orient them on SRHR issues and also to work with them to bring out an advocacy strategy for positioning SRHR as critical to poverty alleviation through integrated community based interventions linking the two issues. All three partner CSOs were also supported by a second sub-grant to conduct SRHR related activities with their poverty alleviation and development work.


    SUCCESS


    A community based qualitative study conducted in the operational area of these partner NGOs brought out very vital nuances on community perspective of SRHR-PA integration. The document worked as a tool in itself to push forward the agenda of positioning SRHR as crucial to poverty alleviation. Once the community opinions were established, it paved the way to work on the advocacy strategy and bring out clear evidences on the need for such an integrated approach.

    This project has attempted to demonstrate an approach to the SRH-PA integrated model that has neither been demonstrated nor documented so far. This model therefore holds a possibility of being a learning model for several NGOs working in the space of SRHR. A documentary film on project learnings was therefore developed and widely disseminated through social media (YouTube). The outcome of the effort can be seen in the linkhttp://www.youtube.com/watch?v=PaKhLeR5Bfo

    Another significant outcome of this two-year project was the generation of an advocacy brief that would now be extensively presented to possible partners and collaborators and convince them of the need to position SRHR as crucial to poverty alleviation as part of overall development. The advocacy brief and the documentary were unveiled during the national dissemination of the project held on June 18, 2014, in New Delhi.

Name of the Project: Human Resource Development for Sexual & Reproductive Health Care Services

Supported / funded by: Tata Trusts

Duration: 3 years (January 2013-December 2015)

Goals: Improve the quality of service provision and enhancement of skills of service providers providing sexual and reproductive health services

Objectives:

  • Capacity building of health care professionals to manage health services effectively
  • Disseminate information related to sexual and reproductive health care and rights to professionals across the country
  • Establish the center as an institution in the area of sexual and reproductive health care and management

Locations / Branches involved: The project is implemented at FPA India - HQs and training courses are being organized at Avabai Wadia Health Center, Tilaknagar, Mumbai. The training courses are for external agencies within the country.

Brief description
The key aspect is to develop human resources for sexual and reproductive health care and management. The project envisages building capacities of 1360 health care professionals through 68 training batches on following themes in three years.

  • Family Planning for Civil Society Organizations
  • Counselling Course in Trauma, Guilt and Self Esteem
  • Meeting Sexual Reproductive Health needs and Rights (SRHR) of survivors of Gender Based Violence
  • Male involvement in SRHR
  • Leadership and Management Programme
  • Basic counselling skills
  • Comprehensive sexuality education
  • Sex and sexuality counselling
  • Use of social media
  • Advocacy Planning
  • Counselling for Children
  • Resource Mobilization through Corporate Social Responsibility

Apart from the above training courses it also organizes custom made training courses for external agencies.

Feedback:

“It is very appreciable for conducting such nice training programs which ultimately helps social organization to achieve goals for the benefits of society. The feedback of training received from our person who has attended training on our behalf is up to mark. We once again congratulate for your move & programs promoted for the benefits of society. We feel proud being associated with you & will definitely attend programs arranged in future dates.” (Shree Bahuddeshiya Sanstha, Nagpur)

Result/ progress/ impact

271 in the year 2013 and 381 individuals in 2014 have attended training courses. Many of them have undergone multiple courses. The participants have improved their knowledge and skills. They are utilizing the information and skills acquired in their routine work. Participants have reported that the training has helped them more in day to day work while dealing with their clients.

Additional info
Here is the training calendar for the year 2015.

Name of the Project: SETU Core +

Supported / funded by: AusAid (Australian Govt.)

Duration: June 2011- June 2014; 3 years (extension 6 months, up to December 2014.)

Goals:

  • People from 10 states, including the poor, marginalized, socially excluded and underserved, have access to family planning and sexual and reproductive health services.

Objectives:

  • To increase the contraceptive coverage by 20% from the baseline in the project locations by 2014
  • To increase awareness of family planning by 30 percent point among all men, women and young people by 2015 in in the project locations
  • Strengthen systems for FPA India to ensure efficient forecasting and logistics management of commodities across the association

Locations / Branches involve: In the year 2014 there has been few changes in the SETU project implementation locations/sites. Previously SETU project was going on in 10 RHFPCS (SETU supported Male clinic) and 18 Outreach locations.

Following units has been winded up under SETU Core+ in 2014

Locations Wind up by - date
10 RHFPCS (SETU supported Male clinic) Madurai  Ahmedabad
Nagaland  Banglore
New Delhi  Bijapur
Nilgiri  Chennai
Panchkula  Dharwad
31st March 2014
2 Outreach Locations North Kanara, Mysore 30th April 2014

Thus, from 1st May 2014 onwards following 17 Outreach locations only, will be functional under SETU Core+

Barwani (Project) Indore
Belgaum Jaipur
Agra Kalachni - Madarihat
Gwalior Kalachni
Bhubaneshwar Lucknow
Bidar Mumbai
Gomia - Bermo New Delhi- 1) Shahadara 2) RK Puram
Gomia - Petravar Pune

Brief description (100 words):
An outreach intervention is implemented in 17 blocks across India in 2014. Each block has a Satellite clinic and an Outreach team. Thesatellite clinic has a Doctor, Staff Nurse, Counselor, Lab Technician, ANM and Aaya. The Outreach team comprises of Community Based Distributor (CBD), Link worker and Project Coordinator. The CBD is the commodity provider at the grassroots level and the rest of the team is for supportive supervision. A block have about 120-200 CBDs with population varying from one-two lakh. Strategies adopted are community mobilization through CBDs for demand generation and referrals to satellite clinic, mobile medical van twice a week, special service sessions in the community and partnerships with private medical practitioner in area.

Case studies/ stories:
Case study 1:
Miss. Muthu Lakshmi, aged 21, was doing her degree course. She was in love with her maternal uncle and her marriage was fixed with him. She had pre marital relationship with her uncle and as a result she became pregnant. After her pregnancy due to some problem in the family her fiancé denied to marry her and went away from the place. Later the family members came to know that he got married to someone else. She felt helpless and was unable to share about her pregnancy to anyone due to fear. At that time there was medical camp organized by SETU project of FPA India in her village. The counsellor explained about treatment for STI/ HIV/AIDS, safe abortion and family Planning. The counsellor also assured that matters shared with her will not be shared with anyone and so the client had confidence on the counsellor and she shared her story. The counsellor explained her about free, legal and safe abortion services. She underwent abortion in RHFPC. Now she is relieved from her distress and able to concentrate in her studies. She is grateful to FPA India SETU project for the timely help.

Case study 1:
Kannan got married 10 years back. His wife is a housewife. They have 3 children. Both husband & wife are HIV infected persons. His wife has undergone 2 operations for the first two deliveries. After the third child was born they decided to go to the private hospitals for doing tubectomy. But in the private hospitals, they refused to do tubectomy due to their HIV infection. The couple came to know about the services provided at the FPA India Madurai branch through the SETU medical camp. The SETU counselor counseled them and shared about the vasectomy. The IEC materials were provided to the client at the camp site. Knowing the services of FPA India the client approached SETU unit after one week. At the second sitting, counselor explained about the vasectomy procedure. They were convinced to do vasectomy after discussing at home. The client came again for the third sitting. The counselor counseled them about the vasectomy and he was confident and accepted for doing vasectomy. After doing vasectomy, the client shared that in many hospitals there was discrimination & stigma for PLHIV but in FPA India there is no discrimination. He felt that he was treated as normal client and so he expressed his gratefulness to FPA India and SETU team.

Case study 3
Mrs. Asha Singh has 3 children and is currently living in Ganga Vihar with her husband and mother-in-law. She was approached by Ms. Sheetal, Link Worker, SETU Project during her survey in the colony. Asha told her that she has not had her menstrual period since 5 days. So, Sheetal immediately referred her to the SETU Clinic where she was given UPT kit to test whether she has conceived. She gave a history of unprotected sex with her husband to the counsellor. Counsellor told her that she has to get MTP done, if she does not want that child. As she was already having 3 children and her husband’s monthly income is very low, Counsellor informed her about other contraceptive methods like IUD, tubectomy after MTP, so that she will not face any other problem once again in future. Therefore she went to her home and consulted her husband . Sheetal also went to her home and counselled her husband and mother-in-law about the procedure. Next day she was taken to RHFPC to get MTP done in the SETU ambulance. After MTP, IUD was also inserted so that she does not face the same situation again. She said, “I was very afraid of the MTP procedure but the staff explained the entire procedure to her before she was operated. Doctors treated me very well and were very supportive. Till now I have not faced any problem and I am living a healthy and normal life.” She also remarked that, “She is very happy with SETU clinic facility in their locality. All the medicines are readily available and staff also treat them very well”.

Result/ progress/ impact (100 words):
During the year 2013, CBDs provided 9, 79,495 (64%) services, satellite clinics provided 6,34,425(42%)services. SETU Project contributed significantly (46%) to the overall branch performance. SETU project model proved to be cost effective for provision of contraceptive services. The cost per contraceptive service by CBD and Satellite clinic was found to be 0.48$ and 0.47$ respectively. Thus a multi-level service delivery point is an efficient and cost effective method of providing family planning and contraceptive information and services. 60% of (1515) of CBDs have opened bank accounts with the help of SETU team. All of these CBDs are women. Honorariums were directly transferred to their bank accounts. This practice gave additional dimension of financial empowerment of women to the project.

Additional info: The Australian AID identifier logo should be at dominant position. The FPA India logo can be included along with the wording - “Australian Aid—managed by FPA India on behalf of AusAID”

  • Rain coats and utility bags provided to the CBDs @ KALCHINI
    IMG_0095.jpg
  • The baby checked by the doctor at the outreach camp: @ KALCHINI
    IMG_0049.jpg
  • Laparoscopic Sterilization Camp, June 2012 at Santhpur CHC @ Bidar
Phase Duration Status Remarks
I 2008-2010 Completed Initiated at 15 FPA India clinics.
II 2011-2012 Completed IDuringsecond phase, Global Comprehensive Abortion Care Project (GCACP) was renamed as Global Comprehensive Abortion Care Initiative (GCACI)
III 2013-2015 Ongoing Began on 1st January 2013. Agra and Mumbai PSK clinics were added.

Supported / funded by

Anonymous donor (The donor has requested that their grant should remain confidential and thus anonymous. The Member Associations and Regional Offices are not permitted to disclose the source of funding and therefore IPPF should be referenced as the donor.)

Duration

Mentioned in above heading

Goals

To increase access to comprehensive abortion care and contraceptive services as an integral component of sexual and reproductive health in 17 Member Association clinics by the end of 2015.

Objectives

  • Increased access to comprehensive abortion care services, resulting in 44,273 clients served through 17 clinics by 2015
  • Provide treatment for incomplete abortion and post abortion care services to 1004 clients by 2015
  • Increased uptake of post-abortion contraceptive services, resulting in at least 98% of the CAC clients adopting a contraceptive method by 2015.
  • Increased access to family planning services, resulting in a total of 55,723 clients choosing a Long-term method and 248,019 clients adopting a short-term contraceptive method by 2015.
  • Use client based data to inform quality of care and programmatic decision making.

Locations / Branches involved:

  • Tamilnadu: Dindigul
  • Jharkhand: Gomia and Murhu
  • Madhya Pradesh: Gwalior and Jabalpur
  • West Bengal: Kalchini and Kolkata
  • Uttar Pradesh: Agra, Nirala Nagar and Cantonment (Lucknow)
  • Maharastra : Avabai Wadia Health Centre (Tilaknagar-Mumbai), Kutumb Sudhar Kendra (Mumbai Central), Kutumb Niyojan Adarsh Kendra (Thane), Prajanan Swasthya Kendra(Bhiwandi), Pune and Solapur
  • Nagaland: Kohima

Brief description ( 100 words)
Global Comprehensive Abortion Care Initiative (GCACI) was designed to address the problem of unsafe abortion by training health care providers and advancing safe abortion technologies through trained service providers.The initiative emphasizes the efforts to increase access to the provision of comprehensive, safe and legal abortion care and abortion related services with special focus on reaching poor, young, marginalized, rural and displaced groups. The initiative includes pre-abortion and post-abortion counseling, surgical and medical abortion, post-abortion care including treatment for incomplete abortion and post-abortion contraceptive services.

Any noteworthy / special comment or case studies/ stories
The stigma attached to abortion at FPA India clinics was addressed through inclusion of rights based messages into counseling session. This intervention was implemented into 5 clinics (Pune, Mumbai, Bijapur, Indore and Bangalore). More than 86% of the clients felt that they were not judged by the clinical staff, felt supported while receiving abortion services and were able to make a decision about the outcome of the pregnancy. This intervention has helped toreduce the abortion stigma at 5 clinics. Most of the clients had fear, myths and misconception about abortion before visiting FPA India clinics. But after counselling session, many of them were able to make the decision about their choice to continue the pregnancy or to go for abortion.

Result/ progress/ impact ( if any) ( 100 words)
The health education and awareness programs were organized at all clinics in collaboration with various stakeholders to sensitize the community about importance of abortion and contraception. All branches adopted different strategies to reach larger section of population through flex boards, wall paintings, sign boards, hand bills, pamphlets, posters, street plays, FM Radio and public transport system (Bus and railways). The establishment of strong referral linkages with other NGOs, CBOs, youth forums, and government health workers, certified or non-certified PMPs, chemist and druggist has resulted into high number of referrals to FPA India clinics. The link workers had played key role in the community mobilization acting as bridge between the community and health service providers.

All clinic staff are oriented to analyze the data and make appropriate decisions at the clinic level to improve the services. Every month the clinic staff have a discussion on the data and analyzes the strengths and weakness to make firm decision. This also resulted into improved reporting of services and a greater coordination in the staff. 11 clinics out of 17, made a programmatic decision using the data. For example: Kolkata made arrangement for night stay for the distant clients; Pune decided to appoint a Consultant for providing NSV services; Mumbai-AWC decided to begin provision of Second trimester abortions in 2014; Kalchini conducted data audit by staff etc.

As a result of GCACI implementation, Jabalpur and Gwalior branches in collaboration with Maries Stopes International (MSI) have been identified as MTP and IUCD insertion training centers for government and private health service providers.

Achievements in 2013:

Total No. of Clients provided with an abortion 16613
Incomplete abortion treatment 305
Total of post abortion clients adopting contraception 16735
Total number of clients using contraception & number of contraceptive services 90140

One special photo

Safe Abortion: Sensitization Workshop Of FPA India Volunteers On Attitudes

Name of the Project: Building Momentum for Sexual and Reproductive Health and HIV Integration in India
Supported / funded by – IPPF- SARO through European Union Duration–
January 2011 – June 2014

Goals - The project will contribute:

  • To MDGs 5 and 6 and significantly increase uptake of both HIV and SRH services, especially for women, young people, people living with HIV and marginalized groups
  • To the fulfillment of international commitments for SRH – HIV integration in the ICPD, the Glion Call for Action and Political Declaration on HIV and AIDS

Objectives:
To advocate for SRH - HIV integration in the operations of the CCM (Country Coordinating Mechanisms) of the Global Fund in India, Afghanistan, Bangladesh, Iran, Maldives, Nepal, Pakistan and Sri Lanka

Locations / Branches involved – implemented by FPA India - HQ

Brief description ( 100 words)

The project is committed to advocacy efforts for SRH and HIV integration. The project has four major components – country team, technical assistance hub, small grants to CSOs and advocacy

Any noteworthy / special comment or case studies/ stories
An issue brief on SRH – HIV Integration has been developed with recommendations for: (i) Policy makers and National Program Managers; (ii) SRH and/or HIV Service Providers; and (iii) Community Groups and Networks of People Living with HIV.
In this project it has been able to form the country team, which includes representatives from – (a) the Ministry of Health and Family Welfare, (b) National AIDS Control Organization, (c) Country Coordinating Mechanism Members and CSOs working SRH and HIV, (d) representative of key populations, (e) National Youth Coalition and (f) youth representatives.
Capacity Building programs:Five workshops; namely on (i) Sexual and Reproductive Health (SRH) and HIV Integration; (ii) Gender Equality and Mainstreaming; (iii) Project Proposal Development and (iv) Project Budgeting and Financial Management were held in Delhi.

Result/ progress/ impact ( if any) ( 100 words)
The learning from the capacity building workshops has shown positive outcomes. During the follow up workshops held in 2013, one of the networks has been able to integration family planning counseling at the Integrated Counseling and Testing Centre (ICTC) and incorporate screening of cancer cervix for antenatal mothers and PLHIV women who access PPTCT/ICTC services.
“An eye-opener that two issues could be integrated to save resources and increase impact. NYK can include such sessions in our regular youth interaction programme… two kinds of support provided to us –technical expertise and second IEC support.” (Representative from Nehru Yuvak Kendra)
“This forum introduced us to like-minded organisations working with young people. It has opened doors for us to collaborate with them. We hope that we can share new research and interventions with each other.”(Representative from International Youth Centre, New Delhi)
One of the CSOs working in the district of Bihar has integrated HIV counseling services in their SRH health centers and has been motivating the pregnant women and their partners for HIV testing. Few CSOs are planning to revise their policies and guidelines and including “SRH – HIV integration” because of the benefits - focus on human rights, meaningfully involve people living with HIV;foster community participation;reduce stigma and discrimination, and recognize the centrality of sexuality. The project staff has been sharing these experiences and learning at different fora – experience sharing meeting Elizabeth Glazer Pediatric AIDS Foundation and PMTCT’s, private – NGOs, various ‘dialogues’ organized by the European Union (EU) – India to share experiences, perceptions and ‘analyze’ as possible, among EU-funded civil society partners engaged in HIV and/or SRH work, from various angles, mainly advocacy, service delivery and/or capacity building. In the first quarter of 2013 another meeting ‘Kolkata Dialogues’ was organized by EU and the lessons learned and key findings of the project was shared. As commented by one of the participants “… heard about some pilot projects on SRH-HIV Integration but first time attended such meeting. We received conceptual clarity on linkage and Integration of SRH –HIV Services; an important and responsible issue for youth population” [Indian Committee of Youth Organizations (ICYO) representative]. “Useful and informative … field level through various activities among young people. While we are implementing AEP in schools of Tamil Nadu, we now can tweak the programme to include informing them of the need for integrated SRH services. The advocacy tools and the information provided will pave the way for an innovative programme will pave the way for an innovative programme to bring about healthy change in society” – Youth participant Another achievement of this project is Building Human Resources: The capacity building programs on different themes – SRH – HIV Integration, Gender Mainstreaming and Equality, Project Proposal and Financial Management and Budgeting has helped the service providers. The participants have shared or organized similar programs in their respective agencies. Few of them submitted project proposals at the local level too. One special photo Additional info