As organizations develop and mature, knowledge management becomes more complex in terms of acquiring, creating, synthesizing and applying information to produce a body of knowledge in SRH. From maintaining a library, conducting research, needs assessments, baselines, end lines and evaluation studies, collecting and collating internal data and service statistics, to producing publications, FPA India has evolved in knowledge management.
The work carried out by all the FPA India branches is reflected through service statistics collected and collated every quarter. This outcome indicator is critical not only internally to the organization but also externally to donors and prospective donors. Both qualitative and quantitative indicators are tracked for programmatic progression, governance and management. These developments in the reporting system require accuracy and consistency in recording and reporting. All the components of Knowledge Management - acquiring, creating, applying, preserving and sharing, is being carried out through the Knowledge Management Supporting Strategy of FPA India.
Data collection, analysis, interpretation and presentation
The work carried out by all the FPA India Branches is reflected through service statistics collected every quarter. This is shared with all stakeholders including donors. Through the on-line Global Indicators consisting of 69 questions developed by IPPF on the eIMS, both qualitative and quantitative indicators, are tracked for programmatic progression, governance and management. Based on 2011 statistical reports, a booklet, "Activities and Performance Report" was prepared and distributed internally.
Mapping for change
A need for obtaining baseline information of some critical areas to develop cost-effective strategies was felt before starting the strategic plan period. Special grant has been provided for carrying out this activity in 23 Branches (Ahmedabad, Bangalore, Bhopal, Bellary, Chennai, Dharwad, Gomia, Hyderabad, Jabalpur, Jaipur, Kalchini, Kolkata, Lucknow, Madurai, Nagaland, Nilgiris, North Kanara, Panchkula, Pune, Shimoga, Srinagar, Solapur, Singhbhum, The baseline provided with information on the poor and marginalized.
A total of 21 types of service providers were identified through mapping, totalling to 1,227 Health Care Providers. A quarter of the Health Care Providers are government and over a third were private. The most neglected service provision was related to contraceptives, abortion, HIV and infertility. Government facilities were a preferred choice for availing services by the poor and marginalized communities. Abortion, infertility and delivery were the costliest service.
The Participatory Ethnography Evaluation Research (PEER) Review is a qualitative methodology used mainly in conjunction with other methodologies for evaluation. The main purpose of this is to get stories of life changes as a result of the project intervention. This methodology is being used extensively by other organisations; however, IPPF is now using this to get stories of change from around the globe to give a human face to statistics. This is proving to be appealing to the donors. IPPF has these stories on their web site as "Changing Lives".
A workshop on PEER Review training was held with six youth volunteers (YV) from SALIN Project, Project Counselor, M&E Officer, from Lucknow Branch; and SALIN Project Officer and M&E Director from HQ and M&E Programme Officer from IPPF-SARO. The workshop was conducted by IPPF Central Office. An analysis of the stories collected by youth volunteers indicated that young people beneficiaries of the Project gained confidence on talking about SRH issues, accessed services and motivated their peers to access services, built skills on conducting training programmes, empowered them to take decision on their own regarding SRH. The challenges in project implementation was also brought out with recommendations.
Leadership Development Programme
The Leadership Development Programme (LDP) concluded at a workshop where the three teams (2 from SARO and FPA India) presented their work for meeting the desired measurable result. The presentation was made to a team from FPA India - FPA India President, President Mumbai Branch, the Secretary General and the Assistant Secretary General (Programme Implementation); among other members from IPPF Central Office and representatives from FPA Afghanistan and Sri Lanka. The FPA India team presented the replication of the Challenge Model at the PSK clinic of the Mumbai Branch. Applying the LDP model at the clinic resulted in Increase in the number of CBDs, Peer Educators, local health care providers and the number of Young People accessing services and referrals. Utilization of LDP tools and techniques such as for focusing and alignment of activities led to the desired measurable result of increasing the number of clients by 52% from September 2010 to January 2011. Visible changes at the clinic level were: better interpretation of data and evaluation, holding monthly meetings together with projects and clinic staff and analysis of activities, improved interpersonal relations, improved coordination for planning and organizing camps and other events.
People Living with HIV; Stigma Index
A cross sectional study design was used to survey a sample of 1594 people living with HIV. The sample was drawn from general category population, men having sex with men (MSM), Transgender (TG) people female sex worker (FSW), and People who Use Drugs (PUD).
The study findings were disseminated to the Project Advisory Committee members and the key stakeholders in September at Chennai. The findings indicate that self stigma among PLHIV is incredibly high, with the marginalized groups expressing more self stigma, reportedly based on their sexual identity or behaviors.
The following recommendations for programme, policy and research have been made
- Sensitization of health care providers on reproductive choices, ensuring pre test counseling during HIV testing and community- based stigma reduction campaigns.
- The policy framework should include mainstreaming issues of self stigma in NRHM trainings programmes, introduction of stigma within a broader human rights perspective in medical curricula, evaluation of workplace policies, relook at mechanisms of legal redress and addressing of integration and linkage of social welfare programmes and schemes for PLHIV.
- Research recommendations include replication of Stigma Index Study to study trends across populations and regions in India as well as evaluation of innovative stigma reduction interventions.
Rapid Assessment of Sexual and Reproductive Health and HIV Linkages in India
The study was conducted between October 2010 - September 2011. A structured assessment team represented by NACO, NRHM, UNAIDS, MSM, TG, (PUD) in particular, PLHIV, Young People, Civil Society Organizations (CSO) and service users was formed to discuss the tools, methods and findings. 115 interviews were conducted at policy, systems and service levels. The study has made various strategic and important findings on policy, system, service level. The recommendations made by this study include:
- Cross programme Working Groups and Task Force to strengthen bidirectional linkages
- Generate evidence around SRH/HIV convergence
- Advocate national laws and civil and legal Rights to facilitate SRH-HIV convergence
- Strengthen systems
- Synergies through allocation of funds
A feasibility study on Injectable Contraceptives Cyclofem and Noristerat (Net-EN) proposed by the Indian Council of Medical Research (ICMR) was carried out during the year through the Population Council. Five training modules were merged into one comprehensive training module which could be adapted for trainers training all cadres of service providers.
The Family Welfare Committee (FOGSI) conducted a technical review of the guidelines for injectable contraceptive service delivery. These guidelines carry updated technical information on injectable contraceptives based on which the content all the documents listed above will be finalized.
Facility-based exit interviews of clients who accepted a new method of contraception were also conducted. New users of ingestible contraceptives were selected and included in the study as also all new users at the clinic during the study period to assess preferences of injectables over other methods. In-depth interviews of providers were conducted to understand their perceptions about injectable contraceptives, counselling and information provided to clients their perceptions about client experiences. The study also gained an insight into the extent which providers would advocate injectable contraceptives in the public health programme.
The June issue of The Journal of Family Welfare was published in a new format. Three issues of ASPIRE were published as well. Additionally, three issues of Med pulse have been published on issues related to contraceptives in PLHIV, Pregnancy and drug use, injectable contraceptives, Nuvaring, HPV infection and vaccination.
Four issues of theme based RCH Bi-lingual Newsletter "GOONJ" in Hindi and English on "Prevention and Management of RTI and STI - Part I (Hindi version) " and "Prevention & Management of RTI and STI, Education and Counseling - Part II ( English version) " and Quarterly Goonj Newsletter were brought out.