SAHYOG Project (CBM-09)

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SAHYOG PROJECT, Delhi An urban empowerment & community health Project Annual Report 2008-2009 Submitted by: Kuldeep Singh

Glimpses of Delhi : 

Glimpses of Delhi

Delhi at a glance….. : 

Delhi at a glance….. Delhi, the capital of India is the 6th most populous city in the world. It is a home for more than 13.8 million people About 400,000 extra people come from villages to settle in Delhi every year. 22 % of Delhi’s residents live in unauthorised colonies and slums ( Ref.2001 National census)

EHA’s Sahyog Project at a glance : 

EHA’s Sahyog Project at a glance Sahyog, which means “to support” – is an Urban project of Emmanuel Hospital Association started in November 1998. The initial emphasis of the project was to provide low and affordable health services to slum dwellers. After a few years of experience and an evaluation, in November 2003 the project adopted an empowerment approach of development. The project works to empower communities such that they have sufficient knowledge of government services and self confidence to access those services for their communities.

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Nov.1998 RCH program initiated in 2 slums in central Delhi July 2003 Project had ‘Review’ with external evaluator (Dr S Dutta, FHI) October 2003 The 3 slums were demolished by the govt. April 2004 Project selected 2 areas for implementing the Empowerment Model’ April 2006 Expansion of project area (2 to 4) & inclusion of health objectives (MDG health goals) June 2006 Mid term Evaluation ’ with internal evaluator (of EHA) August 2006 MoU signed with SCEH ‘Community eye care program’ March 2007 Development disability survey completed (in 4 areas for CBR program & 300 PWD identified) November 2002 A research study was done on ANC services (The study was incomplete) April 2007 Fire mishap in M.Khaddar extn.(2 causalities held &23 families were badly effected) Aug 2008 Internal audit & System review By Barbara CA, Tear UK & Financial review by Tear Australia Dec. 2008 Final Evaluation May 2009 Project Proposal 3yr prepared & approved by Tear Australia TIME LINE Feb. 2009 Organize National Advocacy Workshop on RTI for EFI coordinator Nov. 2006 Registered Member National Campaign (CACT)

Project areas : 

Project areas M Khaddar Ext. 1?1? 1?1? 1?1? 1?1? Harijan Basti Khajuri Basti Madanpur Khaddar-III Madanpur khaddar etn.

Target Community Areas : 

Target Community Areas 1?1? 1?1? 1?1? 1?1? ?? ?? ?? ??

Project Profile : 

Project Profile Name of district: East, South West, North East District of DELHI Name of block : 1. C & B Blocks in Harijan Basti 2. D & E Blocks in Khajuri Basti 3. B-2 Blocks, Phase –III block in Madanpur Khaddar resettlement colony 4. B & C Blocks in Madanpur Khaddar extn.basti Supporting partners: Tear Australia & Tear UK Total Number of slums covered : 4 slums Proportion of block covered : approx 53.85% Total Population in project area : approx. 65000 Project works with: No of men - 16500 No of women- 12500 No of boys: 3500 No of girls: 2500

Sahyog Team : 

Sahyog Team

Major needs / gaps identified in project area : 

Major needs / gaps identified in project area Health ? %ANC(12% in BLS), ? % Immunization (10% in BLS), ? RTI/STI , ? TB, ? Malaria ARI , ? Diarrhea, ? Child hood illness and other communicable disease, low awareness on health problems cum HIV/AIDS, unsafe drinking water Other Development needs Non availability/inaccessible to govt. welfare schemes, Poor advocacy at grass root level Road, Sanitation/Drainage, Community centre, Lack of community centre / educational facilities Domestic violence,Gambling,unemployment

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Sanitation Major Problems Food Health Water Pension Major Problems in Project Areas Unclear Slum Status Domestic Violence

Key Areas of Intervention : 

Key Areas of Intervention Health All under 5 children are immunized against communicable diseases 95% of TB patients from the community in the DOTS programme will be in compliance 80% of those under the age of 40 will have acceptable knowledge of communicable diseases and HIV/AIDS Primary health care services are reasonably available to all women and children All pregnant women are enrolled in ANC programmes All suspected HIV/AIDS people are referred for diagnosis and treatment Other development areas Economic Learning - Education / Literacy Stewardship of resources/ Environment Spiritual

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Other development areas Economic Self- Employment /Entrepreneurship Micro finance through SDF Vocational Training Learning - Education / Literacy Non Formal Education Ensuring primary education by assisting in school admission Adult Education Spiritual Praying with for CBO members during monthly meeting. Encouraging local Church/evangelist to involve in social development work ( Ex- Madanpur Khaddar extn.) Summarizing prayer meeting for mutual relationship & trust building

Project Goal : 

Project Goal “ A sustainable & significantly increased quality of life in urban poor of Delhi.” Specific Objectives : 1.At least 1 CBO independently functioning with its own Vision, Goals, proven problem Solving capacity. 2. 5 example of problem solved through resident actions. 3. Improvement in health status ; Increase in immunization status i.e. 10% in BLS to 80 % in 3yrs Increase in ANC status i.e. 10% in BLS to 80 % in 3yrs Awareness in Communicable diseases & HIV/Aids from 10% in BLS to 80%

Overall project approach/strategy : 

Overall project approach/strategy Community Empowerment model ( using ‘problem solving process’= 10 steps)

Current Activities : 

Current Activities Relationship building Organizing community meetings Networking with NGOs and GOs Training MM staff, CBOs, YGs on various health and development issues Raising awareness through home visits Promoting RTI act Capacity building training for CBOs and MM staff on leadership, vision building Exposure programs for adolescent girls Microfinance activities in collaboration with other NGOs Preventive and curative health program through alliance building Using participatory tools Training CBOs on disaster management Obtaining NOC on unauthorized colonies

Glimpses of Sahyog Project : 

Glimpses of Sahyog Project

What Sahyog does? : 

What Sahyog does? Sahyog interacts and advocates with policy makers and planners at different levels within the government departments. Sahyog works together with communities in solving the problems identified by them through networking with government and other resource providers. At the community level Sahyog works with key residents and CBO groups to increase their Knowledge Self confidence Willingness to work for their own community’s welfare

Problem Solving Process(10 steps) : 

Problem Solving Process(10 steps) Build relationship Community meeting Check commitment Reflection on action Building leaders Copyright . (2006). This problem solving model steps is been developed by Sahyog EHA team, Delhi . Observe & enquire Research solution Withdraw & document the process Planning & action Forming permanent CBOs 1 2 3 4 5 6 7 8 9 10

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Annual Report 2008 -09

Situation Report : 

Situation Report At National Level Right to Information Act 2005 ( some amendment were done last year) National Rural Employment Guarantee (NREGA) Act National Urban Health Mission ( 2005-12) ( Since March 08,Basti sevika >ASHA is been appointed for urban slums) Unorganised Workers’ Social Security Act, 2008: This Act seeks to provide social security to the informal and unorganised sector workers, which forms about 92% of the total labouring population in India. This Act for the first time will attempt to provide basic social security benefits, which would include health insurance, maternity benefits, and pension. This Act will provide an unique social security number and a social security card which will help in identification and claiming of benefits. At Project level >Term end external evaluation in Dec. 2008 > Internal audit/system review ( Tear UK) & Financial review( Tear Australia) > All 8 CBO are registered as societies & functioning as RWA > 3 NGO forum established in 3 target communities.

Main Achievements : 

Main Achievements ?CBOs becoming more self-reliant and willing to take greater initiative in problem solving - extensive usage of RTI ( 8/14 CBO is registered society under society registration act functioning as RWA 17%-20% of women in CBOs) ? Mahila Mandals, Youth Groups and Adolescent Groups more active and willing to lend support to CBOs. ? Acceptance of existence of communicable diseases and HIV/AIDS and willing to test and undergo treatment. Willingness to register for ANC and safe delivery. Observation of media to highlight community issues Increase in Health services >Increase in ANC from BLS 10 % to 48.77% in March 2007 to 58.51% in March 2008 to 69.37% in March 2009 >Increase in Immunization coverage from BLS 12% to38.66% in March 2007 to 39.6 % in March 2008 to 65.91% in March 2009 >Compliance rate for under TB DOTS program 78 % for all 4 target slums

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Community Problems Madanpur Khaddar Ext. Madanpur Khaddar Khajuri Basti Harijan Basti Problem Solved by Resident’s Actions & CBOs 1. Birth certificate 2. Inadequate Sanitation 3. Ration card 4. ICDS program (Angan wadis) 5. Old and widow pension 6. Mosquito breeding 7. Immunization 8. Electricity Supply 9. Water Supply Water Supply Health awareness Widow pension Sanitation Birth Certificates Immunization & ANC NOC of land P. Electric Connection Voter ID Card Drinking water Voter ID Card Birth Certificates Immunization Need for GRC Tetanus Appointment of ANM Malaria Lack of Self-help groups Widow pension Problems in MCD Primary School Ration card Immunization Community Center Savings Bank Account Health awareness General Clinic

Project Outputs : 

Project Outputs Functioning of 6 CBOs in all the 4 communities Regularization of electricity in all 4 communities 293 Groups formed in Khajuri & Harijan Basti for Micro financing through networking SDF (Loan of Rupees 1,25,7800 was disbursed) Sanction for High School in M.K III Regular Mobile Clinics At M.K III/H Basti HIV/AIDS testing and treatment in MKIII in collaboration with DSACS. Total immunization – Increase in Immunization coverage from 38.66% in March 2007 to 39.6 % in March 2008 to 65.91% 78 % Compliance rate for TB patients under DOTS - 48.77% in March 2007 to 58.51% in March 2008 to 69.37% in March 2009 ( % women enrolled in ANC programme got optimum ANC) Health Melas in 4 communities- detection of RTI/STD Formation of 5 SHGs in 3 communities

Project Outcomes : 

Project Outcomes Purpose I: 8/4 CBOs formed are functioning independently, 2 CBO have their own vision , have proven problem solving capacity ( with out project facilitation) knowing/using govt. resources for problem solving. Purpose II: 6/14*major community probelms/16 were been solved through community actions *Electricity, General health clinic, Education (school admission/ secondary education), Widow pension, Safe drinking water, Purpose III : There is increase in coverage of health services >Increase in ANC registration from BLS 10 % to 48.77% in March 2007 to 58.51% in March 2008 to 69.37% in March 2009 Increase in Immunization coverage from BLS 12% to38.66% in March 2007 to 39.6 % in March 2008 to 65.91% in March 2009 >Compliance rate for under TB DOTS program 78 % for all 4 target slums

Impact & Sustainability Analysis : 

Impact & Sustainability Analysis Systematic capacity building of MM/CBO who take ups community issues on their own. CBOs utilizing RTI Act extensively to access /assess information on health & development issues Most of the Sahyog health guides been absorbed as ASHA under NRHM program been implemented in urban slums of Delhi State. Empowerment of the CBOs and residents of the community. CBOs as being registered as RWA are more self reliant & confident in solving community problem process( inner change in some members) Accessibility to healthcare through close networking with GOs/NGOs.

Lessons learnt : 

Lessons learnt CBO members need greater exposure on different urban issues, which have long- term effect on their livelihood Networking with local politicians needs to be made stronger in respective community. Capacity building/exposure of staff should be a continuous process Increasing networking with government and non-government agencies to ease the development process.

Proposed changes in project in the coming year 2009-10 : 

Proposed changes in project in the coming year 2009-10 Sharing the learning of project evaluation in target communities with all stakeholders Organizing consultancy meeting on Urban community empowerment approach with like minded agencies. Continuing the Community Empowerment Approach in 2 areas. Promoting RTI act 2005 ^Compilation of handbook on RTI act 2005 ^^Organizing a National workshop on RTI ^^^ Implementation of evaluation recommendations ( operational, administrative, Capacity building etc.)

Human Resources : 

Human Resources Total staff = 10 Project Manager-1 Project Officer-1 Community Coodinator-2 Community Organiser-4 General worker - 2 Part time accountant- 1 Human Resources Development No of staff pursuing BSW 2nd year -2 No of staff PDP done - 8 No of Staff pursuing MBA -1 No of Staff sponsored by SBSS,CNI for *BHPL-2 *Basic Human Process Lab

Trainings ( in house) : 

Trainings ( in house) Record Keeping MSC Techniques Facilitation Skills Networking Skills Problem Analysis Participatory Tools Problem Reporting

Some Other Significant Trainings : 

Some Other Significant Trainings BHLP (Basic Human Process Lab) RTI Act by JOSH4

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CAPACITY BUIDING TRAINING/WORKSHOPS

Awareness program : 

Awareness program Health guides interviewed by local news channel

Community Meetings & Trainings : 

Community Meetings & Trainings Group work on TB day Adolescents girls training Basti Vikas Samelan (Ngo’s) Exposure to ICDP on SHG RWA training workshop Meeting at Govt. MCD School

Training for the Adolescents : 

Training for the Adolescents Group visited to women's cell Meeting at Harijan basti Group retreat Training on legal rights Trained peer educators Anita empowered to teach other

Health Mela : 

Health Mela Health education along with MCD staff Child immunization done by Govt. ANMs

Immunization Camps and ANC : 

Immunization Camps and ANC MCD vehicle coming for immunization Mothers waiting immunization Health awareness program Govt. ANMS doing immunization

Another Government Initiative…..Right to Information Act : 

Another Government Initiative…..Right to Information Act

Sahyog Using RTI : 

Sahyog Using RTI Training photo Community been trained on RTI for PDS (Ration) Sahyog in the protest rally at Jantar Mantar

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Sanitation Communities Using RTI Different health programs Land Use Food Health Water Pension Process of Availing pension Records of Food Distribution Slum status Duties of Staff Monitoring Report Water/ Testing Reports Individuals & Communities

Impact in communities : 

Impact in communities Informed communities on various government provision and schemes. Decrease in corruption and fake reports. Communities participating in decision making. Communities demanding information. Government employees regular for work. Empowered local authorities.

Networking : 

Networking Minister Harun Yusaff with the CBO members of Madanpur Khaddar in a marriage of widow’s daughter

Networking : 

Networking Networked with both the NGOs and GOs to help resolve community problems. ( 3 MoUs signed in 2005-08) CBO members played an active role in doing regular follow-ups to the problems.

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CAPACITY BUILDING TRAINING/WORKSHOPS FGD on Micro finance CBO team Building trg. Health Guides completing RCH trg. Trg on BLS/First Aid Trust building exercise in CBO workshop RCH training for Health guides

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Thank You!!!