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Society for Elimination of Rural Poverty 9.03.09

Community managed health and nutrition interventions under NRHM. Society for Elimination of Rural Poverty 9.03.09. SHG federations in AP. 9,646,000 Rural Women in 22 Districts of AP. 810,000 Self Help Groups (10-15 women per group). 34,852 Village Organization - VO (approx. 20 SHGs).

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Society for Elimination of Rural Poverty 9.03.09

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  1. Community managed health and nutrition interventions under NRHM Society for Elimination of Rural Poverty 9.03.09

  2. SHG federations in AP 9,646,000 Rural Women in 22 Districts of AP 810,000 Self Help Groups (10-15 women per group) 34,852 Village Organization-VO (approx. 20 SHGs) 1098 Mandal Samakhya-MS (Includes approx. 30-35 villages) 22 ZillaSamakhya-ZS (constitutes 1 district) 1 State Office (State Project Monitoring Unit)

  3. Health Value Chain Curative Care Preventive & Promotive Health Care Financing and Service Delivery • Human/Social Capital • Health activist/ASHA • Community Resource Person (CRP) • Health subcommittee Case Managers Microfinance Product for NUTRITION Health Risk Fund/ Health Savings Nutrition & Health Day (NHD) Health Insurance Community-owned Pharmacy Making Services Work for the Poor – Accessing PHCs & Area Hospitals Nutrition Centers Community-owned Hospitals Water & Sanitation

  4. Universal approach Capacity building of stakeholders Convergence with line depts. Fixed NHDs Screening camps for Women Community managed interventions as proposed in Village health action plans. Health Risk fund Community kitchen gardens Weaning foods Safe water supply and sanitation to make ODF villages Case managers at public and net work hospitals Intensive approach BCC through health CRPs Establishment of Nutrition cum day care centers (NDCCs) Provides balanced, complete meals to pregnant and lactating women and children <5 yrs. Venue for delivery of other H&N Program services: NH Day (immunization, growth monitoring, ANC) Health Education (Films and Flip books and case studies etc.,) Health Savings/Health Risk Fund Discussion of Water & Sanitation activities Community Kitchen Gardens Introduction of weaning foods Approaches adopted

  5. Process: NDCC • The Nutrition cum Day Care Centers (NDCC) are entirely funded by the community – member/beneficiary and the VO – through a “pay-per-use-plan”. The cost of TWO MEALS PER DAY is Rs 25 for pregnant mothers and Rs 10 for children. • The cost of meal for the pregnant mother is SUBSIDIZED. The subsidy is funded by their respective VOs via internal accruals in the year 2007-08. Subsequently, the same is being dovetailed in the form of kind from ICDS which is a Government program targeting pregnant mothers. • The pregnant mothers are extended a micro loan to finance the cost of their meal program, through their respective SHG i.e., consumption smoothing via a consumption loan. • The loan will be repaid over 36-40 months depending on the cash-flow status of the beneficiary.

  6. Status • Adopted BCC strategy thru’ 900 Community Resource Persons (CRPs) and established 680 NDCCs in 63 mandals till the end of Feb 09. • Against Rs 2000 lakhs sanctioned under NRHM for both universal and intensive approaches adopted in the project, Rs 1993 lakhs was the expenditure till the end of Feb 09.

  7. Impact • The Nutrition Center has lead to a reduction in no.of neonatal, infant and maternal deaths and a with improved nutrition seeking behaviour and adequate knowledge on maternal and neonatal care practices among the rural poor. • Impact assessment by SOCHURSOD, the external agency under the supervision and guidance of Dr.Drole, CRHP, Jamkhed and assistance from Interns from John Hopkins University, USA is under way. • Interim report (draft) results from 3 tribal districts is prepared.

  8. Comparison of maternal and child health outcomes *during current or most recent completed pregnancy, # includes children who were weighed within 3 days of birth. ** Birth weight recorded from the base register at NDCCs where the newly supplied weighing machines available are in working condition. *** Birth weight recorded from the registers of AWCs where the weighing machines supplied are not in working condition.

  9. Impact of H&N Program on utilization of government public health services *during most recent complete pregnancy /delivery **during most recent completed pregnancy or current pregnancy

  10. . Impact of H&N Program on health knowledge and behavior change

  11. Thank You

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