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Securing lives and livelihoods: A multi-touch approach for healthy, self-reliant village communities

Oct 22, 2010

By equipping rural communities in Allahabad, India, with tools of education, information and awareness, Japanese NGO: Asian Sustainable Holistic Approach (ASHA) and the Japan International Cooperation Agency (JICA) are transforming lives.

[Click to read in Japanese]

ASHA has been working with Makino School of Continuing and Non-formal Education (MSCNE) for seven years as a partner in rural development activities. The school is a unit of Sam Higginbottom Institute of Agriculture, Sciences & Technology (SHIATS), Allahabad formerly Allahabad Agricultural Institute. The initiatives address knowledge gaps in the critical areas of health, education and self-reliance.

Chota Kanjasa is a small village amid lush green fields on the banks of the Yamuna in the Allahabad district of Uttar Pradesh. The village, located away from the hustle-bustle of Allahabad city, is mostly inhabited by fishermen and landless farm labourers.

kakuta

Accompanied by Dr. Teruo Miura, Dean, Makino School of Continuing and Non-Formal Education (MSCNE-SHIATS), and Project Manager sent by ASHA, we make our way to a little building, which seems to be the command central for all MSCNE/ASHA run initiatives, including a small primary school.

The place is bustling with activity as we enter. A group of women is sitting on a plastic mattress, making entries in their registers; another group is watching intently as a man demonstrates the correct way of planting seeds and covering them with leaves for protection from the wind, rain and animals; a lady addresses some women over the din caused by children and a group of elders busy talking to each other.

“The women are attending a workshop on kitchen gardens today. Since most of the people here are landless, being farm labourers or belonging to indigenous tribes, we are teaching them how to grow vegetables in bags that can be placed in small but safe spaces, even on their roofs. The focus of the workshop today is on benefits of locally grown vegetables,” explains Ms. Manmeet, a health coordinator at MSCNE.

“We realised that there is hardly any awareness here on the nutritive value of food items. People eat to fill stomachs not to stay healthy. An average meal here mostly consists of potato, rice and wheat. The lack of essential nutrients has led to the widespread prevalence of a number of diseases.” she elaborates. “The majority of children here, for example, suffered from chronic malnutrition.”

According to Ms. Takako Miura, a health specialist sent byASHA, “Women and girls were especially marginalised and vulnerable owing to low literacy rates and the patriarchal nature of the local community. Often, the dominance of family elders and husbands in decisions made it harder for women to adopt healthier practices for themselves.”

Superstition mixed with a lack of awareness on good health practices was a potent combination that MSCNE/ASHA had to work hard to address. For instance, it was considered bad luck to acknowledge a pregnancy, so few women sought prenatal care. Few understood the benefits of immediate and exclusive breastfeeding. Families were hesitant to regularly weigh their newborns as they feared it would jinx the baby’s health.

The MSCNE/ASHA team realised that one critical reason of low health indicators was also a lack of better options. It was felt that the best way to improve the health conditions was to adopt a holistic approach; that is centralising knowledge and information sharing while addressing other quality of life issues like education and employment.

To realise this aim, ASHA with support from JICA runs two major programmes in and around six villages in Allahabad. The Improvement of Rural Nutrition and Child and Mother Care Project addresses the problem of malnutrition of mothers and their infants through the identification and training of Village Health Volunteers (VHVs) and organisation of regular health seminars.

Adult literacy

The Practical Farmers’ Education for Improvement of Quality of Life among Small-scale Farmers in North India is synergised with ASHA run school and non-formal education projects to provide critical income-generation and livelihood opportunities through micro-finance and self-help groups and training in animal husbandry and food processing.

“Our aim was to equip the local population, especially women and children, with information and ideas to help them lead healthy and secure lives,” says Dr. Miura.

Addressing early life health concerns

The Child and Mother Care Project was initiated by ASHA in partnership with a Japanese organisation Ajinomoto in 2008. The project entered a new phase with support from JICA, in January 2010.

As part of the initiative, Village Health Volunteers (VHVs) play a critical role in spreading awareness and ensuring follow-up on key health concerns. They conduct seminars and workshops on a regular basis to ensure that the right messages are continually circulated amongst the target communities.

“To make improvements in the health of women, it is very important to educate them and make them aware of the developments taking place around them,” observes Dr. Miura.

Thirteen VHVs circulate in six villages, offering advice and returning often to check in on the expectant mothers and the babies as they are born.

“I was teaching at a village school when I was chosen as a VHV by MSCNE/ASHA a few years back. I am now in charge of three villages. I visit the villages regularly, befriending the women and counselling them - even their families - on the benefits of breastfeeding and eating wholesome food,” says Ms. Phoolkali.

VHVs

Focus has been on training the VHVs and increasing their knowledge of maternal and child health. They in turn, teach families about the importance of prenatal care and signs of stress to the child or mother, during pregnancy, birthing and the postpartum period.

“More than two hundred children are being monitored currently,” confirms Ms. Miura.

“We record the height and weight of newborns every three months in the Mother and Child books which are provided to pregnant women and mothers who have children below the age of five. These booklets provide information about the baby’s growth and vaccination status. There is a remarks column where we can insert specific advice as well,” Ms. Phoolkali adds.

If the baby does not register satisfactory growth over a period of time, the VHV advices the mother on food intake and breastfeeding practices, and visits the family regularly to keep track of the child’s growth. “We try to understand what kind of issues confront the family, why is it that the child is not receiving adequate nutrition,” explains Ms. Pushpa Devi, a VHV from Kanjasa.

“Initially, the women refused to attend health gatherings; many did not believe in our programmes. They have gradually started taking us seriously, after seeing some real results,” says Ms. Manmeet.

“Challenges still remain; our expectation to reach a larger number of people has not been entirely fulfilled. Also, it takes time to bring change in people’s attitudes and to ensure that the change is permanent. So, we have a long way to go,” says Dr. Miura.

Planting seeds of security

The Practical Farmers’ Education Project launched in April 2009 provides essential training in integrated sustainable agriculture, animal husbandry and poultry farming, and food processing to local farmers to expose them to varied ways of generating income.

Kitchen garden

“Since most residents are poor, we focus on affordable, sustainable agriculture that generates some income and encourages a healthy lifestyle. For example, we recommend they use organic fertilisers like husk charcoal as it is inexpensive and easily available,” states Dr. Miura. The produce is sold through cooperatives.

“I was unemployed until a few years back,” says Mr. Rajendra Prasad, as he tends to a batch of yellow chickens. “I heard about the animal husbandry programme in MSCNE/ASHA and enrolled for training. I am a poultry farmer now. Today I earn enough to meet all the needs of my family.”

Along with technical training, MSCNE/ASHA considered it crucial to build the financial management capacity of the residents.

The formation of Self Help Groups (SHGs) by MSCNE/ASHA played a significant role. Today the SHGs, through a system of microfinance and microcredit, enable villagers to get loans for meeting urgent expenses at affordable interest rates. Active SHG members along with members of other youth groups go from village to village, motivating people to reap gains from microfinance.

Availability of credit and opportunities for saving has also contributed to the empowerment of women in the community.

SHGs

“Initially the women were not convinced - as SHGs were not popular in the area. ASHA facilitators addressed this issue by enrolling the support of the more social and well-liked women, i.e. the informal group leaders of the community. Once convinced, these women helped pull the other women in” explained Dr. Muira.

"Each SHG has about 10-12 members. As the women are trained in income generation activities, and are mentored to play the roles of president, vice president and treasurer for the group, they develop confidence. Some take on bigger, leadership roles in propagating MSCNE/ASHA's work," says Ms. Namita, coordinator of microfinance at MSCNE. Ms. Namita has been instrumental in the creation of over 40 SHGs during the year.

"I took a loan too. We invested the money to expand our agriculture business. We could buy better soil and the profit we incurred was deposited back in the SHG account," an SHG member from Bargohana village reveals proudly.

Building bonds of trust

MSCNE/ASHA now shares a relationship of trust with the villages. People not only follow coordinator’s advice but are also eager to learn more. Each family is associated with at least one initiative. There have been many positive changes over time,” says Mr. A.K. Mishra.

ASHA staff

Many local residents report an increase in income; average literacy rates also show improvement. Even more importantly perhaps, a much higher number of girls now attend school. Women feel better equipped to take charge of the well being of their family, as well of their own.

Now that they are planning the next phase of activities, 'ASHA' (meaning hope in Hindi)  is truly hopeful that it will continue to make a difference in the lives of the rural poor by leveraging the lessons learnt so far. Important among those is the need of using the right tools and offering the right incentives to affect lasting change.

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