Who We Are?

Our Experience

This a research collaboration with De Montfort University, Leicester, United Kingdom. Its a nine months intervention (November 2023 – July 2024). The project aims to take forward the findings of MeHeLP India project (https://www.mehelp.in). The idea is to engage with public health professionals and policy makers for knowledge exchange and impact by developing a sustainable mental health literacy programme. Key activities planned are as under:

  • Three workshops on mental health literacy with public health professionals from Public Health Resource Society
  • Three workshops on mental health literacy with public health frontline workers
  • Development of a Participatory Learning Action programme (module) on mental health literacy for public health workforce
  • Pilot the Public health mental health literacy programme with public health professionals and workers in Delhi
  • Evaluation of the programme and modifications for sustainable mental health literacy learning resources for public health professionals and frontline public health workers
  • Submit a substantive research proposal to UKRI (ESRC) based on the participatory action learning programme research for public health professions in other Indian States in association with the Public Health Resource Society, the Public Health Foundation of India and the National Institute for Mental Health and Neurosciences, Bengaluru, India (NIMHANS)

With support from Azim Premji Foundation, PHRS has initiated the Rural Creche Initiative in Odisha which is an extension (with added components) of the Mainstreaming creches to reduce malnutrition in Odisha. The key activities planned are as follow:

  • Sustain the operation of 22 existing creches across three blocks of Rayagada district for the next three years (Rayagada Sadar block -10 creches, Kalyansingpur block -10 creches, and Bissamcuttack block – 2 creches)
  • Establish 40 new creches in villages where particularly vulnerable tribal groups (PVTG) reside in Kalyansingpur block of Rayagada district, Odisha
  • Sustain the 31 existing creches located in three blocks of Malkangiri and one block of Kalahandi until a suitable local organization capable of seamlessly taking over creche operations is identified
  • Provide technical support for operating & managing creches to other organizations in South Odisha and to SC & ST department, Government of Odisha for their creche initiative

“Gender nutrition: Equal access to sufficient and healthy food strengthens the food security of women and small children” has been implemented in 100 villages of Chhattisgarh. PHRS and Chapual have jointly implemented this project. The project will contribute to minimizing hunger, acute malnutrition and increase self-reliance in food and nutrition among marginalized communities, especially women and children in north Chhattisgarh, India. The aim of the project is –

  • to increase gender equality and decision making in fair food distribution by women and girls in the 100 villages
  • ensure food and nutritional security and dietary diversity for children, adolescent girls and women
  • improve quality and access to public services on general women and child health and nutrition
  • promote model of nutrition and health care in community setting for addressing malnutrition and gender rights.

PHRS has undertaken this study in multiple states including Assam, Chhattisgarh, Delhi, Jharkhand, and Odisha with support from the National Health Systems Resource Centre. The aim of the study is to assess the proportion of treatment adherence for diabetes and/or hypertension and identify factors associated with treatment adherence in different contexts. The objectives of the study are –

  • To assess the proportion and describe the enablers and barriers affecting treatment adherence among patients diagnosed with diabetes and/or hypertension at health facilities in selected study sites with varying contexts.
  • To examine the implementation of interventions planned for treatment adherence under universal screening of NCDs in different settings.
  • To formulate general and context-specific recommendations to increase treatment adherence to Hypertension and Diabetes

This project is being undertaken by Public Health Resource Society (PHRS) under the MOMENTUM suite of awards, funded by the U.S. Agency for International Development (USAID). MOMENTUM is made possible by the generous support of the American people through Federal Award Number: 7200AA20CA00002 between Jhpiego Corporation and PHRS. For the purpose of documentation, this project is called ‘Mobilization and Advocacy for the Girl Child’ (MAGiC), Formally, the project is titled ‘Advocacy for importance of girl child through evidence generation and mass communication campaign’. Under the MCGL initiative, the overall goal of the project is to provide funding paired with technical and capacity development assistance to allow PHRS to accept, manage, and deliver on ever growing sums of donor funds, so as to eventually graduate to receiving direct funding from USAID. PHRS will be working with MCGL team on advocacy for the importance of girl child through evidence generation and mass communication campaign in Deoghar district of Jharkhand.

A series of activities were planned under the aegis of USAID MOMENTUM’s MAGiC, as defined by the scope of work. This included a desk review to thoroughly understand the legal and regulatory frameworks related to the status of the girl child in India as well as the past work on these themes; a formative study to understand the gender dynamics in the community; case study documentation to highlight issues of gender discrimination; and a mass communication campaign using culturally appropriate and acceptable methods.

The overall goal of the project is to enable a better quality of life for the girl child with girls and women free to pursue their fundamental rights and freedom. With this context, the objectives of the project are:

  • Increase community awareness on biological sex determination, PCPNDT Act, and rights and entitlements by 50% through community mobilization activities (nukkad naataks, rallies, community meetings, etc.) in 20 villages of Madhupur block by 31 March 2023.

  • Improve girl child education by increasing middle school enrolment of girls by 30% though community mobilization activities (nukkad naataks, rallies, community meetings, etc.) and home visits to influence parents of dropped out children in 20 villages of Madhupur block by 31 March 2023.

  • Reduce cases of early marriage by 50% through community mobilization activities (nukkad naataks, rallies, community meetings, etc.) and activation of Project Panchi committees in 20 villages of Madhupur block by 31 March 2023.

Public Health Resource Society is conducting a one-year research study entitled ‘Prevalence and causes of malnutrition among under-five children across selected geographies in India’ sanctioned by National Human Rights Commission. The study took off in April 2022 and is being conducted across four states in India namely Delhi, Odisha, Rajasthan, and Assam. Malnutrition among under-five children has been a growing menace in the country since many decades. It is caused by multiple short and long-term interrelated factors and leads to detrimental health effects among children, affecting the entire life cycle. Despite an array of national and state programmes to address this issue, the improvement remains stagnant indicating an urgent need to assess the various factors leading to malnutrition with a geographical lens and identify gaps in the implementation of the programmes. With this context, the study aims to find the prevalence and determinants of malnutrition among children enrolled in Anganwadi centres in selected geographies and identify the factors at various levels leading to the poor health and nutritional status of the children. The specific objectives of this study are:

  • To determine the prevalence of malnutrition among children under five years enrolled in the Anganwadi centres in selected geographies

  • To study the household, community, and systems level factors associated with malnutrition among underweight children in the Anganwadi centres

  • To assess the service delivery of ICDS in the selected AWCs

  • To identify gaps and formulate targeted recommendations to improve the nutritional status of children under five

PHRS has partnered with UNICEF to support the Godda District Administration in strengthening the ‘Suposhit Godda’ programme. This programme is focused on community-based management of Severely Acute Malnourished (SAM) children and is funded by the District Mineral Foundation Trust, Godda. While it is currently being implemented in two blocks of Godda- Sunderpahadi and Poraiyahat, the programme will be scaled up across all the Anganwadi centres in the district. As part of the implementation, PHRS has been providing handholding support to ASHAs, AWWs and ANMs (AAA) during VHSNDs, sector meetings etc.

“Mainstreaming Creches to Reduce Malnutrition in Odisha” is an innovative intervention as a result of Public Health Resource Network’s (PHRN’s) experience and expertise on child malnutrition, and Azim Premji Philanthropic Initiatives’ (APPI’s) commitment to reduce the same in Odisha, combined with the government’s strong will.

The model houses community based creches for children in the age group of 6 months to three years in rural and remote geographies of Odisha. Creches caters to the needs of children like facilitated feeding, early stimulation, sleep, and rest while parents are at work. It also supplements the efforts of ICDS and health in growth monitoring including monthly anthropometry, identification of growth faltering and severe malnutrition, referrals to health facilities as per the protocols and follow-up after discharge.

The major objectives of the programme are:

  1. To establish and run 150 community-based crèches across the five most vulnerable districts of Odisha to inform eventual scale-up by Government of Odisha

  2. To achieve continuity of care between the community (ICDS, ASHA, ANM) and Nutrition Rehabilitation Centres (NRCs) and develop a model for the same for scale-up

  3. To assist scale-up by creating the required resources and tools

  4. Support the mainstreaming and scaleup of creches through various programmes and strategies undertaken by the government of Odisha

The programme started with the implementation of 150 community based creches in five most nutritionally vulnerable districts of Odisha i.e., Rayagada, Koraput, Malkangiri, Kalahandi and Nabarangpur spread over 13 districts. Three blocks were explicitly chosen for setting up creches in the villages with the PVTG (Particularly Vulnerable Tribal Group) communities. The programme started in May 2017 and the creches started to roll out from October 2017 in a phased manner.

Support to Odisha PVTG Nutrition Improvement Programme (OPNIP)

OPNIP is an outreach programme of the ST&SC Development, Minorities and Backward Classes Welfare Department, Government of Odisha. Along with the other nutrition programmes like spot feeding centres for children (3-6 years) and maternal spot feeding centres for pregnant women and lactating mothers, the programme has taken over 25 of the 150 creches situated in the villages with PVTG communities. 36 new creches have been added to the programme. Taking forward the objective to support the government of Odisha in scaling up creches in the state PHRS is providing technical support to OPNIP through a programme management unit at the state level.

Support to Women and Child Development, Government of Odisha

The Department of Women & Child Development is the parent department for all the initiatives related to the development of women and children and it is exploring different options to roll out creches in the state. PHRS has set up a PMU at the secretariat to support the department in designing and rolling out creches in the state.

Vaccination Drive

Under the ‘Mainstreaming creche’ programme, PHRS with support from Azim Premji Foundation started an intervention to accelerate vaccination drive in two PHCs of Khairput block under Malkangiri district of Odisha from August 2021 which was later it expanded to other four blocks/CHCs of Malkangiri and Rayagada district and one PHC of Khairput block from December 2021. The objective of the drive was:

  • To support Primary Health Centres (PHCs) and Community Health Centres (CHCs) to achieve 100% COVID 19 vaccination in selected geographies within 6 months as measured through PHC evaluations.

  • To increase vaccine uptake through community mobilizations within months as measured through vaccination status at community-level.

  • To address vaccine hesitancy within communities through mass campaigns and events.

  • Assist in recording and providing relief for side effects of vaccination if any.

This drive was facilitated to bridge the gap between the community and the system to achieve 100% vaccination coverage among PVTG communities of Malkangiri and Rayagada district over a period of six months. Volunteers were identified and engaged for baseline data collection, mass, and targeted mobilisation, and support the vaccination camps. Community level influencers were identified to create awareness via IEC activities such as miking, meetings, and home visits etc. In collaboration with the CHC Khairput, micro plans were developed for organising the vaccination camps. With appropriate support from the district administration, ICDS, frontline workers and other stakeholders this vaccination drive was a success.

A collaborative effort by Public Health Resource Society Ekjut, Child In Need Institute, Chaupal & Idea supported byTata Social Welfare Trust

Action Against Malnutrition (AAM), the flagship programme of PHRS is a multi-strategy intervention in seven blocks of four states – Bihar, Jharkhand, Chhattisgarh and Odisha through a consortium consisting of Public Health Resource Society (PHRS), Ekjut, Child in Need Institute(CINI), Chaupal Gramin Prashikshan Evam Shodh Sanathan (Chaupal), and Institute of Development Education and Action (IDEA). The programme is supported by Tata Social Welfare Trust. The AAM programme has been conceived as a model to demonstrate the importance and effectiveness of community mobilization, working with Systems and specific community-based management of malnutrition. The target group of the programme is children from zero to three years of age. This was initiated in June 2012 and completed in three years in May 2015. An extension was approved to continue the project till April 2016 by the Trusts with unspent funds from previous grant and a small bridge grant being allotted for the extension period which was extended till February 2017 with a fresh grant. Tata Trusts has given further no-cost extension till February 2018. However, PHRS is actively looking for funds to continue the crèches. A baseline and endline study done by Ekjut is still pending, and needs to be followed up.

A total of 5384 children and an almost equal number of mothers were reached through crèche programme till March 2017.

Strategies:

Building on the collective experience of the Public Health Resource Society, Ekjut and Jan Swasthya Sahyog, a three-pronged intervention has been developed.

A full-fledged research protocol and MIS has been developed to monitor and review this project. One of the objectives of this project is to be able to demonstrate a model with rigorous evidence that can be used as a basis for scaling-up through public programmes such as the ‘restructured ICDS’.

Partnerships for Women’s Empowerment and Rights (PoWER)

Public Health Resource Society (PHRS) is in partnership with Professional Assistance for Development Action (PRADAN) to support them to evolve and implement a comprehensive strategy that interlinks health and nutrition with agriculture and other livelihood practices. This collaborative initiative is supported by BMGF Foundation under the aegis of Partnerships for Women’s Empowerment and Rights (PoWER). This project aims to bring positive changes towards health and nutrition of women and children and linking it with agricultural practices and livelihood.

The following strategy is being adopted to achieve the intended outcome:

  • Working with Women’s Group
  • Working with Systems
  • Leveraging agriculture and livelihood practices towards improving health and nutrition by the following strategies –  Facilitating production and distribution of more nutritious staple crops and improving consumption of nutritious food. –  Increase access to nutritious food and improve intake of nutritious food among women and children.

The project was first piloted at Kathikund block in Dumka district, Sonua block in West Singhbhum district of Jharkhand and Balliguda block of Kandhamal district in Odisha where various tools were tested. This pilot phase led to the creation of cadres of mentors and change vectors (CVs) with distinct roles; the mentor guides and enables a team of 20 change vectors to achieve the intended outcomes.

At present, the programme is being implemented in five blocks across two states – Kathikund and Sonua in Jharkhand, and Balliguda, K. Nuagaon and Jaykaypur in Odisha – reaching out to 1,445 SHGs and 18,667 households across 288 villages.

SHG led Transformation of Rural Communities through Partnerships (STaRtuP)

This collaborative project between PHRS and PRADAN is supported by IKEA Foundation under the aegis of “SHG led Transformation of Rural Communities through Partnerships”. The project objectives are to build the perspective, knowledge and skills among the PRADAN staff around the issues of health and nutrition and sharpen their understanding around nutrition sensitive engagements, increase awareness among women to help understand the underlying causes and practices related to malnutrition, increase access to government interventions, especially to ICDS, water and sanitation, and health department, as well as reduce malnutrition and anaemia among women and children. Initially, the project was being implemented in four blocks across three states – Darbha (Chhattisgarh), Jhalda (West Bengal), Mohgaon and Samnapur (Madhya Pradesh), covering 17,035 households across 133 villages.

The project has now grown to cover new geographic areas, namely, Amarpur, Paraswada and Lamta (Madhya Pradesh), Mahagama and Godda (Jharkhand), Katoria and Chakai (Bihar). At the same time, adolescent health and well-being has been added as a new theme in the intervention.

A three-fold strategy has been adopted to achieve the intended outcomes. First, working with women’s groups through CVs who act as community catalysts. The CV is guided and supported by mentors who also act as community mobilizers. Each mentor handholds about 20 CVs through their work. The CV conducts monthly meetings on nutrition, health, and other larger issues affecting health and nutrition such as social determinants, gender, early marriage, etc. Second, working with systems by engaging with frontline workers and government departments, as well as building a movement around rights and entitlements in the community. Last, leveraging agricultural and livelihood practices towards improving health and nutrition of families, and especially among women and children.

Partnerships and opportunities to Strengthen and Harmonize Actions in Nutrition (POSHAN) in India

PHRS in partnership with Institute for Development Studies (IDS), Sussex and International Food Policy Research Institute (IFPRI) has initiated a knowledge networking project in Mayurbhanj and Keonjhar districts of Odisha. The project is for generation of knowledge on nutrition specific and nutrition sensitive interventions; and their mobilization and dissemination among various stakeholders at different levels. The aim of this networking is to initiate/achieve effective multi-sectoral convergence in delivering nutritional services.

The objectives of the programme are as follows:

  • To conduct knowledge mobilization activities around the issues of malnutrition
  • To create a network of Civil Society Organisations (CSOs) and government functionaries working on nutrition related issues, beginning with two identified districts and possibly at the state level
  • To share the experiences and findings from the knowledge network with other stakeholders in the nutrition community
  • To develop knowledge products on POSHAN themes.

The activities conducted under POSHAN included (i) Development of 30 District Nutrition profile and widely disseminating them (ii) State level consultation on 21st May, 2016. This project formally came to a close on 31st May 2016.

The project ‘Partnerships for Rural Integrated Development and Empowerment (PRIDE)’, aims to bring about changes by adopting scientific practices around health, nutrition and hygiene. It also aims to increase access to quality public health services through the collective action of Self-Help Groups (SHGs). This project is being implemented for a period of three years and is running in areas where both women and children are often under-nourished. The focus areas of the project thus include basic health care and the nutrition needs of pregnant women, young mothers, and infants.

The aim of the project is to develop process protocols to trigger transformation of villages in endemic poverty by adopting scientific practices around health, nutrition, and hygiene along with access to quality public health services. The basic premise for the pilot project is as follows:

  • Women acting as change agents can bring about all around multi-dimensional transformation of many lives [100,000 women and their children (~250,000)]
  • Building capacities of women and their collectives triggers mass change.
  • Successful interplay between empowered citizens, responsive state and engaged markets can be demonstrated.

PHRN plays a leading role in the project by anchoring its hub and technical work. It also serves as an implementing partner.

PROJECT STRATEGY

The PRIDE project has a two-pronged strategy:

  1. Developing the perspectives, skills, and knowledge of women in organized collectives to enable them to take responsibility for all members of SHGs and their collectives.
  2. Engaging with the public system to build the capabilities of frontline staff and work at the state level to ensure smooth fund flows around basic services.
    Women as Change Makers

The strategy revolves around supporting women who are part of Self-Help Groups (SHGs) run by PRADAN. Select women volunteers are actively supported by training them on the project themes (described below). These women volunteers – called Change Vectors – are selected based on their commitment to make change happen in their respective geographies and SHGs. In this phase, the plan is to have at least 2 CVs in each village (one CV per hamlet), who will influence the decision making of other women. Having at least two women as CVs in hamlet is a strategy to enable them to support each other as well as function as a cushion against attrition.

Central Themes

The following themes are central to the implementation of the project:

  • RCH: Complete ANCs, HRP detection, institutional deliveries, PNCs, Full-Immunization of children, Adoption of IYCF practices, Mineral & Vitamin supplements, etc.
  • Nutrition sufficiency and Security: Food diversity, linking it to agriculture, dealing with underlying issues of gender (e.g. intra-family food distribution, early marriage, early pregnancy, leading to low birth-weight babies, etc.)
  • Communicable/Endemic diseases: Preventive community led efforts to adopt best practices to deal with 1-2 key endemic diseases in the local area.

Systems strengthening at all levels (block and state)

To actively engage in systems strengthening at the state and district levels. At the village level, at least 5-6 mentors from each block will be actively involved in systems strengthening. Activation of the community public system will be done in close collaboration with the block level Federations of SHGs and PRADAN.

Geography of the project

The project currently runs in seven blocks across three states – Jharkhand, Chhattisgarh and Orissa.


Implementation Strategy

The change process in the health and nutrition domain is triggered by the grassroots NGO, supported by thematic partners working closely with the SHGs and their associative tiers. This in turn is supported by developing an eco-system of public systems, services and entitlements. The adjoining diagram depicts the action framework. Grassroot NGOs supported by the thematic partners work closely with SHG-Federations and the primary groups to trigger latent aspirations. Realizing that change can be triggered only from within communities, the G-NGO triggers processes for:

  • The identification of change vectors from within the collectives.
  • Build capacities of the federation office bearers and various sub-committee members as change agents, strengthen the overall leadership and functioning of the the collectives at different levels.

The G-NGO supported by the thematic partners also works with the local government systems to strengthen the interface between the collectives and the Panchayati Raj Institutions and the last-mile functionaries of the government. The G-NGO also makes efforts to link the community collectives with appropriate services around livelihoods and other basic needs.

Thus, the key grassroots engagement strategy is:

  • Triggering processes in primary groups around issues on which the community can act on their own (these are typically around intra-community practices).
  • Building capacities of the associative tiers (village level or panchayat associations and block level federations) to engage on issues which the community can work on with the support of NGOs and the local government system.
  • The upstream engagement to strengthen public systems will be acted upon by partners with thematic expertise supported by TRI.

PHRN plays the lead role in the Health Sector Council, along with TRI, which is based in Delhi. Two programme coordinators along with the technical lead and project director from PHRN support this council. PHRN is also the thematic partner for technical expertise and implementation of the programme. As a Health Sector Council and technical organisation, PHRS conducts master trainings of trainers, develops micro-modules and protocols, liaisons with other partners in organising planning meetings, etc. For the implementation of the project, PHRS personnel are posted at various levels – at the state level, we have one programme coordinator in Jharkhand and Chhattisgarh respectively. At the block level, we have seven Block Programme Coordinators (BPOs) who work closely with the grassroots NGO (PRADAN). There are mentors (1 per 20 CVs) who are constantly supported by BPOs and provide handholding support to the CVs in village level transactions.

Training Strategy

A cascade training strategy has been designed for training SHG members. The strategy involves the development of a pool of Master Trainers in the curriculum developed around the project themes. These Master Trainers then train the block level pool of trainers. The block level pool of trainers consists of mentors, block coordinators, federation members, and CVs. From this pool, two trainers undertake ongoing mentoring of CVs as they go about implementing what they learn from the Master Trainers. The CVs conduct meetings with their SHGs and impart knowledge on the thematic areas that have been spelt out in the project.

Cascade Design Training Strategy

Training Strategy

Our Perspective Building (PB) Modules on Health and Nutrition

To build the capacities of our Change Vectors, three ‘Perspective Building’ (PB) modules have been developed by PHRN in collaboration with other technical partners. These modules have been designed to discuss selected issues in a interactive and nuanced way, keeping in mind principles of Participatory Learning Activity (PLA) cycle. i.e. a situational analysis leading to action. While the first two modules (PB1 and PB2) are being rolled out in different areas of Jharkhand, Chhattisgarh and Odisha. The PB3 module is in the process of being finalized.

The modules cover the following issues:

  1. Sex, Gender and Power (Difference between sex and gender; introducing concepts of power with respect to gender).
  2. Understanding Food and Nutrition (Three types of food groups and a balanced diet) Micro module.
  3. Food Security: Our Farms, Our Food (Concept of kitchen garden).
  4. Aspects of Care during Pregnancy.
    Care during and after Delivery (Maya’s Story).
  5. Planning our Family (Importance of Family Planning,
  6. Shila’s Story, introduction to different family planning methods).
  7. Adolescent Health and Wellbeing (Changes during adolescence, menstrual health, body mapping/an introduction to body systems).
    Lifecycle
  8. Approach and IYCF Part 1 (Breastfeedin) (Lifecycle Approach, exclusive breastfeeding and neonatal care).
  9. Understanding Malnutrition and IYCF Part II (Complementary feeding) (Introduction to Malnutrition, complementary feeding: helpful and unhelpful practices).
    Malnutrition and Childhood Diseases, Preventing and Managing Diarrhoea (Link between malnutrition and disease, common childhood diseases with a focus on diarrhoea).
  10. Childhood Diseases (Contd.) Pneumonia, Measles, Immunization (Prevention and Management of pneumonia and measles, Importance of immunization.
  11. Early Marriage (Challenges during adolescence, factors which lead to early marriage, disadvantages of and possible interventions to prevent early marriage).
  12. Domestic Violence (What constitutes violence, types of domestic violence, possible interventions at the individual, community and systemic level).
  13. Malaria and Anaemia (Introduction to malaria and anaemia: diagnosis, prevention and treatment, link between malaria and anaemia).
  14. Tuberculosis (Introduction to TB, diagnosis, prevention and treatment: importance of nutrition and completing the full course of treatment).
  15. Rights and Entitlements (Introduction to Rights and Entitlements, importance of voting, direct and indirect taxes, details of some important entitlements).
  16. Community-Based Monitoring (introduction to community-based monitoring and its processes, Jan Sunwai and the Right to Information Act).

Success stories of actions emanating from the modules have been trickling in: of women buying iron kadhais to fight anemia (the module on food and nutrition), of their husbands helping out more with household chores (Sex, Gender and Power), and discussions on the importance of menstrual hygiene with adolescent girls (Adolescent Health).

All the modules can be found on our partner Transform Rural India’s website (www.trif.in). We are extremely excited and proud to share these modules with everyone working in the health and nutrition space!

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