Who We Are?

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!