HEALTH ACTIVITIES

REPRODUCTIVE AND CHILD HEALTH PROJECT
INRECA had been Selected as District Mother NGO for Narmada District Scince-2004-2018 in order to carry out RCH activities in entire narmada district in association with other field NGO in all 4 talukas (now 5 talukas) and during this period; based on the following objective of RCH % Indicators
Overall Achievements of RCH Indicators(%)
 

Sr. No

RCH Indicators

2016-17

2017 -18

1

Early Registration/Total Registration

78.80 %

80.9%

2

ANC 3-4 Checkups/ Total Registration

65.02 %

69.01%

3

Institutional Deliveries/Total Deliveries

78.04 %

80.06%

4

Home Delivery

21.06 %

18.03%

5

PNC 3 Checkups/Total Deliverie

67.09 %

70.18%

6

Breastfeeding on 1stDay/Live Births

88.90 %

90.01%

7

Full Immunization/Live Birth

86.7 %

89.04%

8

JSY Benefit/Institutional Deliveries

65.35 %

79.01%

9

CJY Benefit/Institutional Deliveries

61.78 %

65.89%

10

Use of 108/Institutional Deliveries

74.71 %

82.05%

 

 

ROUTINE IMMUNISATION PROGRAMME
UNICEF has recognised INRECA Sansthan as partner for Narmada District as UNPP w.e.f. 2014-1015 onwards. the following achievements are endorsed as undp:-
 

Expected Results

Accomplished Results

NOVEMBER 2016 TO JULY 2018

 

 

 

90% of mothers with children below 2 years in the intervention area identified and engaged with

 

95.72 % of mothers with children below 2 years in the intervention area identified and engaged with.

Out of a total of 1215 children  1163 children who were already regular with RI were identified + 89 who were left out became regular and + 87 who were dropouts were brought in as regulars + Gray1 34 + Gray2  35 + Migration 29

 

 

Mothers meet conducted in at least 90 % of

project villages

 

Mothers meet conducted in at least 90% of

project villages

 

70% of mothers/caregivers of infants under age 2 years who can enumerate the FIC schedule (20% increase)

 

88.97% of mothers/caregivers of infants under age 2 years who can enumerate the FIC schedule (20% increase) out of a total of 1215 – 919 regular children are identified + 75 left out +87 dropout

are fully immunized=1081

 

85% mothers with children below 2 years maintain Mamta card and following schedule (15% increase)

 

 

86.58 % mothers with children below 2 years maintain Mamta card and following schedule (15% increase) Out of 1052 there are 919 children who already have Mamta cards + 46 left outs have availed Mamta cards + 87 Dropouts Having Mamta Card

 

 

Number of Community based influencers of 80% of villages oriented on RI

 

Number of Community based influencers of 91.14% of villages oriented on RI ( identified 350 PRIs & Bhagat, Bhuvas and Forest committees out them 319 total participated)

 

90% of LWs ,BCs       and VVs trained and can enumerate the RI schedule , demonstrate the

requisite SBCC skills of IPC

 

80% of LWs ,BCs       and VVs trained and can enumerate the RI schedule, demonstrate the

requisite SBCC skills of IPC

 

70% Pregnant Women shall be brought and get

them checkup at least four times till their safe delivery & PNC for their new born

 

67.53% Pregnant Women brought and get them

checkup at least four times till their safe delivery & PNC for their new born

 

 
ENGAGING AND STRENGTHENING LOCAL INSTITUTIONAL CAPABILITIES AND LINE DEPARMENT FACILITATOR THROUGH BEHAVIORAL CHANGE COMMUNICAITON FOR RESILIENT HEALTH CARE SYSTEMS IN NARMADA DISTRICT, GUJARAT. (Period of One Year 2018-20)
 
  Achievements:
 
1.   Against expected result of 70%, 83.89%% of Forest committee members have the capacity / Knowledge to promote four key behaviors of RI, IYCF practices  and Wash to the community.   
 
2.   Against expected result of 60%, 55.24% of identified key stakeholders (Such as Bhuva/Bhagat, Youth group Bhajan mandlaies etc.).
 

3.   Against expected result of 50% coverage of the health messages in the Gram Sabha the health and sanitation/hygiene message

4.   Against expected result of 80%, 80% field functionaries (Workers) have the capacity to promote four key behaviors

5.  Against expected result of 70% of students of Dediapada Block,   

   Challenges:
 
1.   Traditional food habits: the people are not ready to leave their traditional food habits.  
 

2.   Behavioral Problem: they are not ready to leave their traditional practices and behaviours

3.   The geographical layout of the district is such that there are pockets and areas which are very difficult to reach.
 
4.   It was difficult to convince the people to give priority to vaccination. 
 
5.  The influence of the elders over the community is very strong and to convince them
 
6.  There was a general lack of acceptance and it was difficult to convince them to accept the various health issues that the community faced. It was difficult to  make them prioritize issue which are not on their priority list
 
7.   Women are not the decision makers
 
8.   Stakeholders do not see immediate benefits accruing to them
 
9.   There was government staff crunch: there is a shortage of nurses and that result in Mamta Divas not being celebrated properly and the beneficiaries  remaining   deprived.
 

 EYE CAMP AND GENERAL HEALTH CAMP

INRECA is involved in conducting eyes camps and general health camps in tribal area since 1988 with the assistance of Dr. Doshi of Gujarat Blind Prevention Trust, Chikodra, Rotary Club; Ankleshwar, Lions Club, Vadodara etc. The local folks are being treated free of cost and hundreds of patients have been treated to by the INRECA & renewed salt merchant of Ankleshwar Shri Sureshbhai Jayantilal Shah had organized a big Eye camp at INRECA in association with Vishwa Hindu Parishad which covered almost entire Dediapada block. All minor and major 

operations are carried out, the patients were kept in INRECA complex for at least 7 days. Free lodging and boarding had been arranged. Spectacles distribution had also conducted free of cost. INRECA had organized one general camp in INRECA complex in association with Sardar Sarovar
 
Punrvasvat Agency, Vadodara & penal of doctors of Rajpipla jointly. Main emphasis was given to displaced families of Narmada dam as well as the patients of hear by villages likewise about 300 patients work treated during the camp of various diseases.
 
ENGAGING LOCAL INFLUENCERS AND CONVERGENT STRENGTHENING OF FLW CAPABILITIES IN SBCC FOR HOLISTIC DEVELOPMENT AND EMPOWERMENT OF ADOLESCENTS IN NARMADA DISTRICT, GUJARAT: 2019-20 
 
Across the world adolescents are recognized as young people aged between 10 to 19 years. It is a transitional stage of physical, physiological and psychological development from puberty to legal adulthood. They constitute more than 1.2 billion worldwide, and about 21% of Indian population. India has the largest adolescent population in the world. Ensuring adolescent friendly and quality health, nutrition and education services is a certain investment to securing the development, security and prosperity of their futures and those of generations to follow. Programmes for adolescents are f fragmented at present and do not comprehensively address all psycho-social, emotional, physical and aspirational needs of adolescent boys and girls. Access and availability of health care services are severely l imited. Negative norms and taboos accentuate access and opportunity to make life choices especially for adolescent girls. Lack of accurate information, absence of proper guidance, inadequate opportunities to build life skills and ignorance of parents and elders along with the patriarchal structures inhibit their active participation in decisions that affect their lives. The situation in vulnerable and marginalised populations in tribal dominant districts like Narmada in Gujarat need urgent and immediate attention. Drop-outs from schools, especially among girls, early marriage and pregnancies, poor nutritional status, inadequate knowledge and adoption of sanitation and hygiene practices make girls and boys of Narmada multi- dimensionally deprived. To achieve wholesome adolescent health, there is need to have a multidimensional approach covering all the adolescent health and nutrition problems including emphasis on mental health, HIV prevention. A social and behaviour change communication approach towards healthy l i festyle and positive social environment to acquire life skills needs to mainstreamed in this region to ensure girls and boys are fit in all regards to take control of their lives and their future families. There are 1.3 lakh adolescents in Narmada having a sex ratio of 922. Girls are more likely to be illiterate and out of school than boys as per the 2011 census. Education indicators of Narmada are lower compared to the state. Transition rate from primary to secondary is 8% lower. Enrolment rate for the 14-15 year old adolescents is dropping and is lower than the state. 59% of the 14-15 year old adolescents don’t go to school. Narmada district stands 7th at 33.1% of young adult women being married before their 18th birthday and it is higher than the overall Gujarat figure of 24.9%. Nearly 11% of teenage girls (15-19 years) were either pregnant or mothers at the time of NFHS 4 survey. As per DISE in 2016-17, Adolescent girl enrolment is higher in 11-13 years and 16-17 years age group. According to the 2011 Census 8.2% of 10-14 year old adolescents in Narmada are involved in Child Labour. This is higher than the state figure of 6.1%. 85% of the 15-19 year old adolescents who are main workers are literate, however 62% have not completed 10th grade of school. The proposed project is based on the data of NFHS-4 as well as of the Social Behaviour Change in the thematic areas of issues related Adolescents.
 
 
ADRESSING GAPS IN SERVICE DELIVER OF ECD INDICATORS AND CHILD & MATERNAL HEALTH DURING COVID-19 PANDEMIC – 2020-21.
 
 FINDINGS – BENEFICIARIES/VILLAGE INFLUENCERS.
 
1.   There was active participation of the villagers and village leaders/influencers in ensuring that protocols for the lockdown were in place. They ensured that the roads leading to and out of the village were closed; people did not gather in large numbers and maintained social distancing. They also helped in making arrangements for staying for people who came from outside the village and also took them to the PHC for check up. In Tilakwada; Nandod and Garudeshwar they did not pass on the message of wearing mask to the people or frequently washing their hand. This was done in Dediyapada and Sagbara. 
 
2.   The priorities of the villagers used to be to ensure that their family had food and their livestock had fodder. The villagers were allowed to go to their farms for farming and majority of the farmers were busy in their fields. The low number of infections tell us that there was active cooperation by the villagers in maintain the lockdown protocols.
 
3.    In the various Talukas the villagers adopted  various types of coping mechanisms during the lockdown. In Talakwada they helped each other in getting necessities while in Nandod and Garudeshwar they ensured that they did not allow outsiders to enter the village and this was done in the other Talukas as well. Social distancing was not mentioned i n most  of the FGDs.    
 
4.   Though in some of the FGDs they mentioned that they received all the services related to maternal and child health during lockdown the ground reality is that there were gaps in the delivery of these services. Regular MAMTA days could not be organised while the ASHA workers and Anganwadi workers did try as much as possible to reach some of the services to the beneficiaries.  
 
5.    ASHA workers and ANMs were very active during the whole lockdown period – they were the Frontline workers in the rural areas and used to visit the villages regularly during that time. They passed on the various COVID-19 messages and protocols from the government on to the illagers. Along with their COVID duties they were also trying their best in ensuring that their beneficiaries received some services like distribution of iron tables; delivering THR; awareness about vaccination, etc.
 
6.    Majority of the villagers avoided going to the PHC for any kind of treatment but went to private clinics according to some of them. Some of them also managed to get help through the phone. They depended on their Bhuva/Bhagats for treatment of common ailments and were taking ayurvedic medicines.
 
7.  There was not a high level of recall about the messages related to COVID like maintaining social distancing; wearing masks. Some of them did recall them and also followed these instructions.   
 
8.    Only in some instances there were home deliveries otherwise all the deliveries were institutional. 
 
9.   The beneficiaries did feel that during the lockdown they did not get timely service. The pregnant women could not go for regular checkups and they also could not avail their regular services.

 

10.   According to the beneficiaries and village influencers in most of the areas the services have come back to normal after the lifting of the lockdown and they are working towards filling the gaps that occurred during that time.

 

11.  There are instances when the services have been rejected by the villagers because of their fear of Corona and still continue to do so.

 

FINDINGS – FRONTLINE WORKERS:
 

1. The Frontline workers had been assigned COVID duties along with their routine duties. They were trying their level best to make sure that there were as little gaps in their service delivery but the priority during the lockdown was given to the COVID duties.

2. The fear of COVID did keep the people away from availing the services that the Frontline workers were reading to reach to their beneficiaries. Many a times they were asked to leave by the beneficiaries.

3. The Frontline workers also faced the problem of transportation and that restricted them in doing their regular home visits.

4. There were gaps in routine vaccination as the people were afraid to come to the PHC. BCG vaccination could not be given to newborn babies who were born during this time and the deliveries were done at home

5. There was a gap in reaching the ANC/PNC services to the beneficiaries under some of the PHCs. In some cases they were taken to the government centre for the check up and in some cases they went there by themselves. There were some instances of pregnant women and lactating mothers calling them up for advice.

6. The Frontline workers are trying to overcome the barriers/gaps in reaching the services to the beneficiaries by talking to them in person; calling them and giving them appropriate guidance and making sure then get necessary medicines. This they are able to do with the help of the Sarpanch and other elders of the village.

7.  In some of the PHCs the frontline workers did try to make sure that the beneficiaries go their iron and folic acid tablets.

8. In most of the places 108 Ambulance service was available to transport the pregnant women for institutional deliveries.

9. In majority of the PHC in Dediyapada THR kits were not given to the pregnant women and lactating mothers during lockdown because they were afraid to come and collect them for fear of COVID. In the other P H C s o f S a g b a r a ;T i l a k w a d a a n d Garudeshwar they were distributed as per the Corona guidelines of the government or they were made into snacks and distributed to the beneficiaries. But there was definitely a gap in reaching the THR kits to these beneficiaries

10. Other than one PHC in Dediyapada in all the other PHCs it was made sure that the THR kits reached the children at home – there ere either made snacks of sukhadi and then distributed at the homes of the beneficiaries

11. Though the mid-day meals were not available to the students all throughout the lockdown period it was made sure that ration in lieu of the food was given away to the parents or money in lieu of the ration was deposited in their account. There were gaps in reaching these grains in some cases and they could not get their assigned quota of grains

12. MAMTA days were sporadically organised during the lockdown but the Frontline workers made efforts to organise them wherever possible. The biggest barrier to organising these days was the reluctance of the beneficiaries to come for fear of getting infected by the virus. Frontline workers made some efforts to get in touch with the beneficiaries at their homes or on the phone.

13.  In majority of the PHCs in Dediyapada and Sagbara BCG vaccination was provided to the newborn babies during the lockdown as they were institutional deliveries.

14. Majority of the Frontline workers claimed that there were no gaps in the ECD services but the ground reality observed during the lockdown shows a different picture.

15. To address the severe malnutrition among children during the lockdown the frontline workers tried to reach the THR kits by calling the parents to the centre to delivering them at their homes. The biggest challenge faced by them in addressing severe malnutrition was the fear of the people in either coming to the centre or letting them come to their homes. Though in some places they did not encounter any challenges while looking after the severely malnourished children under their care.

16. In majority of the schools under the surveyed PHCs the schools and the students were facing in conducting and attending online classes. The biggest problem faced they are facing is the lack of network; unavailability of mobile phones and poor conditions makes it difficult for the parents to keep recharging their phones.

17. There were no noted cases of violence against children during the lockdown period

18. The migrant families returning had to face a lot of difficulties like: walking home; lack of food or any other amenities on their way back; being quarantined for 15 days after their return; their children having to go without food or water on their way back.

19. Though some of the sickle cell anemia patients did receive their medication there were gaps and some of them were left without medication.

20. In majority of the Dediyapada and Sagbara FGDs the Frontline workers have said that the services in the management of sickle cell anemia patients have normalized after the lifting of the lockdown.

21. Some of the Frontline workers have suggested that a campaign should be run to make people aware about the importance of social distancing; use of mask; regular washing of hands; use of sanitizers. According to them this will help in addressing the gaps and barriers/challenges faced in reaching the various services to the beneficiaries.

22. There are no AFCs under any of the PHCs in the five Talukas.

FINDINGS – INSTITUTION IN-CHARGE:
 
1. The routine work of the Frontline workers suffered due to their COVID duties. 
 

2. There were gaps in reaching the Ante-natal checkups to the pregnant women beneficiaries. The beneficiaries had to face difficulties in availing the services and some of them had to go to private clinics for their checkups and other services.

3. In majority of the cases Antenatal services like iron/folicacid tablets; tetanus injections;monthly  checkups were provided to the registered pregnant women.

4. The Frontline workers did provide them with telephonic advice whenever they were approached.

5. Most of the deliveries were institutional deliveries but there was some increase in home deliveries in Dediyapada; Sagbara and Garudeshwar.

6. 108 Ambulance service was available for transporting pregnant women for deliveries.

7. MAMTA days were sporadically conducted and the beneficiaries were afraid to go to the centre to avail the services.

8. Majority of them faced obstacles in reaching the ECD services to their beneficiaries.

9. Majority of them in Dediyapada and some in Sagbara said that this happened because of the fear of COVID among the beneficiaries as well as being closed due to lockdown.

10. All of them have said that beneficiaries under their PHC received the BCG vaccination while majority said that routine vaccination was also offered during the lockdown

11. In majority of the cases the beneficiaries faced obstacles in getting to the ECD services.

12. The major reason for the gaps/barriers was the rejection of the people due to fear of Corona and being closed due to the lockdown.

13. Some efforts were put in by the ASHA and Anganwadi workers in reaching the ECD services during lockdown by doing door to door visits. Some of them tried to educate the people by spreading awareness about Corona and its protocols.

14. Majority in Dediyapada and in Nandod managed extreme malnutrition during lockdown by distribution THR at the Anganwadi centre. But it is clear that there were gaps in reaching the services to them.

15.  Again the biggest reason for the gaps in reaching the above services was the fear that people had about being infected with the virus.

16. Some of the ECD caregivers were infected with Corona and some of the caregivers did face problems while discharging their duties. The action taken to alleviate the distress of the ECD caregivers was giving them with a pass so as to avoid the harassment of the villagers (only in Sagbara while in the other PHCs no actions seems to have been taken

17. There were gaps in the routine vaccination given to the 0-5 years children. The reasons have not been specified by majority of the respondents in all the Talukas.

18. The gaps in the vaccination are being covered in the MAMTA day and during home visits. But the gaps are still there and have not been covered even after the lockdown has been lifted.

19. As mentioned by the Frontline workers in the FGDs the Institution in-charge have also mentioned that the number of schools that are conducting online classes under their PHC is very low.

20. The biggest barrier that they are facing in the conduction of the online class for the schools as well as attending them for the students is the lack of network followed by irregular electricity supply and non- availability of mobile phones with the parents.

21. The frontline workers have managed to distribute the ration to the parents in lieu of the cooked mid-day meals that are provided to the students. In case there was a shortage of ration the parents were given money to buy it. But the disadvantage of this was that it was not sure that the adequate nutrition was reaching the intended children or was getting distributed among all the family members.

22. The migrant workers have faced difficulties in reaching back to their villages and those included having to walk back in absence of transport facilities. On the way they and their children had to go without food or water and depend on people donating food – but that was also sporadic. After reaching their villages they also had to be quarantined.

23. The government had announced distribution of free ration to BPL card holders and though there were some difficulties in accessing this scheme most of them availed of this scheme.

INTEGRATED DISTRICT LEVEL CMAM PLANNING, MONITORING, IMPLEMENTATION, COMMUNITY MOBILIZATION & COMMUNICATION WITH CAB DURING COVID19 PANDEMIC- 2021-22 IN NARMADA DISTRICT.
 
Achievements:
 
1. A two-day orientation program was organized for staff members. They were given orientation so as to understand what is expected of them in this intervention – their roles and responsibilities.
 
2. A one-day workshop was jointly organised by UNICEF, TRIFED and the Health Department at the Ayurvedic College in Rajpipla. The aim of the workshop was the COVID-19 vaccination drive prioritizing the forest area dwellers to be fully vaccinated. INRECA participated in this workshop as this is their intervention area to ensure full participation by their beneficiaries in the vaccination drive
 
3. A two-day workshop was organised by the District Health Society, Narmada and supported by UNICEF for SBCC related to CMAM. Participation in the workshop was by ICDS, Health department, UNICEF and INRECA – INRECA participated as it was the partner of UNICEF for conducting the monitoring of CMAM and SAM activities in Narmada district of Gujarat.
 
4. Key influencers were identified and they were oriented as to what was expected out of them in this intervention.
 
5. ASHA Workers; Anganwadi workers; Health Workers; Members of VHNSC; SMC; PRI;  VCPC members were equipped to take the core message of the intervention forward.
 
6. A total of 550 village volunteers (VV) have been identified in 590 villages in the district and with this 100% of this work has been completed. In the project period 871 SAM children were monitored for their growth and 1032 home visits were done of CMAM enrolled SAM children by the VV
 
7. A total of 5266 children were jointly identified. 56 new SAM children were found in Quarter 1, Quarter 2 and Quarter-3 who were registered at the Anganwadi but did not benefit from SAM in Anganwadi. Through the 1.efforts of INRECA children have been enrolled in CMAM program and have got the benefit of THR.
 
8. When the program was started a total of 3000 SAM children were registered in the district as per the ICDS records of Narmada district. After the implementation of the INRECA- UNICEF Partnered CMAM Program now there are approximately 1100 SAM Children in the district.
 
9. In the project period 250children were admitted to CMTC and NRC. Also 98 children were admitted as coordinators during the project period.
 
10. During the project period total 9667 people became aware about COVID-19 and SAM management.
 
11.  In the project period 2917 children were successfully enrolled in CMAM program.
 
12. All three quarters total- 829 days the participation on Mamta Divas, Bal Tula Divas; Poshan Sudha.
 
13. In the first, second and third quarters a total of 348 group meetings were held with traditional healers.
 
14. In the first, second and third quarters a total of 3347 home visits and counselling sessions were done with SAM and SUW children of families
 
15. During the project period a total 60 success stories were identified and documented the target have achieved.
 
16. Promotion of Take Home Ration (THR) and documentation of different recipes prepared with through and Locally available foods through PHC coordinators and village volunteers through Mamta Days; Bal Tula Divas and Poshan Sudha Divas.
 
17. Follow up of all SUW/SAM children identified with child wise monthly progress status and submission of 24 Success Stories during the project.
 
18. Group meetings were conducted with each formal and informal institution (PRI Leaders, Bhuwa/Bhagat, Pani Samiti, Dairy, Watershed Committee, and Adolescent Youth Groups) on importance of empowerment of adolescents, nutrition and ending child marriage through PHC coordinators. In the project period 1805 group meeting were conducted where the participation was of the PRI members; Bhuvas and Bhagats; SMC members; SHG members; Milk Cooperative Society members; Forest Committees; Youth groups; VVs and they were conducted by the PHC coordinators and the Village coordinators. The total participation was 7220 members.
 
19. Support in tracking children who were identified as SAM and enrolled in CMAM: Total of 2917 children was admitted in the CMAM program. Out of the 2917 children enrolled in the CMAM program with ICDS and Health a total of 1310 children have recovered.
 
20. Undertook structured supervision of the CMAM programme, using the KOBO Collect Toolkit: Total of 5262 Anganwadi centres were visited by the PHC coordinators out of which 4325 Anganwadi centres were monitored through the KOBO Toolkit – a mobile application.
 
21. The target was achieved during the project period, a total of 2 developing presentation had completed
 
22. Total 10 review meeting had completed during the project period. so that target completed
 
23. Total 9 review meeting had completed in block during the project period.
  
KEY TO SUCCESS OF CMAM PROGRAM: 
 
1. As a result of the partnership between INRECA and UNICEF for the CMAM programme now the Anganwadi are actively participating in screening of the children using proper technique
 
2. During the project period INRECA has strived successfully to bring awareness about the CMAM program at the Anganwadi level but are working towards brining awareness at the community level During the implementation of the CMAM program in the district the SAM children were provided medicine as per the CMAM program guideline but the ratio was very low. INRECA did advocacy about this issue in the review meeting and now the health department is actively involved in the distribution of the medicine to the SAM children who are enrolled in the CMAM program.
 
3. The INRECA coordinators played a major role in this activity. ultimately leading to end 3 of child marriage. Through this project key influencers are activated and better equipped in SBCC capabilities for empowering the adolescents of intervention areas of Narmada District. The key elements of the partnership are: 1. activating all village level functionaries in health, WCD, education, protection and WASH 2. strengthen their capacities to engage with formal (PRI, etc.) and informal institutions (including committees such as VHSNC, VCPC, SMC, etc.) 3. engage with adolescents in the village such as Peer Educators (4 in each village in RKSK) and members (2 boys and 2 girls in each village) of VCPC to effectively contribute to adolescent life quality outcomes 4. build solidarity among key influencers in the district including traditional and faith leaders on adolescent issues.
 
PROPOSED GEOGRAPHICAL COVERAGE: 
 
Entire Narmada district comprising all 5 blocks Dediapada ,Sagbara ,Nandod, Garudeshwar and Tilakwada TOTAL covering  400 villages.PROPOSED  TARGET  GROUPS:  Work  with government officials at the district level; block level and village level including ASHA workers; ANMs; Anganwadi workers; Female Health Workers; teachers; Gram Mitra, Key Influencers like the Traditional Healers; members of SHGs, Caste Boards, PRIs; AWCs; SMCs; VCPCs; VHNSC; Gram Sanjeevani Samitis; Dairy Cooperatives; representatives from KGBY; Ashramshalas; Peer Educators; 4 boys/girls of the village.
 
OPERATIONAL STRATEGY:
 
ACTIVITIES IN DETAIL In the implementation of previous projects the focus was on PRI Members; Bhagats and Bhuvas; Elders of the Community; Youth Groups, etc. It is proposed that in the next one year along with the above groups more focus will be on the
 
PHASE 1: DECEMBER 2019: 1. Baseline assessment of situation of adolescents in Narmada District a. There is need to understand the situation at the ground in relation to understanding knowledge, attitudes and practices as regards education, health, marriage, etc of adolescents. This can be done by having a consultation of the traditional healers; caste boards (panch); members of the Dairy Cooperatives; SHGs. This will give an overview of the traditional practices as regards adolescents as well as the penetration of government schemes pertaining to them. This meeting will be done at the district level and all of them invited to one place for a day long consultation. b. Conduct a detailed Baseline Survey at the beginning of the project period. The Baseline Study will find out the gaps in the service delivery of the various schemes that have been introduced by the government that directly or indirectly affect the status of the adolescents in the area. This baseline survey will undertake the mapping exercise of the platforms that are available that will take the messages of this project to the intended beneficiaries – like the Health and Family Welfare Department; Women and Child Department;  Education  Department;  Child Protection – SJED; DRDA; Tribal Welfare Department; Youth and hens, I in the wake covid-19 pandemic we could not work in field activities except few activities & followed appropriate covid behaviour during the period till 2020-2021, However UNICES Has approved the project further for year 2021-22 which would we implemented after the insuring year 2021-22 Sports Affairs department. The baseline will be carried out in  ollaboration with a university social work department and a consultant hired to design the research tools, monitoring of data collection and the analysis of data gathered. The above consultation and baseline survey will give the inputs in selection of the PHCs in Nandod; Garudeshwar and Tilakwada as well as make effective interventions. Phase –II of this project shall be operationalised almost by advent of April 2020-21.
 
 INTEGRATED DISTRICT LEVEL CMAM PLANNING, MONITORING, IMPLEMENTATION, COMMUNITY MOBILIZATION & COMMUNICATION WITH CAB DURING COVID-9 PANDEMIC-2022-23 IN NARMADA DISTRICT

  

ACHIEVEMENTS: 
 
1.in the project period 871 SAM children were monitored for their growth and 1032 home visits were done of CMAM enrolled SAM children by the vv
 
2. A total of 5266 children were jointly Identified. 56 new SAM children were found in Quarter 1, Quarter 2 and Quartier-3 who were registered at the Anganwadi but did not benefit from SAM in Anganwadi. Through the efforts of INRECA children have been enrolled in CMAM program and have got the benefit of THR.
 
3. When the program was started a total of 3000 SAM children were registered in the district as per the ICDS records of Narmada district. After the implementation of the INRECA UNICEF Partnered CMAM Program now there are approximately 1100 SAM Children in the district.
 
4. in the project period 250children were admitted to CMTC and NRC. Also 98 children were admitted as coordinators during the project period.
 
5. During the project period total 9667 people became aware about COVID-ig and SAM management
 
6. in the project period 1917 children were successfully enrolled in CMAM program.
 
7. All three quarters total ag days the participation on Mamta Divas, Bal Tula Divas, Poshan Sudhu
 
8. in the first, second and bird quarters a total of 348 group meetings were held with traditional healers.
 
9. in the first, second and third quarters a total of 3347 home visits and counselling sessions were done with SAM and Suw children of families
 
 
Key to success of CMAM Program: 
 
1. As a result of the partnership between INRECA and UNICEF for the CMAM programme now the Anganwadi are actively participating in screening of the children using proper technique
 
2. During the project period INRECA has strived successfully to bring awareness about the CMAM program at the Anganwadi level but are working towards brining awareness at the community level
 
3.During the implementation of the CMAM program in the district the SAM children were provided medicine as per the CMAM program guideline but the ratio was very low. INRECA did advocacy about this issue In the review meeting and now the health department is actively involved in the distribution of the medicine to the SAM children who are enrolled in the CMAM program. The INILECA coordinators played a major role in this activity

 

 

 “Hinduism the pernnial philosophy that is at the core of all religions.”

                                                                                                         -Aldous Huxley

 

 

Narmada Hospital & Research Centre (NHRC) (10 or More Bedded Hopital)
 
INRECA Sansthan is engaged in health awareness and SBCC activities since last 21 years. Last previous 3 years, we had realized to start OPD hospital with some few beds at our existing premises so that health services could be imparted to the local tribal community. Truly demand is on higher side but due to financial constraints facing a lot of problems in rendering services properly. So, we decided to approach to Ministry of Tribal Affairs, New Delhi under GIA scheme which has been duely considered our request under 10 or more bedded Hospital Scheme by Ministry of Tribal Affairs, New Delhi Future Plan for expending hospital in full-fledged manner by seeking loan from Nationalized bank and develop a SUPER SPECIALITY HOSPITAL named NARMADA HOSPITAL & RESEARCH CENTRE ( NHRC) in order to provide quality medical facilities in remote and tribal area. gyanec, pediatric, General Surgery. Orthopedic department & other Facilities Shall be initiated along with our lab, X-ray, OT, Pharmasict Facilities shall be available in ending year 2022-23 In the wake COVID19 pandemic, Protocol we Continued to care & Medicare to the Patients who coming across the boundaries of Dadiapada & Sagbara Blocks. Total-18818 patients are treated, diagnosed & Counseled during the year-2022-23. The details are given as under:
 

During Year-2021-22

During Year-2022-23

Sr

No.

 

MONTH

No. of OPD Patients Benifited

No. of IPD Patients Benifited

No. of OPD Patients Benifited

No. of IPD Patients Benifited

1

APRIL

891

342

984

320

2

MAY

1119

334

966

323

3

JUNE

1274

334

883

305

4

JULY

1377

352

1185

308

5

AUGUST

2433

487

1818

675

6

SEPTEMBER

2869

303

1830

534

7

OCTOBER

1931

378

1041