Regional Resource CentreServices
RRC ACTIVITIES IN ORISSA-
Govt of Orissa has successfully established partnership with civil societies including NGOs in delivering Reproductive and Child Health (RCH) services through mother NGOs (MNGO) to the marginalized population of the un-served and under-served area. As of June 2007, 21 MNGOs and 119 FNGOs are working in 287 sub-centers of 29 districts of the state providing RCH services to 12,93,921 population. In addition to this there are 2 SNGOs initially started functioning targeting 2 lakh population. A sum of Rs. 307.5 Lakhs (18 months grant) was disbursed by NRHM to 10 nos of MNGO ( old ) and a sum of Rs. 292.5 Lakhs was released to 11 MNGO (12 months grant) to carry out activities as per the approved planned measures. Basically the MNGOs & FNGOs are working concertedly in eco- inhospitable 119 blocks and sub-centers for demand generation at the grass root to have access to RCH services and information and for addressing the unmet needs of the identified targeted population. A cadre of about 628 well trained and committed human resource pool positioned at MNGOs and FNGOs are constantly persuading for orienting adolescents for responsive parenthood through life skill education, counseling and camp activities. Orissa perhaps the only state where the MNGO scheme is fully operational in 14 inland and 15 costal districts out of a total of 30 districts. The left out district, viz. Bhadrak will be covered shortly under this scheme. This achievement is due to effective decentralization, flexibility in decision-making, timely release of funds and proper accountability.
Basically the MNGOS and the counterpart FNGOs are delivering :–
a) MCH services
The tailor made and innovative gender responsive reproductive health services are provided to the marginalized population in identified areas in close cooperation with district/block health authority and other stake holders including PRI members.
Apart from the ongoing activities, the MNGOs are supplementing and complementing implementation of both state and central Govt sponsored schemes and programmes. e.g. -
CAPACITY BUILDING by RRC to MNGOs
Membership of MNGOs & FNGOs in various committee at the district level :
WORK DONE BY FNGOs
In real sense the FNGOs are the front liner in providing RCH services and information to the marginalized population residing in hard to reach areas .The low paid but motivated staffs, volunteers and functionaries facilitating routine immunization work ,ANC/PNC activity with close cooperation of health department and functionaries. Involvement in conducting ASHA training seems to be a success and the input delivered was qualitative one and replicated in their functioning. Though FNGOs faced management challenges to implement activities in hard to reach area but the programme managing well. It is also observed that the capacity of field NGOs to deliver the programme is constrained due to non-availability of financial and human resources. The scheme demands a strong leadership at local levels and ownership from the community. This can be achieved through more advocacy effort by the MNGOs. It is the right time to enhance the knowledge base practices and behavior of the staff, functionaries of the field NGOs on NRHM, Government of Orissa has already published Field NGO, ToT Manual in Oriya Language and distributed to all file level functionaries.
We can not deny the contribution made by MNGOs for the realization of the goal and objectives laid down in the NPP-2000 and in the state RCH-II PIP. In addition to this, NRHM has already attempted to enhance more involvement of MNGO/FNGOs in Advocacy activity to reach at the goal by 2012.
THE PROCESS OF SELECTION OF NGOS
The MNGO selection process is participatory & transparent. It passed through well structured procedure and norms. District and state administration were consulted in each stage, right from advertisement, field appraisal, identification of un-served and underserved area, baseline survey to project proposal development and recommendation by District NGO committee to State NGO committee for technical input and final approval.
The rigorous MNGO selection process was systematized one and institutionalized a process of collective responsibility both of the district and state authority.
NON SCALEPAL VASECTOMY CAMP HELD AT PADMAPUR ON 26.6.2007 FACILITATED BY MNGO USO, RAYAGADA
Women play a major role in the tribal communities. From the management of kitchen to forests the family depends on women. Polygamy among the tribals of the region is common. In addition to maintenance of children the women largely contributes towards the maintenance of male member in the family. consumption of Alcohol among the male member is the main factor for poor economic standard of the family, despite the best efforts put in by women. Major part of the income of male members goes to drinking Excess drinking leads to unemployment and results in food shortage. excess responsibilities of family maintenance does not provide any time for women to come together. In the absence of education and leadership the women are exploited in day to day activities of wage earning, marketing and social functions. The male members don’t bother about how many children they need. more number of children and more number of wife is considered to be asset to the family, which the male member can enjoy from their income.
But the turnout in the NSV camp held at Padmapur on 26.6.2007 has established the fact that right approach in the motivation can bring a change in the behavior and beliefs of the people. The turnout of 104 persons in the first NSV camp of Rayagada district has encouraged the basic health care providers, the Medical officers, the health administration and the health NGOs to understand that it is possible. The credit goes to the leadership of Dr. Chandrasekhar Ojha, Medical Officer I/c. and the Team Members of Padmapur CHC. The encouragements, support from the Chief District Medical Officer and the DPMU, Rayagada is noteworthy. The first of its kind – the best initiative is the unfolding for the health system of Rayagada district.
Number of persons operated – 104.
VALUE ADDITION MADE BY RRC TOWARDS MENTORING OF MNGO SCHEME
The MNGO Scheme came as a new paradigm and presently 11 regional resource centers (RRCs), across the country are shouldering responsibility for capacitating the staffs and functionaries for better functioning and operationalisation of MNGO and SNGO scheme as per the revised guidelines with financial assistance from MOHFW & UNFPA. SWASTHA SIKHYA started formally functioning as Regional Resource Centre (RRC) since October 2006. Regional Resource Centers Orissa is presently located at SIH & FW, Nayapalli, Bhubaneswar,Orissa.
For an effective implementation of the NRHM/RCH-II programme,, RRC, Orissa has been instrumental in providing technical and managerial support and information to the NGOs (M/F NGOs) as well as the State Government. Apart from regular activities RRC Orissa continuously extending support to NRHM, Govt.of Orissa on monitoring of various programme, designing of advocacy strategy, technical input for designing appropriate IEC/BCC materials .Regarding training in the context of ASHA,BCC and for middle level functionaries, RRC team meaningfully shared their expertise. RRC Orissa has successfully established good rapport and contact with other stakeholders including UN bodies and civil society organizations and trying hard for GO-NGO collaborations/partnership especially in NRHM related areas.
MID-TERM EVALUATION OF MNGOs:
Very recently after one year of intervention of MNGO scheme under NRHM/RCH-II, Govt. of Orissa empanelled five independent evaluating agencies to assess the effect and impact of this programme over the targeted population. The evaluation was done by adopting participatory approach. By end of July 2007 the qualitative and quantitative outcomes would give clear perspective and direction towards quality service delivery & effective management of the MNGO scheme. From the draft evaluation report, NRHM, Orissa has identified various systemic and management issues including development of accountable and performance oriented system, financial & programme monitoring with involvement of community & local bodies, building trust and accountability in the system, effective integration and convergence, and fostering true sense of partnership between the state and Non-Governmental sector.
GUIDELINES/TOR by RRC
PPP INITIATIVE in URBAN SLUM HEALTH:
NRHM, Orissa through NGO P3 Cell & RRC, Orissa has initiated the operationalization of Urban Health Programme in Orissa. The NGOs selected by District NGO Committee followed by final approval of State NGO committee will manage one / two tier UHP. The thrusts areas are to provide package of RCH, PH and outreach services including community mobilization and demand generation in identified slums. baseline survey will be conducted in the project area to understand the health service coverage/issues related to maternal and child health, health and hygiene, behavior pertaining to the underserved settlements in the city.
The Urban Health Programme will be implemented on pilot basis in 7 (Seven) Urban slums involving NGOs, corporate sector, Private NGO Hospitals and municipality health units. The project will cover following areas.
These urban areas have vulnerable population like drug users, commercial sex workers, and street children etc. Since there is poor health infrastructure and the health personnel are not adequate to cater to the health needs of these populations, the involvement of NGOs have been given priority.
Progress made so far:
The District NGO Committees under the chairmanship of Collector-cum-District Magistrate after field appraisal have recommended the following credible NGOs to implement urban health project in five cities /town.
The State Government has formed a Technical Support Team for Urban Health with following members to monitor the programme:
The technical Committee will develop policy documents, guidelines from time to time for successful intervention of the UHP
Appraisal & Concurrent Monitoring:
The CDMO, ADMOs & DPM & DAM Municipality Health Officer will conduct regular monitoring of the programme. The Regional Resource Center (RRC) and the State NGO-P3 Cells will conduct half yearly review/monitoring of the programme.
At the end of the year, evaluation will be done by independent evaluating agencies to assess the progress of the UHP . Mission Director in consultation with the technical team has the discretion to empanel the evaluating agencies.
Process for Selection of NGOs:
All the proposals received from NGOs and corporate house were placed before District NGO Committee under the Chairmanship of Collector. CDMO convened the meeting of the District NGO Committee. The DPM coordinated the whole programme as Nodal Officer of PPP. The State NGO Coordinator & RRC representatives were also present at the District NGO Committee for smooth selection of NGOs .The Mission Directorate through NGO-P3 Cell/RRC-Orissa reviewed the proposals received from the districts with reference to the Schemes and will submit the same before State NGO Committee under the chairmanship of Principal Secretary for final approval. The process will be completed by mid of August, 2007.
The following list of NGOs recommended by District NGO Committee will be placed before the State NGO Committee for final approval by October, 2007.
Technical Assistance, Monitoring & Evaluation Support:
NGO-P3 Cell and Regional Resource Center (RRC) under the supervision of Mission Director, NRHM and Dp3 Cell under the direct supervision of CDMO will provide technical support for PPP programmes, besides monitoring and capacity building support. The framework guidelines for PHC management has been developed and the cost plan and MOU has been finalized by the technical committee.