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MATERNAL HEALTH IN MADHYA PRADESH July 31, 2015

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Maternal Health is a issue of women’s human right, is an issue of social inequity as it is faced by the most marginal communities and women in vulnerable situations that kills women on a grand scale. Maternal mortality is also the one-point and the most visible indicator on the quality of primary health services, and poor health systems.

As per SRS (2010-12), Madhya Pradesh reports shocking MMR of 230 per 1000 live births that explains the vulnerability of maternal health or women’s health on several counts. However, govt. has invested thousands of crores of rupees in NRHM to improve maternal mortality. Despite the efforts from govt. we have failed to achieve the target of reducing maternal mortality, set by MDG.

Maternal Health Rights Campaign (MHRC) aims to ensure government’s responsibility for maternal health services, discrimination free access to health services for the women of marginalised sections, monitoring the quality of maternal health services, influencing the policy level issues through advocacy. Maternal Health Rights Campaign (MHRC) was formed as state wide network in 2013. MHRC is actively present across 18 districts of Madhya Pradesh. Working since past two years MHRC has taken various steps to improve the condition of maternal health like capacity building of partner organization and community leaders, community based montoring, discussion with health care providers at various level, Jansamwad and various ICT products and use of media for advocacy.

In the 1st series of COPASAH workshop on “Using ICT for Social accountability” in Bhopal, MP, MHRC has learned the use of ICT and finally they have developed innovative ICT products like the photo story, video/audio recording and photographs for evidence generation by using camera and mobile phone. They themselves did the recording and took the photographs on poor quality of services, violations of health rights, denial of healthcare services etc. MHRC also incorporated ICT in Jansunwai that was very effective. The three districts who were involved in Jansamwad were Seoher, Morena and Chhindwara with the support from NGOs SATHIYA, Dharti Sanstha and Satykaam Jankalyan Samittee respectively.

MHRC also faced a lot of challenges while using ICT. Communities were not very comfortable in front of camera while explaining the situation because of the fear from govt. officials. Using camera during VHND process was a very challenging task. They also faced several risks with the community after dissemination of the information provided by them. The inclusion of the community in whole ICT process as they were not very comfortable in revealing the truth was also a great challenge that they faced. In addition to that some more challenges that they faced were lack of new technologies, limited time and resources, collection of the evidence etc.

While using ICT, MHRC learned many may important issues like they got a new medium to communicate with health care providers, identification of issues among urban community, Monitoring through ICT, understanding the influence of private sector in urban health system etc.
By Deepak Kumar

 

Experiences of a working mother

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working mother

The top three obstacles when a mother tries to work from home

Obstacle number 1: Your daughter won’t go to sleep – your premium writing time – unless you sing “lungi dance lungi dance” or “ringa ringa roses” and dance with her.

Obstacle number 2: Your daughter wakes up from her nap, stands up, blows you a kiss, and asks you to take her in lap when you are busy in writing

Obstacle number 3: Your three year old daughter already learnt to use computer and push the delete button. The DELETE BUTTON!!

A very good luck to me “working mommy!!!”

By Nibedita Phukan

 

An Ode to COPASAH July 29, 2015

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(The world of COPASAH -This ode to Community of Practitioners on Accountability and Social Action in Health (COPASAH) sums up my perception of COPASAH as I have understood it in the span of over eight months of being involved in different processes and events of COPASAH)

COPASAH! COPASAH! COPASAH!

The intriguing word that is COPASAH!

  

The world of Community Practitioners it says

The passion for Community Monitoring and Social Accountability it sways

 

The reach is far and wide…………………

Ranging from S Asia, Latin America, Central Europe to East Southern Africa it strides

For a new Paradigm of ‘Social Accountability’ it strives

 

Citizen led community centric health systems it posits

Grassroots Practitioners are its strengths and facets

 

Accountability lessons, practices, methodologies they share

To mutual handholding and innovations is that they adhere

 

The world of Community Practitioners it says

The passion for Community Monitoring and Social Accountability it sways

 

– Surekha Dhaleta

 

 

“मर्दानगी ” के सन्दर्भ में मेरी पहली ट्रेनिंग July 28, 2015

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यह मेरा पहला ब्लॉग हैं जो मैंने CHSJ ट्रेनिंग में सीखा, महसूस किया, उसका कुछ अंश यहाँ आप सब के साथ शेयर कर रहा हूँ ….

CHSJ ज्वाइन करने के एक साल बाद पहली बार मुझे मौका मिला मर्दानगी पर अपनी समझ बनाने के लिए और यह मौका मैंने दोनों हाथों से स्वीकार किया! मुझे जैसे ही पता चला की CHSJ एक ट्रेनिंग शुरू कर रहा हैं मर्दानगी के सन्दर्भ में तो मैंने सोच लिया की मुझे भी अपनी एक अच्छी समझ बनानी हैं बस फिर क्या था मैंने अपना रजिस्ट्रेशन करवाया और ट्रेनिंग के लिए अपने आप को तैयार कर लिया ट्रेनिंग का समय और दिन निर्धारित था जो की 22 जून से 25 जून तक सुबह 10:30 से 05:30 तक CHSJ मीटिंग हॉल में होने जा रही थी! मैं समयानुसार अपने निर्धारित समय पर ट्रेनिंग कक्ष में पहुच गया! चूकी ट्रेनिंग 4 दिन की थी इन चार दिनों में मुझे मर्दानगी से संबंधित काफी  कॉन्सेप्ट क्लियर हुए हैं ! चार दिन की ट्रेनिंग में तक़रीबन 25-40 लोगो ने भाग लिया सबके साथ मिलना- जुलना, उनके साथ समय बिताना , उनके अनुभव को सुनना सच में एक अलग ही अनुभव था ये सब मेरे लिए बिलकुल नया था! ट्रेनिंग को हमने सिखने के साथ साथ बहुत एन्जॉय किया और अपने अन्दर एक आत्मविश्वास महसूस किया की मर्दानगी को लेकर मेरा जो नजरिया था वह बहुत ही अलग था और जबकि वास्तविक जीवन में बहुत अलग हैं! ट्रेनिंग को लेकर मन में अजीब अजीब से सवाल और डर भी थे की मेरे लिए सब कुछ नया हैं और में कैसे मैनेज करूँगा लेकिन जैसे ही ट्रेनिंग रूम में गया वहां का माहौल देख के मेरे मन का डर दूर हो गया! पहले दिन सुबह हमे ब्रेकफास्ट दिया गया उसके बाद सबका परिचय एक दूसरे से करवाया और सब ने अपना अपना परिचय दिया! परिचय होने के बाद यह निकल के आया की कुछ लोगो की मर्दानगी पर अच्छी समझ थी और कुछ लोग बिलकुल नए थे इसीलिए ट्रेनर ने सभी को मध्य नजर रखते हुए एक साथ लेकर चलना उतम समझा और यह मेरे लिए बहुत महत्वपूर्ण था! ट्रेनिंग के पहले दिन हमे बताया गया की :-

  • मर्दानगी क्या होती हैं ?
  • मर्दानगी के क्या NORMS हैं ?
  • मर्दानगी कैसे काम करती हैं ?
  • मर्दानगी को किस दृष्टिकोण से देखा जाता हैं ?
  • मर्दानगी की क्या पहचान हैं ?

यह सभी topic को Role Play के और Act के द्वारा समझाया गया जो की बहुत ही impactful था! कुछ एक्टिविटीज के द्वारा सामाजिक वास्तविकता को भी दिखाया गया!

ट्रेनिंग के दूसरे  दिन समानता के बारे में बताया गया समानता जेंडर नजरिये से किस तरह ACCESS और CONTROL होती हैं! समानता को लेकर जब एक्टिविटीज की गयी तो RESOURCES को लेकर सबके अलग अलग विचार निकले तो हमारे सामने बहुत बड़ा रिजल्ट निकल के आया की महिला और पुरुष घर के बहार, घर के अन्दर और सार्वजानिक स्तर पर किस तरह महिला की और पुरुष की पहुँच होती हैं ट्रेनिंग के दूसरे दिन यह निष्कर्ष निकला की किस तरह भेदभाव,हिंसा,मर्दानगी सत्ता को लेकर आपस में एक दूसरे से जुडी हुई हैं और यह सब खेल सत्ता का होता हैं

ट्रेनिंग के तीसरे दिन धौसपूर्ण मर्दानगी के उपर चर्चा हुई और उसमें यह समझाया गया की किस तरह मर्दानगी यूनिफार्म, लैंग्वेज ,के साथ भी काम करती हैं ! collective Masculinity किस तरह society पर असर डालती हैं! पुरुषो और महिलाओ के छवियो, व्यवहारो के बारे में बताया गया

ट्रेनिंग के चोथे और आखिरी दिन जेंडर समानता बदलाव के ऊपर चर्चा हुई और यह भी बताया की हमे अपने स्वयं के स्तर पर क्या करना चाहिये ! ट्रेनिंग में हमे बहुत कुछ सीखने को मिला! मैं यहाँ बताना चाहता हूँ सब ने अपना अपना Experience शेयर किया! ट्रेनिंग के पहले दिन मेरे लिए सब नया था और ट्रेनिंग के आखिरी दिन मुझे ऐसा लगा की हाँ अब मैं भी समझता हूँ मर्दानगी क्या हैं ! मैं इस ट्रेनिंग से आये बदलाव को अपने अंदर समेटने की पूरी कोशिश करूंगा और मेरी हमेशा यही कोशिश रहेगी की मुझे और सीखने को मिले!

धन्यवाद

धीरज गिरी गोस्वामी

 

Photo Story on first National Convention of ANMs July 15, 2015

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1st National Convention of ANMs

For the first time in India, a National Convention on ANM’s was organised from 10 to 12 July 2015 at Talkatora Stadium, New Delhi, India. The ANM’s convention is the outcome of extensive deliberations with groups of Auxiliary Nurse Midwives and Lady Health Supervisors. They assembled here to discuss their problems and issues as health service providers. The participants were from 25 states of India. The convention was organised by ANSWERS in partnership with Society for Midwives, India, Human Rights Law Network and National Alliances for Maternal Health and Human Rights.

Nibedita

From 9 am on 10 July 2015, registration process started, more than 1500 ANMs participated in the convention. Participants from civil society organisations, lawyers, health service providers and politicians participated in the convention

From 9 am on 10 July 2015, registration process started, more than 1500 ANMs participated in the convention. Participants from civil society organisations, lawyers, health service providers and politicians participated in the convention

Facilitators were discussing their plan for the day. All the facilitators were provided red sachet so that participants could easily recognise them and take help

Facilitators were discussing their plan for the day. All the facilitators were provided red sachet so that participants could easily recognise them and take help

State level ANM leaders lighting candles to start up the auspicious occasion and singing the song “We shall overcome – hum honge kamyaab”

State level ANM leaders lighting candles to start up the auspicious occasion and singing the song “We shall overcome – hum honge kamyaab”

ANMs from different parts of the country singing together “We shall overcome”

ANMs from different parts of the country singing together “We shall overcome”

Honourable Health Minister of Delhi Shri Satyendra Jain inaugurated the convention. In his inaugural speech he said that ANM are the first point person in Indian Health System. He appreciated the work of ANM as a health service provider.

Honourable Health Minister of Delhi Shri Satyendra Jain inaugurated the convention. In his inaugural speech he said that ANM are the first point person in Indian Health System. He appreciated the work of ANM as a health service provider.

Participants sharing their experiences and challenges as health service providers

Participants sharing their experiences and challenges as health service providers

Exchanging thoughts, phone numbers, addresses and sharing experiences with each other

Exchanging thoughts, phone numbers, addresses and sharing experiences with each other

Heavy rains could not stop them from participating group activities. A Group of nurse participating in some group work

Heavy rains could not stop them from participating group activities. A Group of nurse participating in some group work

Jotting down the key-points before presenting to the audience. State ANM leaders are discussing about the major issues and challenges

Jotting down the key-points before presenting to the audience. State ANM leaders are discussing about the major issues and challenges

A total of fifteen hundred ANMs did not have only discussions and presentations. They also had fun time too. An ANM from West Bengal was ready for her dance performance. The cultural evening was held on the second day of convention.

A total of fifteen hundred ANMs did not have only discussions and presentations. They also had fun time too. An ANM from West Bengal was ready for her dance performance. The cultural evening was held on the second day of convention.

A dedicated nurse from Arunachal Pradesh shared her disappointment on changing their uniform from white to pink by state government of Arunachal Pradesh.

A dedicated nurse from Arunachal Pradesh shared her disappointment on changing their uniform from white to pink by state government of Arunachal Pradesh.

A book on ANMs stories was released on second day of the convention. ANMs holding the book of their stories on the stage

A book on ANMs stories was released on second day of the convention. ANMs holding the book of their stories on the stage

Enjoying the day by the ANM. They dance and sing in the evening of day 2 of the ANM convention

Enjoying the day by the ANM. They dance and sing in the evening of day 2 of the ANM convention

Skill building session on day 2 of the convention

Skill building session on day 2 of the convention

A session on delivery care by Society for Midwives, India

A session on delivery care by Society for Midwives, India

A nurse is demonstrating how to take care of a newborn in a technical session on newborn care.

A nurse is demonstrating how to take care of a newborn in a technical session on newborn care.

Preparation for the cultural evening by the ANMs

Preparation for the cultural evening by the ANMs

On a legal aid session, the ANMs were told how to approach for legal support. A young lawyer from Human Rights Law Network was having conversation with ANMs from West Bengal. Many ANMs shared problems they faced and these were like abuses, sexual harassment, unnecessary suspension orders. Many a times they need legal support to deal with these problems. HRLN hosted a session for legal aid on the second day of convention.

On a legal aid session, the ANMs were told how to approach for legal support. A young lawyer from Human Rights Law Network was having conversation with ANMs from West Bengal. Many ANMs shared problems they faced and these were like abuses, sexual harassment, unnecessary suspension orders. Many a times they need legal support to deal with these problems. HRLN hosted a session for legal aid on the second day of convention.

Dr. Sunil Kaul from the ANT, Assam addressing the ANMs. He spoke about the role of ANMs in maternal health care and how ANM could help in reducing maternal and neo-natal death in our country. He also added that ANMs should dedicate themselves to provide basic health services to all section of the society without any bias and with sensitivity to their needs.

Dr. Sunil Kaul from the ANT, Assam addressing the ANMs. He spoke about the role of ANMs in maternal health care and how ANM could help in reducing maternal and neo-natal death in our country. He also added that ANMs should dedicate themselves to provide basic health services to all section of the society without any bias and with sensitivity to their needs.

A session was held to map the career path of each ANM who gathered in the convention. All 1500 ANMs participated in the exercise. The career graph shows the year of joining to till now. More than 70 percent ANM’s career graphs show that they are in the same position from the day they have joined their job.

A session was held to map the career path of each ANM who gathered in the convention. All 1500 ANMs participated in the exercise. The career graph shows the year of joining to till now. More than 70 percent ANM’s career graphs show that they are in the same position from the day they have joined their job.

Career graph of ANM who joined as ANM in the year 1979

Career graph of ANM who joined as ANM in the year 1979

Looking for career graphs by two ANMs

Looking for career graphs by two ANMs

Small group discussion of young ANMs on day 3 of the convention. In the small group discussion, ANMs from different states spoke about their career situation in their own state and what would be their aspiration as ANMs

Small group discussion of young ANMs on day 3 of the convention. In the small group discussion, ANMs from different states spoke about their career situation in their own state and what would be their aspiration as ANMs

Small group discussion on future career path on day 3. They discussed about the scope of their work as ANMs.

Small group discussion on future career path on day 3. They discussed about the scope of their work as ANMs.

Reading the demand charter put by the ANMs

Reading the demand charter put by the ANMs

Dr. Prakasamma, Chairperson, ANM Convention, Y K Sandhya from NAMHHR and Sanjay Sarma from HRLN discussing about the charter of demand

Dr. Prakasamma, Chairperson, ANM Convention, Y K Sandhya from NAMHHR and Sanjay Sarma from HRLN discussing about the charter of demand

State group ANM leaders thanking each other for making the convention successful

State group ANM leaders thanking each other for making the convention successful

Thanks Giving Session

Thanks Giving Session

 

Learning experiences from front line health workers

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The Talkatora Stadium was colourful for three days as it absorbed the colour the nurses from across 25 states brought with them. The colours of their vibrant dresses added oomph to the Delhi’s Talkatora Stadium for three days.

A pretty nurse from Arunachal Pradesh was smiling at me for a photograph and I kind of found of my old age in her. She was happy to share her experiences with me. She shared how her career got stagnant since 30 years. She was appointed as an ANM and remains as ANM since 30 years. She showed her disappointment on the changing dress code of nurses in her state.  She said that the nurses look good in white and they were the care givers and white colour gives them the feel of values of Florence Nightangle.

She said “it is heartening to see our ANMs come across from 25 states assembled here to discuss their problems and fight for their rights.” She said “We raise that we would not like to see us in the category of multipurpose health workers. This designation means, we are forced to do all the works of public health department. We are nurses and we demand our post should be called as Public Health Midwives”

Anjali Devi from Assam shared her happiness on serving the people at her sub-centre. She said that work of ANM is a continuous one and hard work goes into it and it involves identifying range of issues including anaemia to other critical condition in women. “It is quite a big and challenging responsibility. Sometimes we face abuses of community and senior officials” she added.

Kumari Indu shared her story of how she saved a life of woman and her newborn. She was posted in a very remote area in Jharkhand. One day she was called for an emergency case at middle of the night. When she reached there, she saw a woman was having severe pain after delivery. She checked and swabbed the private part of the woman and she saw that the women’s vagina was infested with worms. She asked the family to take the woman immediately to a hospital. The doctor of the hospital where the woman was treated said that the family should thank the nurse who sent the woman to the hospital. After one week of treatment the woman came home healthy and the family thanked Kumari Indu by giving her a treat. She proudly said “when community recognises our contribution and appreciate us we really feel proud”

Pooja Nagar from Madhya Pradesh shared her sufferings. She was humiliated and abused by one of her seniors and she complained and raised her voice against it to the higher authority.  She was suspended from her job but she fought for her rights and at the end she was reinstate in the job.

Sushma from Madhya Pradesh shared her problems of sexual harassment, suspension, recurrent transfers over many years. She filed a case in the court and the decision is still pending and she hopes that she will get justice.

These are some of the stories of ANMs whom I met in the National Convention of ANMs. For the first time in India, the National Convention of ANMs was organised in Delhi. A total of 1500 ANMs assembled and discussed their issues with each other and they also put a demand charter. All the ANMs demand that there should be a regular post and a uniform salary structure across all the states. They demanded for four stage career progressions in their career.

Nibedita

 

ICT कार्यशाला से जुड़ा अनुभव July 14, 2015

Filed under: Uncategorized — paintedpostcards @ 9:34 am

कोपासा द्वारा वडोदरा मे जुलाई २-४, २०१५ आयोजित ICT sharing and Documenting Workshop के माध्यम से Video Volunteers (VV) के कार्य को जानने का एक अवसर मिला. VV के प्रतिनिधियों ने अपने कार्य का व्याख्यान दिया एवं स्वास्थ्य से जुडी कुछ videos का प्रदर्शन किया. उसमे से यह जानकारी उभर कर आयी की VV अपने Community Correspondents के माध्यम से भारत के १८ राज्यों मैं कार्य कर रहे हैं. गुजरात मैं कार्यरत VV के Community Correspondent बिपिन सोलंकी ने अपना ११ साल का अनुभव साझा किया. बिपिन ने कहा की इस माध्यम से वे वंचित समुदाय के अधिकारों के हनन की बात को उजागर करते हैं. इस कार्यशाला में कोपासा से जुड़े ६ राज्यों के Community Practitioners ने ICT से जुड़े अनुभव साझा किये. इन अनुभवों से सामने आया की फोटोवौइस् के माध्यम से अधिकारों के हनन के लिए साक्ष्य का संचय किया जा सकता है एवं इसे पैरोकारी के लिए प्रयोग मैं लाया जा सकता है.

इस कार्यशाला मैं दो अलग माध्यम उभर कर आये, एक समुदाय आधारित निगरानी के लिए ICT का प्रयोग एवं दूसरा VV का अनुभव. इस कार्यशाला मैं फैसिलिटेटर के माध्यम से यह विचार भी साँझा हुआ की हमें community को romanticize नहीं करना है. समुदाय के सबसे निकट है Grassroots Practitioner, और CBM मे bottom up approach के लिए Grassroots Practitioner ही nodal point है.

मेरा पत्रकारिता का अनुभव है कि हम जब हम कोई मुद्दा/विषय लेते हैं,किसी स्टोरी या News के लिए,या तो वह need based होता है / need based in the sense that the topic is in currency or it depends upon the discretion of the editor, what topic needs to be done, or it is the prerogative of the journalist as to what s/he wants to chose depending upon her/his expertise or the grasp over the subject.

इन अनुभवों से कुछ विचार/प्रशन हैं- की VV के Videos के विषय का चयन समुदाय से चुने गए Community Correspondents कर रहे हैं, या समुदाय ने चिन्हित किया है, या वह स्क्रिप्टेड है/ एडिटर या अन्य द्वारा चुने गए हैं. क्योंकि VV का tie-up mainstream media के साथ भी है. Photovoice methodology के अनुसार समुदाय पर Focus है और समुदाय द्वारा ही मुद्दों का चयन किया जाता है.

दो अलग methodologies हैं, जिनसे अधिकारों के हनन का विषय उजागर हो रहा है, इनमे से कौन सी कारगर है यह मुद्दा नहीं है, कैसे दोनों का प्रयोग वंचित समुदाय के अधिकारों के लिए किया जा सकता है, और बेहतर तरीके से किया जा सकता है, यही देखना है, or whether the alignment of these two is possible?

सुरेखा!