Community Education, Training Health Organisation
Item
- Title
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Community Education, Training
Health Organisation - extracted text
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II
Section
Community Education, Training
Health Organisation
ACKNOWLWDGEMENTS
The implementation of
the CETHO p
—
programme
was dependent on the
approval from the district level
authorities
a.
--- to utilise
existing government
the
infrastructure. We
a+.a
keen
interest taken in the programme by Shri B. apprecciate
Vir, C.E.O Beed,
for
the approval to utilise the ICDS infrastructur
and
in Georai
Taluka.
For Paithan TaIuka
we extent our gratitude to Shri. S. S.
Yadwadkar for the guidance
and leadership and personal interest
that he has taken in the involvement
of ICDS workers, the Z.P
school teachers and
through them the school children
organising
for
one of the largest
information, education
and
communication(IEC) programmes implemented
in the state.
dedicate this report to
We
the
staff
of
the
IHMP
and the I CDS
workers,
school teachers and
1
'
-J balsevaks(child health educators)
who have collectively inspired
change in their communities
towards a healthier environment,
We would like to put on record
our appreciation for < '' ‘
all those who implemented this programme
and assisted in the evaluation.
CETHO Staff
1- U.B. Mahankale
2. S.Dhakne
list a collection
1• S.
S. D. Kakade
2. A.
A. B. Pawar
3. R. Salgaonkar
4. K. Kharat
Data Analysis
1. S. Sen
2. N. Kurian
3. K. Abraham
4. R. Salgaonkar
5. R.R. Chaudhuri
6. J. Weiner
S£W TECHNICAL STAFF
1. V.M. Mitkari
2. S.M. Shinde
3. B. Sasane
4 . E. Bansode
5. R. Ahire
6• A. Sonwane
Report Writing
1■ S. Sen
2. M. Khale
3. J. Weiner
Drivers
1. G. Dahiwal
2. S. Ghule
3. M. Bankar
A. Dyal Chand
(Director)
d
institute of Health Managemnet
achod, Aurangabad, Maharashtra 431 121.
COMMUNITY EDUCATION TRAINING AND HEALTH ORGANISATION
1,THE CETHO IEC
CONCEPT
The Institute of Health Management Pachod
an
i nnovative
(I EC)
ComiDun i c a t i on
and
Informati on 5 Educat.i on
(IHMP) has evolved
strategy for the Safe Drinking Water Programme implemented in the
Gearai t a. 1 u k a h EHeed Di str i c:t -
experi ence
It is based on the IHMP
of the health p r o y r a m m e b e i n g i m p 1 e m e n t e d s i n c e 1977I EC
The
concept
a
e n c o mp a s s e s
d e m o n s t r a t e ch n g e s in c o m m u n i t y b e h a v i o u r .
to
perspective
broad
The I EC st r at eg y £■< i ms
e
at
maki n g i n d i vi dua1s„ a n d the c o m m u. nit y a w a r e of
related to
prob1ems
the
dr i n k i ng wa.t er ;i an d g en er at i n g t he i r par t i c i pat i on i n
assessing interventions to overcome these problems.
the
as
B€?haviour relate?d to drinking water needs to change at
both
Ind i vidual practices
such
d i seases
are
Change in community behaviour.
such
i nd!vi dual a n d communi t y 1eve1s.
water
storage
and management of
relatively easier to change.
as
mai ntenance
d i sposal j,
change
of hygenic source surroundings and
in
nor ms
if
can only be e st ab1i sh ed
waste
every
water
single
deci si on
a
t h e c o m m u n i t y compile s a n ci makes
to
i ni tiated
and
on 1 y if the st i mu1 us for change comes f rom wi thin
the
h i s or her p r act i ce.
sustained
born
is difficult and requires a longer time period.
Commun i t y
ind i vi dual
water
T h i s p r o cess can be
communi ty rather t han being i mpose?d by an external change
Indivi dual
behavi our
may be
influenced
by
agent.
i n t er p er so n a 1
c ommun i c a.t i on b u t normati ve change in a c o m m 11 n i t y c a n o c c u r
onl y
w i t h e f f e c t i v e g r o u p i n t e r actio n w h i c h f a c i 1 i. t a t e s p a r t i c i p a t ion.
A
mechanism which generates peer pressure is required t o
comp1i anee
and
sustained
n o r m a t i v c? c h a n g e
in
the
ensure
communi ty.
T h e IE C s t r a t e g y s h o u 1 d e m p h a s i s e d e c i s i o n m a k i n g and ensure
fol 1ow-up
through
a process of
r e i n f or c e me n t h
mot ivat i on
and
mobi1i sation
of
c: o n i m u n i t y a c t i o n .
involve
It. should
c. 1 ear
a
mechanism whereby i ndi vi dua1s make an i n f or med choice. Hence, the
s t r a t e g y t h a t e v o 1 v e s is situation, ti me and pr ob1em specific-
The
whi ch
I EC
was
i ni ti ated
attempted
of the Safe
componG?nt
in
Dri nki ng
Georai Taluks, of
Water
in
Deed
t o o p e r- a t i o n alls e t h e s e c o n c e p t s.
Programme
1988
has
T h e r e s u 11 s o f
the
CETHO programme i n Georai a r e p r e s e n t e d EVOLUTION OF THE PROGRAMMES
The
wh i ch
first phase of the Safe Drinking Water
in
began
1986-87,
was
or i entcd
(SDW>
towards
Programme
meet i ng
the
€
i mmediate
d r i n k i. n g
water
needs of the
people.
The
prcgramme
st-arted with t h e r e c o n s t r la c t i o n and react i va t ion of h and pump s «
In
the
s e c o n cl p h ass the foe u s s h i f t e d t o
mai nt©nance
and
of handpumps and communi ty educat ion and organ!sat i on.
CETHO
activities
si tuational
were
introduced in
analysis was u nde rt a ken i n the area.
practices
were?
studied and i nter vent ion s
awareness
were
planned.It
heal th
i nf or mat i on
behavi oural
of
1988.
in
the
was assumed
communi ty
to
that
wi 1 1
Initial], y
Water
create
method„
Change in com m u n i. t y b e h a v i o u r woul d
dynami c
process
of
prob1em
community
fi nally
thi s
i nteract ion,
related
d i ssemi nat i on
change. The CETHO team soon realised the
a
1 ead
of
to
inadequacy
require
i den t i f i cat i on
a
and
deci si on n t a. k i n g a t. t h e c o m m u n i t y 1 e ve 1 .
4
The
IHMF
p a r t. i c i p a t i o n
evolved
an
TEC
strategy
to
f oster
communi ty
a n d < a. c i ] i t a t e n o r m a t i v e c: h a n q e s in water
r el ated
behavi ours. Th i s IE C s t r a t e g y i n v o 1 v e d t h e c o n d u c t i o n of
women's
awareness
women
camps on water. The focus of t hese camps has
as they a r e t h e c r u c i a 1 elements
1. Fl
f u1 f i 1 1 i ng
been
t he
on
dai 1 y
*
water
r equ.i r emen t s ot their f ami 1 y «
sources
is
women.
by
So f
38
8671 of contact
a w a r e n ee s s
with
camps
water
have
been
conducted by the IHMF' st af f „
S
By the encl
1989 thc? CETH0 team realised that covering the
w o lx 1 d req u i r e a 1 a r g e m a n p o w e r i n p u t.. A p a r t
ta1 uka
entire
— r
UT
11' i i s t h e i m p a c t. of t h e a w a r g? n e s s c a m p s c o u 1 d o n 1 y b e
IHMP
estab1i shed
s u s t a i n e? d c o n t a c t u To ensure a r ep 1 i cab1e IEC
through
deci deci to involve the government.
I CDS
the
supervisi on,
have conducted 39 water camps in
strategy,
inf r astructure f or
under
IE C p r cj g r a mme. A n g a n w a d i w o r k e r s ?
i mplementing
from
thei r
IHMP
respect!ve
vi11 ages„
The
i n De t.
*
negot i at i ons
89.
to obt ain Govt - permi ssion
started
were
The? approval for the involvement of ICDS workers
was
on 1 y ob t a i n ed i n March 1990.
Fol low!ng
workers
and
approval,
government
30 he 1 ps?r s were trained
c arnp s.
The?
Anganwadi
workers
results
of awareness
encouraged
IHMP
for
Anganwad i
conduct i ng
awareness
camps
to
In Sept.
f un c 11 on ar i e?s
in Georai t a 1 u k a.
Sevi kas
another two batches of AiWWs
and
27
a batch
of
organ!sed
all
tra i n
and Oct.
were
by
the
1990,
the
I CDS
Mukhya.
trained.
To st r g?ngt hen 3.nd suppor t commun i ty mon i t c<ring of handpumps,
CETHD conducted in—service
4
4
4
volunteers.
field train in g of
1/00 village
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♦
T h e t h r e e S t r a t e g i e s a r e:
A) H
Awar eness;
Government
wc'cnen
or gain i seel
by
IHMF
st a.-f f
and
In vo1vement ot c cmmunity r e p r esen tat i ve s i n
t he
■f or
ICDS workers.
€
8) .
Ca.mprs
T r aini n g an d
inanagement of thei r w/ater resources.
A
C) .
H e 11 h e d u c a t i o n an d niot i vat i on of adults by school
chi 1 dren
(Child Educators or Bals evak st r at eg y).
5.
AWARENESS CAMPS FOR WOMEN -(MANILA MELAWAS>QN WATER;
wi th in
CETHO has independently conducted 38 awareness camps
*
a period of
t w o y e a r s. T hi e IE C s t r a t e g y i n v o 1 v e d i n these camps i s
t he
t i m e 1 y i ci e n t i f i c a t i o n o f p r o b 1 e m s.
1 ed
by
and
parti ci pate
ca
process of
in
Th e c ommun i t y
g r o u p d y n a tn i c s t o t a k e c o 11 e c t i v e
f o ]. 1 ow
up
act i on
to
women
are
deci si ons
ex i st ing
overcome
problems.
The Awareness Camp strategy is as follows :
I.
Preparatory Phase.
11.
C o fi d u c t i n g t h e c. a m p.
III.
Fol 1ow—up Phase.
I.
PREPARATORY PHASE FOR THE CAMP:
a)
Situational
A
s i 111 t i o n a 1
conduc ti on
sources
Analysis
of
and
a n <3.1 y s i s is done i n every vi11 age
the? melawa.
dr i n h: i ng
Th i s i n c 1 ud es i d en t i f i c a t i o n of
studying t h e i r condi t i on ..
user habits such as storage
water
pr i or
methods 5
s o u r c e s la r r o u n d i ng.
Ubserving
water
c1ea nliness of
act i v i t ies 1i ke
to
water
r el at ed
t In e
washing
of
c1othes,
animals at t h e cl r i n k i n q w a t e r source.
vessel s j,
d e -f- a e c a t i n g a.t t h e
knowledge
of
of
water.
t hi e i r
and
var ious
water
w c j m e n? s c o n c e p t
t hi e r e 1 a t i o n s h i p t• e t w e e n w a t e r
hi^b its.
h yg ieni c
a.nd personal
sour ce?;
t h i s i n -f o r m a t i o n 5
•f r om
Apart
water
chi1dren
b o r n e d i s e a s e s is collected.
b)
11 e n d Camp:
Con t a c: t 0 p :i. n i o n L e ad er s a n d Mo t i v a t i n g Wo men t o
Vi 11 age
on
the
i d en t i t i c at i on
and
op i n i on 1eaders a re c ont ac ted and briefed
camp
ob .j ec t i ves.
use
o-f
(ey -
dawandi
The! r
tradi ti onal
etc. ) ,
su p p o r t i s sou g h t t or
the
commun i ty
commun i cation
channels
in
o-f
women t o
attend the melawa?
motivat i on
camp site and •f i x i. ng camp t i mmi ngs.
solecti on of
A p a r t -f r o m t bi i s t h e c a n i p organisen contacts women living i n
the
vi c i n i ty
of each water source and in-forms
camp«
These
women are m o t i v a t e d a. n d r e q u e s t e d
•f r i en d s j.
c)
1ocati on
suitab1e
in
KAF‘ pretest of
A pre-test
•f or
their
p r e p a r a t c:/ r y
phase
t h e camp
is selected.
women:
pract i ces..
and
c on d u c t i n g
consul tat ion with t he c omm uni t y.
i s conclucted far
attitudes
camp) .
br i ng
the
of Camp Site and Dates s
D a t e s a. r e -f i x e d
d)
to
about
relatives and neighbours.
Seiect i on
A
them
is
women to assess t h e i r know!edge.
relatcd
to
use
of
comp 1 et eel o n e week prior
to
water.
(The
the
£Ac t ua 1
e
ii.
CONDUCTING THE CAMP:
a. B
R e g i s t r a. t i o n of women a. nd
□r i en t a. t i on t o c a nip ag en d a. a.n d
objectives.
a.
b..
Rol e cuf
c-
G a. m e S e s & i o n.
d.
Dr a w i n g Sess i on .
e.
Di scuesi on.
f«
D e c. i s i cj n M a k i n g.
women and their association with water.
Intreduct ions
The
camp objectives and agenda are discussed and women
a.r e
introduced to the IHMP’s safe d r i nki n g wat er pr ogramme.
bn
Di scussion on F<ol e of
The
Women And Their Association With Water s
o n li s o f r u n n i n g a home is on women -
They
manage
d a. i 1 y
h o u s e h o 1 d c: h ores and take care of their children for which
their
associ at ion wi th water
i s obvious u
sour cess are made by women.
br i n g i ng
about
Therefore.
of
contacts with water
f or
women are key elements
any change in user habits and
m an a g e men t
1 evel
86"Z of all
water sources.
The
ensuri ng
vi11 age
are
women
communi t y
encour a g ecl t o p er c. i e ve t h e i r c1ose rel at i onshi p with water.
dc
Game Session
n
T li e c amp starts wi th a. f ew
sessioh
h e .1. p« s
creating
an
in creating a c o n g e n i a 1
in tcrest
in
w i 11 j. n g n e s s t o p a r t i c i p a t e.
e d u. cat :i
games
ga ai es p1 ayed by the women ..
n t c> p i c:.
a t m o si p h ere.
the a c tiv i ti es
of
the
It
bi e 1 fj s
camp
The gimmes are r e 1 a t e d t o t h e
T ken prizes ar e g iven to those who wi n
Thi s
an d
in
a
heal th
in these
g.
Dr w i n g Sess i on "
The women are divided into smal1
groups and
to
askGfd
draw p i c t u. r e s o n t o p i c s r e 1 a t e d to water and various user habits.
E ac h g r ou p prov ided wit h some paper and a bowl
of water
col our sj,
i S5
+ingers.
Through
m o t i v a. t e d t o d r a w t h e s e t o p i c s w i t h 11-) e i r
t hese
the women e x p r e s s t h e i r c o n c: e p t
p a i n t i n g s-
an d
pr act 1 cess
r e 1 a t e d t o d r ~ i n k i n g water.
t.
Di scussi on::
One
member
-From each g r oup explains their pint ur e
rest ot the p arti c ipan t s.
process
of
seiecti ng
di scussion
and
The b est pa int ing g e t s a prize.
t h e b est p a i n t i n g a
group
i nteraction
is
dynami c
init iated
to
the
In
the
process
of
among
the
p a r t i c: i p a. n t s>.
every
After
di scussion
on
pr es>entat i on
it.
the
camp
organi ser
The organiser facilitates^
initiates a.
part i ci pat i on
and
c h an n e 1 s
t h e d i s c: u s s i o n in such a manner s-; o as to rein f or c e
the
posi tive
habi ts
subst itute
presented by the women i n
barmf ul
informati on
ones
with suitable al ternatives .
i s give n w here r e qui r ed.
By means of
and
through
proce>ss
or ig inate
a
f t" o m
t hi e i r In ow 1 e d g e is u s e d to
t h g?
of
sharing.
group
The
suggesti ons
i tself rather
than
as
strategy
awareness
educate
and
Add i t i onal
this
the women i n the group) who posse?ss a high level of
i denti f i ed
drawi ngs
thei r
the
are
others
f or
change
an
ex ternal
st imulus f r om the orgarniser.
The
camp)
organi ser s u m m a r i s e s 11" > e e n 11 r e
emphasis a n d r e i n f o r c e m e n t o f r e 1 e v a n t
messages.
di scussion
w i t. h
y-
Deci s ian Maki n g:
The
leads the women into
or gam ser
camp
water
h a b i t s i'- e J. a t e d t o t h e i r d r i n k i n g
li ser
reg arding changes in
deci sions
making
a n d 1T1 a n a. gem e n t o t water borne
ill nesses..
They are encouraged to take up the management of
t h e i r water
w a t e r s t o r i?. g e
source,
sourco
mon itor i t s m a i n t e n a. n c e M
an d
water
regardi ng
Deci si c?ns
drai nage and filling up stagnant water pools a r e e n c o u. r a g e d .
the
The camp e n d s w i t h p r i z e di st r i b u t ion for t hos e wi nn i ng
game and ■F o r t h e b e s t d r a w i n g s.
These are an
t S* i e women t o p a r t i c i p a t e? i n t h e
mot i vat i ng
further
i ncentive5
sessicna.
fol 1ow-up
a date f o r t h e f o 11 o w -up session i s f ixed.
F i n a 11 y
Foilow—up phase:
III.
the
T he fi r st foilow up se?ssi on i s I’i e 1 d wi th i n a week after
camp.
During this session respons: bi1it i es are assigned and women
undertake
groups are formed for collective action.
Commi ttees
c>
organ iser
onl y
provides
s u p p o r t i v e s u p e r v i s i t? n .
camp
The
know-how
techni cal
and
mobi1i si ng
T h e o r g a n i s e r al so assists in
The
required for executing the decisions.
material
the
the required
c amp.
the
foilow-up ac t i cn on d e c i s i o n s t a k e n d u r i n g
actual
activi ti es a r e u n ci e r t a k e n b y t h e c o m m u n i t y w o m e n .
Dur i rig
t h e p> o s t -1 s s t r e s 1.111S h
done t. I’i r o u g h s m a 1 1
fi
f ol1ow-up session a post-test.
ed
assess
to
on t h e i i n o w 1 e d g e J. e v e 1 s o f women i s conducted.
impact
on
th i s
The
n C: j i t
Dependi ng
messages
is
fol1ow up session
is
r e i n f o r c. e n i e ri t o f certain
g r cj u p meet ings «
the
a 11
t hO
deci sians
mot ivat ing
the
women
and
obj ect i vt?
of
a w a r e n r. •• s s p r ..«g r a m m a i s t o m -a I =: e t i e c o m m u r i i t. y p a r t i c: i p a i ’. c?
in
and
det ai1 ed
ac tion
p 1 an
cover in g
f inalisod.
The
provi cl i ng
t In e
camp
organiser
con t i nu.es
t h em t h e n e c e s s ar y g u i d a n c e -
The f i n a 1
the m an agemen t of thei r water resources. Ensuri ng
, to
water
habi ts.
on the
u Sier s
The p r og r a mme a i ms t o b r i n g ab out
pract i ce?s
a 11 e m p t
a 1 a r g g? e x t e n t cl e p e n cl s«,
a. nd
sub s t i t u t e t h em w i t h
par t i c i pat i on
at
t he
village level
d r i n k: i ri g
water
rel £<tc?d
a change
suitab 1e
i s rn a d e t o s o 1 v e p r o b 1 e m s r e 1 a t e d
sate
in
harmful
a 11 e r fi a t i v e s u
An
t c w a t e r w i t h’l c o m m u. n i t y
i t. se 11
through
t l*i i s
can ip)
strategy-
A - ASSESSMENT
6u
OF THE WOMEN’S AWARENESS CAMPS ON WATER CONDUCTED BY CETHO
I n t r od uc t i on
E v a 1 u a t i on 0b j e c t i v e s
E v a 1 u a t i o n M e t bi o d s
Res uIts:
a- Storage af Drin king Wat er
b, Concept of Water
c -< Wat er and Di sease
d. H a n d p u m p S u r r o u n d i n g s
Di scussion
Pr ob 1 ems Encoun t or ecl
C o n c 1 i.a s i o n s a n d I m p 1 i c a t i o n s .
6. 1 „
6.. 2.
6. 3,
6« 4«
6. 5.
6. 6.)»
7.
6- 1.
Introduction
A s i t u a t i o n a 1 analysis of the water
Gearai
f or
elated practices in the
t a 1 u. I< a i n die a t e d t h a t p r i mar i 1 y women,
t h e h o u s e h o 1 d..
storage
vessels
<86Z) fetch
F’ r a c t i c e s r e 1 a t e d t o w a t e r s t c> r a g e ?
a n d c 1 e a! "i 1 i n e s s of wa t er
source
water
c1ean i ng
s u. r i - o u n d i n g s
determi ne t h e c o r: t a ?n i n a t i c- n of d r i n ! •-: 1 n g wa t e r u
Women wash their
vessels and
animals at the
water
source.
T r, some c a SC'S, smal 1 chi1 dron a r e allowed to
def acc:ate
near
hand pump..
J. n v a r i a b 1 y t h e r e i s a c c u m u 1 a t i cj n
of
E’-artti filling
p 1 a.t f or m
the
around the hand pump 0
is usually eroded5
e
c: 1 othes ?
(murram)
around the
1 o a v :i. n g t hi e p .1. a t f o r m e d g e s u n d e r m i n e d .
si ush
water
Seventy -five per cent ot the households store drinking
whi cch are large? earthen ware? pots
2.5 to 3
•feet
c-F
the
in
Van J an s’ ,
in
height e^nd 2 -feet or more in diameter. Thr ee t ourths
pot
bur ied in the ground in order to keep
is
cool f
water
the
h en c e t h e ranjans are di-f-ficuIt to clean.
These? ranjans are
covered with a basket or a piece of cloth.
water
Any vessel is used -for removing water •from the Ranjan. The
source surroundings in most of the villages
(897.) are unclean.
It was felt that interventions specifically targeted towards
these
user-practices.
change
in
The
are necessary to bring
about
quali tati ve
drin k i n-g wa t e r .
women.
Awareness Camp IEC strategy was used to educate
The IHMF* has i ndependen111 conducted 38 womens awareness camps on
safe drinking water.
Messages
were
disseminated in the following
during
areas
awareness camps:
- Concept of safe water.
How germs enter water and cause disease
borne disease).
(transmission of
water
«
Water borne diseases and
diarrhoea and jaundice).
their
management
(emphasi s
hygi eni c
Methods of preventing water borne diseases:
habits, hygiene of water source and personal hygiene.
on
storage
i n matkas
Hygi enic water storage: storage of drinking water
earthernware pots) ..use of ranjan for storing water f or
(smal1
other purposes, solid cover on storage vessel? use of a vargal a
(dipper with a handle) to remove water from matkas.
Hygiene of water source: prevention of activities such as washing
clothes,
vessels and animals near the water source, prevention
of
children defecating at the water source,
maintenance of
clean platform conditions, regular cleaning of
the drainage,
regular
murram filling around water source.. - Personal
hygiene
related to water habits.
S
b.2. Evaluation Objectivess
1 „ To assess the change in the knowledge ot rural women regarding
the concept of safe water, water borne diseases.
cleanliness of water sources and waste water disposal.
methods !»
2.
water storage
To assess the change in the behaviour of rural women
related
to water storage methods and the water source.
of
the
a) Pre-tests conducted by the IHMF* team compared with the
post-
3. To
assess
the
and
ef f ec t i veness
replieability
awaren ess c amps st rat eg y.
6.3. Eval nation Methods;
tests conducted by external investigators.
xHMP team randomly selected 8 villages
The
the
4r
pre-tested
and
seiected
randomly
knowledge;, attitudes and practices of 10
community women per village.
who
In the post-test a random sample of 100 community women
attended camps. from these 8 villages.. was drawn. A larger sample
that
than
for the pre-test was drawn. since it
was
felt
that
several women would not be aval 1ab1e?due to the sowing season.
Only 90 women were available for interviewing.
The
external
investigators conducted the KAP tests on women a fortnight
A
the
awareness camps were held. The interview schedules used
the evaluat i on ar e anne xed
1
af ter
(refer annexures
for
A-I and A-II).
6.4. Rpsults:
6.4.1.
Profile of respondents:
Even though the number of
women
pre and post-tested was marginally different. the general profile
of these respondents was comparable. 627. of the respondents
in
the
age
1i terate.
(607.)
group of 20-40 years.
Onl y
107.
respondents
The occupation of the respondents included
1 an d1 ess 1 ab our
(21.37.) s house work
(12.57.)
were
were
agr i culture
and
servi ce
4
4
*
Table 1 : Storage of Drinking Water
i
£
Water Storage
Fract i ces
i
Pre test
scores of
80 women«
Conducted
by CETHD
i
i
’a) Storage vessel:
Post test
i
J
scores of
{
90 women
’ conducted
' by external I
!Investigators I
»_ ____________ *
•
i
i
■
Ranj an
60 (757.)
55 (61.17.)
16
18 (207.)
i
i
Mat ka
Metal vessel
(207)
i
i
I
i
1
(1.27.)
I
16 (17. 87.)
i
■
Other vessels
*
!b) Covering storage
{
vessel :
3 (3. 87.)
£
i
j
j
1
Yes
I
Mo
1
I
69 (86.27);
i
83 (92.27.)
j
j
i
11
7 < 7.87)
(13.87)I
I
«
' c) Cover used:
I
<
Wooden p 1 ank
<
i
Metal plate
i
I
I
i
31
(38.77)
I
10 (12.57.)
I
J
«
<
30 (33.37)
■
32 (35.67)
1
I
I
ft
r
(1.17)
I
I
t
1
I
J
!
I
Cl oth
I
2 ( 2.57.)
|
1
(1.17)
I
Basket
26 (32.57)
20 (22.27)
I
I
I
N. A.
i
11
7 (7.87.)
(13.87)
i
I
4
6.4.2.
1
Storage of drinking water;
In the pretest 757 of the respondents stored their
water
in ranJans.
post-test.
Af ter
drinking
This pr op or t i on had reduced to 61.17 in
the
the awareness camps
were
37.87
respondents
using a matka or a metal vessel ■for storing their drinking
as compared to 21.27 previously.
water
4
>
€
€
92.27. of the respondents were covering their storage
vessel
cover
their
contami nation.
The
a
cloth
camp,
the
after
water
dri nking
56.67.
remai n i ng
35. 6%
and
protect
a
metal
it
against
pl ate
to
used inappropriate covering such
plank or basket.
wooden
used
as
7. 87m women did not cover thei r
storage
water at all.
Concept of waters
6.4.3.
proportion of women who stated that water could
The
increased from 207 to 94.57..
unclean
could relate unclean water to germs.
that
responded
Only 87. of the
become
respondents
After the camp 85.67.
water becomes unclean with the
women
introduction
of
suspended material as compared to 18.87 in the pretest.
In
the
pretest 73.87 women felt that
stored
water
could
become unclean. This increased to 94.57 after the camp.
The proportion of respondents who believed that stored watet
can become unclean was higher in the pretest
1
to
responses? that water at source can
(73.87), as compared
get contaminated
<207/.
The reason for this difference could be that the contamination i n
stored
water is easily visible as a majority of the
associated
women
unclean stored water with suspended material.
have
Table 2 : Concept of Water
i
t
I
I
I
I
I
Concept of water
Pre test
scores of
80 women.
Conducted
by CETHO
i
i
Post test
scores of
90 women.
Conducted
external 1y
j
la) Can water become
unclean
Yes
<
I
i
■
i
<
No
16 (20X)
63
85 (94.57.)
(78.87.) I
i
i
Don’t know'
1
(1.27.)
i
j
e
i
i
I
i
«
I
I
Ic) Can stored water
become unclean
Yes
<
i
•
I
i
15
(18.87.) ‘
77 (85.67.)
1
(1.27.)
7 (7.87.)
i
1
(1. 17.)
64 (807.)
5 (5.57.)
i
59 (73.87.) J
<
21 (26.27.) I
85 (94.57.)
5
(5.37.)
i
Introduction of
suspended material I
Due to germs
54
i
i
i
i
j
i
I
<
(67.57.) I
77
(85.67.) I
I
7
(8. 97.)
cr
(5. 57.)
3 (3.87.)
If stored for many I
days
*
(2. 47.)
i
j
I
N.A. as (c) was
answered no
I
i
i
I
<
<
I
i
i
i
i
i
Introduction of
I
suspended material I
«
Due to germs
«
i
Don’t know
I
I
N.A. as (a) was
not ans. yes
■
No
<
Id) How does stored
water become
unclean
I
I
lb) How does water
become unc1ean
(1. 17.)
4 (4. 47.)
i
c
1
i
I
21
(26.37.) I
Table 3a.: Water and Disease
«
i
Post test
Pre test
i
Concepts related to .Conducted by I Conducted by I
I Investigators I
water borne
ICetho team,
diseases.
'scores out of I Scores out of I
_____________________ I______ 80_____ I_____ 90______ '.
i
i
i
Can water transmit!
disease?
Yes
i
i
i
i
!
■
<
Don 71 know I
i
lb)
i
88 (97.87.)
(43-8%)!
How does water
cause illness
_
<
I
45 (56.2%)I
<
1
(1. 17.)
1
(1 . 17.)
Suspended material'
in the water
I
25
30 (33.57.)
Due to germs
10 (12.5%)I
58 (64.57.)
N.A. as (a) was
not answered yes
i
2 ( 2.27.)
45 (56.2%)I
I
I
Illness caused by
water
J
I
I
Water borne
diseases
9 (11.27.) '.
69 (76.7%)
i
71
I•
i
(88.87.) I
I
21
(23.37.)
I
«
I
i
t
■
i
I
8
(107.)
No
Don t know
I
I
I
(1. 17.)
I
I
(23.3 %)I
68 (75.6%)
i
i
i
i
i
i
«
Don ’ t know
I
Id) Are water borne
di seases
I
preventable?
Yes
t
«
i
I
i
I
i
I
«
*
(31.37.) ’
I
i
Ic)
j
i
No
I
35
i
1
(1.2%)
i
1
71
(88.8%)I
21
6.4.5.
Water and Disease:
Respondents
who perceived contaminated water as a cause
illness increased from 43.8Z to 97.87..
o-f
The concept that germs in
the contaminated water cause disease increased -from 12.57. in
pretest
64.57.
to
related the suspended material
The
result of question
question b.
table-2.
mi si nterpreted
the
33.57. of
in the post test.
the
women
the
sti 11
i n water as a. cause of illness.
bf
consi stent
is not
table-3.
with
This discrepancy may be because respondents
question "How does
This question could have read
water
become
unclean?"
"How does water become unsafe?".
In the post test 76.77. of the respondents were able to
specif i c
water borne diseases as compared to only 11.27.
pretest.
75. 67.
women in the post test
that
responded
in
cite
the
water
borne disease were preventable as compared to 107. in the pretest.
Table 3b.:
Information on Diarrhoea
<
PreTest
Score of 80
I Women
I Conducted
by CETHO
i
!
I
1
Post Test
Score of 90
I
Women
Conducted
< External 1y
i
I
i
I
I
a) Association
!
between diarrhoea!
and dehydration
Yes
I
I
I
No
I
I
8 < 107.)
No
b) Pr ep ar at i on of
OPS
Yes
i
I
I
Don’t Know
i
I
40 (44.47.)
I
1
( 1 . 17.)
72
(907.)
49
(54.57.)
10
( 12.. 57.)
37
(41.17.)
70 ( 87.. 57.)
53 (59.97.)
I
The
recognised
associati on
between
di arrhoea
and
dehydration
was
by only 107. women in the pretest as compared to 44.47.
in the post-test. Women who could describe the preparation of the
oral
rehydration solution increased from 12.57. to
the post-test.
41.47.
dur i ng
(Refer Table 3b.)
Table 4a: Water Source Surroundings:
I PRE TEST
5 Score out
lof 80
!Conducted
’.by CETHO
! team
I
j
i
i
1P0ST TEST
'Score out
lof 90
1 Conducted
1 by extern-1
1 al i nvesti 1
1 gators
I
i
I
! a) Does the presence of slush accumulated!
around your water source cause any
I
problems/hazards
1
I 32 (407.)
Yes
I
4 ( 57.)
No
<
I
i
<
44 (557.)
Don’t know
I
Sb) Problems caused due to accumulated
slush around the water source
i
-Water becomes contaminated and
• 24 (307.)
causes illness
I
i
8 (107.)
Don’t know
i
i
’.53
N. A.
yes
as
48 (607.)
(a) was Not answered
i
i
c) Observation of slush and dirt present
around drinking water source:
i
Present
Not Present
I
I
<
: 46
! 34
(58. 97.) 1
I
I
i
i
137(41.47.)
<
I
i
I
149 (45.67.) 1
I
4 ( 4.47.) 1
i
■
i
i
«
I
i
137 ( 4.1 7.) 1
I
i
i
(56.57.) 145
(38. 97.) 1
J
(42. 57.) ! 55 (61.17.) 1
Table 4bs
Women’s Responses Regarding Activities At The Water Source
j
I
Pre test
I
Post test
‘scores out of!scores out of I
I 80. Conducted I 90. Conducted I
I by CETHO
I externally
i
i
ACTIVITIES
i
j
i
t
I a)Women wash ing
J
clothes
■
Yes
»
No
I
i
i
I
I
i
53 (66. 37.) I
9 (10. 07.)
27
81
(33.77.) I
i
(90. 07.)
i
■
I
i
lb) It no, why not?
i
i
I
■
I
I
I
Because the water
becomes contami
nated
■
10 (12.57.) I
73 (81.17.)
i
Don’t know
17(21.257.) I
i
8 ( 8.97.)
i
N A
53(66.257.) I
9 (107.)
i
Jc)Animals bei ng
bathed at the
i
drinking water
i
source
■
Yes
i
I
i
i
f
56
(707.)
*
I
t
i
6 (6. 77.)
i
i
i
No
i
<
Id) I-f no, why not
24 (307.)
I
84
(93. 37.)
I
i
i
i
!
To prevent the
water -from getting
contami nated
e
I
I
Don t know I
i
8
( 107.)
16 (207.)
I
I
!
i
67 (74. 57.)
17 ( 18.87.)
i
N A
56
(707.)
i
6
(6.77.)
41 (51.257.) I
41
(45.67.)
i
39(48.757.) I
49
(54. 47.)
i
i
Ie)Children defaecating at the drink— I
■
■
ing water source
i
I
i
Yes
i
i
<
No
i
i
6.4.6.
Handpump Surroundings:
407.
around
post
the
o-F
resspondents in the pre test
test this proportion increased to 597..
in
However
the post test stated that slush and
si ush
that
drinking water source causes problems while
the
women
■Felt
onl y
dirt
the
in
45. 67.
around
the
drinking water source contaminated the water and caused disease.
the awareness camps. 907. o-F the women responded
Af ter
had
they
stopped
washing clothes and 937. said
they
had
animals at the drinking water source.. but
only
stopped
bathi. ng
that
that
54.47. could prevent children -from defaecating there.
On observing the condition of the drinking water sources
in
these villages. 42.57. were clean during the pretest. and 61.17. at
the
time o-F the post-test.
The
1evels
results o-F this study indicate that.
though
awareness
of
the
post test also included a few questions related to
the
have increased substantially in most areas. some
user habits have only marginally changed.
The
i nf or mat i on
74.47.
i imparted
given and decisions taken during the camp.
of
at
the
women
recal 1ed
the
complete
the camp while 20% had partial
recal 1.
i nformat!on
Only
5. 67.
women did not remember anything.
68. 97.
taken
of the respondents could state the various
during the c amp.
deci si ons
6.5.
Di scussion:
The
results
i ncrease
camps
this KAF* study indicate that
a
substant i al
in knowledge levels was brought about by the
amongst
(947.) ,
q-F
rural women regarding the
water borne diseases
prevent!on
awareness
c1eanli ness
o-F
water
(987.) , their transmission (657.)
(707.) . A majority (85.47.)
and
o-f the women related unclean
water with the presence of suspended material.
64.57. women
coul d
relate water borne diseases to germs.
These results indicate that awareness levels can be
i mproved
f or
associ ate
concepts
wh i ch
rural
their
daily
experi ences.
wi th
women
contami nati on
of
difficult
comprehend without a practical
to
water
can
readi1y
vi suali se
Concepts
and
such
as
germs
are
demonstration
and
due to the introduction
of
situation specific examples.
The
after
user
women s
awareness regarding water storage had improved
the camps, but the proportionate change in
habits
was smal1 er.
An example of this
vessel which is used for drinking water.
had
water
related
the
storage
is
13.97. of the rural women
stopped using ranjans to store their drinking water.
results
cl ear1y
i ndi vi dual
and
indicate that changing behaviour
community level
is a gradual
both
process
These
at
the
requi ring
sustained and periodic reinforcement and follow up.
The awareness of the need for maintaining clean water source
surround!ngs
had
i ncreased
the
after
camp,
but
the
causal
association between the accumulated slush around the water source
and water borne disease was perceived by only 45.67. of the women.
Women
is
who use the handpump for drinking water feel that
a closed protected structure drawing water
an d h en c e c. on t am i nat ion c an not occur.
water
seepage is not considered.
vi sual1y
f rom
it
underground
The possibility of surface
Surface water
seepage
demonstrated is a difficult concept to convey.
uni ess
Aval 1ab i1i ty
This
moti vati ng
and
related
participate i n i ssues
easy.
o-F
al 1
women
to
drinking water is a priority need
of
Organising
communi ties.
e
Implications:
Conclusions, Lessons 1parnt an
6.6.
to
community
rel ati voly
drinking water is
IEC
term
1 ong
study indicates that a well planned
camp and its
strategy is required. The planning for an awareness
-f ol 1 ow—Up j,
need to be based on the specific village situation.
conveni ent
day,
choi ce
It should be a logical
most rural women remain at home.
day
bazar
time and place is necessary. On the
/X
for conducting a camp.
on
The awareness camp strategy has had a substantial impact
Changi ng
levels of rural women.
knowledge
the
related
water
behaviour is a gradual process requiring sustained reinforcement«
Indi vidual
behavi aural change is easier to sustain than
changes
needs to be
extended
in community behaviour.
e
The IEC programme
to al 1 the groups in the community. but with emphasis on women.
change
New practices can be introduced in small groups, but
in
communi ty
enti re
norms requires active parti ci pation of the
and is possible only through sustained contact and follow up.
using
a
smal 1
team
However,
assi stant).
organ!ser
and
i t was soon realised that effective
1 arge
of
faci1i tators
(camp
seale i mp1 ementati on of the IEC programme would be
through
a
strategy
IEC
i ts
CETHO had planned to implement
Initially,
decentralised infrastructure.
It
woul d
possible only
ensure
cost
♦
ef f ec: t i ven ess.
J nvolvement
i n f r a st r u c t u r e,
eg.
wor kers, etc.
of
such
woul d
I CDS
of
wor kerSj,
an
ex i sti ng
sch oo1
teachers,
also increase the potential for
a programme at a district level.
government
heal th
rep1i cat ion
Formal government permission and recognition of
i nvolved
the
>
i nterest
of
necessary.
is
i nfrestructure
sustain
To
the
and
mot i vat i on
the workers. an incentive for the best
and
worker
best village needs to be introduced.
The IEC strategy should have a mechanism for identifying 1 ow
response
more
and non-compliant individuals and introduce
frequent
them.
wi th
contact
These
intensive,
indi viduals
can
be
motivated through peer pressure and group interaction.
The IEC strategy, should be planned to ensure a
from
increased awareness to change in individual
the
estab1i shment
of
new
communi ty
norms
progress!on
practices.
to
finally
to
and
collective action in the management of water resources.
Apart from these IEC inputs,
a
community
behaviour ’ are
alternati ve
f ac i 1 i t i es
a
al so
i t is important that changes in
promoted
the
by
i e. cattle troughs.
pi ts
appropriate
for waste
water management,
of
area
at
a specific
permissible distance from water source for
soakage
provi si on
washing
etCn
The
clothes,
for
need
technology to manage individual and community
waste
water is imperative.
Fi nal1y,
with
a
drinking water programme should
be
a sanitation programme for an effective overall
i ntegrated
impact
on
the community’s health status.
As a prototype,
the
IEC
field
to
or
model
f cor
demonstration
programme requires a strong
to
research
p o1 icy
component,
i n v e? s t i g a t o r• s, researchers and datct processing
study
its impact.
Only empirical evidence
initiative for repl i cat.i on.
n i a k e r s,
wi th
faci1i ties
would promote an
9
To
summari ze?
any
IEC programme needs
to
on
■focus
the
•following aspects:
9
I
9
4
1„
The outcome of an IEC programme should be behavioural change.
2.
IEC should be issue. situation and time specific.
3.
IEC strategy requires detailed micro-planning.
4.
IEC strategy requires facilitators rather than educators as
the need for change should be generated from within the
community and not imposed by an external change agent.
cr
Intensive training o-F change -Faci 1 itators is required.
6•
Provision of alternative
community norms.
7.
Requirement of
technological
know how for waste water
management (specifical 1y for water related programmes).
facilities
to
sustai n
changed
7-
Assessment cf Women's . Awareness Camps on Water
Conducted By
ICDS Workers
7. 1.
Introduction
7.2.
Evaluati on Obj ect i ves
7.3. Evaluation Methods
<-
7.4. Results
7.5. Problems Encountered
7.6.
Di scussi ons and Cone1usi ons
7. 1
Introduction:
The
March
-first batch o-f 27 Anganwadi Workers (AWWs)
1990 have conducted 39 water awareness camps for women
their respective villages.
7.2
a.
trained
in
These camps were evaluated in 1990.
Evaluation Objectives:
To study the effectiveness of ICDS workers
as
c ommuni c a tor s
and facilitators of behavioural change i n rural communities.
b.
To determine the potential
for replication of
the
pr ogr arnme
at the District level.
7.3
Evaluation Method:
The
4
4
(CETHO)
Communi ty Educat i on, Training ^^nd
team
evaluated
Anganwadi Wor hers
using
study
the
Organ!sati on
9 awareness camps conducted
a pre-post
knowledge, at t i tude
by
I CDS
study design.
The CETHO team conducted the pre-tests.
to
Heal th
and
They were instructed
practi ces
of
randomly
selected women. A semi-structured interview schedule was used.
< Ref er annexure B I
II)
in
<*
The
AWWs were directed to ensure that the women
was done. attended the camp.
who
not
€
The CETHO team interviewed the women
questi onai re,
attended the camp. using the same
1ater.
In case the women
KAP
whose
10-12
days
who were administered the pre-test were
available during the post-test. others who had attended
camp were interviewed.
the
A total of 184 women were interviewed.
A
C
A
A
7.4.
Results
7.4.1.
Profile of Respondents:
467.
of
respondents interviewed both in the
tests were less than 30 years of age.
were
pre
and
post
In the pre-test 50.67. women
in the age groups 31-50 years and 3.87. were above 50
year s
whilst in the post-test 43.4% women belonged to the age group 3150 years and 10.87. were above 50 years.
A majority of the women interviewed during the pre and
post
tests were illiterate <787. in the pre-test and 827. in post-test).
A
Table 1: Drinking Water Source used by respondents;
■
DRINKING WATER SOURCE
SCORES OUT OF 184
PRE-TEST
!
POST-TEST
i
i
Hand Pump
I
105 (57. 17.) !
120 (69.67.) !
i
i
i
Well
36 (19.67.) I
22 (12.07.) 5
Tap
19 (10.37.) :
24 (13.07.) !
I
(
5.47.)
J
10
i
i
12 ( 6.57.) :
Ri ver
i
i
Stream,Pond
7.4.2.
The
i
12 ( 6. 57.) !
I
Drinking Water Source Used :
various drinking water sources used by the
in the pre-test were handpumps (57. IX) >, wel 1 s
(10.37.) , river stream and pond (13.OX).
ot
handpumps
had
(19.67.) <, tap system
In the post-test the use
increased to 69.6X, and the use
system has marginally changed to 13.OX.
respondents
o-F
the
tap
Table 2: Storage o-F Drinking Water:
SCORES OUT OF 184
PRE-TEST
I
POST-TEST
I
I
I Water storage Practices’
i
j
<
la) Storage Vessel
Ranj an
i
Mat ka
Metal Vessel
Other Vessel
Yes
No
(42.97.) I
(48.97.) I
( 3.87.) I
( 4.47.) I
•
67 (36. ^7.) I
105 (57. 17.) I
11 ( 6.07.)!
1 ( 0.57.) I
180 (97.87.) I
4 ( 2. 17.) I
«
182 (98.87.) I
2 ( 1 . 17.) I
i
i
■
79
90
7
8
lb) Covering storage:
t
i
i
I
i
Ic)Cover used:
Wooden Plank
Metal Plate
Cl oth
Basket
No cover used
77 (41.87.) I
60 <32. 67.) I
i
43 (23.57.) I
4 ( 2. 17.) I
I
•
<
j
Id)Cover why:
I
To prevent water from I
becoming dirty
I
Don’t know
I
N. A.
I
(32. 17.) I
(55. 47.) I
( 2.77.) I
( 8. 77.) I
( 1. 17.) I
i
i
i
21 (11.47.) I
159 (86.47.) I
4 ( 2.27.) I
150 (81.57.) I
32 (17.47.) I
2 ( 1. 17.) I
<
Storage of Drinking Waters
7.4.3.
In
59
102
5
16
2
the pre-test 42.9% o-F the community women
thei r
stored
post-test.
drinking water in ranJans as compared to 36-47. in the
The use of matkas -For storing drinking water increased -From 30.07.
to
CT-7
\J / c
-4 ■/
X /. >|
and
metal
vessels from 3.S7.
to
6.07..
98.87. of the women were covering their storage vessels after
the
camp,
35-47. w e r e u s i n g a met al pl at e cover’.
(8.77.)
or a
On 1 y 1.17.
of
respondents were using a wooden plank (32. 17.) , basket
c 1 oth
the
pi ece
<2. 77.)
respondents
Tabl e
vessel
to cover their storage vessel.
were not covering their storage
2a?b and c). The perceived need for covering
to prevent contamination..
Table 3.. Concept of water
remaining
The
vessel
(Ref er
the
storage
increased from 11.47. to
81.57..
i
I
I Concept of water
i
i
i
SCORES OUT OF 194
I
PRE-TEST
?
POST-TEST
I
<
■
!a) Can water become
i
Unclean
i
I
Yes
i
i
No
i
Don 71. know
I
I
Jb) How does water
become unc1ean
due to introd. of
i
suspended material
due to germs
i
dont know
i
N.A as (a) was not t
<
ans. yes
i
i
<
134 (72.8%)J
46 (25.07.) !
4 ( 2.2%)J
«
68 (37.0%):
55 (29.9%)!
61 (33. 1%) :
<
i
97 (52.77.) 5
16 ( 8.77.) J
21 (11.47.) I
45 (24.5%):
11 ( 6.0%) :
12 ( 6.5%);
I
50 (27.27.) I
116 (63.07.) :
i
; c) Concept of safe
water
t
— Has no germs
— Looks Clear/
Transparent
— Don’t know
i
i
22 (12.5%) J
28 (15.2%):
■
i
I
142 (77.2%) J
20 (10.9%) I
46 (25.0%) J
1 10 (59.8%) J
t
7.4.4.
Concept of Safe and Clean Water:
The
proportion of women who stated that water could
unclean
test.
increased from 37% in the pretest to 72.8% in
After
the
awareness
associate
unclean
water
respondents
beli eved
that
camp
wi th
water
however,
germs.
became
introduction of suspended material in it.
regard!ng
the
A
onl y
due
The women’s
concept of safe water marginally
12.5% in the pretest to 15.2% in the post test.
the
post
coul d
8.7%
majori ty
unclean
become
of
the
to
the
awareness
increased
from
25% of the women
still perceived water which looks clear and transparent as sa.f e.
Table 4
Wate?r and Disease
SCORES OUT OF 184
PRE-TEST
!
POST-TEST
!Water and Disease
<
t
J a) Can water transmit
di seass?
Yes
Mo
t
Don’t know
i
i
88 (47.87.) i
72 (39. 17.) :
24 (13.07.) :
I
167 (90.87.) i
8 ( 4.37.) I
9 ( 4.97.) i
i
: b) How does water
transmit disease
due to introd, of
i
suspended materia.!
due to germs
don’t know
N.A as (a) was no
and don’t know.
i
48 (26. 17.) 1
12 ( 6. 57.) i
28 (15. 27.) i
i
: c)
i
■
Illness caused by
water
- Water borne
di seases
- Don’t know
I
i
i
t
96 (52.27.) !
17 ( 9.27.) J
i
i
78 (42. 47.) I
106 (57.67.) I
159 (86.47.) I
25 (13.67.) .*
i
i
I
t
I
I
<
id) Methods of preven
I
i
ting water borne
I
J
- Boiling water
3
(1.67.) J
I
- Filtering water
(1.67.) !
3
i
- Chlorinating water 5
8
(4.37.) I
i
- Keeping the water !
i
■
source surrounding'
j
cl ean
6
(3.37.) J
i
i
- Hygienic storage
»
1
of water
(0.57.) J
1
I
J
- Don’t Know
104 (56.57.) i
i
|
I
- Water Borne
J
<
Diseases Cannot
l
Be Prevented
39 (32.27.) I
I
j
7.4.5.,
102 (55. 47.) i
20 (10.97.) i
45 (24.57.) I
i
27 (14.77.) I
46 (25.07.) I
28 (15.27.) i
43 (23.47.) i
I
6
(3.37.) i
28 (15. 27.) i
I
i
6
(3. 37.) ;
t
I
Water and Disease:
In the post test. 90.87. ot the respondents stated that watcer
transmits disease as compared to only 47.87. in the pretest.
The
concept that germs in the water cause disease increased from 6.57.
in
the
still
pretest to 10.97. in the post test.
55.47. of
the
related the suspended material present in the water
cause of disease.
women
as
a
After
specific
for
the
camp,
86.47. of the community women
water borne diseases.
thei r
prevent!on.
81.67.
could also
14.77. of the respondents
boi1i ng
water could prevent these diseases.
should
be
f i1tered ? and 15.27. felt the
coul d
cite
list
methods
heli eved
that
257. said that
water
need
f or
chi ori nating
water to prevent water borne diseases.
23. 47.
of the women perceived the need to keep water
surround!ngs
methods
women
to
clean and 3.37. stated the use of
hygienic
prevent the spread of such illnesses.
in the post test did not know how to prevent
15.27.
source
storage
of
water
diseases and 3.37. of them believed that water borne diseases
not preventable.
Ta.bl e
5a.
Water Source Surroundings.
<
■
i
■
»
i
SCORES OUT OF 184
PRE-TEST
J
POST-TEST
i
i
i
■
■
J a) Does the presence of'
I
dirt & slush accum. 5
i
around your drinking}
<
water source cause
any problem.
Yes
I
No
Don't Know
i
■
i
I
i
i
<
76 (41.37.) :
35 (19.07.) :
73 (39. 77.) }
<'b) Prob, caused due to I
accuml. of slush
J
i
dirt around drk.
:
water source
I
“Water becomes cont.I
I
& causes illness
62 (33.77.)
J
-Don't Know
14 ( 7.67;):
I
i
—M.A as (a)was not
i
ans.
yes
108 (58.77.) 5
<
<
124 (67.47.) J
22 (12.07.) }
38 (25.67.) I
i
: c) Observation of water!
source surroundings I
“Slush
dirt prs.
:
—clean waterr source I
i
surround!ngs
J
1 19 (64.77.) !
27 (14.77.) J
i
38
(20.67.) :
i
1 16
(63.07.) :
94
I
(51.17.) }
68
(37.07.) !
90
(48.. 97.) I
i
i
<
i
the
borne
are
Table
5b.
Response Regarding the
Drinking Water Source
Women’s
Activities
SCORES OUT OF 184
PRE-TEST
I
POST-TEST
I Act i vi t i es
i
t
I
I a) Women washing
clothes
Yes
No
i
l
94 (51.07.) I
90 (49. 07.) I
I
I
4
(2. 27.) I
ISO (97.87) I
68 (37.07.) I
z^'r7 (12.07.) I
94 (51.17.) I
178 (96.77.) I
2
(1.17.) I
4
(2. 27.) I
1
r
lb)
If no why?
— Because water
becomes contarn.
~ Don’t Know
~ N.A.
I
I
I c) Animals being washed I
at the water source I
Yes
No
I
i
Id)
i
i
•
97 (52. 77.) I
87 (47.37.) I
3
181
*
(1.67.) I
(98.47.) I
i
If no j, why?
- Water becomes
contami nated
- Don't know
- N.A.
i
j
76 (41.37.) I
(6.07.) I
11
97 (52.77.) I
175 (95. 17.) I
(3.37.) I
6
(1.67.) I
3
i
i
I
i
<
i
Children defecating
at the drinking
water source
Yes
No
i
If)
i
If no, why?
- Contamin. water
- Don’t Know
- N.A.
Ig) Do you wash the
platform of the
dr i n ki ng water
source after use?
Yes
No
t
i
t
I
<
I
i
I
61 (33.27.) I
123 (66.87.) I
184
(100%)!
i
t
76 (41.37.) I
47 (25.57.) I
61 (33.27.) I
I
176 (95.77.) 5
(4.37.) I
8
______
i
»
37 (20. 17.) I
147 (79.97.) I
I
«
80 (44.67.) I
102 (55.47.) I
at
the
7.4.6.
Water Source Surroundings:
A
large number o-F the repondents
recognised
si ush
of
>
(67.47.) in the
post
the problems caused by the accumulation of
around the drinking water source.
test
and
dirt
In the post test
64.77.
the women could also make a causal association between
water
borne diseases and unclean water source surroundings as
compared
to only 33.77. in the pretest.
r
After the awareness camp 97.87. women responded that
of
>
clothes at the drinking water source was
undesirable,
stated
that animals should not be bathed at the
source
and
1007.
respondents
felt
prevented from defaecating there.
that
98. 47.
dr i nk i ng
chi 1dren
water
should
be
(Table 5b.)
Even though a majority of the women had knowledge
the
wash!ng
activities which should be prevented at the
regarding
dr i nki ng
water
source to keep the water clean. the scores in Table 5a.
i ndi cate
that there is a gap between user practices and knowledge
1evels.
On
observing the drinking water sources in the
duri ng
the
post test
the
drinking water sources still had dirt and slush
vi11 ages
51.17. of them had clean surround!ngs.
48. 97.
of
accumulated
around them.
The
i mparted
vi11 age
post test included a few questions on
the
during the camp and the decisions taken to improve
water situation.
66.87. of t h e r esp on dents could
the
complete information given to them during t h e
had
part i al
recal 1
i nf ormati on
any
knowledge of this information and
of
rel ate
30.47.
camp.
2.77.
coul d
methods
surround!ngs
not
this information.
887 women responded that decisions regarding hygienic
storage
the
and
maintenance
of
cleanli ness
were discussed at the camp
Al 1
the
of
water
handpump
respondents
*
-felt that decisions both
at
individual
and community level
woul d
be followed up.
7.5
1.
Problems Encountered;
Several
vi11 age
women who were pretested were not available
■for the post test.
in
the
Some o-f the pretested women had
not
attended the ’-aimp and hence could not be included in the
sample.
2.
A p a r t -f r o m t h e pre-post test design used -for the
the
CETHO team hi-»d wanted to observe the camps conducted by
AWWs„
When a team member would attend a camp.
eval nation,
the AWW would want
them to conduct i t as she -felt that the impact
of the camp
€
increase.
7.6
Observation
of
AWWs
The
was in-flueced by this.
KAP study undertaken by the IHMP indicates
that
camps
conducted by the anganwadi workers have had a substantial
impact
awareness levels o-f rural women. They have become more
of the need for clean water,
borne
Thi s
woul d
Discussions and Conclusiona;
<
>
on
the
diseases.
i nrease
in
transmission and prevention o-f water
and cleanliness o-f water
knowledge
aware
may
be
an
source
i niti al
surroundings.
step
towards
behavioural change in water related user habits.
Findings o-f the study indicate that a -few topics need to
repeated!y
the
reinforced.
concept
associated
o-f
The community women have not
clean and safe water.
Onl y
15.27.
unsafe water with the presence of germs i n
be
understood
women
have
it.
257.
women believe clear and transparent water is
safe whilst 59.87. of
them have been unable to explain this
concept
at
al 1 .
These
women relate safe water to
vi sual percepti on. Suspended materia1
floating in the water is easily visible and hence associated with
S
*
contami nati on.
Unless microscopic organisms are shown to them
the
concept will not be understood and accepted.
0
Another observation made from this study is the gap
change in awareness levels and user habits.
between
An excellent ex amp1e
a
is
the awareness regarding activiti es which should be
prevented
€
at
the water source.
responded
More than 95’4 of the women have
against washing clothes. bath i ng animals and chi 1dren
near t h e w a t er source.
assoc: i ated
al 1
the
In fact, these respondents have correctly
above mentioned act i vit i es as
contamination of water at the source.
handpump
def ecati ng
a
cause
of
But on obser vat i on at
t he
sites some of these activities are still continuing.
A
strategy for estalishing community norms needs to be developed.
The
«
£
Changing user habits of the community is a gradual
process.
change
contact
wi th
the
the
members
to
agent
needs to have
a frequent
communi ty
and
should
i denti fy
the
existing problems and adopt
Deci si ons
f or
change
rei nforcement
It
was
of
mot i vate and mob i1i se
can only be
sustai ned
found that ICDS workers reinforce
i nter-personal
a
choices.
through
repeated
heal th
messages
knowledge and skills.
given at the camp during their house visits.
This
al ternati ve
contact
in the form of
This is done through
i nd i vi dual
could be used as a strategy of additional
counsel 1ing.
inputs
for
non
object!ves,
and
compliers and community members who resist the change.
A
p1 anned
mechanisms
of
IEC strategy with well def i ned
mon i t or i n g
imp1 emented b y I CDS workers.
an d sup er v i s i on
can
be
eff ecti vely
It is imperative for the success of
this strategy that suitable audio-visuals and o t h e r m a t e r i a 1 s a r a
provided
to these workers. AWWs are good communi caters
mot i vate
and i nf 1 uence the? commun i ty to change.
and
can
*
The
through
e
the
mot ivati on
o-f
these workers
needs to be
special efforts which include community
workers
and
other
Final1y
it
must
sustai ned
recogni ti on
ot
i ncenti ves.
*
be
remembered
that
implementing
thi s
strategy on a large scale would result in some dilution of impact
C
and
it
wou Id t a k e a. 1 on ger t i me for d emon s t r at i n g
<
behavioural change.
€
4
1
outcomes
in
8. C, TRAINING OF ICDS NORKERS
8. 1
Introduction
8.2 Objecctives of the training programme
8.3 Training methodology
8.4 Evaluation of the training programme
8.5 Discussion
8.6 Problems Encountered
8.7 Conclusions
8.8 Lessons Lea.rnt
Introducti on
8. I.
Communi ty
started
(CETHO)
Dr inking
1988.
Educati on,
IEC
the
immp1ement i ng
Thi s
The
38
October
process
of
By December 1989?
IHMP
studi ed
thei r
camps
women’s awareness
Saf e
f or
in
a
IEC strategy which developed through
conducted
outcome.
strategy
Water in the Georai t a 1 u k a, Seed District
experimentation was established in 1989.
had
Grgani sation
Heal th
and
Tr a i n i n g
and
A
impact of the camps was favourable.
measurable
change in the women’s water related practices was observed.
By
1990,
t al u k a
enti re
it was apparent that covering the
changes
in
c o m m u n i t y b e h a v i o u r can be sustained only through continuous
and
require
woul d
1 ar ge
manpower
i nputs.
frequent contact with the community.
Besides,
Hence a deci si on was
to involve an existing government infrastructure,
(I CDS
taken
wor kers)
for the implementation of this IEC strategy.
The ICDS scherne pr i mar i1y ser ves women and children.
is
one
An g an wad i p er 1000 p op u 1 a t i on.
Water ,
sanitat i on
There
and
h e?a 11 h ed uc at i on are included in their- pressent job description.
It
were
was observed that most of the anganwadi
workers
interested in partici pating and assisting i n the
(AWWs)
awareness
camps conducted in Georai Taiuka by the IHMP. Some AWWs had
even
conducted independent meetings on their own i n i t. i at i ve.
These
workers are local residents and have a close
with the commun i t y
especially with women..
contact
Most AWWs are
hi ghly
respected and can influence the community.
Involving the ICDS infrastructure also ensured replicabi1ity
of
this IEC strategy.
In
formal
November 1989 the IHMP approached the CEO,
ZF
E*eed
perm!ssi on
in
the
programme.
first
In
to
involve the I CDS
workers
March 1990, on receiving formal
for
CETHO
permi ssi on.
batch of 27 Anganwadi workers and 30 helpers
was
the
trained
for conducting water awareness camps for women.
Subsequent1y,
total
three
more batches of AWWs were
83 AWWs, 30 helpers and 16 Mukhya Sevikas from Georai
Pai than
Ta1ukas
have been trained till now.
The IHMP
A
trai ned.
and
plans
to
train all 266 Anganwadi workers in Georai taluka.
ICDS Workers (Mukhya Sevi kas & AWW) Training Objectives?
Broad Objective:
To enable ICDS workers (Mukhya
Sevi kas and Anganwadi Wor kers) to
conduct an IEC programme for drinking water in rural communi ties.
Specific Objectives:
au
To orient ICDS workers on health education and its methods.
b.
To impart cognitive and technical skills to ICDS workers
f or c on cl
d uc ting a sit ua t i on a1
an a1ys i s
and planni ng an
awareness camp for women on water.
c.
To orient the
ICDS workers
w i t. h
s k ills
awareness camp for rural women on water.
to
conduct an
d-
To
orient the
ICDS workers with skills to organise the
commu.ni ty
women and to follow up on decisions taken during
the camps.
e-
To
arid
the Mukhya Sevikas in
the supervision
orient
monitoring of awareness camps conducted by their AWWs.
of
<
To impart information to the ICDS workers on the concept
preventive maintenance of hand pumps and the skills required
for their mon i t or i ng.
9.3. Training Content and Methodoloqy:
9.3.1.
the
Training o-F Mukhya Sevikas.
A 3-day residential training -For Mukhya Sevikas was held
at
were
as
The areas covered in the Training Programme
IHMFn
tollows:
a. Concept of clean and safe water.
b. Water borne diseases.
c. Concept of health education, conduction of
women's awareness camps on water and sanitation.
d. Roles and responsibilities of Mukhya Sevikas.
e. Preventive maintenance of Handpump.
f . Immunisation.
g- Growth monitoring and nutrition education.
h. Maternal and child health care.
(The last three topics were included at the request of trainees)
cogniti ve
and
on
the
of supervisors which covered the planning, supervision
and
practical
rol e
Sevi ka? s
Mukhya
The
skills.
were
both
The main emphasis was on the section
of awareness camps.
moni tori ng
imparted
Conduction of monthly
meeting for AWWs and regular reinforcement of health
i nservi ce
i nf ormat i on
related to water were also emphasised.
A
major part of the training was done through lectures
di scussi ons.
Training
aids
such
as
u. d i o ~ v i s u a 1 s,
The concept of germs
ex ere i ses
and case studies were used.
explai ned
by demonstration through a microscope.
and
group
was
The I EC strategy o-F awareness camps for
demonstrated
train!ng
through a si mu. 1. at i on e;< er c i se«
curri culum5
drinking water
was
(For details on
the
learning objectives and the
used j.
methods
refer Annexures).
8.3.2.
A
Training of Anganwadi Workers.
2-day
resident ial
workers.
training course
was
f or
hel d
An gar. wadi
The topics covered in the training were as follows:
a.
b.
c»
d.
Concept of safe water.
Water borne diseases.
Health education and conduction of Mah i 1 a. Me 1 a was.
Roles/responsibi 1ities of the Anganwadis in
conduction of Mahila Melawas.
e. Preventive maintenance of Handpumps.
e
The
emphasis of the training for Anganwadi workers
was
practi cal skills required for the conduction of awarceness
A
si mulati on
illustrated
exerci se
vari ous
the
on
the
steps to be
Camp
Awareness
camps.
strategy
Through
foil owed.
on
gr oup
discussions the objective and purpose of each of these steps
was
explained
and
and
practi cals
were
c 1 ar i f i ed.
Group exercises.
case
other methods used during the
studi es3
training.
(For
detai 1s? refer Annexures CI ?< CID.
8-4 pvaluati on
Workers.
8.4. 1
of
the Training Programmes Conducted
for
the
Objectives of Eval uaiti on :
To study the ef f ect i veness of
the
training health change facilitators.
me t h od o 1 o g y
used
f or
b.
To study the effectiveness of ICDS workers as c ommun i c a tor s
and facilitators of change in r u r a 1 c o m m u n i t i e s.
c.
To
provide
policy guidelines
for the
trai n i ng
for conducting IEC programmes on S a f e D r i n I •: i n g W a t e r
of
AWWs
I CDS
fa* —A A
library
0 f
f
AND
INFORMATION
information
\
?
C5NTF.fi
*
A "*->______V*
Evaluation Methods
8. 4.2
of
A pre-post test design was used to evaluate the training
Standardised questionnaires were used for the
ICDS workers.
wi thi n
the
questionnai re was fi11ed by
t est .Aft er the t r a. i n i n g t h e same
trai nees,
pre-
a t ime per iod of
one? and a
hours.(refer
h a ]. f
annex tires C 111 ?< IV f or d stalls of F’r e / F‘ os t Gues t i o n n a ires) .
The
sc or :l ng
used for the pre/post
system
Each question was scored as:
e
tests was:
Wr on g Answer
0
Parti al 1y Correct
1
Completely Cor r ect
The
ques t i onnai r e f or
t. h e ma.x i mum p o ss idle i n d i v i d u a 1
1 he
scores
for
max i mum
in
score was 74.
p a11ern was fol 1 owed
scori ng
each topic.
possible group score was 28
(14x2).
group scores for the two batches of
the
same manner.
For 23
scares f or each top;i c are
AWWs were trained 3
out
AWWs trained in
of 54.
out of 46..
to
present
group
the
t rain ed
(Refer' ta^ble
AWWs are
f i rst
the
2) .
presented
batch j,
In the second
batch
therefore.group scores for each topic
are
(Refer tables 3 and 4).
c omb i n ed a ver' a g e score to assess the performance
A
1) .
(Refer Table
For the 14 Mukhya sevikas
The
group
27
same
questions,
t he Muk:In ya Sevi kas had 37
the AWWs is presented in Table 4.
of
al 1
y'M'VO
Results
8.4.3
A.
R e s u 11 s o f t h e? T r a. i n i n g P r o g r a m m e for S u p e r v iso r s
B.
R e s la .1. t s o f t h e T r a i n i n g P r o g r a m m c? f o r A n g a n w a d i
8.4.3.1.
A.
The results of the 3—day
trai ning
Wor k e r s
programme
for
Mukhya Sevikas
Tabl Ei
1
presents
the
i nd i v i dua1
scores of
the Mukhya Sevikas.
Table 1:
Individual Scores of Mukhya Sevikas.
SCORES OUT OF 74
PRE-TEST
!
POST-TEST
Actual
I
7.
} Actual
!
7.
INDIVIDUAL
i
(
i
I
1
18
24 a 3
29
< 39.2
46
I 66.2
t
I
I
67
90 „ 5
i
3
I
I
4
5
6
i
27
i
I
36. 4
59
i
27
36. 4
i
59
< 79. 7
18
I 24.3
i
46
62. 2
i
i
< 28.3
57
77.0
i
7
I
I
i
37
i
i
8
9
i
i
!
i
10
16
18
19
I 50. 0
«
21.6
I
24.3
i
i
25.6
i
11
I
23
I
i
12
I
20
I
i
13
I
<
I
14
|
<
I
53
» 71.6
t
•
59
i
79. 7
58
I
78.3
i
58
78.3
48
64.8
51
68.9
i
i
20.2
i
24
77.0
f
• 31.1
«
27.0
15
!
ET-T
i
t
i
79. 7
I
i
21
I
I 32. 4
I
<
I
59
79.7
i
<
i
■
*
15
■
*
16
i
7/74
36. 4
I Absent
<
i
Absent
35/74
i
I 47.2
i
The individual scores of Mukhya Sevikas indicate that except
for
5 trainees,,
post-tests.
the? rest of them have scored above 757. in
The scores of the remaining 5 trainees
62. 27. to 71.67..
range
thei r
from
Subject-Wise Group Scores
Graph 1.
*
Percent Scored
100.0%------------------------
80.0%
60.0%
40.0%
"1R
20.0%
ra
H
0.0%
A
H
B
Topics*
Pre-Test
S® Post-Test.
* See Table 2 tor Topic Listing
Graph 2. Scores of the Group
of AWW-Teachers (Group 1)
Percent Scored
100.0%
80.0%
60.0%
40.0%
20.0%
0.0%
A
C
B
D
Topics; *
Pre-Test
'Sue Tfeblti 3 for Topic LLotinge
EM Post-Test
E
8.4.3.2.
Group scores of the Mukhya Sevikas for each topic
presented in table
are
2
Table 2:
Group Scores of 14
Mukhya Sevikas for each Topic.
TOTAL SCORE OUT OF 28
Pretest
I
Posttest
Actual
!
7.
I Actual
Ii
7.
i
I
I
i
9
32. 1
23
82. 1
I
i
15
53.6
27
96.4
TOPIC
I A. Concept of water
i
IB. Water borne disease
■
i
i
I C. Hea1th education and
conduct ion of mahi1 a
i
melawas for water.
<
t
«
i
i
4
I
14.3
24
t
85. 7
i
■
I
ID. Role/responsibi 1ity of
supervisors in the
■
conduction of melawas.
7;
«
I
i
:e. Preventive maintenance
<
IF.
of hand pumps
Immunisation
3.6
i
I
■
12
12
Child Care
i
»
Tabl e
2
covered
illustrates
in
the
The
9
32. 1
22
I 78. 6
i
■
42. 8
group
has
•
i
i
I
I
42.8
■
35. 7
the group scores
training programme.
scores are above 75"4.
prevent!ve
10
89.3
i
i
•
i
«’H. Maternal
I
I
■
i
IG. Growth Monitoring and
i
nutrition education
the
25
I
1
i
i
4
10. 7
on
24
i
I
i
85.7
■
64.3
18
I
i
t
i
i
i
vari ous
topi cs
A majority
of
group
scored
1 ow
maintenance of handpumps.
the
a
the
32. 17.
Another area
on
wi th
comparatively low score is maternal and child health care.
8.4.4.
B.
Results of the Training
Programme
for
Anganwadi
Workers
50
AWWs have been trained
in
2
batches.
Group scores
the first batch of Anganwadi workers is presented in table -3.
of
Table 3:
Group Scores of 23 AWWs by Topic.
S
TOTAL SCORES OUT OF 46
}
!
Pretest
1
Posttest
I
<}
! Actual
I
7.
I Actual
7.
I
i
I
30
65.2 j
52. 1
24
*
76.0
35
24
52. 1
i
i
TOPIC
i
i
«
i
i
i
i
i
t
i
A. Concept of safe water
i
I B. Water borne diseases
i
■
C. Health education and
conduction of Awareness
Camps on water
I
1
i
65.2
30
2. 17
<
«
D. Roles/Responsi bi 1i ti es
of AWWS in conduction of
Awareness Camps
i
0
E. Preventive maintenance
of hand pumps
I
0
44
95.0
20
43. 4
i
I
i
i
8.4.4.1.
The
scored highest
group
responsibi 1i ti es
of
(95%)
in the area
AWWs in the conduction of
rol es
of
Awareness
followed by a score of 76.07. for water borne diseases.
and
Camps
A similar
score of 65.27. was obtained for the topics - concept of water and
health education and conduction of Awareness Camps on water.
group
scored
a
percentage
1 ow
(43.37.)
for
the
The
prevent i ve
maintenance of handpumps.
8.4.4.2.
The
4
post-test
results
of
relatively lower t h an t h e f i r s t.
the second
batch
AWWs
of
The group•"s scores var i ed
is
f rom
35.27. for the topic concept of safe water. to 42.67. for the topic
prevent!ve
maintenance
of
responsi bi 1i ties of the AWW
of
handpumps. 51.67. for
and
the
role
55.6% for the topic on
health educat i on and conduction of Awareness Camps on
and
concept
waterM
*
4
Graph 3. Scores of the Group
of AWW-Teachers (Group 2)
Percent Scored
80.0%
60.0% --•~"1-‘
40.0%
>
20.0% *
0.0%
D
Topics 4
Post-Test
e
♦ See Table 4 for Topic Ustlngs
Graph 4. Combined Average Scores
of the 2 Groups of AWW Trained
1
80.0%
Percent Scored
60.0%
40.0%
20.0%
1
0.0%
A
c
B
D
Topics *
BBS Pre-Test
* Ses» Table 5 for Topic UKtlngs:
S® Post-Test
9
4
€
The
group
The
group score
scored 72.2Z -For the topic o-F water borne
o-f
the
second
di seases.
batch of Anganwadi workers
is
presented in table 4.
Table 4:
Group Scores o-F 27 AWWs by Topic.
i
i
TOPIC
i
i
A.
Concept of water
4
r
*
i
i
i
J
TOTAL SCORES OUT OF 54
!
Pretest
!
Posttest
: Actual
:
7.
.'Actual
Ji
7.
B. Water borne diseases
C. Health education and
conduction of mahila
I
melawas on water
i
16
I
I
I
28
29. 6
i
19
35.2!
i
51.9
i
39
72.2 1
i
i
i
I
r
I
I
2
t
3. 7
r
30
i
55. 6 :
i
e
D. Roles/Responsibi 1ities
of AWW in conduction of
mahila melawas.
t
i
2
i
3. 7
i
28
51.9:
i
E. Preventive maintenance
of hand pumps.
I
i
0
i
23
42.6:
i
ft
I
8.4.4.3.
The
Combined group scores for 50 Anganwadi workers
trai ned
in two batches is presented in table 5. The combined group
is
*
1 ow
for
the two topics. concept of
preventive maintenance of handpumps
(437.) .
safe
b
a
(497.)
and
The anganwadi workers
scored 607. and above in the remaining 3 topics.
for combi ned group scores)
water
score
(refer Table
5
Table 5:
Combined Average Group Scores o-F 50 AWWs by Topic.
5
TOTAL SCORES OUT OF 100
5
Pretest
5
Posttest
(Actual
J
7.
(Actual
5
7.
I
TOPIC
<
<
•
i
<
it
i
<
i
■
A. Concept o-F safe water
40
4. 0
t
I B. Water borne diseases
I
49
52.0
52
74
i
i
i
I
i
I
C. Health education and
conduction of mahila
melawas on water
i
49.0 5
f
I
D. Roles/Responsibi1i ti es
of AWW in conduction of
mahila melawas.
74.0 5
5
5
i
3. 0
3
I
(
J
2.0
60. 0 5
60
i
i
j
i
I
2
I
72. 0 5
72
■
i
E. Preventive maintenance
of hand pumps.
i
0
I
8.5.
i
43
43.01
i
Discuss!ons
The pre/post test results o-F the training programme indicate
that certain topics need reinforcement.
reori entati on
concept
The Mukhya Sevi kas
need
in the preventive maintenance o-F handpumps.
is di-Ft icu.lt to understand and
requires
This
reinforcement.
Field
training -For
from
this the 4 Mukhya Sevikas with a general low score need
explaining the
concept is
necessary. Apart.
to
be separately reoriented during their monthly inservice meetings.
The Anganwadi workers need to be regularly reoriented during
the circle meetings.
top i cs
The Mukhya Sevikas should reinforce all
covered in the training programme.
Apart from
the
i mparti ng
cognitive skills Mukhya Sevikas should focus on the c ommuni c at i on
ski 1 Is
The
di scuss
of the AWWs during the monthly
i nservice
trai ni ng.
circle meetings provide a good opportunity to plan
the Awareness Camps to be conducted by the AWWs.
and
Mukhya
Sevikas
should provide supportive supervision and resolve
level problems,
i i el d
during these meetings.
The training period for AWWs should be increased to 3
days.
This will facilitate reinforcement of the more difficult concepts
enable a general summary session and more time will be
for
trainees”
The
In
eval nation.
training
addi tion
avai1able
methodology requires
to classroom sessions.
certain
field
modi f i cat i ons.
ej-terci ses
should
be
included for imparting skills to make a situational analysis.
to
conduct
pretesting of community women, monitoring of
Hand
pump
di scourages
the
information to rural audiences.
It
performance etc.
The
I EC
concept
developed by
the
IHMP
presentation
of only factual
advocates
an
act!ve
deci si on
making through group i rit er act i on .
process
(ie.the AWW) has to facilitate
to
of
prob1em
identification
The
camp
and
organ!ser
discussions and decisions related
use of water. so that informed choices can be made
by
rural
women. The trainers need to impart effective communi cation skills
to
the
camp organisers.
This is only
possi b1e
through
field
exercises.
8.6-
Problems Encountered:
A period of about 5 months was spent in negotiating with the
government and obtaining sanction for the involvement of the ICDS
workers
Even
now
an
agreement
f or
i n voIvin g
the
I CDS
courses
has
infrastructure has not been formalised.
Ti me
been
constraints
another problem.
for conducting the training
The
some
CPDO not being directly involved with
this
pr ogr arrifne.
of the Anganwadi workers will not be motivated to
act i vely
participate in the programme.
8.7.
Conclusions;
There are no clear guidelines or strategies for implementing
IEC programmes at the District 1evelthe
bl ock
The IEC infrastructure
and District levels has not been able
to
evolve
at
an
imparting health education and bringing
effective methodology for
about a change in community behaviour.
The
and
broad objective of the CETHO programme
was
to
establish an IEC strategy replicable within
the
government
i nfrastructure.
regardi ng
the
Several
Th i s
study has
replicabi1ity of
trai ned
conducti ng
women7s
behavi aural
change
AWWs
this
substant i al
Camps
the community.
evi donee
strategy.
(957.) have actively
Awareness
in
provided
evolve
on
parti ci pated
water
A
and
ini tiated
proport i on
1 arge
women in these villages have become aware of the concept of
water?
water
etc.
Changes
effective!y
have
borne diseases;, their prevention
been
1eadi ng
to
and
successf ul
in generating collective action
mangement
safe
been
have
In several villages Anganwadi
their partici pation in the
of
management,
in individual and community behaviour
d emonst r at ed.
in
workers
by
women
of
communi ty
pr i z e
incentive
water resources
To
sustain the mot i vat i on of the AWWs,
should be introduced for those
a
AWW’s who demostrate a change
in
communi t y behaviour in their villages.
There is need for better coordination with the Dy.
GSDA, for the effective implementation of this strategy.
Engi neer
r
The
provi si on
supportive
aud i o-vi sual
material„
and
effect!ve
wi 11
i ncrease
the
■Fol 1 owi ng
supervision and monitoring of wor kers
the impact of this IEC programme.
8.8.
To
Lessons Learned;
rc-?pl i cate
this
IEC strategy on
a large scale
aspects are imperative:
- Requirement of an unequivocal government directive.
Involvement
of the
entire ICDS infrastructure
includi ng
the
CORO is necessary to sustain motivation of workerrs.
There is need for a regular review by the CEO of the
and
recogni ti on
of the inputs of the
Mukhya
di stri el
Sevi kas
and
Anganwadi workers.
- Require a formal
link between the ICDS workers and the G.S.D.A.
^intersectoral co-ordination).
Require some incentive to sustain the motivation of
workers
- Require
the
ICDS
this could be a prize for the best performance.
parameters
parti ci patory
for
evaluati on
evaluati ng
the
IEC
strategy
techniques for selecting
the
and
best
performers.
- Require a budget for:
a. Training
b. Audio-visual aids
c. Monitoring system for the IEC
programme implemented by the
Anganwad.i s.
d. Evaluation of the IEC strategy.
*
9
D. VILLAGE LEVEL VOLUNTEERS
9. 1
Introduction
9.2
Training of Village Level Volunteers
9.2.1 Training Objectives
9.2.2 Training Methodology
9.2.3 Areas Covered During Field Training of VLVs
9.3
<
Evaluation of the Training of VLVs - A KAF Study
9.3.1 Evaluation Objectives
9.3.2 Evaluation Methodology
9. 4
Results
9.4.1 Profile of the Respondents
9.4.2 Handpump Monitoring
9.4.3 Role of VLVs in Case of Breakdown
9.4.4 Water and Disease
9.4.5 Maintenance of handpump surroundings
9.5
Di scussi on
9.6
Problems Encountered
9.7
Conclusions and Implications
9. 1
Introduction:
The village level volunteers (VLVs) are community members
e
who monitor the functional status and maintain the cleanliness of
the
handpumps in their villages.
households
a woman ?
1ocated near
an
adult?
Present1y
has
These
the handpump.
VLVs are selected
from
Each
VLVs
pump
5
a leader and 2 students.
the IHMPj, Safe Drinking Water
(SDW)
1795 VLVs taking care of 359 hand pumps i n 180
the Georai ta1uka in
has
Deed district.
programme
vi11 ages
of
*
9.2.
Training of VLVss
9.2.1.
Training Ojectives:
Broad objective
To
train
VLVs
to
strengthen
support the
and
commu.ni ty
management of hand pumps.
Specific Objectives:
1).
To increase the levels of knowledge of VLVs regarding
the concept of safe water, water borne diseases and their
prevent i on.
a
2).
To orient VLVs in the maintenance
hand pump surround!ngs.
of
3) .
To
impart necessary skills to the
mon!tor their hand pumps.
VLVs
cl cali ness
to
of
regular1y
4) .
Provide skills to the VLVs to involve community members
t-t? maintain the cleanliness of their handpump surround!ngs.
9.2.2.
Training Methodology:
The
(CETHO)
Community Education, Training and
Heal th
team
and
trai ned
the VLVs to support
Organ!sati on
strengthen
the
community monitoring of handpumps and maintain the cleanliness of
their surroundings.
This
training was conducted because a large number
initially selected VLVs (707.) had
e
4
a
of
two
been
over a
peri od
c 1 ear
about
t hei r
years. The new VLVs were not very
and
needed to be oriented. A total of
trai ned
by
the CETHO team in June and July 1990.
1)
2)
3)
4)
5)
the
replaced
rol es
9.2.3.
of
1700
VLVs
were
Areas covered during the field training of VLVs:
Concept of clean and safe water
Water borne diseases - transmission and prevention
Maintenance of the cleanliness water source and its surroundings
Monitoring of hand pumps on a daily basis
Responsibilities of the VLV.
*
The
training
Information
of VLVs was conducted at the
site.
han dp Limp
related to the transmission of water borne
di seases
and their prevention and maintenance of cleanliness of the
source
and
The
a
water
its surroundings was imparted with a. v« aids.
responsibilities of the VLV were discussed in
The importance of handpump monitoring was emphasised.
details.
the HP card
and its use was explained.
Subsequent to this training the Block Level Mechanic
has been training
the vi11 ages,
and
mot i vates
c 1 ran
its
(BLM)
the VLVs during his routine monthly visits
He reinforces the? water related health
i nformation
the VLVs to regularly monitor the hand
sur r ound i ngs. This orientation is done
to
at
p ump
and
the
pump
si te-
9.3. Evalpation of
The
VLVs
he Training of VUVs ~ A KAP Study
trained
by
the CETHO
team
were
evaluated
in
August 1990.
9.3.1.
Evaluation Objectivess
a)
To study the effectiveness of VLVs for
monitoring of hand pumps.
the
community
b)
To assess the awareness levels of the VLVs iregard!ng
the concept of clean and safe wateru water borne■ diseases
and their prevent! on.
c)
To study the effectiveness of VLVs in maintaining the
cleanliness of the hand pump and its surround!ngs.
d)
To study the effectiveness of the methodology used for
training VLVs.
*
9.3.2.
The
Evaluation Methods:
VLVs were evaluated by external
i nvestigators.
A
pre
post LAP study was done on a sample of 70 randomly selected VLVs.
A
semi- structured interview schedul e was used.
DI) .
(refer
annexure
The
*
4
ML Vs were pre-tested before
the! r traini ng
and t h e i r
post test was cz on ducted
one week after the training
programme.
Inf ormation regarding monitoring
was obtained from VLV cards
and
exter na1
i nvest i gat ors made observations of
the handpump
si tes,
for
cleanliness of the handpump
surroundings.
9.4. Results
The
■f i ndi ngs
of the KAF' tests administered to
70
randomly
selected VLVs are presented below.
9.4.1.
Profile of the Respondents:
67. 1
4
a
were
females.
47. 27.
40
years
VLVs
These VLVs
were
Hi ndus
Lamanis
amongst
the
These
farmers,
busi ness
were
i nterviewed
varied
15.77.
in
above
VLVs
VLVs
were
have
and
students,
years.
of
had
been
32. 97.
distributi on.
82. 97.
them
of
to
t he
were
Musii ms
The
1 i tera.cy
was high 75.77. .
di f f f erent
occupations,
daily wage labourers,
whi 1 st
while
age
Van jar is (2.87.) .
207
working
were
27. 17.
were
5.77 had their
own
27. 17. of
housewives.
as VLVs for
28.67 had worked for over 9 months
mere
the
VLVs
52.87
of
the
than
a
year
and the rest of them had been
working for a period of 3 to 8 months
4
thei r
40
while the rest
(8.67.)
ma les
and 4.47. were employed in service.
respondents
4
were
44.67 were in the age group of 21
and only 107. were
<5-77.) „
rate
VLVs
below 20 years j,
*
4
■z
(18.67).
9.4.2.
Responsibilities of VLVs:
Table 1.
Responsibilities of VLVs
Pre test
Post test
1. Monitoring of HRs.
reporting HP breakdown
and maintaining the HF
surrounding clean
51
(72. 87.)
63
(907.)
2.
19
(27.27.)
7
(107.)
70 (1007.)
70
(1007.)
respondents
coul d
Not sure / Dont know
Total
r
In
thei r
9
9
the
Pre-test 72.87. of the
responsibilities in monitoring functional status
pumps and maintenance of cleanliness of its surround!ngs.
state
of
In
hand
the
post test 907 VLVs stated these roles and responsi bi 1i ti es.
9.4.3.
Hand Pump Monitoring:
Table 2a:
Hand pump Monitoring - Cards.
I
I
PRE-TEST
5
POST-TEST
I Scores out of 701 Scores out of 70 5
’_________
\
I
i
i
Hand Pump Cards
i
t
la) Do you have a Card : Yes
No
«
.’b)
i
i
•
<
<
4
*
i
58 (82.87.)
I
12
i
I
«
•
I
Use of card :Check funct-l
ionality of !
HP
report I
I
breakdown
<
JO Filling of
!
HF card
(17.27.)
67
29 (41.47.)
I
(95.77.)
3 ( 4.37.)
i
50 (71.47.)
t
i
I
I
i
I
Don’t know
i
41
(58.67.)
i
20
(28. 67.)
<
: Ever yd ay-
39 (55. 87.)
Irregular
31
(44.27.)
63 (90. 07.)
—y
(10.07.)
In the post test the respondents who were able to state
the
use ot hand pump cards for checking the functional status o+
the
hand
pumps and reporting breakdown had increased -from 41.4 "Z
to
71.4
"Z
. The number of VLVs actually filling
increased
to
907.. This indicated that 18.67. of
thei r
cards
had
the
VLVs
were
filling their HP cards without knowing its use.
Thee
duri ng
condi t ion
the
of
pre-post
the hand pump card was
tests.
the
In
pretest
al so
19.7
observed
7
of
the
respondents had lost the cards and 4.27. had torn or damaged ones.
ihis reduced to IO 7. in the post-test.
9.4.4.
Role of VLVs in case of HP breakdown:
Table 2b: Hand pump monitoring.
i
!
PRE-TEST
I
POST-TEST
!Scores out of 70{Scores out of 70}
’.Role of VLV in case of
JHP break down
i
i
i
J a) Mark a cross on the card
i
«
6
(8.67.)
I
18 (25.87.)
t
i
i
Sb) Send an application for
i
HP repair.
!
<
t
31
(44.27.)
i
<
! c) Personally inform the
I
Gadi office or BLM
i
<
47 (67. 17.)
i
>
j
<
<
id) Don’t know
3
( 4.37.)
30
(42. 97.)
5 ( 7.17.)
J
In the pre-test 40 VLVs
(57. 17.)
!
could percieve their role
case
of
h a n d pj u m p b r e a k d o w n .
6 VLVs
(8. 67.)
mar k
a
cross on the card.. 31
(44. 27.)
send an
stated
in
that
t. h e y
appli cati on
f or
repai r
and 3 VLVs (4.37.) personally inform the Maintenance
team
or the
BLM.
their role.
a
25.87. ot the VLVs had responded that they would
cross on the card. 67.17. would send an app 1 i cat i on
o-f
aware
the post-test all the respondents <1007.) were
In
■for
mar k
repair
and 7.17. would personally in-form the o-f-Fice or BLM for the repair
ot
thei r
remi nder
hand
in
pump. 77.27. VLVs indicated
no action is taken after
case
they
send
wou.l d
the
send!ng
a
t i rst
i n f or mat i on .
9.4.5.
Water and Disease:
Table 3.
Water and Disease
I
PRE TEST
POST TEST
'Scores out of 70iScores out of 70 :
<
_ J
i
ia) Can water cause Yes
illness
No
i
i
i
i
49 (70. 07.)
Jb) How does water
cause illness
:Germs
i
60 (85.77.)
<
0
i
21
(30.07.)
- 10 (14.372)
i
i
i
i
14 (20. 77.)
42 (60.07.)
i
(80.07.)
28 (40. 07.)
i
55 (78.67.)
i
i
i
i
Don’t know’
56
<
<
i
Ic)
I
Illness caused
by water:
Water borne J
Di seases
I
i
i
33- (47. 17.)
i
(52. 97.)
i
i
«
i
i
Don’t know
i
37
15 (21.47.)
<
i
!d) Prevent i on of water borne
I
diseases
I
1 . Soiling water
i
i
i
■
11
(15. 77.)
25
(35. 77.)
18
(25. 77.)
J_7i
( 2.97.)
I
I
2. Keeping HP surroundings'
I
c 1 ean
i
5 ( 7. 17.)
i
•3.
Adequate storage
technique of water
1
(
1.47.)
i
4. Filtering water
i
10
«
i
12 (17.17.)
(14.37.)
i
i
cr
Don t know
43 (61.47.)
30
i
(18. 67.)
1
The proportion o-f VLVb who percieved that contaminated water
can cause illness ranged from 707. in the pre test to 85.7% in the
The concept that germs in the contaminated water cause
post test-
disease increased from
the
In
pre-test
20 "Z to 60 7..
the VLVs could name water
47. 1’Z of
borne
diseases as compared to 78-67. after the training.
Awareness
regarding the prevent! on of water borne
increased to 81.47 after the training as
pre test
(refer table 3).
9-4-6.
Hand Pump Surrounding
compared
diseases
to 38.67. in the
Table 4a) Hand Pump Surroundings:
{
PRE TEST
I Scores out of
I
70
i
POST TEST
1 Scores out
}
70
i
I
t
i
i
of I
<
<
J
Yes
•a)Is there a need
■
I
to keep HP surroun
dings clean
s
Don’t know!
64
(91.47.)
69 (98.67.)
i
«
i
t
6( 8.67.)
i
:b) Reason for keeping HP surr-l
oundings clean
'
1
i
( 1.47.)
t
i
i
i
i
i
i. Prevent water from
becoming contaminated
causing illness
3.
}
21
(30. 07.)
33
(47. 17.)
Don ’ t know
43
(61.47.)
36
(51.17.)
N A
6
( 8.67.)
1
44
(62.97.)
(
1.47.)
c) Method of preventing accu- 1
mulation of slush around HP!
i
I
1 . Pegu1 ar cleani ng of
drai n
Murram filling
I
2- Don’t know
J
<
i
I
52
(74.37.)
18
(25.77;)
I
26 (37. 17.)
i
i
Table
4b: Role of VLVs in the maintenance of the cleanliness
of
their hand pumps.
i
I
PRE TEST
i
POST TEST
J
{Score out of 70{Score out of 701
j
‘a)To prevent washing of cloth-!
es, vessels?animals at the
HP
prevent children from
defecating near it
«
13 (18«67.)
<
30 (42.97.)
i
Jb)Regular murram filling and
cleaning of drain
I
Ic)Both
(a)
«
(b)
id)Don’t know
25 (35. 77.)
27
(38. 67.)
2
( 2.87.)
8
(11.47.)
30
(42. 97.)
5
( 7. 17.)
i
The need to keep handpu.mp surroundings clean was
by
91.47. VLVs in the post test as compared to 90.17 in the
test .
□nl y
contaminate
the
recogni sed
47.1 X stated that unclean
the water.
accumulation
hand
pump'
51.1 Z VLVs were not able
pre
surroundings
to
of slush and dirt around hand pumps
associ ate
with
the
(98.67.) stating the
need
spread of disease.
The high percentage of respondents
to
keep hand pump surroundings clean. may have
associ ated
this
requirement only with convenience.
After the
train!ng
52 VLVs (74.37.)
felt the necessity
murr am filling and regular cleaning of the drain compared to
of
44
(62.97.) VLVs in the pre test.
In the pre test only 57.17. respondents could recogni se thei r
role in
maintaining cleanliness of hand pump surround!ngs.
proporti on
i ncreased
stated
washing of
that
defecation
at
the
to
pump)
92.97. in the post test.
clothes. vessel s
site
should
This
42. 97.
VLVs
bathing animals
and
be
prevented,
38.67.
emphasized
the i r
role
in regular
of
11.47.
felt
that
drai ns.
murram filling
their
ro1 e
and cleaning
i ncl u.ded
al 1
these
their
1 evel
of awareness of water borne diseases and their prevention.
and i n
reeponsibi1i ti es.
9.5. Di scussion:
The
t he
study indicates a substantial increase in
role of VLVs in monitoring of handpumps.
78.67. of the
listed water borne diseases and 81.47. stated preventive
VLVs
methods.
The
responsib i1i t i es of the VLVs in monitoring the functionality
of
hand
pumps
training
had
was identified by
907.
r e s p o ndents.
the proportion of VLVs monitoring
increased.
After
han dp> u.mps
Likewise the percentage of
regular1y
filling
VLVs
the
cards
completely increased from 55.87 to 907..
However
filling
187.
of
these VLVs did not know
the monitoring cards. The BLN during
the
purpose
the
f or
r eor i en t at i on
training should focus on these VLVs emphasising the importance of
cards
for
filling
HP monitoring. Unless VLVs to know
cards
or
else it may be difficult
the
to
purpose
sustai n
of
their
i nterest.
407.
safe
water.
germs
is
That visually clear water can be
a
experience.
wi th
VLVs have not understood the concept of clean
illness
concept
the VLVs cannot
contami nated
rel ate
to
thei r
Un1 ess germs are shown to them., and the
explained in a rational way.
and
wi th
daily
associat i on
acceptance
concept will be limited and change in practices may be
of
this
difficult
to sustain.
VLVs were not clear about their roles in maintaining
handpump
t op i c s.
*
sur r oundings.
They
need to
be
reoriented
Field demonstration and training are necessary
practical application of this knowledge.
cl ean
on
f or
these
the
t
9.6. Problems encountered;
e
that
The
mai n
al 1
the
not
village.
5 VLVs -For each hand pump could
not
VLVs
be
was
trained
and
A large number ot VLVs would leave early for work
together.
were
problem encountered in the training o-F
aval 1able
when
visited
thei r
or two VLVs tor a hand pump
coul d
the
Occassi onal 1 y only one
CETHO
team
be trained per visit.
sever ail occasions discussions had to be limited. as
On
VLVs
be in a hurry
woul d
the
to leave tor their work.
9.7. Conclusjons and Implications:
The
*
hand
Gear a i Ta 1 u k a,, aimed to increase the ettectiveness ot
maintenance. Village
were
in
IHMF
community monitoring system introduced by the
pump
Level Volunteers appointed tor this purpose
also involved in maintaining the cleanliness ot their
hand
pump surroundings.
For
monitoring ot hand pumps VLVs need an initial
tollowed by
periodic reintorcement ot skills. The present monthly
i n-service
training provided by the E<LM is sutticient
purpose^
Their
recogniti on
VLVs
ot
are
surroundinqs.
in
training
interest
can
be
sustai ned
tor
communi ty
with
their services.
expected to ensure the cleanliness ot
In
this
•future it
hand
pump
is felt that they can also be involved
the primary maintenance ot hand pumps. For these functions
br i et
monthly contact with the BLM will not be sufficient.
will
require
educator.
a constant and intense contact
with
the
and special training in primary maintenance .
a
VLVs
heal th
VLVs
can only initiate behavioural change in the
but the establishment of norms requires a strong support
system.
Their efforts need to be linked with the network of other
change
agents
such
change
community behaviour. A planned IEC strategy
as ICDS workers, school teachers, and
for this purpose.
1
communi ty
chi 1dren
is
to
required
10.
E. THE PACHOD BALSEVAK EXPERIMENT
10. 1
Inroducti on
10.2
The Balsevak Concept
10.3
The Balsevak Strategy
10.3.1 Tr ai n i ng of School T eachers
10.3.2 Selection and Training of Balsevaks
10.3.3 Dissemination of Health Informati on
10.3.4 Bal-Melawas and Arogya Dindi
10.5
Ca.se Study
10. 1.
Introducti on:
The Institute o-F
Heal th
IEC initiative
innovati ve
Management ? Pachod, has started an
i nvolvi ng
school
who
chi 1dren
are
trained to educate rural adults on hygiene. water an d san i t at i on.
This
"Balsevak”
exper i mented
in
(child
25
vi11 ages
of the
is
strategy
health educators)
proj ect
Pachod
bei ng
area
in
Maharashtra.
10.2.
The Bailseyak Concept:
The Balsevak concept evolved from the
chi 1dren
as
a
major part of the
acti ve
experience of
havi ng
at
village
audience
meet i ngs.
V
The
■Format i ve
years of children can be
behaviours conducive to health. A
towards
easi1y
posi t i ve
influenced
atti tudinal
*
change
in
chi 1dren, not only has sustained
benefits
extendi ng
d
into adult life, but also inf1uences their peers
Th i s
vast human
resource
can
be
eff ect ive1y invo1ved in
creating health awareness in the community;,
change in health related behaviours.
and elders.
leading to a
gradual
10.3.
The Balsevak Strategy;
e
The Balsevak ex peri ment was started in January 1989, with
group
of
10 moti vated schoo1 teachers. The teachers
start
an
IEC programme on personal
sani tati on
i nvolving
by
school
hygiene
chi 1dren.
r
deci ded
to
and
en v i r onmentai
Th i s
subject
selected by the teachers as they felt that unhygienic
was
conditi ons
prevailing in villages were the major cause of i 11 health in
the
communi t y.
as
The
teachers
d ec i d ed t o t r a i n
school
chi 1dren
health educators and chose to call them -• Balsevaks'’ .
10.3.1.
The Training of School Teachers;
The
They
school teachers underwent a 2 day training
were
vari ous
at
Pached.
oriented to the objectives of the programme
steps
involved in the strategy.
The
and
training
the
i mparted
communi cation and management skills.
10.3.2.
The
Balsevaks.
of
Selection and Training of Balsevaksi
teachers
seiected
school chi1dren to
be
trai ned
The main criteria for selection included the
the children to communicate and their interest and
as
ability
readi ness
to disseminate health information to the community.
The Ba1sevaks
were
f ocussed
trai ned
at Paehod. Their training
programme
imparting both cognitive and communi cation skills^
home
vi si 153 j,
u s e a f a u d i o - v i s u a 1 aids for
on
for eg. making
di sseminat ing
heal th
informati on etc.
Balevaks
were
al so
or i ented
to
the
object i ves
of
the
programme and their role as change initiators in the community.
♦
10.3.3.
Dissemination of Health Information through Homevisits:
Balsevaks
e
work in pairs. The older Balsevak
gives verbal messages and the younger Balsevak
a
head
band and two placards with health
fortnightly-
home
vi sits.
each pair
(10-12
(8-10 years) wears
messages .
vi si t ing
100
Duri ng
thei r
related
to per son a1 hyg i ene, water and sanitation.
home
visits the
Balsevaks
years)
They
make
households.
di sseminate
messages
The
ini ti a1
focus was an '-hanging existing defeacation related practicos. The
s
Balsevaks
conti nue
the
behavi oural
change
is observed in the
same
message
unt i 1
a
communi ty.
measurabl e.(
The
process
requires continuous contact and reinforcement.
A
10.3.4.
Bal — melawas and Arogya Dindis:
Apart
from
these home visits during which
given primari1y to the woman in the family.
i nformat i on
the strategy includes
Bal-melawas for both school going and non school chi 1dren
to
chi 1 d
educati on),
followed by village
with slogans) and a ’shramdaan’
is
"Dindis’
(child
(process!on
(voluntary community service).
The school teacher along with his Balsevaks organises a Bal -
melawa
with
<
in
a
the
di vi ded
personal
into
hygi ene
Thi s
is
groups.
They
pai nt
a
begi n
street
play
The
ch i1dren
are
pi ctures
related
to
thei r
pai nti ngs
the
i ni tiated
through
the
topic of hygiene and health.
chi 1d r en share th ei
4
Bal-melawas
recreational activity such as a game or
i ntroducing
then
*
the village once in 3 months- The
and sanitation. Through
cone ep ts of san it ation.
fol 1 owed
by
di scussi ons
presentation
of paintings by the children to the
ent i re
group.
The
identifies children who already have
the
required
teacher
knowledge
and f aci1i tates shari ng
with the rest of
MO
Llu2
the
group.
t
€
9
The
e
«
teacher
fur t. her
helps the children
i d en t i f y
the
Alternatives
to
The process of change
is
sa.ni tsry
problems existing in their cofnmun i t y.
overcome
these problems are discussed.
thereby
ini tiated
through
i nteract i on
instead
of
i mposed
by the
bei ng
to
between
teacher B
the
ch i1dren
Sol u.t i ons
to
identified problems are selected from several available
Deci si ons
regarding choice of messages for the
procG^sion ?
and
choices.
r- d i n d i ■
vi11 age
collective action during the
the
"shramdaan
are
also taken at the Bal Melawa-
The
chi 1dren
march through the
vi11 age
shouti ng
slogans
related to personal hygiene and sanitation. After the "dindiy the
chi 1dren
un d er t a k e
Chi 1dren
have made mud heaps at the defeacation
*
Shramadaan
to
c 1 ean
thei r
vi11 age.
sites,
c .1 eaned
their school surround!ngs, filled murram and cleaned water source
surround!ngs,
planted
The
process.
has
filled waste water pits with earth. made
gutters j,
trees, et c, during the shramadaan.
adults have usually assisted the children
In several cases following the Shramdaan,
voluntarily taken further action to improve
during
this
the
community
the
sani tat i on
and water conditions of their village.
10.4.
Case Study;
The Balsewak strategy is illustr ated with a case study of
a vi11 age where the
*5
experiment is
bei ng
c on due t ed since
a
1989.
R a h a t g a o n i s a small village in the Pachod Project area with
365
households. 877.
peop1e
b e 1 on g t o t h e H i n d u
are Neo-Budhists (schedule castes)
and
commoni ty
117. are Musi i ms.
the families are daily wage agricultural 1 ahourers.
127.
507. of
The
vi11 age
teachers«
has a primary school with a total staff-
In Rahatgaon,
of 5-14 years,
of
there are 265 children in the age
out which 154 are enrolled in the primary
The remaining children look after thei
6
group
schoolh
younger siblings.
assist
in household chores. graze animals or work in the fields.
The
January
Balsevak
programme
1989
Golande
when
d i ssemimating
health
started in
Guruj i
Rahatgaon
showed
keen
vi11 age
i nt.er est
in
through
hi s
information to the community
students. He believed that. s i mu 11 aneous 1 y, a st.r on g
base
towards
health and hygiene
would be
in
att.i tudi nal
estab1i shed
in
the
children t hemseives.
He
attended a 2 day workshop in Fachod a n d p ar t i c i p a t e d
developi ng
a
strategy
for
implementing
this
in
programme.
A
si tuat i onal analysis of the san i t ar y cond i t i on in the village was
done by the teacher. He identified three defeacation sites
were
wi thin
drainage
the
system
accumulati ons
open ?
soap
not
of
village and close to
the
of
and
vi11 age was choked
waste water. People were
wat er
whi ch
source.
The
were
1 arge
there
defeacati ng
covering their faeces with earth and few
were
usi ng
for washing hands.
One Balsevak pair was selected and sent to the IHMP,
for
the
in
training. Kachru aged 11 years and Kanu aged 10
trained
wi t h
the
concept J, strateg y
chi 1dren.
At
f i rst
batch of
30
ch i1dren.
Pachod
years
The
were
Balsevak
and programme objectives were explained to the
the end of the t r a i n i ng, each
pai r
C)T
Balsewaks
a d cj p t e d 3 (J h o u s e h o 1 d s f o r giving h e a 111") e d u c a t ion.
The
shari ng
routi ne
of
increasing
month!y
i nservi ce
meet i ngs
field experiences which had an
encouraged
apparent
t bi e c o n f i d e n c e in t h e B a 1 s e v a k s. Thei r
the community increased rapidly.
the
i mpact
on
acceptance
by
to
heal th.
adopt the necessary practices for better hygiene and
Their health messages focussed on
spread
women
women
made regular home visits and started motivating
They
of diseases due to
poor
sani tary
conditi ons.
period of 2 months the awareness
Within
a
in
th i rt y
the
defeacation behaviour and
households increased from 337.
1evels
of
the
to
827..
But
Kachru and Kanu were not satisfied. They felt that, even
though j,
defeacation
related
school
teacher
the
awareness
1evels
had
increased
the
behaviours had changed only marginally.
3 months of programme initiation the
After
conducted 2 Balmelawas for school and non-school children. During
these
a
' di ndi
seiected
or health procession. followed by a
They
shramadaan.
a convenient defeacation site for their
30
a
out
melawas about 200 children took a decision to take
hpuseholds
and made mud heaps to be used as earth cover after defeacation.
col 1ected
money
from the villagers and bought soap for their 30 households.
They
K.achru
that
felt
and Kanu along with a few children
if the use of soap was initiated in their
30
houses
people would continue this practise there after.
There
d i nd i
and
after
was a greater acceptance of the Balsevaks
shramdaan. All the member from
their
30
the
households
started using defeacation sites far away from the village and 617.
had bought soap for washing hands after defeacation.
80.37. of the
household members were covering their faeces with earth cover.
This initial suecess met i vat ed t he Ba1sewaks» They felt that
u n 1 e s s t h e s a n i t a. r y c o n d i t i o n of the enti re v i11 age was
changed ?
improvement in the? community’s health status would not occur.
The
children wanted to extend th® programme through out the village.
The teacher selected 3 more pairs and sent them for training
to
F'achod.
Each Ba1sevak pai r now adopted 100 households.
T wo
been
more E<al-mel awas followed by dindis and shramdaan
he1 d
chi 1dren
water
in Ra.hatgaon since then. During the
shramadaan
1 ast
cleaned drains and -filled basalt around their
source.
They were assisted by the entire
have
drinking
communi ty»
The
Gram F’anchayat members also participated in this activity.
The
1 arge
Balsevaks.
-f orce
entire
along with village children. have
regard!ng
envirunmantai
of
the
sanitati on
increased from 34 7. to a 867.. A gradual but apparent
have
behavioural
related to defeacation habits is being observed.
Most
sol ve
a
of change initiators. The aware?ness levels
communi ty
change
become
of the villagers are convinced that only latrines
the
vi11 age.
communi ty
problems related to the sanitary
A
The Gram F'anchayat is willing
to
the
of
condi ti ons
demand has been created for the construction
1atri ne.
can
of
a
undertake
responsibi 1ity for maintaining it.
Rabatgaon
vi11 ages
represents
a peoples movement
with the help of school ch i1dren.
in
ini tiated
25
The strategy
has had
communi cat!ng
heal th
an impact at all levels of the community.
Balsevaks
have
been
effect!ve
in
messages and persuading the community to adopt conducive sanitary
behavi our.
pressure
the?
Even
though compliance has been
gradual,
on other children and moral pressure on the
the
elders
peer
of
community is resulting in change.
The
. They
impact of this experiment on children
is
are aware of the hazards of unhygienic sanitary
and are influencing the village
encouragi ng.
condi t ions
e1ders by demonstrating a change
in their own practices.
The Balsevaks represent an entire generation moving
a
heal thi er
life with improved norms in
e n v i r o n m e n t a 1 sani t c-xt i on .
personal
towards
hygiene
and
ANNEXURES
ANNEXURE
A
I
Institute of Health Management Pachod
Safe Drinking Water Programme
IHMP Awareness Camp Pretest
1.
Name o-F Respondent
Vi 11 a. go
3.
Age of Respondent:
4.
Education of Respondent:
5.
Caste of Respondent:
6.
Where do you fetch your drinking water from?
Handpump
Wei 1
Ri ver
Tap
Others (specify)
■7
What do you store your drinking water
Ranj an
Mat ka
Metal Vessel
Others (specify)
8.
How do you clean your storage vessel?
9.
How many times do you fill your drinking water ?
Once a day
40 - :50 years
50 - 60 years
> 60
years
20 yrs.
20 - 30 yrs.
30 - 40 yrs.
Li terate
Illi terate
Hindu (specify)
Musii m
Eudh
Others
in?
Others (specify)
10. Do you cover your storage vessel?
Yes
Mo
11.
If yes.,
what cover is used?
12.
If yes.,
why do you cover your storage vessel?
13.
How do you remove water from your storage vessel?
14.
What i s t he di f f er ence between c 1 ean and unc 1 ean water?
15.
Can water become unclean?
16.
If yes ? how does water become unclean?
17. Can water cause illness?
Yes
Yes
No
Don’t Know
No
Don’t Know
18.
If yes j, how does water cause illness?
19. State 4 water borne diseases.
20. Can we prevent water borne diseases?
Yes
Don’t Know
No
21.
If yes ? how can we prevent water borne diseases?
no
J-J- a
Is there an association between diarrhoea and dehydration?
Yes
No
Don’t Know
23.
If yes, what is this association?
a
chi Id
your
water
24. What
can you do at home to prevent dehydration in
suffering from diarrhoea?
ntr
xL -J .
How do you prepare Oral Rehydration Solution
(ORS)?
26. Are? your hand pump surroundings clean?
Yes
No
27. Does t h e dirt and slush accumulated
source cause any prob1ems/hazards?
Don’t Know
Yes
No
around
28.
If yes, what are the hazards caused?
29.
What should you do to keep your handpump and its surroundings
clean?
30. Should you wash clothes at your drinking water source?
Yes
No
Don’t Know
31.
If no. why?
32. Should you wash animals or let them drink at
water source?
Don’t Know
Yes
No
33.
the
dri nking
If no j, why?
34. Should children be allowed to defecate at the drinking water
source?
Yes
Don’t. Know
No
33.
Do you clean the handpump platform after filling water?
Yes
No
0 b s e r v a t i o n o f the Drinking Water Source by the Investigators
— Condition of the d r i n k i n g w a t e r- source:
Presence of s 1 u s h a n d d i r t a r o u n d source:
Good
Yes
Bad
No
I nd i cat i ons of community m i suse of dr i n 1: i ng water sources
Yas
No
Name of Inves ti gator:
Date s
ANNEX’JRE
A
II
Institute of Health Management F’achod
Safe Drinking Water Programme
IHMP Awareness Camp Post Test
.t „
Name of Respondent
Mill age
€
3«
Age of Responden t s
4«
Education of Respondents
5.
Caste of Respondents
6.
Who conducted the awareness camp in your village?
7-
Were you present r o r t h e e n t i r e c a p ?
8„
If no. f or how long did you attend the camp?
9.
What information was given to your in the awareness camp?
10.
Where do you fetch your drinking water from?
Handpump
Wei 1
Ri ver
Tap
Others (specify)
11.
What do you store your drinking water in?
Ran j an
Mat ka
Metal Vessel
Others (specify)
12.
How do you clean your storage vessel?
20 yrs.
2C - 30 yrs.
30 - 40 yrs.
40 - 50 years
50 - 60 years
> 60
year s
Li ter ate
Illi terate
H i n d u (s p e c i f y )
Musiim
Budh
Others
Yes
No
13.
How ma n y t i mes d o you fill y o u. r d r i n k i n g w a t e r ?
Once a day
□ n c e i n t w o ci a y s
0nee in 11"!rec days
D111 e r s (s p ec i f y)
14.
Do you cover your storage vessel?
15.
If yes ? what cover i s used?
16.
If yes ?
17.
How do y o u r e m o v e w a t e r f r o m y o u r s t o r a g e v e s s e 1 ?
Yes
No
why do you cover your storage vessel?
IB,
What is the cli f f erencg between c 1 ean a n d Lt n c: 1 e a n w a t e r■ ?
19.
Can water b e c o rn e u n c 1 e a n'?
20.
If yes, how does water become unclean?
21.
Can water cause illness?
X. .u.. «<
If
yes j,
Y es
Yes
No
Don’t Know
No
Don’t Know
how does water cause illness?
24. State 4 water borne diseases.
e
*
X. uJ M
Can we prevent water borne diseases?
26.
If yes, how can we prevent water borne diseases?
^“7
-C. / m
Is there ani assoc i at i on b et ween cl i ar r h oea an d deh yd r at i on ?
Yes
No
Don’t Know
28.
If yes
Yes
No
Don’t Know
what is this association?
29. What can you do at home to prevent dehydration in
suf f er i ng from di ar r hoea?
30. How do you prepare Oral Rehydration Solution
a
chi 1 d
your
water
(ORS)?
31. Are your handpump surroundings clean?
Yes
No
32. Does the dirt and slush accumulated
source cause any problems/hazards?
No
Don’t Know
33.
around
If yes. what are the hazards caused?
34. What should you do to keep your handpump and its surroundings
clean?
35. Should you wash clothes at your drinking water source?
Yes
No
Don’t Know
e
36.
If no, why?
37.
Should
you wash animals or let them drink at
water source?
Yes
No
Don’t Know
38.
If no
39.
Should children be allowed to defecate at the clr i nI-:: i ng water
source?
Yes
No
Don’t Know
40.
Do you clean the handpump platform after filling water?
Yes
No
41.
Were there any decisions taken at the awareness camp?
No
Don’t Know
the
dr i nking
why?
4k
42. What were these decisions?
Indi vidual?
Communi ty Level?
♦ Observation of the Drinking Water Source by the Investigator:
S
Condition of the drinking water source:
Good
Bad
Presence of
slush and dirt around
source:
Yes
No
Indications of community misuse of drinking water source:
Yes
No
• Name of Investigator:
Date:
*
1
a
4
e
ANNEXURES-B
ANNEXURE B I
Institute of Health Management Pachod
Safe Drinking Water Programme
Awareness Camp Pre-Test
(ICDS Workers)
A
1.
Name oF Respondent
7
Vi 11 age
3.
Age of Respondent:
4.
Educat i on of Respondents
5.
Caste of Respondents
6.
Where do you fetch your drinking water from?
Handpump
Well
Ri ver
Tap
Others (specify)
7.
What do you store your drinking water in?
Ranj an
Natka
Metal Vessel
Others (specify)
8.
How many times do you fill your drinking water?
Once a day
Once in two days
Once in three days
Others (specify)
9.
How do you clean your storage vessel?
10.
Do you cover your storage vessel?
11.
If yes.. what cover is used?
12.
If yes j,
a
13.
How do you remove water from your storage vessel?
4
14.
What i s the? difference between clean and safe water?
15.
Can water become unclean?
16.
If yes, how does water become unclean?
17.
Can water cause illness?
t
4
a
<
40
50 years
50 — 60 years
> 60
years
20 yr s.
20 - 30 yrs.
30 - 40 yrs.
Illi terate
Li terate
Hindu, (specify)
Musii m
Bu.dh
Others
Yes
No
why do you cover your storage vessel?
Yes
Yes
No
Don’t Know
No
Don’t Know
<
e
€
C
18.
I-F yesP how does water cause i 11 nessi?
19.
Can water which looks clear and transparent cause illness?
Yes
No
Dont know
20.
1 + yes, how?
21. State 4 water borne diseases.
22. What are the methods ot preventing of water borne diseases?
No
Yes
Is accumulated waste water harmful to health?
23.
31. What can you do to prevent waste water from accumulating?
32.
Is there dirt and slush accumulated
water source?
Yes
No
33. Does this affect the water?
34.
around
Yes
drink ing
your
Don’t Know
No
If yes.. how?
3S. What should you do to keep your drinking water source and its
surroundings clean?
36- Should you wash clothes at your drinking water source?
Yes
No
Don ’ t Know
37.
If no. why?
38 M Ghould you wash animals or let them drink at
water source?
Don’t Know
Yes
No
39.
<
drinking
If noj, why?
40. Should children be allowed to defaecate at the drinking water
source?
Don’t Know
Yes
No
41.
4
*
the
Do you clean the handpump platform after filling water?
Yes
No
Observation of the Drinking Water Source by the? Investigator:
Condition of the drinking water source:
Good
Presence of s 1 u.sh and dirt around source:
Yes
Bad
No
I nd i cat i ons of community misuse of drinking water source:
Yes
No
Name of Investigator:
Date:
ANNEXURE B II
Institute of Health Management Pachod
Saf e Dr i nking Water Programme
Awareness Camp Post Test
(ICDS Workers)
1.
Name of Respondent
2
Vi 11 age
3.
Age of Respondent:
4.
Education ot Respondent:
5.
Caste of Respondent:
6.
Who conducted the awareness camp i n your vi11 age?
7
Were you present for the entire camp?
8.
If no. for how long did you attend the camp?
9.
What information was given to your in the awareness camp?
20 yrs.
20 - 30 yrs.
30 - 40 yrs,.
Li terate
40 - 50 years;
50 - 60 years
> 60
years
Illi terate
Hindu (specify)
Musii m
Budh
Others
No
Yes
10. Where do you fetch your drinking water from?
Handpump
Wei 1
Ri ver
Tap
Others (specify)
11.
What do you store your drinking water in?
Panj aan
Mat ka
Metal Vessel
Others (specify)
12. Did you change your drinking water storage vessel af ter
camp?
No
Yes
13.
If yes. what vessel did you use previously?
14.
If yeSj, why did you change your storage vessel?
15.
Do you cover your storage vessel?
16.
If yes j, why?
17.
If yes ? what cover is used?
Yes
No
the
18. Were you covering your storage vessel before the camp?
Yes
No
19.
If yes. with what?
20.
How d o you remove water from your storage vessel?
21.
After the camp, did you change this method?
Yes
No
If yes, how did you previously remove water from your storage
vessel?
23.
Can water become unclean?
24.
If yes. how does water become unclean?
25.
What is the difference between clean and safe water?
Yes
26. Can water cause illness?
No
Yes
Don’t Know
No
Don’t Know
27.
If yes. how does water cause illness?
28.
Can water which looks clear and transparent cause illness?
Yes
No
Don’t Know
29.
If yes. how?
30. State 4 water borne diseases.
31. How can we prevent water borne diseases?
32.
Is accumulated waste water harmful to health?
Yes
No
Don’t Know
33.
If yes, how?
34.
Is there dirt and slush around your drinking water source?
Yes
No
35.
Does the dirt and slush
siush accumulated
source affect the drinking water?
Yes
No
Don’t Know
36.
If yes
37.
What
should you do to keep
surroundings clean?
38.
Should you wash clothes at your drinking water sour ce?
Yes
No
Don’t Know
39.
If no j.
40.
Should you wash animals or let them drink at
water source?
Yes
No
Don’t Know
41 .
If no?
around
your
water
wat er
source
how?
your
dri nki ng
why?
why?
the
dri nki ng
42. Should children be allowed to defaecate at the drinking water
source?
Yes
No
Don’t Know
43. Do you allow your children to defaecate near
water source?
Yes
No
the
dri nking
44. Do you. clean the handpump platform after filling water?
Yes
No
43.
Were there any decisions taken at the awareness camp?
Yes
No
Don’t Know
46. What were these decisions?
Indi vi dual?
Community Level?
47. Of these decisions discussed at the camp, which ones have you
followed up on?
Indi vi dual?
Communi ty Level?
Observation of the Drinking Water Source by the Investigator:
~ Condition of the drinking water source:
Presence of slush and dirt around source:
Good
Yes
Bad
No
Indications of community misuse of drinking water source:
Yes
No
Name of Investigator:
Date:
Annexure
3 - DAY HUKHYA SEVIKAS TRAINING PROGRAMME ON AWARENESS CARPS ON WATER
Day '
Topic
LEarning Objectives
; Clsss Roots Retnods-
wics
HSSe'=SC;£'r
i
' Day - 1!
•£
• State the underlying cause of
! safe water! ccr.tatsinaticr, ol hater
’ Lertd.rc cu’i
’ Discj^kr
’ Randuut
; Fre-post
! test
i.L'ur.cept of • Describe germs, hc-w they are
; Desc^stratior of ; Hicr-ooccpe
• gcru.s
■ detected and their role in dic-vsce'' csr-i.c - Observe
(
■ cavEfticn
i ge.-ss under -Eire !
: -scope
;k:attr b«?T.t: Ust the water borne diseases,
: Lee terc evr
(disease ’■ ! vescritie their trar.ssissicn
:rheir
through water, toed GutO.
(transffis- i cist agents transsittir.g h7t?':sicr:
; tcr'? siseaeest
• P: 5C'.SC '. jr
: List the signs I sysplnrs c.'f
; jaursice. State the h;gh r:-:>
'. groups in the cnounity.
cectvrE cu?
‘ Disc.-ss- 5"
..'■jvfi czc?:
! Handouts
! Overhead
: projects
P'-e-Pcst
test
!transparencies-
' • .* •
■;
IPreventiur. 1 Stats the preventive fceastres
!ot water i be taken - Individual action
it-orne
!
- Cosmnity action
1
!d:seases
?
!
1 Health
!'Educat ion
I
I
! State the importance of Health
! Education. State the terminal
I impact of health education in
: teras of behavioural Dulcoses.
{
! State relationship of behavioural
! outccae to health cuttoe.
- Write hehaviwal and health
! sutccses for health Education ir! water and sa?iitaticn.
I
■ Cdsps
r
<
i
Group exercise
!
i
! List the steps inconduction of
'. awareness caeps.
i Sisulate the conduction of a carp
!
-dc-
I
;
{Conduction
of
f awareness
-dc>-
-dd-
Role play
! Situational
! analysis
i gaffe
! Colour
: paper
’Pre-Post
; test
Day !
Topic
learnin'
Object! s-es
:
Methods;
’ Day - O/PrecsEp
■ Et-^e f-e L'jrp-'-se and use ox a
• lecture -1U?
!chase or i Situations'’, t-r.i’.ysi =•»
■ Disc;?.?;
’C'repsratc-ry •:
ffite a
ty rap.
!Phase o4
State ths purpose end use ct a
■ Exercise ard
I
!ca?p
' pretest •Dewstratc the retrod
' Dl-Cl-'lSiC'
; cj pretesting. Hok to sake
SSuunity contacts and skills
!
■ reqi.ir8O tor it.
List criteria, rcr selection c<*
! Lecture :
I
! ti^e and place Tor car.p concoc-icn: Discus'ier
: T-3 rs>t an erJuraiicr.al diaqnr-is ':
based cn the situatiorai analysis !
■ decision n-skiny.
• Caifip
• State tne purpose o4 3u icc • lecture fi-r
I canduct;on \ breaker,
’ Disci'sci:!Ice break?-*'; State advantage o? ifcaling *jcse'
iDrawing
i draw.
Discuss!Di! ■ State the ' areas on which drawing-’
it- Decision ; is taken.
'.sakinq arc ! State cc-r.^urricatio'' skills
I
'FgIId* up • req-n-sd to conduct the casp,
!
!?nase
' Tr; state appropriate eessaaes
’■
: which need to be given with the ;
i drawing.
1 To be able to facilitate
! discussior, based on drawing,
I Tc use audio-visual aids appropri-J
’ ately. ;
; To identify what decisions should I
i
i be taken.
!
j
■. State probleisB areas for fellow up I
! and how tc evercase thee.
!
i
•;
!Awareness 1 To be able to state the fol lew up I lecture '-.us
icasps
! required for the decisions taken ! Di seres lur.
1 and their jgportance.
I List the types of follow up.
I
i
I Describe hux to motivate wo^en to
‘ take fsliow up action.
’ State how to mobilize wo»en ; individual and group level» for
; follow up action.
■> State frequency a? follow up ar-d
hc-K to sustain follow us a-tion.
Aids
:
cess rent .
H?ndokt
• ^e-post
test
Case study
;
’ r're-pcst
' test
i pre-pest
test
i
*
I
!
1 Pre-Pc-st
’ test
! Topic
Leering Objectives
Day-2 iHandpu^p '■. OeS'inte a her.dottp. List causes
'Ccntu.. Jand its
I ot non-furctiunai nandpusp.
Maintenance; Dcsc^ite concept cr c^e/entivs
I
: sainteGance, Describe the ispor-
=
;
! C'ess r-scr- ^stt.ods'
! Lecture cm?
! Discussion
! Deuo'‘£t<at • cn
; EiiS'cisc
;'
' tar.ee '■> r.rct.crai isor-itoring
'.
i
<
'-.
! -ss cospared to t-resi'. dc^n sonitor-!
■ in.j. D^anstraic znvsically (HP/ '
i the car-i tor
■:-■? ,d: scharae,
•
! Desoasfrate -ii'ir-: th? santhly
!
cirds.
!-These topics ^are inckded c< tts request st the
■ ‘^c-post
‘ test
Csv-.;•.£■•<■
State the jap or tance zs. im'nisa- Lect:jrc cj?
i tic-r,. Describe Mrunisaticn
discuscicn,
schedule, State haw to pl an.
Group tve'dees
i&plesent and assess an issunina
tion pr ogrme.
I
i
Pre-post
test
State the iapartanue af growth
! Lecture cu?
sanitwing. Describe the planning,’, Di scussicn
isplemtation and supervision of Group Exercises
ths Growth -lanitoring prograsfr.e. i
State the importance o! nutrition !
education.
t
! Describe nutrition education tc bei
I elven upto preschool stage,
‘
!
?
State purpose end i®port5nce of
Lecture cup.
‘ maternal care,
{ D’scjsciior.
i P^e-post
i test
;-o.unisat- ■
iion
«
I
’<
i
I Growth
IKonitorin§
I
I
‘Nutrition
«Education
t
1
J
e
*
J Maternal
icare
‘ Asssssrtnt !
1 rre-post
test
•.Eole of
. Stat? definition of supervision , ! tyerc; 'J.:?
!Super visors’ Lisi tasks to be perferfted in
! ditc^ci--^
•
' supervision c> ca^ps.
Diy -3
Aids
i Stats the antenatalynatal ipost :
; “natal services given tothe
!
■ mother and neonate.
•
t
i
!
{
i
i
i
: Pre-past
1 test
Annexure
2 - DAY AKGAMADI WORKERS TRAINING PROGRAMME ON AWARENESS IWS ON WATER
Dsy !
: De-
Topic
Lrarnif 3 Ob?set:vc-e
i’ What is • State the unde’’ • 7i ■•.•;• ciUEt o?
sa^’e water ’. ccGta^atie:1
^Concept
; Descries
: ce^TrtS
= detectec acd
; ca-.-sati on
; uhss Roes1 *!etk-,is;
■ lectcre r-jn
i DisciGaicr
i Assessikent ;
1 Pre-post
• test
! Denor-stret'.cr of 1 ^’crosccpe
:’c ;r disease* gerffs - Observe
• •; er re c'-.d'*' fkrc 1
ho« ttoy
‘Water borne’ List the «Ete»'
diEeaf.e.:.
isisease h Bescritie thd*' tracEr-ission
jtheir
• tr-'c-egh Kaier -:c: 1 auto.
• tr ar; eh: s- : List agents tr■%■ ^ater
Jeico
i boms diseases.
' LecUrc i 'j‘*
Di cc..
•. List t?<? signs ‘ :;'rptc?s c*
State the Lie'" -isi
! Lee? jrv c-iSi
'■j-jcncecc
i'::
: -a^cuts
• Gw'-ncad
‘ projector
: P'e-R'oEt
! test
-do-
■ 0: ecv s
'. ar o ups ir Ut COO- ' l:! ;’t
i
ir-evectiar * State tb? :•’•?•>.?••••?• vr r??.5;/vs to
!oT >;«ter ; be takE? - Inci vid.'.si action
!torre
’
- Ccv-f:..'!:tv action
5 diseases
• Heal th
! State the iaoortme of Health
{Education I Education. State the te‘ «!inai
«
:
■
e
<
:
I
e
i
i
l
»
«
i
-do-
-dc-
-do-
• Situational
i analysis
; ^ase .
! vol ou-
{Pre-Post
I test
! ispact of health education in
I
J teras of behaviour?.l oiitcoses,
;
• State relationE-hip of behavioural '
!
i outxQae tc health outcome.
’ Writs behavioural and health
I outcoaes far health education in
5 water and sanitation.
{
Group exercise
{
I
!
IConteti^n list the steps in conduct ion of { Role play
I ;t>t
< awareness camps,
’. awareness Simulate the conduction of a canip '
: casps
1
‘
<
i
’. pipe-’-
i
f'iv
'.
r
ft
"'<7
-
v&£
e
ft
t
i
i
ft
i
I
i
i
I
e
hct^cds1
! LcCt.-■•■■: CJv.
I'Free asp
! State the p.:rpc=e i■•.’phase cr 1 s:tuotk'a’ ?*i: ■•?!£.
i Cisc^L-s:""
'creparatDryi To cake :■ tm.':*.. ty ce;.
‘ Ft eSt c-F
! •Stats ths pirpcEe and -.se i?’ a
•' Exercise sr-d
'”?np
! pretest
:: t>: icetkd
I Pi21J?.j'.CH
oF p-T-test irc!•. k* to
rarrunity cent
rv4>:fed k-r i
List criteria
selection 0‘
; Lecture cu^
tke and place - :?np cond-jction’ Discussicn
"a Mte an educational ag-.asi? ;
based c-n the situational ana wks ;
'• decision eciing.
1 State the p !jr pose
3 2 ice '. Lecture cu*
'ccrduetier i breaker.
■ Di sc-j. ss ion
Ice treater’ State advantage of Mking women
:Drapine
draw,
!
'. 3; £<USS ion State the 4 areas or- wh:<r kawing:
U' Dec: si of? is taken.
; Mid ng and State cosRuni:at:on ski11 a
tFollow up
required tc condict the carp.
•phase
To state appropriate messages
which need to ce given with the
drawing.
I
To be able to -facilitate
discussion based on drawing.
I
i To use audio-visual aids appropri-!
5
$ ately.
’
5
To identify what decisions should I
be taken.
•
» State problems areas far follow up!
I
and how tc- overcome thee.
*
!Awareness
To be able to- state the follow up ! Lecture cuk.
1 casps
i required for the decisions taken !. Discussion
and their importance.
i
List the types o-F Fol low up.
5
Describe hc-w to ROtivate wo?en tc I
i
take Tolicw up action.
Stat? how to mobilize woaer. individua! and cr-oi-o level, isr
follow up eiticn.
State f'equcit}
up and
■ •.ow tc ?■-st£:'•- i :• i io'■ i-;■ actiov..
:uE>?-p
ft
■ Clc-s:-
As=£?S'13.€r>. <
Hsr cc-l’t
; -n-pcst
test
I Cft? StuG)
• PrE-pCSt
' test
: P-'c—pc-st
test
i
! Fre-Pcst
i
test
!
' T:pir.
e
r
e
: 01?ss ^gck K^thsds-
A: de
'■ ^-sencffent •
• Lay -2 -ter dpt 5.3
! Describe -3 tenteusp. List causes ’ Lecture Cun
1 Conte.,.tend its
: -•> n^ntentticnal tendpu??.
! Discvssicr
De’Ear-stritisn
tetentEPdfiCE; Describe; concept c-t preventive
Exercise
’ »?.ainternee, tescrite th? tepcrI tense
Mctec-dl p.C’-'itc-'-in;
c.5 cleared tc t'cc^ sor-c.“?i:or-:
Destnstrete p’iysicaily
1
. the sonitori ng cr ctetesres.
■
1 Derccterete Hteir-: f.e
'.
1
.’ turds.
•
: :-'e-p'L3t
test
v; £t«te the rotes 3.-;d resptnsibili- ; Exert.:ie-cu^
: -ti.E'£ ■:? Ak'Xs.cite tee tetes mvc-! discveei on
! ive-j in c?c.p ."O'dccticn,
-;
• ?re-pc«’L
■ v.sst
e Qt
iAQan^adl
'.
*
learn
lei’
Annexure
Institute of Health Management
Safe Drinking Water Programme
Mukhya Sevika Evaluation Questionnare
Name
'• Shrimati.
Name of Village '
Date
Q. 1
Difference between clean and unclean water ?
Q. 2
What is meant by safe water ?
Q.
List four water borne diseases .
1.
2
3.
Q.
4
How are water borne diseases transmitted ?
Q. 5
State the methods of preventing water born diseases ?
Q. 6
What is the purpose of Health Education ?
Q. 7
What are objectives of the women’ s awareness camps on water ?
Q. 8
What are the steps followed during the awarness camps ?
Q. 9
What are the preparations involved in the pre camp phase ?
Q. 10
What observations are necessary to study
water situation ?
Q. 11
Why is 11 necessary to do a situational analysis ?
Q. 1 2
What are the factors to be considered when deciding on
the time and place for conducting an awareness camp ?
the
community’s
Q- 13
State the relationship between the situational analysis of
the village and the decisions taken in the camps n
Q- 14
What is the purpose of playing a game in
camps ?
Q- 15
State the four topics given to the women for drawing ?
Q- 16
State the three main messages given
camps ?
in
the
av?areness
Q. 17
Decision making is an important step of
camps.Why ?
the
awareness
Q. ] 8
State any three decissions which need to be taken
change the women’s water storage behaviour 7
Q. 19
St&.t<? . ^ny three , decisions which need to be taken to
maintain and keep the drinking water source surroundings
clean ?
Q. 20
State the relationship between the follow up action
the decisions taken during; the camp ?
Q. 21
What are the types of follow ups which can be done to
improve the condition of the community’s drinking water ?
Q. 22
When and how many times should a follow up be done after the
camp conduction ?
Q. 23
What are the follow ups which should be done regularly ?
Q. 24
State any five responsibilities of the Aa.ganwadi workers in
the conduction of awareness camps ?
Q. 25
What. is your role in the
monitoring of hand pumps ?
Q
26
regular
the
awareness
maintenance
Explain the concept preventive maintenance
pumps ?
of
to
and
and
hand
optimally
functioning
Q. 27
State the discharge of an
hand pump ?
Q- 28
What is the importance of immunisation ?
Q. 29
by
State the diseases which can be
prevented
schedule to
immunisation? What
What is the immunisation
be followed for this purpose ?
Q. 30
What
Q. 31
State importance of Growth Monitoring ?
Q. 32
State the various degrees of malnutrition ?
Q. 33
Why is it important to feed a new born colostrum ?
Q. 34.
When should a infant be weaned ? What are
foods which can be introduced ?
Q. 35
Why is it important to provide maternal health care ?
Q- 36
State any three services to be provided during
care ?
antenatal
Q. 37
State any three services to be provided during
care ?
postnatal
is the. importance of the Cold Chain ?
the
weaning
ANNEXURE- C'Et
Institute of Health Management
Safe Drinking Water Programme
Aaganwadi workers Evaluation Questionnaire-
Name
: Shrimati.
Date
Name of Village :
Q. 1
Difference between clean and unclean water ?
Q.
What is meant by safe water ?
Q- 3
List four water borne diseases ,
♦
1.
2
3.
4.
Q. 4
How are water borne diseases transmitted ?
Q. 5
State the methods of preventing water born diseases ?
Q. 6
What is the purpose of Health Education ?
Q. 7
What are the objectives of the women’s awareness camps
water ?
Q. 8
What are the steps followed during the awareness camps ?
Q. 9
What are the preparations involved in the pre camp phase ?
Q. 10
What observations are necessary to study
Wetter situation ?
Q. 11
Why is it necessary to do a s i t \ i a t i c n a 1 a n a 1 y s i s ry.
Q. 12
What are the factors to be considered when dec i ding
the time and place for conducting an awareness camp
the
on
community’s
on
e
Q. 13
State the relationship between the situational analysis of
the village and the decisions taken in the camps ?
Q. 14
What is the purpose of playing a game in
camps ?
Q. 15
State the four topics given to the women for drawing ?
Q.
Q.
16
17
the
awareness
in
the
awareness
Decision making is an important step of
camps. Why ?
the
awareness
State
camps
the three main mesages given
ri
to
Q. 13
State any three decisions which need to be taken
change the women’s water storage behaviour 7
Q- 19
Stste any three decisions which need to be taken to
maintain and keep the drinking water source surroundings
clean ?
Q. 20
State the relationship between the follow up action
the decisions taken during the camp ?
Q. 21
’ can be> done to
What are the types of follow ups which
the
condition
of
the
community
’s drinking water ?
improve ---- ---------------
Q. 22
When and how many times should a follow up be done axter th«
camp conduction ?
Q. 23
What are the follow ups which should be. done regularly ?
Q. 24
State any five responsibilities of the Aaganwadi workers in
the conduction of awareness camps ?
Q- 25
What is your role in the
monitoring of hand pumps Q
Q. 26:
Ex pl -/.in the concept- preventive m3intenanc<
pumps ?
Q. 27
State the discharge of an
hand pump ?
a
regular
optimally
and
maintenance
of
and
hand
functioning
ANNE'. X URE
D
I
Institute of Health Management Pachod
Safe Drinking Water Project
VLV Training Questionnaire
1.
Name o-F VLV
2.
Vi 11 age
3.
Sex o-f Respondent VLV -
4.
Age of VLVs
«=j
Caste of VLVs
6.
Education of VLV:
Li terate
7.
Occupation of VLV:
Agr i culture
Housework
Servi ce
Unemp1oyed
8.
For how many months have you been a VLV?
1
3
6
9
Mai e
Female
< 10 yrs.
11 — 20 yrs.
21 -- 30 yrs.
31 - 40 yrs.
41 - 50 yrs.
51 ~ 60 yr s.
> 60 yrs.
Hindu (specify)
Musii m
Laman i
vanjari
1 month
3 months
6 months
9 months
12 months
Illi terate
Labour
Susi, ness
Student
12
18
18 months
24 months
> 24 months
Don’t Know
9.
What are your functions as a VLV?
10.
Do you have a card?
Yes
No
1 1. Have you received a card this month?
Yes
12.
What is the use of this card?
13.
How often do you fill the card?
14.
Where do you keep your card in the house?
No
IS. How often do you. receive this card?
16.
How often is the card collected from you?
17. Who collects the card?
IB. Where is your card collected from - does the BLN come to
your house or do you go to the handpump site to submit it?
19. Wh at i nf or ma t i on is given to you when your card is collected?
20. What should you do when your handpu.mp breaks down?
21. How will you follow up in case nobody comes for
the handpump even after information is sent?
repai rs
no
Did you send information for the handpump's repair the
time it broke down?
Don 71 Remember
No
Yes
23.
If no. why not?
24.
If yes, how was this information sent?
25.
If yes, after how many days was your handpump repaired?
of
1 ast
26. Were you present at the pump site when the handpump was being
repai red?
Yes
No
27.
Is it necessary to keep your handpump surroundings clean?
Yes
No
Don't Know
28.
If yes,
c1ean?
29.
If yes, how will you ensure the cleanliness of your
surround!ngs?
handpump
30.
What precautions/care will you take to prevent your
platform from breaking?
handpump
why is it necessary to keep the handpump surroundings
31. How will you prevent dirt and slush from accumulating
the handpump surround!ngs?
around
32. What is the? condition of your handpump and its surround!ngs?
Good
33.
Bad
Is your handpump water clean?
Yes
34.
Don?t Know
No
If yes. why do you think its clean?
35. Can handpump water become contaminated?
Don’t Know
Mo
Yes
36.
If yes. how?
37.
If no. why not?
38. Can water cause illness?
No
Yes
39.
Don’t Know
If yes, how does water cause illness?
40. List water borne diseases.
41. How can we prevent water borne diseases?
42. Has there been a change in your
you have become a VLV?
Yes
No
water
Don’t Know
43.
I f yes
44.
If yes. why has this change occurred?
what was this change?
avai1abi1i ty
si nee
Observations to be made by the investigators:
A.
Observations o-f the handpump card
1. Does the VLV have a card?
2
Place card kept in the house
3.
Condition o-f card:
4.
Is the card -filled?
Card Lost
No
T orn/Damaged
Completely -filled
B.
Yes
Good
Not at all ■filled
Par t i ally -filled
Observations o-f the handpump
1. Condition o-f handpump plat-forms
Cracked/Broken
No Platform at All
Intact
2- Condition of handpump rim
Cracked/Broken
Intact
No R i m
Cl ean
Line 1 ean
3. Hand pump) Surroundings:
4.
Can the handpump body be shaken?
5-
Is there a drain?
Yes
No
6. Drainage Condition:
Cl ean
Choked
7. Murram Filling:
Name of Investigator:
Date:
Present
Yes
Absent
No
No Drain Present
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