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DRAFT FOR DISCUSSION
Sustainable Integrated Mother and Child
Healthcare in Rural India
Updated knowledge on health status of mother and children in select villages in
rural India, as well as overview over the current accessible primary health care and
self-care options
STUDY PROTOCOL
TransDisciplin ary
University
Institute of Trans-Disciplinary Health Sciences and Technology,
Bangalore, India
and
o NAFKAM
/ROV'
and Comnlammiwy Madkirw
National Research Centre in Alternative and Complementary Medicine
(NAFKAM),
UiT Arctic University of Norway, Tromso, Norway
(Grant Letter Ref. No.Ind-14/0006)
Protocol Version 1.0
1
COMMUNITY HEALTH CELL
Contents
Library and Information Centre
No. 367, Srinivasa Nilaya, Jakkasandra,
I Main, I Block, Koramangala, Bangalore - 560 034.
Contents
THIS BOOK MUST BE RETURNED BY
____________ THE DATE LAST STAMPED
Abbreviations and defin
4
Introduction
5
Background
5
Indo-Norway Initiativ-
6
Collaborating Partner
6
Objectives
7
Methodology
8
1.
Study design:
8
Study settings:
9
Sample size
9
Study Design and Sar
9
Expected baseline
10
Implementation of tf
11
Project Timeline
11
Expected outcome
Components of questionnaire
Study site Profile
J
1
.12
13
Interview schedule for community based health workers (folk healers, dais, knowledgeable household
(especially women, such as grand-mothers who have expertise and experience in home remedies with a
focus on MCH)
Error! Bookmark not defined.
Household health expenditure
Error! Bookmark not defined.
Important information of sub-districts
Error! Bookmark not defined.
Assumptions of study
16
3
Abbreviations and definitions
ANC
Ante Natal Care
AYUSH
Ayurveda, Yoga, Unani, Siddha and Homeopathy
CBO
Community Based Organisation
IMR
Infant Mortality Rate
MCH
Mother and Child Healthcare
MMR
Maternal Mortality Rate
NAFKAM
National Research Centre in Complementary and Alternative Medicine, Norway
PNC
Post Natal Care
PRA
Participatory Rapid Appraisal
TDU
Trans Disciplinary University
U5MR
Under 5 children Mortality Rate
UHC
Universal Health Care
4
1. Introduction
1.1 Background
Observers of the healthcare scenario in India, and perhaps other countries in Asia, recognize that
in the 21st century innovative knowledge and strategies are required to achieve universal
coverage in primary healthcare. In India the current effective reach of State sponsored health care
programs is estimated to be around 30% of the population and 69% of health expenditure of
average households, even today, is out ofpocket. Furthermore national surveys reveal that the
second highest reason for rural indebtedness is on account of “borrowing” for meeting health
care expenses. The Western medicine-based model of primary healthcare thus has had limited
penetration in rural India despite huge investments^).
Two of the Millennium Development Goals specifically target mothers and children. The United
Nations Development Program (UNDP) in India has been monitoring the development, and
report substantial challenges in achieving these goals. India’s Under Five Mortality Rate
(U5MR) is expected to decline to 70 per 1,000 live births by 2015 which is still short of the 2015
target of 42 per 1,000 live births. Likewise, the Maternal Mortality Rate (MMR) is required to be
reduced to 109 per 100,000 live births by 2015. India is expected to fall short of the 2015 target
by 26 points. Both U5MR and MMR are influenced by several aspects in society, but adequate
and appropriate primary health care is always central.
In this situation several strategies are possible. To achieve full coverage of state sponsored health
care programs is likely to remain a long-term goal. In the meantime the 70% of the population
without these programs need to gain access to alternatives which are optimized with regard to
documentation and, subsequently, access. The existing “Traditional Indian Health Sciences”
acknowledged as AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy)
constitute the core of primary health care services for this segment of the population. For
emergencies and surgery Western medicine is the preferred first choice, for common ailments it
is usually Ayurveda, Siddha, Yoga, Unani, Swa-rigpa or homeopathy, for chronic conditions it
may initially be Western medicine, if available, and then a rebound to some other system if there
is insufficient relief. India has, over 200000(2) herbal formulations in its traditional
pharmacopeia, and 6500(3) traditionally known medicinal plant species distributed across
ecosystems.
The “Traditional Indian Health Sciences” are based on a long-standing traditional use with
wealth of experiential knowledge supported by sophisticated theoretical foundations. In 21st
1 Planning Commission, Govt, of India, 2012 Steering Committee Report on Health Sector confirms that 69% of health
expenditure of households is out of pocket
2 FRLHT data base 2013
3 WHO, Global Atlas on Traditional Medicine, Gerard Bodekar, 2008
5
century societies this knowledge needs to be supplemented with, and revalidated by modem
basic, clinical and translational research in an epistemologically appropriate framework.
1.2 Indo-Norway Initiative for Sustainable Integrated Mother and Child
Healthcare
An Indo-Norway Project (Ref. No. IND-14/0006 ITD-HST University) has been financially
supported by the Ministry of Foreign Affairs, Government of Norway for a planning phase of a
Mixed-methods Research and Development Project to optimize sustainable integrated primary
health care for women and children based on available Indian Traditional Health Sciences in
collaboration with Western conventional medicine.
Treatments prioritized in the project will be chosen based on this background situation report and
priorities given in governmental and WHO/UNDP reports and strategies. The deliverables will
support local and central health authorities in planning and implementing improved low-cost
health services for women and children in rural areas in India.
During the Planning Phase of the above project for Sustainable Integrated Mother and Child
Healthcare in rural India, it is proposed to prepare a comprehensive plan for the implementation
of a mixed-methods program for Norway-India research and development cooperation, to
optimize sustainable integrated primary health care for women and children based on available
Indian Traditional Health Sciences in collaboration with Western conventional medicine.
The planned effect for the target group of the project is:
Mother and children in select villages of rural India gain insight into their own health risks and
current treatment options.
Planned products and/ or services of the planning phase are:
1) Baseline data on health status of mother and children in select villages in ruraHndiajind
2) Overview of current accessible primary healthcare and self-care options.
1.3 Collaborating Partners
The India team comprises of 3 partners:
a. Institute of Trans-Disciplinary Health Sciences and Technology University (TDU),
Bangalore.
b. Pune University and
c. Field CBOs: i) Accord, Gudalur, Nilgris District, ii) Tribal Health Initiative, Sittilingi,
Harur Taluk, Dharmapuri District, Tamilnadu and iii) Sri Vivekananda Youth Movement,
H.D. Kote Taluk, Mysore.
The Norway team comprises of 3 partners:
a. NAFKAM. Tromso
6
b. Arctic University of Tromso
c. University of Oslo
2. Objectives
In all the objectives, the target population will be women and children, with emphasis on mothers and
children under 5 years. Both preventive and curative aspects of health care will be enquired into in order
to obtain as broad a canvas as possible on the utilization of traditional folk and AYUSH systems.
1. To document the existing knowledgeTegarmng:
a. use of traditional home based health practices including ethnic diets, in prevention
and management of common health conditions (households)
b. services of traditional healthcare providers - folk healers, dais and knowledgeable
women
\
c. services of institutional healthcare providers, both government and non- y
government (non-profit and for profit)
/
2. To generate data on health outcomes with special focus on mother and child healthcare
(MCH4)
'
•
Incidence of diseases with special focus on mother and child healthcare (MCH)
(Secondary data)
•
Clinical outcomes of MCH related conditions covered by existing public health
system and institutional providers (Secondary data)
3. To document health seeking behavior (conditions, percentage trends) and costs involved
especially regarding women’s health with a focus on mother and child
f•
Households: Home remedies (preventive and curative), ethnic diets, health
practices, life style, Household health expenditure as baseline information on
Primary, Secondary and Tertiary care (Sample survey)
y •
Costs saved by the self help inputs (Sample survey)
$ •
Folk healers: Different streams including Traditional Birth Attendants (Sample
survey + PRA)
Institutional healthcare providers: Both Government and Non-govemmei
(Primaryjiata from providers)
—----------------- ——
4. To document presence, scale of abundance and distribution of medicinal plants known
and used in community knowledge and Indian Systems of Medicine, Te. Ayurveda or
4 MCH includes healthcare needs of women and children in Reproductive, Maternal, Newborn, Child and
Adolescent stages.
7
Siddha or Unani, including assessment of availability of these plant entities by the local
communities.
3. Scope of the Project
3.1 The survey findings will establish baseline incidence, prevalence, clinical outcomes of select
mother/child health problems in selected sub-district sites. It will also describe currently used
treatment options in selected sub-district sites including community use of locally available
medicinal plants, government and non-govemment (for profit and not-for-profit healthcare
providers), household health expenditure
3.2 The findings of the baseline survey will also provide a basis for developing a taluka level
database which in turn would result in short-listing of Traditional Knowledge (TK) interventions
in mother/child health problems to be designed and implemented during the implementation
phase of the above project.
3.3 Shortlist high priority Primary Healthcare needs of community with a focus on Mother and
Child Health by triangulating community perception, CBO experience, local government and
National Household and Family Survey Data (based on primary and secondary data)
4. Methodology
4.1 Study design: The study will include mixed methods research employing qualitative and
quantitative research methods.
4.1.1
a.
b.
c.
Quantitative research methods
Baseline Survey of households
Household health expenditure
Assessment of scale of abundance of medicinal plant resources
4.1.2 Qualitative research methodsa. Key informant interviews5:
i. Structured interviews of traditional healers, community health workers,
birth attendants /midwifes and primary care providers
b. Participatory data collection methods:
i. Free listing - illness and possible causes, home remedies
ii. Timeline - pregnancy, postnatal and childhood events (illness and
treatment)
Nordeng et al.: Traditional medicine practitioners’knowledge and views on treatment of pregnant women in three regions of Mali. Journal of
Ethnobiology and Ethnomedicine 2013 9:67.
8
5. Study settings:
The proposed survey is proposed to be undertaken in southern Indian states and in at least two
with CBO’s (possibly in the third taluka which will depend on the availability of financial
resources from the project grant) and one without CBO Sub-districts (Talukas) in Karnataka and
Tamilnadu, India,6
Annexure X contains map depicting 3 CBOs and their information.
Field CBOs are identified as follows
i)
ii)
iii)
Accord, Gudalur, Nilgris District,
Tribal Health Initiative, Sittilingi, Harur Taluk, Dharmapuri District, Tamilnadu
Sri Vivekananda Youth Movement, H.D. Kote Taluk, Mysore.
5.1 Sample size for household survey
Assuming that about 40% of households7 use of traditional healers and home based remedies
with an error rate of 20%, type 1 error of 5%, power of 80%, the sample size in each Taluka will
be around 200.
5.2
Study Design and Sampling Plan
i. It is proposed to utilize a two stage sampling with first stage being the
block and the second stage being the villages and surveying all the
households in the selected villages or a sample from the selected villages
would provide ultimately the total sample of 200 households per Taluka.
Approximately at least 800 households from the four talukas would be
selected for the survey. 10% of the sample will be randomly selected for
Quality Control and will be resurveyed by a supervisor.
ii. The questionnaires will be administered to these households and the
resulting data will be tabulated as frequency tables. Appropriate summary
statistics will be calculated.
6 Profiles of 3 proposed CBOs are given in Annexiire-2 of the Project Plan along with their web addresses, namely
http://www.adivasi.net, http://www.svym.org/ and http://www.tribalhealth.org.
7 The above assumption is based on the finding from the National Health System Resource Centre's Survey on Role
of AYUSH and LHT, by Ritu Priya and Shweta, 2010, NHSRC, Ministry of Health and Family Welfare, Government of
India, which reported the use of LHTs to be still in the range of 50-75% in the states with relatively good health
services, i.e., Tamil Nadu, Kerala, Haryana and Karnataka (those with higher average state per capita income and
better-developed general health services in the public and private sectors).
9
6. Expected baseline data
The baseline survey protocol would be designed based on both qualitative and quantitative
methods as follows:
6.1 Collection of data from Institutional healthcare providers
Data on a) health service providers and the populations covered by them, b) incidence of diseases
and c) clinical outcomes will be collected from Primary Sources viz. i) Government and NonGovemment (for profit and not for profit) institutional healthcare providers and coverage of
populations served by them and ii) non-institutional healthcare service providers, viz. folk
healers at the village level and knowledgeable persons at the household level. The details of data
that will be collected as per the attached in-depth questionnaire for institutional healthcare
providers in Annexure-2. Secondary data published by Government Health Department which
will also need to be collected through focus group discussions with representatives of
government and non-govemment healthcare providers.
6.2 Botanical Survey
Data on a) presence, b) distribution pattern, c) scale of abundance of medicinal plants used by
local community as well as the codified Indian Systems of Medicine (Ayurveda, Siddha and
Unani) will be collected through Participatory Rapid Appraisal (PRA) including Transect Walk,
followed by botanical survey. The botanical team of TDU will undertake botanical surveys in the
selected sub-districts through perambulation and sampled plots to assess the presence and scale
of abundance of the medicinal plant resources. As per the prevailing standards for assessing the
forest plant resources a sampling intensity of 0.01% will be employed in each of the strata,
identified using base maps generated by KSRSAC. Randomly located sample plots of 0.1 ha
each will be laid to assess the population of tree species. In each of these 0.1 ha sized plots, two
subplots of 3m x 3m will be laid to assess the population levels of shrubs and climbers and
another four subplots of Im x Im to access the populations of herbaceous flora.
The details of data that will be collected as described above is given in Annexure-3.
Appropriate plot sampling after stratification including home gardens and neighbouring
landscapes, available vegetation and ecological GIS maps, to assess the distribution pattern of
medicinal plants in the selected sub-districts along with an assessment of scale of abundance.
Participatory Rapid Assessment (PRA) exercise, in the selected cluster of villages, to document
local knowledge and practices regarding use of medicinal plant resources by the inhabitants.
6.3 Household Survey
Data on community utilisation of health service providers, including folk healers and
knowledgeable persons as well as on household health expenditure would be obtained through
household sample survey with the help of an interview schedule. A sample of the interview
10
schedule that will be used to collect household data as described above is given in Annexure-4.
A sample each of in-depth questionnaires which will be used to collect the data from mothers
with Under 5 children is given in Annexure 5 and mothers who have recently delivered is given
in Annexure 6.
6.4 Collection of data from Non-Institutional / Community based healthcare providers
Data from Non-institutional healthcare providers regarding a) number of patients covered by
them, b) health conditions treated and c) costs of treatment will be collected from Primary
Sources viz. folk healers and dais at the village level and knowledgeable persons at the
household level. The details of data that will be collected as per the attached in-depth
questionnaire for folk or traditional healers or dais in Annexure-7.
6.5 Prior Informed Consent
A Prior Informed Consent will be obtained from the respondents before collecting baseline data.
A format of the same is given in Annexure-8. A Confidentiality Agreement is given in
Annexure-9 which will be provided to the respondents of Traditional Knowledge prior to
colletion of data.
6.5 Pilot testing
Pilot testing of the survey tool will be undertaken in at least one or two villages each in one nonCBO area before the Protocol Workshop scheduled to be held from 10th to 12th February 2014.
An user friendly software which supports field documentation using tablets and statistical
analysis will be designed by TDU team for collection and analysis of the baseline survey results.
7. Implementation of the survey
10 Field Investigators in each of the selected sub-districts would be trained and involved in the
household data collection as per sampling design. They will be monitored and supervised by one
Supervisor per sub-district. A Survey Coordinator would coordinate the implementation of the
survey.
8. Project Timeline
As a part of the planning phase activities, a draft protocol for “baseline” field survey to collect
data from selected sub-districts in India is to be developed and presented at the Protocol
Workshop to be held from 10th to 12th February 2015. The survey will be implemented from
16th February to 15th July 2015.
11
9. Expected outcome
Sub-district level baseline survey reports on:
•
Health seeking behavior
•
Documentation of Traditional Knowledge for selected health conditions with a focus on
mother and child health
•
Population coverage
Clinical outcomes
•
Health expenditure
•
Medicinal plants (Presence, Abundance and Distribution pattern)
10. Components of questionnaire
The core portion of the questionnaire includes questions about the following:
•
Attitudes and feelings about the most recent pregnancy
•
Content and source of prenatal care
•
Maternal alcohol and tobacco consumption
•
Physical abuse before and during pregnancy
•
Pregnancy-related morbidity
Infant health care
•
Contraceptive use
•
Mother's knowledge of pregnancy-related health issues, such as adverse effects of
tobacco and alcohol; benefits of folic acid; and risks of HIV
This will generate data for
•
Incidence of MCH diseases,
•
Clinical outcomes of MCH related conditions covered by existing health systems
•
Discussion: Should this be used as is, or some modifications are needed? This does not
have many post natal questions.
•
Source: http://www.cdc,gov/prams/questionnaire.htm#core
12
11. Study site Profile
(Based on WHO document ‘Community-Based Initiatives Series’ Monitoring, supervisory and
evaluation tools for community-based initiatives. WHO Regional Office for the Eastern
Mediterranean, Cairo 2010)
11.1. General Information
• Name of the country:
• Name of the state or province:
• Name of the district or locality or municipality:
• Name of the demonstration site:
• Type of the demonstration site (select only one): Rural Urban
• Specify in which year the programme started at this site:
11.2. Demographic information
• Number of households:
Male Female
• Number of the population under 15:
• Number of the population above 15:
11.3. Management of health facilities
Is any health facility available at this site? Yes No
If yes, select the type of staff responsible for running the health facility at the site:
Doctors
Nurses
Midwives
Dispensers
Health workers
Health volunteers/activists
Others (specify)
11.4. Availability of basic infrastructure and social facilities
Please select the available facilities in this site (select all that apply):
Mobile health team
Trained birth attendants
Primary school
Secondary school
13
Electricity
Bank
Safe drinking-water (partial)
System for garbage collection and disposal of waste
Paved roads to the closest city/town
Public transportation to closest city/town
11.5. Community organizations
• Number of trained cluster representatives (CRs):
• Number of established village or community development committees (VDCs or CDCs):
• Number of male members in VDCs or CDCs:
• Number of female members in VDC s or CDCs:
• Number of established village or community development sub-committees:
If sub-committees have been formed, indicate the relevant area of work:
Health
Women
Youth
Education
Others (specify):
• Is there any local nongovernmental organization or community-based organization that is
active at the site? Yes No
If yes, specify name and area of work for each:
No.
Nongovernmental
organization or community
based organization
Areas of work
11.6. Education Male Female
• Number of children of school age (between 5 and 15 years):
• Number of children 5 to 15 years old enrolled in schools:
• Number of illiterate adults (15+ years):
11.7. Health and sanitation
(all data should be based on last 12 months)
• Number of live births:
• Number of deaths under 1 month of age:
• Number of deaths 1 month to 12 months of age:
• Number of deaths 12 months to under 5 years of age:
• Number of newborns with low birth weight (< 2500 g):
• Number of mothers who died due to pregnancy and its complications:
• Number of pregnancies assisted by trained birth attendants:
• Number of children who completed 12 months of age at the reporting date:
14
• Number of children who completed 12 months at the reporting date and were immunized
against vaccine-preventable diseases:
• Number of households with access to safe and sustainable drinking-water:
• Number of households with access to sustainable sanitation facilities (latrine and solid waste
management):
11.8. Major community-based interventions
Health/nutrition
Major outcome:
Gender equity and women’s development
Major outcome:
Water and sanitation
Major outcome:
Community-based health insurance schemes
Major outcome:
Literacy classes
Major outcome:
Upgrading schools
Major outcome:
Women's vocational training centres
Major outcome:
Computer literacy centres
Major outcome:
Road construction
Major outcome:
Agriculture
Major outcome:
Livestock
Major outcome:
Irrigation
Major outcome:
Micro-credit
Major outcome:
Other (please specify)
Major outcome:
15
12. Assumptions of study
However, it is targeting to areas where delivery of modem medicine is ‘at its best’ with the
presence of CBOs. The CBOs we have selected are now delivering healthcare only through
modem medicine as additional services to the community with available government healthcare
delivery system. We want to know how Ayurveda based healthcare interventions can improve
this situation when tried with modem medicine in these ‘privileged pockets’.
Delivery of modem medicine in many villages is currently poor but it may improve in future (our
assumption is within 5 to 10 years) and they may reach to the level of‘privileged pockets’ where
our CBOs are currently working. Our study will be helpful for these villages even in future. Thus
the importance of our study is, it will be much more relevant for ‘future India’. Not even for
India, Prof Vinjar thinks that it may be helpful to developed world where modem medicine is
already ‘at its best’. Thus this study, in true sense, explores ‘Integrative Medicine intervention’.
Our Norway team thinks that a control village (without CBO) will represent India (and
developing world) where modem medicine is ‘not delivered as expected’. This will solve
representation of other strata of such villages and communities.
This is the basis of selection of these sub-districts and scientific rationale of our study.
These will be used for ‘baseline survey’; we will conduct the pilot study in the same population.
Another important aspect is about objective of baseline study. More than measuring prevalence,
it aims at ‘assessing needs in the areas of MCH and define interventions’. Hence our methods
also include qualitative studies like focused group interviews and timelines. For example, our
questionnaire may have a limit for cross sectional data as 3 - 6 months to reduce recall. In this
case, the quantitative design (survey) may not be sufficient to cover events for a complete year;
hence qualitative methods may supply that piece of information. We are going to consider a
particular observation, which may not evident in survey. At the same time, we want to maintain
power and precision of our study, hence our sample size logic and calculation should also be
robust.
16
Annexure 1 - CBO Profiles - Population Details and Maps
ACCORD
The genesis of ACCORD begins itself with the establishment of Adivasi Munnetra Sangam (AMS) which
means Tribal Development Association. It goes back to 1986 when Stan and Mari started ACCORD as a
part of an activist group and in response to the rampant land alienation of the adivasis in the Gudalur
Valley joined the adivasis to help organise themselves in order to assert their human rights - especially
their land rights. Some adivasi youth came forward to go from village to village, urging the adivasis to be
united, to protect their land and to stand up to the people encroaching into their livelihood resources,
however powerful they might be. They went from village after village exhorting the people to be confident
and fight the injustice.
LAND STRUGGLE
These motivated adivasi youth, called Animators held a series of meetings in the villages. This resulted in
the formation of many village level Sangams - a name for the unity of the adivasis. The village sangams
started responding to issues of injustice and exploitation and helped the adivasis regain their land. People
started resisting.
Suddenly they realised the strength of their numbers - and the value
of their Unity. The village sangams helped adivasis shed their fear of
‘powerful’ people - be it the non-tribal landowners or the Government
officials. Till today, everyone in the adivasi community considers this
‘freedom from fear’ as the biggest achievement of this movement.
The village sangams eventually federated to form ‘Adivasi Munnetra
Sangam’ (AMS). In 1988.
A massive Land Rights Campaign was organised in the entire^
region, culminating in a protest demonstration by AMS in Gudalur on J
December 5, 1988. This was the first public display of defiance and*
show of solidarity by more than 10000 adivasis. The issue of adivasi |
land alienation and their struggle for human rights were emphatically |
articulated by the adivasi leaders in the demonstration.
w
I
From then onwards, AMS continues to be the political voice of the adivasi community in Gudalur valley,
highlighting the major issues concerning the adivasi community. Today, there are about 12500 members
in the AMS spread in more than 200 villages in the Gudalur and Pandalur taluks of the Nilgiris district in
Tamilnadu.
The law enforcement agencies and the development machinery of the Government, the local population,
and most importantly, all the adivasis recognise AMS as the representative and identity of the adivasi
community here. This mass organisation of the adivasis has come a long way since then - successfully
fighting for their rights, encouraging them to take back the land and pursuing legal means to demand
justice.
But, it was not a question of land alone. The social indicators of the adivasis in terms of health, education
and economic status were very poor. Even while organising the people for their political rights, the adivasi
activists of AMS were moved by the plight of their people and resolved to address the other problems
facing the community. The village level discussions prompted us to initiate some ‘traditional’
development programmes, along with the political activities.
DEVELOPMENT PROGRAMMES
I
1
i J
|MThe health situation of the adivasis was pathetic. There was an urgent need to
■prevent unnecessary deaths and provide health care. So, they launched the
■community health programme in the villages - training adivasi women on
■preventive health care, immunising and monitoring the pregnant women and
^children, and improving health awareness in the community. This intensive
^programme immediately resulted in a dramatic improvement in the health status
■of the adivasi community.
■Simultaneously, they had to tackle the question of economic needs and
^productivity of the land taken over by the adivasis. When the land was not
k productive and did not generate any income, it was difficult for the adivasis to
wkeep it under their possession. After lot of discussions in the villages, it was
^decided to plant the land with Tea.
The choice of tea was a strategic one - it was a permanent crop and hence can be a proof of their
possession and cultivation of land for many years. Moreover, the mainstream economy in Gudalur valley
was tea-based and hence the adivasis too will become active participants in the predominant economic
activity of the region.
A massive tea plantation programme was undertaken. They raised their own tea nursery, and trained
some adivasi youth on the management of the nursery. Simultaneously, sangam members were trained
intensively in tea cultivation and provided all the necessary support and skills for maintaining the plots.
Today, more than 1000 adivasi farmers are Tea growers (traditionally a rich man’s crop!) and more
importantly, their land is productive and safe from encroachers. Many adivasi families are settled
agriculturists now and their wage incomes are supplemented by the earnings from cultivating tea, coffee
and pepper.
Similarly, they made interventions in the education field too. As the mainstream educational system was
alien to the adivasi community, the first job was to become a bridge between the children (most of whom
were first generation learners) and the Government schools. Taking the children to the schools and
teaching them in their own languages were the tasks of the adivasi education volunteers.
Right from inception, they believed that the role of external development agencies like ACCORD is
basically that of a catalyst and hence it has to withdraw as an institution once the process of change
initiated by us becomes sustainable. After that, they adivasis have to take over the entire development
process in their own hands. They also realised that they have to institutionalise the development activities
into formal or informal organisations in order to effect an irreversible change in the process of
development of the adivasi community.
So, their strategy was to institutionalise the development programmes, train the adivasi youth to manage
these institutions by providing necessary managerial skills and to encourage the adivasi sangams to
govern these institutions.
HEALTH
Accordingly, the entire health programme was hived off as a separate organisation called ASHWINI,
which is at present covering over 220 adivasi villages through 8 health sub-centres and the Gudalur
Adivasi Hospital. All the nurses in the hospital and the health animators in the sub-centres are chosen
from the adivasi community by the village sangams. They were trained intensively by well-qualified
doctors to provide comprehensive health care to the adivasi community.
Today, maternal mortality of the adivasi women in Gudalur Valley has
been reduced to zero - thanks to the elaborate Ante Natal Care
provided to all the AMS members. A systematic immunisation
programme has succeeded in bringing down the death rate among the
adivasi children. The infant mortality rate among the AMS families is
less than half of the national average. Given the extremely difficult
physical terrain in the area and poor economic conditions of the
adivasis, this is no mean an achievement. This was possible only due
to the sustained involvement of a large number of women and men in
the adivasi community at various levels. A wealth of knowledge and
resource persons have been created in the adivasi villages.
The Executive Committee of ASHWINI is comprised entirely of adivasi members. The entire financing of
the health programme is being managed by ASHWINI independently through internal incomes, donor
support and with the help of an innovative health insurance programme.
Though ASHWINI as an independent organisation was started only in 1990, its genesis dates back to
1986 when Stan Thekaekara and his wife, Mari started ACCORD, a Non-Governmental Organisation in
Gudalur. Their main objective was to to fight against the unjust alienation of the adivasi lands and other
human rights violations by organising them as a strong group.
They facilitated the formation of village level sangams and
these sangams enabled the adivasi families to prevent any of
their land getting encroached by powerful non-tribals of that
area or by the Government authorities. More than 200 such
village sangams had been formed within two years. These
sangams were federated at the taluk level into "Adivasi
Munnetra Sangam’’ which till today remains the representative
organisation of the adivasis, fighting for their just rights and
striving for the socio-economic development of the adivasi
community.
But, it was not only the problem of land. The village sangams again and again brought up the issue of
health care. Women were dying during childbirth. Children were suffering from easily preventable
diseases. Some intervention was urgently required. But, Stan and Marie were not doctors. They started
looking out for some doctors through their contacts. Fortunately, they met two young doctors,
Dr.Devadasan and his wife, Dr. Roopa, quite eager to take up the challenge.
COMMUNITY HEALTH PROGRAMME
Deva and Roopa joined ACCORD in 1987 just after their
graduation from the Christian Medical College, Vellore and
launched a community health programme in the adivasi villages. The main focus was to train village level
Health Workers (HW) selected from the community itself, to identify and prevent illnesses like diarrhoea,
to provide immunisation and nutrition to the pregnant women and young children, and generally to
improve health awareness among the adivasi community. The team went from village to village,
participated in the sangam meetings and regularly monitored the progress of the pregnant women and
children.
Within a few years, the preventable deaths among the adivasis (like due to diarrhoea or during childbirth)
were more-or-less eliminated. The HWs did a tremendous job in the programme, kept highlighting the
health issues in the villages and closely followed-up the individual cases. The immunisation status of the
children & pregnant mothers dramatically improved with the launch of the community health programme.
Issues like growth monitoring and nutrition were constantly brought to the notice of the parents by the
health workers.
Thus far, the health programme consisted entirely of these field activities. In spite of the successful
community health programme, there were inevitable cases needing hospitalisation, there were high-risk
pregnancies which required the women to deliver in a hospital, and acute cases of diarrhoea and fever
among children too needed hospitalisation. Deva and Roopa used to refer such patients to the local
Government hospital or to the private clinics.
But, the experience with these hospitals was not very encouraging since the care and treatment given to
these patients was not satisfactory, the doctors weren’t there many times in the Government hospitals,
the costs of treatment in private clinics were high (ACCORD subsidised these costs). Deva and Roopa
were torn between following a few cases in these hospitals and visiting the villages all over the taluk.
Quite encouraged by the success of the community health programme and the role played by the adivasi
health workers, the adivasi community felt that the next logical step would be to start a hospital of their
own. There was a heavy demand from the village sangams to start a hospital. But the doctors were
reluctant, saying that Hospital is a permanent institution which needs to be run 24 hours a day, all through
the year - and for many years. The health team at that time was not equipped to handle such an
institution. Moreover, the ACCORD team strongly felt that their intervention had to be time-bound and
they will withdraw after a few years when the AMS can take over the initiative of protecting the rights of
the adivasis. But, hospital is a permanent form of intervention which cannot be withdrawn. And, in any
case, where are the nurses in the adivasi community? Another basic philosophy of ACCORD was to
identify youth from the community itself to deliver all the services to the people and to train them! And,
GUDALUR ADIVASI HOSPITAL
However, the community was strong in its demand and felt that the community health programme needed
a hospital of its own to make it much more effective and acceptable to the people. So, they started a
search for suitable people. Again as a curious coincidence, there landed up a doctor couple, Shyla and
Nandakumar, willing to be part of the health programme. Having the ideal combination of skills as
Gynaecologist and Surgeon, they were what the "doctor ordered" and the people were looking for! Young
adivasi girls were identified by the sangams and the new doctors started training them as nurses. Thus
was born the "Gudalur Adivasi Hospital" [GAH]. In 1990.
With the establishment of the Hospital, they realised that this intervention is going to continue for many
years, and structurally, it has to be different from that of ACCORD or AMS. So, the health programmes,
activities and the staff were hived off from ACCORD and a separate legal entity called ASHWINI was
registered. From then onwards, Ashwini took care of the health issues concerning the adivasis and poor
people of this area. While Deva and Roopa continued their focus on the community health programme,
Shyla and Nandakumar started training tribal girls as Nurses. It was a major cultural change for the girls -
from innocent village life to a three-shifts-a-day routine in the hospital. Training had to start from
elementary Maths and English.
These adivasi nurses have come a long way in the next 18 years. They have become experts in
conducting deliveries, in assisting the doctors in surgeries, in the general administration of the hospital, in
ordering and managing the drug stocks, in designing systems to monitor the performance of the hospital
(All the patient details have been computerised after 1996) and in analysing the financial aspects of the
hospital management. They are constantly trained and their skills are upgraded to keep up with the
growth of the programme.
Today, the Adivasi Hospital is one of the most sought after hospital in the Gudalur valley, not only by the
tribals, but also by the non-tribals of the local area. Patients are brought from distant villages by
ambulance and good quality care is given. As all the staff are from the community and can talk the tribal
languages, the tribal patients feel at home. Efforts were constantly made to keep the place culturally
acceptable to them and the community gradually adjusted to the change. Today, there are cots in the
hospital, they come forward for surgeries and many of them regularly show up for antenatal checkups,
etc. Some more young doctors came and worked in the hospital for brief periods - the health team getting
enriched by the interaction with each of these doctors. Some quantitative details on the functioning of the
hospital can be given by their Statistics section, if required.
SUB-CENTRES
Till 1994, the health programme consisted of preventive care given by the
HWs at the villages and curative care provided at the GAH. However, during
many interactions with the sangam members, a need was felt to have
another intermediate level comprising of a group of villages. The AMS had
already divided the sangam villages into eight administrative zones called
"Areas” and an Area Centre was coordinating the sangam activities of that
particular Area. From 1995 onwards, a health Sub-Centre was started in
each of these Area Centres.
These Sub-Centres coordinate
the community health programme
in the villages of that Area,
provide first aid and primary level
curative care by dispensing
I
St.
medicines, Screen patients regularly, refer those needing
•
doctor’s intervention to Gudalur Adivasi Hospital and follow-up
the patients discharged from the Hospital. Initially the senior
nurses and health staff took responsibility to manage these
I
\
sub-centres. Later, a few more adivasi girls were trained
specifically to run these sub-centres - They are called "Health
Animators". As per the need, they keep shifting between the hospital and the sub-centres, so as to strike
a balance between the curative and preventive programmes and to keep their skills sharpened and
updated.
42^4
MANAGEMENT
Monitoring and review of the activities, both in the villages and in the hospital are done by the staff
themselves in the monthly meetings. Besides, a Working Committee comprising of a few senior nurses
and health animators has been constituted. This group looks ahead, takes care of the long term planning,
budgeting and other policy issues.
ASHWINI is registered as a Charitable Society under the Tamilnadu State Societies Registration Act. The
General Body of the Society is constituted from the senior AMS activists, the adivasi nurses / health
animators and the doctors. All the members of the Executive Committee are adivasis. Thus, though
ASHWINI is legally an independent identity, it continues to function under the umbrella of the AMS as an
institution owned and managed by the adivasis themselves for their own development.
FUNDING SUPPORT
The Community Health Programme was started in 1987 with the financial assistance of Action Aid, a
charity agency from UK. The Hospital programme was supported by CEBEMO (at present called CORD
AID), a Dutch funding agency for about six years till 1997. There were many individual donations from
friends in India and abroad.
At present, there are a few Donor Agencies / Institutions supporting their work. Sir Ratan Tata Trust,
Mumbai is supporting their Health Insurance Scheme, by providing the Insurance Premium for the last
five years. SRTT is also supporting their community mental health programme. During the last few years,
they are able to mobilise resources from the Government of Tamilnadu as well for HIV / AIDS control
programme, tuberculosis control programme and for the mobile outreach activities.
Even though the hospital is able to generate income from the non-tribal patients and the Health Insurance
Scheme, the community health programme needs to be subsidised for some more years. Hence, the
financial support of these institutions and many individuals / friends is quite crucial to continue their work.
For more details, visit their website: http://www.adivasi.net
Contact Person
Mr. Stan Thekkekara.Dr. Nandakumar Menon
Postal Address
Post Box No.20, Gudalur - 643212, The Nilgiris District, Tamilnadu,
India.
Email
accordgudalur@gmail.com
Telephone
+ 91-4262- 261506,261504
Fax
+ 91-4262-261504
Population Details, Census 2011, Provisional abstracts
Gudalur Taluka (Sub-district), Nilgris District, Tamilnadu
Population details
Rural
_____________
Urban_________________
Population_____________
Children in group 0-6 years
Literates
__________
Male
Female
4176
4071
47721
49228
51897
53299
5455
5241
42229
39726
Total
No. of households
Household size
8247
96949
105196
10696
81955
Rural households________
Not yet available
Urban households
The Nilgiris : Gudalur Taluk
Revenue Villages
/
(Map Net to Scale)
Oigrtal Map Source : TWAD Board, Chennai
Web Design: NIC.TNSC
Gudalur Taluk - Revenue Villages
^Number of Revenue Villages
------------------------------
ICherumuIly
Mudumalai
Devala
8
Gudalur
Nellakotta
O’valley
Padanthorai 'Sreemadurai
Tribal Health Initiative
Tribal Health Initiative was started in 1992 by Dr. Regi George and Dr. Lalitha Regi. Today, they have
expanded into a team of over 45 highly trained people, working to improve the lives of the tribal
communities living in the Sittilingi valley and surrounding hills through a variety of programmes in
health care, community health, farming and craft initiatives, etc...
Brief history
The Sittilingi valley and the surrounding Kalvarayan and Sitteri Hills are inhabited primarily by tribal
people, Malavasis or Hill People" who eke out a living through sustenance or rain fed agriculture.
About fifty thousand people live here.
Less than two decades ago, in 1992, one out of five babies in the Sittilingi valley died before they
completed their first year and many mothers died in childbirth. The nearest hospital was 48 kilometres
away and to find one with surgical facilities meant a journey of over 100 kilometres. The area was
remote and badly served by public transport. Buses at that time would run four times a day but even
getting to a bus could involve a walk across fields lasting several hours.
Tribal Health Initiative campus in 1995
THI started with a small Out Patient Unit in a thatched hut IN 1993. Three years later, mostly due to the
support of friends and a few grants, they had built a ten bedded hospital with a rudimentary operation
theatre, labour room, neonatal care, emergency room and laboratory.
In 1996, Tribal Health Initiative (THI) started training local tribal girls as Health Workers (THI's term for
nurse midwives). They are now dedicated, competent and mature women who form the backbone of
their hospital. They are able to diagnose and treat common problems, assist in the operating theatre,
conduct deliveries, care for inpatients and go out to the villages for antenatal and child health
checkups.
THI also has a second group of older women called Health Auxiliaries who have been chosen by their
respective communities. They live in the villages and come to Sittilingi every month for reporting and
training. They offer advice on good nutrition, hygiene, birthing practices and simple ailments. They host
the field clinics for pregnant mothers and children. They also ensure that all babies born at home are
seen within the first week by their Health Workers. Many of them are now the key stones for
community activities like farming and craft and act as facilitators for all community development work.
THI's old operation theatre with a steel table and 100W bulb
Today, Tribal Health Initiative runs a full-fledged 30 bed primary care hospital and has extended its
services to conduct education programmes and outreach clinics in the 33 villages situated in the area.
The impact has been dramatic.
TH1 was featured in Reader’s Digest in 2001
The proportion of pregnant mothers coming for antenatal check-ups has increased from 11 per cent to
90 per cent since the outreach clinics began. Infants dying within one year of birth has plummeted to
20/100 [it was 147/1000 when they started] and undernourishment has come down by 80%.
After 10 years of work in the Sittilingi valley, the project underwent an impact evaluation. A significant
outcome was the conclusion that their work, based on their vision of health, should encompass areas
such as education, livelihoods and basic community needs. In order to understand unmet needs, the
team decided to have one to one discussions with the villagers of the 21 villages covered by THI. Out of
this process, their newer initiatives have emerged such as the Organic Farming Initiative and the Tribal
Craft Initiative.
They have demonstrated that in a relationship of trust, ordinary tribal people can come and
successfully learn the skills needed to care for their communities.
Who are die team members of Tribal Health Initiative?
The THI Team consists of more than 60 permanent staff as in 2013.
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More than two third of their permanent staff are women.
Tribal Health Initiative was started in 1992 by Dr. Regi George and Dr. Lalitha Regi. Today we have
expanded into a team of over 45 highly trained people, working to improve the lives of the tribal
communities living in the Sittilingi valley and surrounding hills through a variety of programmes in
health care, community health, farming and craft work.
THI’s vision is that the people of Sittilingi valley and Kalrayan Hills lead a better
quality of life.
THI’shope:
•
To attain the highest possible level of physical, mental and social health.
•
To enhance their socio-economic status while retaining their pride, self-respect and selfreliance and ensuring their active participation in programmes meant for their welfare.
•
To create an atmosphere highly conducive for the growth and development of local cultures
and customs.
THI seeks to work with tribal people in a spirit of peace, understanding, trust, and justice.
THFs mission for the people of Sittilingi and the Kalrayan Hills is:
•
To be an educator to protect and promote health and improve basic knowledge levels.
•
To provide affordable and acceptable basic health care services to the area.
•
To be a facilitator to help people undertake collective action for their welfare
To provide a support system to help people come back to sustainable methods of farming
•
To facilitate peoples knowledge about their rights and responsibilities and help them exercise
•
To help them acquire additional skills and assist them in achieving self reliance through small
scale entrepreneurship
•
To provide support for the social upliftment while retaining and building on their local cultural
strengths
The basic values for THI work is:
•
Faith in the people and their wisdom
•
Sincerity, honesty and total commitment in our work
•
Secular and non political
•
To respect the dignity of every individual
What THI team does?
Tribal Health Initiative views health as a state of mental, social and economic well-being and not the
mere absence of disease. Their health interventions go beyond merely providing curative and
preventive medical services. They see their farming and craft initiatives as being directly connected to
maintaining health and well-being in the communities they serve. This is supported by the Educational
Initiative, Thulir and the Technology Initiative.
Broadly speaking the following are the activities of THI:
Tribal Hospital
THI runs a 30 bed secondary level hospital which admits patients with medical, surgical and obstetric
problems. The hospital serves as a base for their health outreach programme.
Community Health Programme
THI s health outreach programme provides simple curative, preventive and ambulance services to 33
villages in the Sittilingi valley and the Kalrayan Hills. This programme caters to a tribal population of
16000 tribals.
Farming Initiative
THI s Farming Initiative aims to enable farmers to practice economically and ecologically sound
agriculture. They have 200 farmers now doing wholly organic agriculture.
Craft Initiative
The Craft Initiative enables local Lambadi women to become economically self-reliant while preserving
their traditional embroidery. Their products are sold under the brand name Porgai, which means 'pride'
in their dialect.
Governance
They are accredited by the Credibility Alliance [certificate CA/28/2014] for accounting transparency
and good work culture.
Board of Trustees
Dr. Regi M George
Dr. Lalitha Regi
Prof. M Ravindran
Dr. Sara Bhattacharji
Dr. Indru Tupulur
Prof. N. Kamalamma
Dr. Sukanya Rangamani
Dr. Guru Nagarajan
The Board of Trustees meets twice a year to discuss policies and major projects. The Executive
Committee, consisting of 3 trustees, meet once in 3 months to review work and take decisions.
A Working Committee consisting of 7 Staff members, meet every month to take day to day decisions on
work. Full Staff meetings are held every month to review work and plan ahead.
Their summarized accounts can be viewed from their website.
For more details about our CBO partner, please visit their website http://www.tribalhealth.org.
THI’s address is:
Tribal Health Initiative,
Sittilingi, Harur PO, Dharmapuri District,
Tamil Nadu-636 906.
INDIA.
Contact persons and phone numbers are:
Dr. Regi George or Dr. Lalitha Regi:
+91-9585799061; (Office phone - to contact ward, farming office and craft, ask for extension from
office)
Email
thisittilingi@gmail.com
office@tribalhealth.org
Population Details, Census 2011, Provisional abstracts
Harur Taluka (Sub-district), Dharmapuri District,
Tamilnadu________
Population details
Male
Female
Total
Rural
103511
18705
122216
13903
83863
99330
18811
118141
12865
64274
202841
37516
240357
26768
148137
Urban
Population____________
Children in group 0-6 years
Literates
No. of households
Rural households
Not yet available
Urban households
Dharmapuri : Harur Taluk
Revenue Villages
‘"V
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_
133 \
/
152
7
c-____ /'—•“i-'U
156 /'
/
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(Map Not to Scale)
Digital Map Source : TWAD Board, Chennai
Web Design: NICJNSC
Household size
T
Harur Taluk - Revenue Villages
Number of Revenue Villages
177
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Veppasennampatti
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SRI VIVEKANANDA YOUTH MOVEMENT
Swami Vivekananda Youth Movement (SVYM) is a development organization, engaged in building a new
civil society in India through its grassroots to policy-level action in Health, Education and Community
Development sectors. Acting as a key promoter-facilitator in the community's efforts towards selfreliance and empowerment, SVYM is developing local, innovative and cost-effective solutions to sustain
community-driven progress. SVYM is also rooted to its values of Satya, Ahimsa, Seva and Tyaga, which is
reflected in its program design and delivery, transactions with its stakeholders, resource utilization,
disclosures and openness to public scrutiny. Buying in support from the community, working in healthy
partnership with the Government and corporate sectors and sharing its experiences with like-minded
organizations have been the hallmark of SVYM's evolution over the past 28 years.
Core values are the driving force behind SVYM's work:
Satya
Ahimsa
Seva
Tyaga
- Truthfulness
- Non violence (both in thought and deeds)
- Service
- Sacrifice
SVYM's Vision
A caring and equitable society, free of deprivation and strife
SVYM's Mission
To facilitate and develop processes that improve the quality of life of people
History
The year was 1984. A group of young medical students led by R. Balasubramaniam at the Mysore
Medical College (in Karnataka State, India) were starting to feel that the career in medicine they dreamt
of pursuing was very different from the practice of medicine around them. They believed that they had
in them to make a difference and make a positive impact on the lives of the poor and the marginalized.
And so, they started the Swami Vivekananda Youth Movement (SVYM, for short), with initial assets of
high ideals and all the positive benefits of inexperience.
Their initial intention was to provide rational, ethical and cost-effective medical care to the needy. They
started small - collecting physician samples of medicines and distributing them to poor patients,
organizing blood donation camps and weekly rural outreach clinics around Mysore. In 1987 destiny took
them to Heggadadevanakote Taluk, the home of the displaced and dispossessed forest-based tribes.
These indigenous people, belonging to five different clans - Jenukuruba, Kadukuruba, Yerava, Paniya
and Bunde Soliga - had been displaced twice from their natural habitat by development projects of the
Government, namely 'Project Tiger' and 'Kabini Reservoir', and were forced to live in penury on the
fringes of the Bandipur National Park.
The medicos set up a clinic at a tribal hamlet named Brahmagiri, at a distance of about 80 km from
Mysore city, with a little help from the Mysore District Administration. Realizing early that medicare by
itself is not enough and hoping education to be a panacea to the gen-next, they opened an informal
school for the tribal kids in a cow-shed in Brahmagiri. They were able to sail through the initial days of
extreme uncertainty and struggle (and even ridicule!) by pluck, some luck and with help from
unexpected quarters. As days passed, more people joined hands and the work took a definite shape.
Socio economic empowerment activities were added to health and education, and the rural poor were
also brought under the ambit - as the organization moved from the role of a 'provider7 to a 'facilitator'. A
10-bed hospital was started at Kenchanahalli, along with a host of community-based programs in Health
and Education. As the medicos returned in batches after completing their post graduation, the multi
specialty Vivekananda Memorial Hospital took shape at Saragur, with generous help from donors,
friends and well-wishers. The organization continued to grow and expand in the 90s, with a definite
vision and strategic direction.
SVYM's Programs
All of SVYM's programs and projects fall into 4 major sectors, namely 1. Health, 2. Education, 3. SocioEconomic Empowerment and 4. Training, Research, Advocacy and Consultancy, with Health being the
largest in terms of number of people reached out to.
1. Health Program
The goal of the health program is to sustain quality of health care by providing equitable care with
involvement of community and in alignment with the organizational interpretation of the core values.
The key focus areas are — tribal and rural health, ayurveda (the Indian system of medicine), reproductive
and child health, hygiene and sanitation, care and control of HIV/AIDS, tuberculosis and blindness.
The institution-based services under health are provided through the Vivekananda Memorial Hospitals
(VMH) at Saragur and Kenchanahalli. VMH - Saragur is a 90-bed facility offering multi-specialty
secondary care at an affordable cost to the rural and tribal populace. It is affiliated to the Rajiv Gandhi
University of Health Sciences (RGUHS), Bangalore and offers the India's first post-graduate fellowship
course in HIV medicine for medical and dental professionals. VMH - Kenchanahalli is a 10-bed facility
offering primary care, along with options for ayurveda chikitsa. Our hospitals are recognized training
centers for capacity building of entire gamut of health professionals — from specialists to grassroot
workers.
Community based services are provided in the key focus areas listed above, through the outreach
program and a network of grassroot level health workers called health facilitators. Our HIV control
program, that offers comprehensive, inclusive and end-to-end care, is rated as one of the best in the
country and has been hailed as a best-practice model by UNAIDS.
2. Educational Program
SVYM s educational initiatives strive to provide joyful, experiential and child-centered learningfocusing on values, literacy, numeracy and appropriate vocational training. The focus is on educating
children in tribal hamlets, rural areas and urban slums. The key result areas are enrolment and retention
of children, empowerment of communities, promotion of child rights, prevention of child labour,
providing impetus for higher education and promotion of teaching methodology and curriculum that is
contextually relevant and culturally appropriate.
The services are provided through two schools - the Viveka Tribal Center for Learning at Hosahalli (semiresidential, formal school recognized by the Government of Karnataka) and the CBSE-affiliated Viveka
School of Excellence at Saragur, and four community based initiatives - Shikshanavahini, Prerepana,
Vidyakiran and Premavidya.
3. Socio-Economic Empowerment Program
SVYM's Socio-Economic Empowerment Program supports the development of self-reliant, informed, and
engaged individuals and groups in rural and tribal communities. It was established in the 1980s when
SVYM expanded beyond just providing health care and added a focus on addressing the root causes of
the community s problems. With a special emphasis on youth and women's empowerment, the SEEP
department seeks to enhance local awareness for social, political, and economic issues and catalyze
community progress on the path of development.
Through programs in tribal development, public transparency, and community radio, SEEP expands
social and economic opportunities for rural and tribal communities, works with communities to
eradicate corruption in local government, and spreads information and awareness on local issues to
promote real and lasting change.
Tribal Development Program
The Tribal Development Program works to promote the well being of tribal communities through three
initiatives: self help groups, self-employment and entrepreneurship, and infrastructure creation.
Self Help Groups (A community-based initiative)
The Tribal Development Program established Self Help Groups serve as platforms for social, economic,
and political empowerment. With support from the Tribal Development Program, these groups of 15 to
20 women meet weekly in their communities to collect group savings, take out micro-loans, discuss their
community issues, and work together to solve their own problems. The Tribal Development Program
organizes regular training sessions, regional meetings, and exposure visits to facilitate knowledge
sharing, support, and collaboration between the groups, and the result has been inspiring. Increasingly,
confident women leaders are asserting themselves and using their collective social power to effect real
and lasting change in their communities.
Self-Employment and Entrepreneurship (An institution-based initiative)
The Tribal Development Program's project in Self-Employment and Entrepreneurship seeks to create
local and sustainable sources of income for rural and tribal people. In many communities, local
employment opportunities are scarce, and people are forced to either work as daily wage laborers or
migrate for months at a time to find work - uprooting their families, pulling their children out of school,
and fracturing the community in the process.
The Self-Employment and Entrepreneurship initiative provides a local alternative by training people and
skilled labor and encouraging them to stay local and generate wealth within their own communities.
Through income generation projects across multiple villages, participants in the Self-Employment and
Entrepreneurship initiative produce high-quality, hand-made artisan products such as fabric files,
patterned bags, and woven lantana wood furniture. Coming Soon — Support these local artisans by
buying products directly from our website! 100% of the profits go to the individual producer.
Infrastructure Creation (A community-based initiative)
In many rural areas, people are unable to live healthy lives because they lack access to basic things like
safe drinking water, safe sanitation facilities, and efficient fuel sources. The Tribal Development Program
facilitates the construction of basic infrastructure that solves these problems, such as toilets and ecofriendly biomass stoves, in order to reduce disease and improve their quality of life.
Community Movement Against Corruption
The Socio Economic Empowerment Program launched the Community Movement against Corruption
project (a community based initiative) in 2009 with the goal of creating community awareness about
social, political, and economic rights and entitlements, holding government offices accountable for
providing basic services, and empowering local people to become strong advocates for their own needs.
Through pamphlet distribution, street play, video showings, village meetings, and a mobile clinic, the
Community Movement against corruption works towards strengthening Public Distribution system in H
D Kote taluk.
A new initiative of the Community Movement Against Corruption is Mahiti Vedike, or "Information
Forum," a project that empowers local youth to act as voluntary information ambassadors for their
communities. By presenting information about government schemes at monthly Taluk meetings, telling
people about their basic rights, and ensuring that they know how to access them, these young people
use their energy and enthusiasm to act as disseminators of knowledge in their communities.
Community Radio
The Socio-Economic Empowerment Program launched "Jana Dhwani, or "Voice of the People" (an
institution based initiative) in 2012. The first ever community radion station in Mysore district. Jana
Dhwani provides listeners with timely and relevant information about local news, political, social, health
issues, government schemes, and upcoming events through programs in various formats, including
interviews, panel discussions, songs, soap operas, and public quizzes.
With community involvement in all stages of program planning and production, Jana Dhwani is truly a
reflection of community ownership. By providing a platform for rural communities to express
themselves, share their experiences, and discuss their problems, SVYM is able to facilitate the discovery
of effective solutions.
4. Training, Research, Advocacy and Consultancy (TRAC)
TRAC was conceptualized to consolidate the learnings of our 25-plus years of work in the community
and share them with like-minded organizations. It aims to serve India by building the potential of
individuals & institutions for the development sector (Govt, NGOs and Corporates) and synergize their
efforts for better, collective gain. It also strives to develop innovative programmatic models for the
development sector and influence public policy.
TRAC services are provided through three institutions —Vivekananda Institute for Leadership
Development (V-LEAD), Vivekananda Institute of Indian Studies (VIIS) and Grassroot Research and
Advocacy Movement (GRAAM).
V-LEAD is affiliated to the University of Mysore and offers the Masters Program in Non-Profit
(Development) Management. Another flag-ship program of TRAC, the 'Youth for Development, aims to
create a trained, committed workforce of youth who can take up value-based developmental activities
in rural areas. These two programs create career opportunities in development sector for the youth.
Vivekananda Institute of Indian Studies aims to enable contextually relevant development, founded in
an understanding of Indian values, culture and tradition, and interpreted in a spirit of appreciative
inquiry, while GRAAM is an institution for public policy research and program evaluation.
Governance
A 7-member Governing Body of SVYM is elected annually from among the General Body of
members. The Governing Body is guided by a team of advisors, who are eminent and
distinguished people drawn from various walks of life. The Governing Body meets regularly to
take important decisions related to governance.
The Chief Executive Officer (CEO), nominated for a 3-year term by the Governing Body, is the
Chief Functionary and oversees the management of the organization.
The heads of the 4 sectors of SVYM report to the CEO. The CEO’s office directly looks after
public relations, networking, resource mobilization and legal affairs of the organization. The
CEO is assisted in his work by the Human Resource Development (HRD), Finance, Internal
Audit, Documentation and Monitoring & Evaluation cells. The CEO is also guided by a
consultative and facilitative body called Development Support Team (DST), comprising of
people in the senior management. The DST initiates, supports, guides and synergizes
organizational efforts towards achieving the strategic goals and objectives.
The Governing Body for the year 2014-15 is as follows:
£ma'l
President
Dr. M.R.Seetharam
■.. 1. g
emmaress@svym.org.in
Vice President
Dr.Sudheer B.Bangalore
sudheer@svym.org.in
Secretary
Mr.Praveen Kumar Sayyaparaju
praveen@svym.org.in
Joint Secretary
Dr. Anil C
anil@svym.org.in
Treasurer
Dr. Dennis Chauhan
dennis@svym.org.in
Executive member
Dr. Vijayabhaskar Reddy
emailredd
Executive member
Dr. Ashwin A.M
drashwin@svym.org.in
ahoo.com
Contact Persons:
Chief Executive Officer Dr. (Fit Lt).M.A.Balasubramanya mab@svym.org.in | ceo@svym.org.in
The CEO will be a permanent invitee to the Governing Body meetings.
Dr. R Balasubramaniam, Founder, Swami Vivekananda Youth Movement drrbalu@gmail.com |
rbalu@svym.org.in |
For more details about SVYM, please visit their website: http://www.svym.orq/
Administrative Office Address is as given below:
Swami Vivekananda Youth Movement
Hanchipura Road, Saragur
H.D.Kote Taluk, Mysore District - 571121
Karnataka State, INDIA
Tel/Fax: (08228) 265877, 265412
Mobile: +91 9686666312
Email: svymffisvym.org.in
H.D. Kote Taluka (Sub-district), Mysore District, Karnataka
Population details
Male
Female Total
Rural
Urban___________
Population
________
Children in group 0-6 years
Literates
Rural
Urban
119929
12819
132748
118039
12919
130958
No. of households
Household size
237968
25738
263706
Not yet available
84021
66085
150106
55430
6039
£
4
H.D.KOTE TALUK - VILLAGES WITH BUS STAND
MYSORE
TALUK
HUNSUR
TALUK
NANJANGUD
TALUK
KERALA
STATE
CHAMARAJANA GARA
DISTRICT
0
5
kilometers
BUS STAND
10
KYATHANAHALLI
KANCHAMALLI
MADAPURA
THUMBASOGE
NOORALAKUPPE
K.BELTHURU
HANCHIPURA
BEECHANAHALLI
BIDARAHALLI
SAGARE
HEGGANURU
CHAKKODANAHALLI
ALANAHALLI
G.B.SARAGUR
CHIKKEREYURU
HYRIGE
HEBBALAGUPPE
NAGANAHALLI
HIRIHALLI
ANNUR
BHEEMANAHALLI
SAWE
MANUGANAHALLI
KALLAMBALU
MULLUR
M.C.THALALU
B.MATAKERE
ANTHARASANTHE
N. BELTHURU
N.BEGURU
D.B.KUPPE
17
V
Annexure 2
DRAFT FOR DICUSSION
V
Date:
Schedule code:
In-depth questionnaire for Institution^fhealthcare^royider^
Objectives:
1.
To document the a.
2.
List of Services of institutional healthcare providers, both government and
non-govemment (non-profit and for profit)
To generate data on a.
b.
c.
d.
health outcomes with special focus on mother and child healthcare
Incidence of diseases with special focus on mother and child healthcare
lie)
Clinical outcomes of MCH related conditions covered by existing public
health system and institutional providers
List of conditions treated and costs of treatment
1.
Name and-address of the institute
2.
Name of the respondent «—•
3.
Designation
4.
Working hours and working days of institution
SI. No.
Days
r
Working hours
1
r
p/v
5.
Population served by the institution
6.
List of services provided at institution
List of services
List of services
7.
Who are the users of your services and why?
8.
Who are not the users and why?
9.
What are the cost for various services provided by your institution?
2
10.
Average OP per month
11.
Average IP per month
12.
Health Conditions treated and costs of treatment
Health Conditions
treated
13.
Cost of treatment
in Rs.
Specify the conditions treated for mother and children and costs of treatment
MCH Health conditions
treated
Costs of treatment in Rs.
CPHE - SOCHAixA
(
■
",=)
Ko«■amanyals
VVM?an9a,ore
) s
3
14.
Please provide data on incidence of important health conditions with focus on mother
and child health
SI. No.
Health conditions
Total number of
the cases
reported during
last one year
15.
Do you provide any emergency services for mother and child health?
a. Yes
b. No
15.1
If yes specify
15.2
If not, what you do?
16.
Immunization coverage
A.
B.
17.
Mother
Child ..
%
%
ANC registration %
4
18.
Number of deliveries in last one year?
19.
Number of infant deaths in last one year?
20.
Number of maternal deaths last one year?
21.
Number of under 5 deaths last one year?
22.
What educational and health service programs related to mother and child health that
are conducted in villages?
23.
Who are the audience of these programmes?
24.
What is the impact of these programmes?
5
Annexure 3: Data to be collected during Botanical Survey
Objectives:
To collect the data on
a) presence,
b) distribution pattern,
c) scale of abundance of medicinal plants
used by local community as well as the codified Indian Systems of Medicine (Ayurveda, Siddha
and Unani)
1. Date of survey
2. Name of the village:
3. Taluka:
6. Forest range / Beat.
4. District
7. Alt
5. State
8. Lat./Long
9. Collection No:
10. Botanical name (With popular synonyms):
11. Family:
12. Habit
13. Vernacular Names:
SI. No.
Name
Language/ Dialect
1
14. Habitat (tick appropriate box):
Dense
forest
Open
forest
Rocky/Slopes
River side
Grassland
Marshy
Sandy
15. Unique characters of the plant
16. Local usages:
Name of the Preparation/
formula, if any
Detail of storage of medicine
-if applicable____________
Dosage and Administration
Use this column for
translation/ remark on
standard measurement, if any
How much? (E.g. one teaspoon
or one tablespoon, one pinch
etc.)____________________
How many time per day
How many days_____________
Specification on dos for children
above
day (s) up to
year______________________
Specification on dose for infant
aged above
day (s) up to
...... Month______________
Vehicle/Adjuvant used in the
administration and its quantity
(if any) e.g. Honey, warm water,
water, etc.
2
18. Parts used:
19. Trade information:
20. Status (please tick whichever is applicable):
Wild
Cultivated
Planted
21. Occurrence of species with approximate numbers (as per the healers' perspective):
Very
common
Common
Less
common
Rare
22. Name, age, gender, years of experience & address of the information provider:
Name and signature of the investigator
Date:
Name and signature of the person authenticating the data collected
Date:
3
Annexure 4
DRAFT FOR DICUSSION
Schedule code:
Date:
Household Sample Survey Questionnaire
Objectives:
1. To document the -
1.1 health seeking behavior and costs involved especially regarding women’s health with
a focus on mother and child health
1.2 existing knowledge regarding use of traditional home based health practices including
ethnic diets, life style, home remedies and medicinal plants in prevention and
management of common health conditions
1.3 Household health expenditure including costs saved by the self help inputs (home
remedies) on Primary, Secondary and Tertiary care
1.
Identification of study area
1.1
1.2
1.3
1.4
1.5
1.6
1.7
Name of the Non Governmental Organization
Name of the field Investigator:
Name of the village:
_
Name of the panchayat:
Name of the Taluka:
Name of the district:
Name of the state:
2.
Respondent and household details
2.1
2.2
2.3
2.4
2.5
Name of the respondent: Code number
Religion:
Caste:
House details (no, name street, etc)
Type of family (Please tick whichever is applicable):
a.
Joint family
b.
Nuclear/single parent
1
2.6
Occupation of household members
SI.
No.
1.
2.
Household
members
Member 1
Respondent
Member 2
3.
Member 3
4.
Member 4
5.
Member 5
Age
2.7.
Family Income per annum in Rs.
2.8
Ownership of House
Sex
Education
Occupation
T
A. Owned
B. Rented
C. Free
2.9
Type of house:
A. Pucca
B. Semi pucca
C. Kutcha
2.10
What are the arrangements for drinking water?
A. Well
B. Bore-well
C. Grampanchayat supply
D. River
2.11
Does your family own farrh?
A. Yes
B. No
2
2.11.1 If yes, what are farm produces?
0
3.
Perception of health and illness
3.1
What is health to you?
3.2
What is sickness or disease to you?
4.
Response to Health and illness
4.1
What actions do you take to maintain the health of the family members?
A.
B.
C.
D.
E.
F.
G.
H.
(
Diet (Specify)
Lifestyle
Vaccination
Mosquito control: Net / Repellent
Personal hygiene:
Environmental hygiene:
Exercise
Any other specific measures, Please specify?
4.2
Do you have home remedy kit at home?
4.3
Does any of the member knows about home remedies / traditional health practices
J
4.4
Where do your family members generally seek help from for health needs (for minor
problems)?
A.
B.
C.
D.
E.
4.5
Visit a temple
Home remedy (Specify)
Folk healers
Government hospital
Clinic of Private practitioners, please mention type (Allopath/AYUSH system)
Where do your family members generally seek help from for health needs (for major
problems)?
A. Visit a temple
B. Home remedy (Specify)
C. Folk healers
D. Government hospital
E. Clinic of Private practitioners, please mention type (Allopath/AYUSH system)
F. Private Hospital. Mention type (Allopath/AYUSH System)
4.6
Does anyone in the family suffering from any chronic illnesses such as the following?
A.
B.
C.
D.
E.
4.7
Did you or any of your family members experience any illness during the last one year?
A.
B.
4.7.1
Hypertension
Diabetes
Tuberculosis
Sickle Cell Anemia
Others, Please Specify
Yes
No
If yes, what was the problem?
A.
Minor (outpatient care)
B.
Major (hospitalized)
4
Who Experienced?
4.7.3
Where did they seek help from in an order of priority
A.
B.
C.
D.
E.
F.
Went to temple
Home remedy
Sought the help of traditional healers
Went to a private practitioner
Went to a private hospital
Went to a government hospital
4.7.3.a
If went to temple what did you do and what happened
4.7.3.a.i
How much did it cost?
4.7.3.b.
If home remedy, what did you do and what happened?
4.7.3.b.i
How much did it cost?
4.7.3.C.
If went to traditional healer, what did he/she do?
4.7.3.c.i
How much did he/she charge:
4.7.3.d.
If Private practitioner what system he/she practices?
A.
B.
C.
D.
E.
F.
Allopath
Homeopath
Ayurveda
Siddha
Unani
Others,Specify:
5
4.7.3.d.i
How much did he/she charge for the following?
1.
2.
3.
Consultaton:
Diagnostics if any?
Medicines:
Total:
4.7.3.d.ii
What happened
4.7.3.e.
If went to a private hospital, where, what did they do and what happened?
4.7.3.e.i
How much did you spend for the following?
A. Consultation:
B. Diagnostics:
C. Medicines:
Total
4.8
How many times you or any of your family members went to each of the following
places during the last one year?
4.8.1
Traditional Healers
A. Once/twice/ thrice/ more than three times
B. Approximate Cost: Rs.
6
4.8.2 Private Practitioners Clinic
A. Once/twice/ thrice/ more than three times
B. Approximate cost:
i. Consultation Rs.
ii. Investigation Rs.
iii. Indirect costs like travel and food Rs.
Total: Rs.
4.8.3 Private Hospital
A. Once/twice/ thrice/ more than three times
B. Approximate cost:
i. Consultation Rs.
ii. Investigation Rs.
_________
iii. Indirect costs like travel and food Rs.
Total: Rs.
4.8.4 Government Hospital
A. Once/twice/ thrice/ more than three times
B. Approximate cost:
i. Consultation Rs.
ii. Investigation Rs.
_____
iii. Indirect costs like travel and food Rs.
Total: Rs.
5.
Do you have any kitchen garden or medicinal plant?
Name and Signature of the Field Investigator:
Date:
Name and Signature of the Field Supervisor:
Date:
N.B. We need to work out how we -will estimate the annual health expenditure of
the household and the purposes for which the expenses was incurred from the data
of this questionnaire.
7
Annexure 5
DRAFT FOR DICUSSION
Schedule code:
Date:
In depth questionnaire with mother of U/5 children
Objectives:
1. To document the -
1-1 health seeking behavior and costs involved especially regarding U/5 children’s health
1 existingTmowledge regarding use of traditional home based health practices including
etmuc diets, life style, home remedies and medicinal plants in prevention and
management of common health conditions with a focus on U/5 children
1.
2.
3.
4.
Code No. of the mother (Respondent)
Village Name:
Age:
Total No of children
SI.
No.
j__
2 __
3 __
4 __
5 __
6
5.
Name
Age
Sex
How do you take care of health of your child? (What measures you take to prevent and
promote the health of your children)
a. Nutrition
b. Personal hygiene
c. Boil water and give
d. Mosquito repellent/net
e. Others specify
_____________
1
6.
What traditional knowledge based diet or lifestyle practices you follow?
7.
What do you know about (colostrum) first milk of the mother after the delivery of a
child?
7.1
If you fed colostrum to your child, why?
7.2
If you did not feed colostrum to your child, why?
8.
What do you know about additional feeding to a child?
9.
When is the right time to give additional food?
a. <6 month
b. After 6 months
c. After 9 months
2
10.
What will happen if additional food is not given at the right time to the child?
11.
What do you know about immunization to children?
12.
Why immunization is given to children?
13.
What are some of the health problems your children faced during the last one month?
a.
b.
c.
d.
e.
f.
g.
h.
Fever
Cough
Cold
Diarrhea
Jaundice
Scabies
Head lice
Skin
Others specify
3
14.
Where did you seek help from and how many time?
SI.
No.
Health
Conditions
1
2
3
4
5
6
7
8
9
10
11
12
13
Fever______
Cough
Cold
Diarrhea
Jaundice
Scabies_____
Head lice
Skin_______
Throat pain
Stomach pain
Vomiting
Indigestion
Constipation
Home
care
Folk Healer/
Knowledgeable
woman
Allopath
AYUSH
How many
times
4
15.
How much did you spend for each of the health conditions?
SI.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
Health Conditions
Direct expenses
Indirect expenses
Fever______
Cough_____
Cold_______
Diarrhea
Jaundice
Scabies_____
Head lice
Skin_______
Throat pain
Stomach pain
Vomiting
Indigestion
Constipation
5
16.
Can you name some of the medicinal plants available in and around your village and
What conditions are treated by them?
SI.
No.
Plant name
17.
Who practices home remedies for U/5 children at your home?
A. Grandmother
B. Mother
C. Myself
D. Others (specify)
18.
Do you seek help from outside the family?
19.
What is the motivation for them to practice?
Uses
6
Annexure 6^
DRAFT FOR DICUSSION
Schedule code:
Date:
In depth questionnaire with mothers who have recently delivered (less than a year)
Objectives:
1. To document the 1.1 health seeking behavior and costs involved especially regarding pregnancy
1.2 existing knowledge regarding use of traditional home based health practices including
ethnic diets, life style and home remedies with a focus on pregnancy
1.
Code number of mother who recently delivered:
2.
Village Name:
3.
Age:
4.
Date of delivery:
5.
How did you come to know you were pregnant:
6.
What was the rank of your last pregnancy?
7.
Can you explain your pregnancy experience?
1
8.
Why was this pregnancy necessary?
9.
Where did you go for check up?
10.
How many times did you go for Ante-natal visits
a.
b.
c.
d.
11.
One
Two
Three
> three
Did you receive IFA tablet
a.
Yes
b.
No
11.1 If yes did you take regularly?
12.
What happened during those visits?
13.
How much money did you spend, for what?
A.
B.
C.
D.
E.
Consultation Rs.
Investigation Rs.
Medication Rs.
Travel and food costs Rs.
Others (Specify) Rs.
Total Rs.
2
14.
What problems did you experience?
15.
What medicines did you take?
16.
What special diet did you take?
17.
What food did you avoid?
18.
What support did you get from the family?
19.
Can you explain your delivery experience?
20.
Type of delivery
A.
B.
C.
Normal
LSCS (Caesarian)
Others (specify)
3
21.
Place of delivery
A.
B.
C.
D.
E.
Home
Sub-center
PHC
Government Hospital
Private Hospital
22.
Complications if any during delivery
23.
How long were you there in the hospital?
24.
What advice was given during discharge?
25.
What did you like and what you did not like about the place of delivery?
26.
How much did you spend, for what?
a.
b.
c.
d.
Normal delivery Rs.
LSCS (Caesarian) Rs.
Was Episiotomy done ( she may not know what it is the interviewer has to
explain) Rs.
Others specify (complication if any) Rs.
4
Tl.
Did you experience any of the following conditions during pregnancy and if experienced
what was done?
Health Conditions
1.
Anemia
2.
Diabetic
3.
Hypertension
£ Bleeding
5.
Constipation
6.
Others
(specify)
28.
What did you do?
Was there any complication during delivery?
a.
b.
Yes
No
28.1
If yes, specify?
28.2
What was done?
29.
Did you follow any traditional practices during 9 months of pregnancy and for the safe
delivery?
5
30.
Have you done any traditional practices after delivery?
31.
Do you follow any traditional knowledge based diet or lifestyle practices
A. Yes
B. No
31.1
If yes specify
6
Annexure 7
DRAFT FOR DICUSSION
Schedule code:
Date:
In depth questionnaire with folk healers
Objectives:
1.
To document the -
1.1
Services including the list of health conditions treated and costs involved in treatment of
especially mother and child
1.2
Existing knowledge regarding use of traditional health practices with a focus on mother
and child health
1.
What is your name?
2.
Father’s / Husband’s name:
3.
Age:
4.
Sex:
a.
b.
?
Male
Female
5.
Village name :
6.
Since how many years you are practicing?
7.
How did you acquire the knowledge and skills?
1
8.
What are the various conditions that you treat including problems of mother and children:
a.
What conditions you treat in general?
b.
What specific conditions of women and children do you treat?
c.
How do you diagnose?
d.
How do you treat?
e.
How long is the treatment?
Fill in the following table as per the answers given by the respondent to the above n
questions
Name of
Health
Condition
Symptoms
you observe
to identify
the condition
Treatment
details
(plants,
method of
preparation,
dose)
Duration
Subsequent
Correlation by
supervisor of
condition with
Ayurveda/
Allopathy name
2
9.
What is your motivation
10.
What do you do when you can’t treat a condition?_ ^^7
11.
What preventive and positive health practices do you advise related to mother and child
health?
12.
Who uses your services and why?
13.
Who do not use your services and why?
rhat do you get in return for providing your service?
3
14.
Do you charge yotir patients?
a.
b.
Yes /
No /
c.
Sometimes
14.1
If yes/sc/metimes, how much?
15.
What benefits do you get out of this practice?
16.
How^an-we pass on this knowledge and practice to the next generation?
Do you know anyone^wpractices folk medicine in your village?
17.
4
Annexure 8
Respondent’s Details
Name of the respondent:
Sex:
Age:
Address:
Community:
Organisation:
Prior Consent Form (in Local Language)
I have been informed by the under-mentioned CBO/ NGO/ Government representative/
Researcher whose name and address are as given below:
Mr/ Ms/ Dr.
Address
That the information relating to baseline survey as per the format enclosed to prepare a Project
Proposal Document on Sustainable Integrated Mother/Child Health Care in Rural India by the
above mentioned CBO/ NGO in collaboration with Trans Disciplinary University, Bangalore.
I hereby give my prior informed consent to disclose the details with reference to baseline survey
as mentioned above.
Sign / Thumb Impression of the respondent)
Date:
Place:
Annexure-9
Confidentiality Agreement (in Local Language)
We, the undersigned agree to keep the confidentiality of the information with reference to the
baseline survey that we have obtained from the respondent and as shown in Annexure-10. We
work for the CBO/ NGO / Government / Research Institution as given below.
Name of the investigator: Ms/ Mr/ Dr
Sex:
— Age:
years
Designation:
Name of the Chief Functionary of the
CBO/ NGO / Government / Research Institution in which the investigator works:
Ms/ Mr/ Dr
Address of the CBO/ NGO / Government / Research Institution which the investigator
represents:
We also confirm that after our explaining to the respondent that the information relating to
baseline survey as per the format enclosed to prepare a Project Proposal Document on
Sustainable Integrated Mother/Child Health Care in Rural India by the above mentioned CBO/
NGO in collaboration with Trans Disciplinary University, Bangalore.
Signature of the Investigator:
Signature of the Chief Functionary of the
CBO/ NGO / Government / Research
Institution in which the investigator works
Date:
Date:
Place:
Place
Guidelines / Questionnaire for Focus Group Discussion
Folk / Traditional Healers
1. What system do you practice?
2. How long you have been practicing?
3. How did you acquire this knowledge and skills?
4. What are the various conditions that you treat?
5. How do you diagnose a particular health problem?
6. Who seek your help?
7. What specific health conditions related to children you treat?
8. How do you treat each of them?
9. What specific health conditions related to women in reproductive age?
10. How do you treat them?
11. What would you do if you cannot treat a specific health condition?
12. What is your motivation for practicing?
13. What in return you get from the people whom you treat?
14. How many medicinal plants you will be able identify in your vicinity?
15. Can you comment on the availability of medicinal plants in your vicinity in the past and
present?
16. How do you think this knowledge and skills be passed on to the next generation?
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