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Lasting change goes beyond the present to promise a brighter future. See the multiplying effect of our programmes on communities.
SAKSHAM
AXSHYA (GF/TB)
Bihar Family Health Initiatives
Bihar Health Sector Reforms (SWASTH)
Enhancing Mobile Populations Access to HIV/AIDS Services Information and Support EMPHASIS
Orissa Health Sector Plan and Technical Management
Gaon Kalyan Samithi (GKS)
Sure Start
Urban Health Initiative (UHI)
Initiative to Manage People Centred Alliances (IMPACT)
Community Health Care Management Initiative CHCMI
MP Tribal Project - SEHAT
Location: Andhra Pradesh (AP)
SAKSHAM project’s key objective is that by 2012, NGOs and CBOs will have enhanced capacity to apply community mobilisation strategies for reducing risk of HIV/AIDS and STD contraction amongst marginalised populations, particularly sex-workers. SAKSHAM works to train institutions and civil society through programmes to mobilize communities and develop innovative strategies for reaching sex workers with interventions for HIV/AIDS and STD prevention. These interventions include training that builds capacities of sex workers to address socio-cultural and political structures which keep them exploited, disadvantaged and excluded in society, thereby increasing their vulnerability to HIV/AIDS and STDs. Training is provided to programme implementation units, mentoring programmes are utilized, and evaluation is undertaken to determine programme effectiveness. Support is also provided in the form of technical assistance in implementation of the National AIDS Control Programme (NACP).
In the current phase II of the SAKSHAM project, CARE is shifting the focus of work to the Government of India’s HIV/AIDS prevention efforts and transferring the learnings from phase I to the government’s programme in AP. CARE will facilitate adoption of best practice on community mobilisation amongst NGOs and CBOs working with the government, and strengthen learning sites so that community mobilisation strategies can be documented and replicated by NGOs and CBOs. CARE will also document the success stories of community mobilisation for HIV/AIDS prevention among female sex workers, and share it with all partners and stakeholders for wider dissemination.
Location: Madhya Pradesh (MP), Jharkhand, Chhattisgarh
AXSHYA works to address identified challenges in the treatment of Tuberculosis (TB) such as insufficient laboratory capacity for detection and follow up of requisite drug resistance cases along with funding gaps for procurement of second line drugs for all Multi-Drug Resistant TB (MDR-TB) cases to be initiated with treatment. The first objective is to establish and enhance capacity for quality assured rapid diagnosis of Drug Resistant TB (DR-TB) in 43 Culture and Drug Susceptibility Testing (DST) laboratories in India by 2015. The next objective is to scale-up care and management of DR-TB in 35 States/Union Territories of India resulting in the initiation of treatment of 55,350 additional cases by 2015. Another objective is to improve the reach, visibility and effectiveness of the Revised National TB Control Programme (RNTCP) through civil society support in 374 districts across 23 states by 2015. The final objective is to engage communities and community-based care providers in 374 districts across 23 states by 2015 to improve TB care and control, especially for marginalised and vulnerable populations including TB-HIV co-infected patients.
Location: Bihar
Bihar, one of the poorest states in India, is poised to significantly improve maternal, newborn and child health outcomes by 2015. Strong government leadership, movement toward integration and system strengthening through the Bihar Health Sector Reform Programme (BHSRP), and increased resources create a unique opportunity for progress. In this context, the Family Health Initiative in Bihar, with support from the Bill and Melinda Gates Foundation, catalyses a dynamic process of developing, testing, and scaling-up innovative solutions that transform frontline and first level facility family health services, dramatically increasing coverage and quality of life-saving interventions, improving survival and health for women, newborns and children throughout the state.
Project goals include:
1) Increasing the consistent availability of high impact and cost-effective family health interventions
2) Improving the quality of key family health services and delivery processes
3) Increasing utilization of key services and uptake of health promoting behaviors
4) Facilitating identification and consistent adoption of successful approaches concurrently at state level and nationally.
By the end of the 5-year project period, significant reductions in maternal, neonatal and infant mortality – consistent with government of Bihar targets – and in malnutrition will have been achieved. This will result from improved health behaviors and increased coverage of services known to be associated with mortality and nutritional impacts: increased contraceptive prevalence rate, skilled birth attendance, emergency obstetric care, immediate newborn care, asphyxia management, prevention and management of newborn sepsis, early and exclusive breastfeeding, appropriate complementary feeding, and complete immunization. In concert with the other Foundation grantees in Bihar as well as other stakeholders, CARE will increase equity in the receipt of health services by ensuring that all families are mapped and included by frontline workers; equity is monitored and addressed by supervisors and managers; and accountability mechanisms benefit all population groups. Documentation of effectiveness of strategies, tools and innovations that can benefit family health throughout India and globally will also be produced from project learnings.
Location: Bihar
As part of Sector Wide Approach to Strengthen Health in Bihar (SWASTH), CARE is providing Technical Assistance (TA) support to Government of Bihar (GoB) to develop a comprehensive health sector reform, a nutrition policy and capacity building within the concerned departments. CARE’s approach to health sector reform makes concerted efforts to link improved health status to poverty reduction and human development. The overall strategy adopted by CARE under this initiative is to enhance understanding and acceptance of the sector approach in the government. The project is divided into three phases: design; interim; and the implementation phase. The project is currently in the implementation phase, though the design phase focused on situational analysis in Bihar, and made policy recommendations, while the implementation phase focuses on developing ownership of the policy recommendations. Key focus areas include: poor and vulnerable sections, health service delivery, nutrition service delivery, capacity building of health service providers, behaviour change, health financing, institutional development, and public-private partnership.
Location: National
This project has been developed by CARE’s three country offices to address vulnerability in terms of HIV-AIDS amongst population from low prevalence countries Bangladesh and Nepal to high prevalence areas in neighbouring India. The target groups under this project include mobile populations and their families, with a particular focus on women. The target locations are the two high mobility routes in the region: (i) from Achcham in Western Nepal, down through northern India to Mumbai; and (ii) ten selected unions in Jessore and Satkira districts of Bangladesh, across to Kolkata in West Bengal in India. The project includes multiple closely linked interventions focusing on: improving access to HIV prevention and care support for inter-country mobile populations; capacity building of government, civil society and community efforts to reduce vulnerability of mobile populations; and facilitating evidence-based advocacy towards creation of an enabling environment supportive of reducing vulnerability of mobile populations to HIV-AIDS in India, Bangladesh and Nepal.
Location: Orissa
The overall goals of the OHSP are to reduce mortality and morbidity, particularly maternal, infant and child mortality and to provide equitable and accessible health care to protect the poor and disadvantaged from the financial costs of illness. Another focus of the project is to increase public satisfaction with the health services provided. The key outcomes of the OHSP are reduction in the Infant Mortality Rate from 83% to below 50%, reduction in the Maternal Mortality Rate from 367 per 100,000 in 2000 to below 250, elimination of leprosy and polio, mortality due to TB, malaria and other vector and water borne disease to be reduced by 50%, and reduction in severe malnutrition in all children under five by 60%. A further outcome will be education in disparities in key health indicators amongst religions, under privileged girls and boys, scheduled castes and tribes (SC/ST) and others. CARE is a key member of the Technical Management and Support Team (TMST). Community Centric Monitoring will also be implemented in different districts in Orissa over the course of a year.
The purpose of the technical/management plan is to bring about: improved planning, budgeting and targeting at district levels to ensure equitable health services for the poorest/vulnerable groups; improved monitoring and supervision for implementation of PIPs/Nutrition Operational Plan with a special focus on improving institutional deliveries, immunization and infant and young child feeding; review of existing government schemes and policies , providing input to streamline and make it result oriented; capacity building of district and block managers/supervisors to monitor coverage and quality; pilot capacity building of village service providers and selected Gaon Kalyan Samiti members to institutionalize the lowest level of governance for creating demand and ensuring provisioning of services. Incidentally CARE, through its Integrated Nutrition and Health Project (INHP), initiated some important measures in seven out of the 11 KBK (Kalahandi, Nuapada, Bolangir) districts to enhance programme management skills of programme leaders particularly those of the ICDS. INHP has also undertaken initiatives to strengthen the supervisory system by introducing structured field visits and review tools for supervisors and CDPOs. Some of these good practices are also adopted and are being included in the Nutrition Operation Plan. In this context, CARE proposes to provide technical and management support mainly at the district level to fulfill the objectives of the nutrition operational plan and health equity plan implemented with the health and ICDS departments through the Technical Management and Support Team. The experience and past learning gained from INHP can be best utilized for better planning and targeting the most vulnerable and for effective monitoring and supervision of the programme to achieve the targets set under Orissa Health Sector Plan.
Location: Orissa
CARE India is supporting the National Rural Health Mission (NRHM) by building the capacity of Gaon Kalyan Samitis (GKS) members to enable them to carry out their functions effectively. This is done through cascading modes of trainings where a cadre of Master Trainers at state and district levels are utilised. These trainers build the capacity of trainers at the block level, who in turn train select members (four from each GKS) from each of the approximately 9000 Gan Kalyan Samitis in nine districts where CARE India will extend support. CARE is partnering with other NGOs considering the volume of work. While these NGOS are selected by NRHM, CARE India acts as a nodal agency to other NGOs to provide technical, managerial and operational support for timely completion of planned trainings. CARE also provides supportive supervision to NGOs and monitors all activities.
NRHM mandates the formation of GKS in each revenue village of Orissa to ensure community participation and ownership of health programmes. This is one of the key strategies of NRHM to facilitate decentralised planning, implementation and monitoring for better health outcomes. The formation of the GKS is held under the overall leadership of the Medical Officer in the block. S/he is supported by the BEE, BPO and Ayush doctors. Block level officials are designated as nodal officers to oversee and facilitate formation of the GKS in a certain assigned sub centers. ANM would be responsible for the formation of GKS in their sub center villages. After being duly constituted members of the GKS shall be oriented and trained to carry out the activities expected out of them. The project objective is to include: (1) Capacity building of 36, 000 GKS members in 8 CARE assisted districts of Orissa over a period of one year and (2) Providing technical, managerial and capacity building support to 20 NGOs to facilitate effective functioning of 9000 GKS as per NRHM guidelines in nine programme districts over a period of three years.
Location: Uttar Pradesh (UP)
Sure Start is aimed at bringing about sustainable improvement in maternal and newborn health status through effective community action in Barabanki and Raebaraeli districts of Uttar Pradesh (UP). The initiative’s twin objectives are: to significantly increase individual, household and community action that directly and indirectly improves maternal and newborn health; and to enhance system and institution capabilities for sustained improvement in maternal and newborn health status. Sure Start uses awareness and advocacy, community mobilisation, household empowerment, and household services and commodities as innovative approaches to remove misconceptions related to maternal and newborn health. The project works closely with families of pregnant women and newborns; Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs) and Auxilary Nurse Midwives (ANMs), for referral and counseling services; and Village Health and Sanitation Committees for ensuring quality and regularity of services.
Location: Uttar Pradesh (UP)
UHI is designed to contribute to India’s efforts to achieve the Millennium Development Goal (MDG) of Universal Access to Reproductive Health by 2015. The overarching goal of the Initiative is to increase Contraceptive Prevalence Rate (CPR) by 20% in four cities of UP: Allahabad, Aligarh, Agra and Gorakhpur. Specific objectives of the initiative focus on increasing demand, supply, public-private partnerships and advocacy to ensure sustainability of impact on CPR. Major strategies include: competitive voucher scheme with private sector for urban poor to purchase Family Planning (FP) services; testing Base of the Pyramids business models to engage urban poor in slums; demand generation by using mass, mid, traditional media and community mobilisation; advocacy to build a supportive policy environment.
Location: West Bengal
The goal of IMPACT is to support the Revised National Tuberculosis Control Programme (RNTCP) to decrease the morbidity and mortality caused by Tuberculosis (TB), Multi-Drug Resistant TB (MDR-TB) and HIV/AIDS co-infection, in West Bengal in India. The project achieves this goal through several strategic objectives. First, intensification and expansion of community based DOTS treatment in the poor performing units; next, strengthening and case-holding and completion of treatment among re-treatment and MDR patients. The project also works to strengthen the TB-HIV/AIDS coordination at state and district level to improve cross referrals.
To achieve these outcomes the following strategies will are employed:
a) Supporting positive health seeking behavior of patients linking them to welfare schemes
b) Improving community capacities to support patients to adhere and complete treatment
c) Facilitation of participation of partners in TB/HIV interventions
d) Building capacities of partners
e) Strengthening managerial capacities and linkages of state and district level RNTCP structures to sustain the developed linkages.
Location: West Bengal
The Community Health Care Management Initiative (CHCMI) is an opportunity for CARE and the Government of West Bengal to collaborate on the public health agenda through pro-active engagement with PRIs, civil society organisations and government departments. Some of the constraints that CARE has experienced during its association with CHCMI will also be addressed through comprehensive planning to enable this pioneering initiative to have a sustained impact. The project strengthens health and nutrition interventions through micro-planning processes across five districts and involves PRIs and CBOs with proper representation of women from the poorest and most marginalised groups. The project works to improve the health care delivery system at the Gram Sansad level through institutional development and convergence of health and ICDS services and advocates for good practices for replication in blocks of remaining districts.
Location: Madhya Pradesh (MP)
The goal of the project is to improve nutrition and health status of women and children and enable access to quality education for children from Scheduled Caste and Scheduled Tribe (SC/ST) communities in 500 villages across Sidhi and Shahdol districts of Madhya Pradesh. The main objectives are to strengthen the system that addresses malnutrition with utmost emergency, improve quality in pre and primary education that increases enrollment and attendance and to improve access to livelihoods.
The goal is to improve nutrition and health status of women and children and enable access to quality education for children from SC/ST communities in 500 villages across Sidhi and Shahdol districts of Madhya Pradesh. The main objectives are to strengthen the system that addresses malnutrition with utmost emergency, improve quality in pre and primary education that increases enrollment and attendance and improve access to livelihoods.
CARE India strives to overcome discriminatory practices that prevent girls from accessing and completing their education
CARE’s livelihood programmes enable marginalised communities to access greater economic opportunity
With a close network of government and civil society partners, we act quickly to identify and fulfill community needs
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