1. Overview of the organization
Azad India Foundation (AIF) was formed in the year 1998. It got formally registered in the year 2001. AIF is primarily working in the district of Kishanganj of Bihar. The mission of the organization is to empower the grassroots communities to determine their own needs and development by themselves with the active participation of the rural women in particular. Their activities include, female literacy, formal education for children, rural employment, SHG formation, community health and awareness raising on improving the status of the women. Their activities reach out to poor, marginalized women and children who largely belong to Muslim communities. Spreading literacy is the core strategy of AIF around which they have weaved their development interventions. AIF's journey owes much to the unstinting support of a large number of friends, supporters and well-wishers.
2. ARSH Intervention
NFI supported Programme Sanjivini has been the first institutional project for AIF. The project is being implemented in 15 villages of 3 blocks of Pothia, Thakurganj and Kishanganj. AIF is focusing on reproductive and sexual health by sensitizing through group meetings, training and communication programs like drawing, painting and poster making etc. Their initiative is also addressing immediate concerns of adolescents, i.e., awareness on delaying early marriage and pregnancy by taking an integrated approach of providing education and skill training simultaneously. AIF's Non-Formal Education (NFE) centres are the focal points for dissemination of information.
3. Key Observations
3.1 Institution building AIF has been working in the most backward district of Bihar - Kishanganj. The promoters of AIF have been involved with social welfare program much before they received NFI support. They have been holding health camps for poor marginalized population of rural Kishanganj. They are also running a school. NFI support is the first concrete program they have had and they have built on their other development intervention on project Sanjivini.
The organization as working with the Muslims has been very strategic to get community acceptance by using health and education as the entry points. Gradually through their NFE centres they started working on ARSH issues very cautiously and in keeping with the cultural sensitivity of the community. Frequent interaction by the leadership has not only helped in consolidating their credibility with the community but also has created a good base for ARSH. AIF has been quite successful in evoking a positive response from the men in the community. Strategic engagement with the opinion leaders has helped the organization to get a buy in of the community.
AIF though has always hired local human resource as staff but due to various reasons, like, women tabooed by reproductive and sexual health issues, poor family support and etc. they have had a huge staff turnover. That has slowed down their process but constant mentoring by the leadership has enabled AIF to have a small but committed staff for ARSH. Currently, they have one coordinator, a field supervisor, five health animators and ten Peer educators. Strategically, AIF has integrated the NFE instructors as animators.
AIF is now trying to integrate ARSH principles in all their other programs. It is reported that they have received support from Block Development Officer, Block Education Officer of Thakurganj. AIF has also carried out intensive meetings with local Panchayat and ward members. The local media has also reported widely about their work and making people aware of project Sanjivini.
a. Kishori Samooh (Adolescent Girls) Focus Group Discussions were conducted with two groups. Girls were meeting regularly on weekly basis but meetings were still dependent largely in the presence of the animators. Girls were shy and hesitant initially but as the discussion progressed they started opening up with issues. Knowledge regarding bodily changes, age of marriage, girls education was adequate though there were girls in the community who got married at younger age. Some of the girls were quite knowledgeable on issues of sexual behaviour like STD, HIV-AIDS and contraception etc but they were mainly school going older girls from relatively better off families. However, the girls lacked confidence at this stage to initiate dialogue with the parents on these issues.
Powakhali block was a remote Muslim dominant block with poor systemic infrastructure of education and health. There were girls who were not attending formal school but were going to Madarsas(local Muslim schools) which were imparting religious teachings only. Some of them had started coming to
AIF's NFE centers. It was motivating to see a girl "Marghuba" from the community working as teacher at NFE centre and as a peer educator. She was a role model to other girls in the community. Knowledge regarding other issues of Family Life Education especially sexual health issues was also appreciable in 15-19 age group. These girls expressed confidence to discuss about issues related to contraception, family size with their future spouses.
It must have had been an uphill task for the organization to initiate processes related to attitudinal and behavioural change. Since the health services were poor in the area, despite good knowledge on ANC and childcare all children were not being vaccinated and no community initiation had really taken place to address that issue. Girls knew about oral contraceptives and where they could access them. Dais were not trained but girls and women knew '5 Clean' at the time of delivery and care during pregnancy but on child care issues the knowledge was not only inadequate but some unsafe practices are still prevalent. The programme needs to relate knowledge building with changes in practices. Kishangung being a border area, trafficking and high prevalence of sexual behaviour is present. However, HIV-AIDS was not much talked about with the girls, which is essential to address the concerns.
At the urban center the girls were largely from well off families and were confident and knowledgeable about many of the ARSH issues. These girls had good communication skills and were influencing their peers. There were few example of collective action. It was good to see that they were conducting their meetings inside the premises of a Madarsa and had openness in talking about sexual health issues.
In one of the villages, there was a lot of resistance from the community, which was hindering regular meeting of adolescent girls. Women in this village were illiterate and prevented their children from sending to NFE centres also. It was hard to overcome such community inertia and it was felt that the skills of grass-root level worker of organization were falling short of the need. ARSH being a critical issue which is further occustrated by the marginalized community needed innovative strategy.
Meeting registers were kept which recorded attendance and topics discussed in the meeting in a very theoretical manner. The records revealed that the meetings were not consistent.AIF with many limitations has made a dent within the community to discuss ARSH issues. Currently, the acceptance is low but gradually it will be build the pace.
b. Service Providers (Dai/AWW/RMP) DAI The Dai met in Powakhali was not exposed to any training in ARSH. She was practicing a lot of unsafe methods during childbirth and post natal care. She was willing to upgrade her skill and knowledge if given a chance. She did not know about ARSH intervention in the village but when informed she endorsed the same. Programme intervention did not address the anganwadi workers or ANMs, beyond one sensitization meeting. Working with the adolescent community, developing linkages with the system is critical. Kishangujn being an area with poor infrastructure and services available, it will be ideal for AIF to strategically address the service providers to assure a better quality of life.
c. Opinion Leaders Women group/Community Women seemed to be approving of ARSH issues with regard to adolescent girls. Women accepted the need of such intervention with girls and expressed such information would improve their health and have an improved family life in the time to come. While they were not exactly in favour of marrying their daughters early but due to societal pressure on such issues, they were not able to do much. However, influencing the decision on issues like marriage and pursuing higher education, women has limitations. Therefore, the organization need to mainstream men and the other male community to assure practices on ARSH issues. Otherwise, the programme will have limited reach and unable to have a larger tangible impact.
d. Madarsa Teachers A brief discussion was held with two Maulvis teaching in the Madarsa. Maulvi Saheb was aware about the discussions held in the group meetings and approved of the same. Zindagi behtar dhang se jeene ke liye ye sab malumaat nihayat zaroori hai, remarked Maulvi Saheb. Maulvi Saheb informed that chairs were not usually allowed where Quran Sharif was kept or recited, but during meetings held in the Madarsa, they allowed the chairs in the verandah, and shifts the Quran Sharif inside the room. A major attitudinal change reflected and space for adaptability amongst the Muslim clergy, and AIF should be credited and appreciated for this endeavor. AIF having the potential need to expand and take its learning ahead.
3.3 Gender As discussed earlier, AIF is working largely with the Muslim community and restricted to women and girls. As elsewhere, women have very limited role in decision making. While ARSH is advocating for a radical shift in reproductive and sexual behavior of girls and women, it is clear that unless men are ready to behave more responsibly, for instance, adopting contraception for delay or spacing of the child, the women alone would not be able to make any dent. Therefore a more active involvement of men is seriously critical in the RSH issues to the success of the program. AIF a women headed and managed organization needs to develop a gender policy. In future with time, a articulated plan can be developed.
3.4 Monitoring and Evaluation AIF has a simple monitoring mechanism. The project areas are divided among the coordinator and supervisors. While inputs are regularly monitored, the organization relies on community feedback to measure their outcome. This is not done systematically but more at the level of anecdotes and subjective perception. For AIF, the single most achievement has been in terms of community awareness building, which is the most critical indicator for them. Their monitoring and evaluation system is more process oriented than results driven. However for organization learning and better performance of the program, it is essential that AIF develop systematic monitoring tools for organization's inputs and also for tracking changes if any.
3.5 Communication Field Supervisors in AIF use flip charts and other material developed by Pathfinder. The exposure by NFI has helped the organization to develop a user-friendly guidance note in Hindi on adolescent and reproductive health issues which are being used by animators and peer educators in the field. AIF has also been putting up thematic stalls in various haats in their field area. Stalls had charts, posters and pamphlets on specific health issues. AIF team has been recording the number of visitors and the queries to make further improvements. A cultural team has also been trained and developed for staging street plays, forum theaters and puppetry shows on ARSH issues. People from IPTA and NECTOR have trained this team on script writing & message building techniques.
4. Potential : Effectiveness of the Strategy Reach of the program in remote & difficult geographical area with illiterate population is in itself a rewarding step. Program has managed to have community acceptance on issues of ARSH built on the foundation of non-formal education. Organizational head's involvement down to grass-root level has created space to understand the dynamics around problems and their possible solutions. The conceived strategy is appropriate and effective. Using the NFE centres as the entry point is strategically viable and sensible in addressing culturally sensitive community. The community based teams' involvement in the implementation has provided strength to the programme. However, the intervention area is found to be too scattered (five villages in each block) and is not strategically viable to make an intense impact on the community. The programme has interventions limited to tolas(hamlets). Considering the status of Muslim women in the society, with respect to their literacy and awareness level, and the conservative attitude of the Muslim society, this is an extremely crucial intervention. AIF has both, competence and capability to develop and demonstrate a model of sensitizing marginalized community adolescents and women on reproductive & sexual health, piercing the iron veil of conservatism and illiteracy.
5. Challenges Considering the organizational stature and capacity, the physical coverage made by AIF was reasonable. However, the coverage was limited to tolas. Outreach too was confined to girls attending NFE centers and few women groups. One of the most critical stakeholders, the men/boys folk was not reached at all, though they acknowledged the importance of the intervention. Nearly defunct health service delivery system is a big challenge to make effective linkages in the program. Program has not reached all the desirable stakeholders i.e., Dai's, RMPs to some extent PRI & men folk. Age-old hard religious influences that guide the community will be hard to over come in order to advocate ARSH intervention.
6. Recommendation Based on the above observations, it is recommended that AIF consolidates confines and continues its field intervention exclusively in Pothia block where the organization is working in 9 villages. For the other 2 blocks, a support to the organization for a short duration (3-6 months) to facilitate consolidation and sustainability of NFE centers with community efforts.AIF should focus on working with men and adolescent boys to have a holistic impact. The goal of the programme, would be limited if they continue to working only with girls and women, The larger issues of the programme, e.g., increase in age of marriage, delay of first child & spacing, require equal acceptance by the larger community specially men to have a sustained impact and behavioral change. Advocacy at district level with ICDS and health department to mobilize the nearly defunct system in the operational area is strategic. It was felt at places that inadequate knowledge and poor communication skills of staff are also hindering the implementation of program. In house capacity building of staff to address ARSH issues, sensitively in the community is important.