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Sampark's Desk

Small Steps Big Leap

This is a compilation of the 20 stories (case studies) of interventions in Sure Start project. These stories highlight the remarkable efforts made by the women health workers in communities

Book prepared by Team Sampark in association with Team PATH.

Editor : Hemant Karnik

Contributers : Mahesh potdar, Manisha Sawale , Sonali Kulkarni, Shivaji Kamble, Madhavi Kulkarni, Vrushali Aigalikar, Digvijay jirge, Varsha Joshi-Athavale, Sulabha Shertate

Sure Start addressed the misconception that ill health and suboptimal care of mothers and children is seen only in rural and tribal areas and not in city settlements. The implementing partners in Sure Start helped educate communities, bringing the agents of government schemes and policies closer to the public. During this journey, the health workers realised that they too could change their own lives.


Sampark partnered with 7 other organisations in the Sure Start project to help them learn communication and advocacy skills, to orient mainstream journalists & opinion makers on Sure start’s efforts, and to highlight socially relevant issues in print & electronic media.

There seems a significant shift in urban health trend in Mumbai  

The ninth International Conference om Urban Health (ICUH) concluded in New York, USA recently. At the behest of PATH, Sampark had the opportunity to make a poster presentation there on the subject of "Case Study as a Medium of Advocacy". The poster was prepared under guidance from PATH and was presented at the conference (see page 18 of http://www.professionalabstracts.com/icuh2010/itinerary/program.pdf) by Ms Benazir Patil, The State Manager, Sure Start, Maharashtra.

CUH - International Conference on Urban Health is held every year where delegates from all over the world gather and present papers, hold discussions and pass resolutions on the subject of Urban Health. To cite an example, The Nairobi Statement on Urbanisation and Health, passed during the last conference held in Nairobi, Kenya, reads as under:


We Urge Recognition of the Facts of Urbanization:
* Over half the world’s population live in cities
* Urbanization is a reality facing all countries
* Between now and 2050, 3 billion people will settle primarily in cities, a fact that demands planning and action now to assure urban health and well being
* The majority of urban residents in developing countries live in informal settlements where they lack proper housing, water, sanitation, garbage disposal, security, schooling, and health services. We Recognize the Benefits of Urbanization
* People move to urban areas largely to improve their lives and economic opportunities and urban residents often provide important support to their rural home economies as a result.
* Formal and informal economic contributions of the urban poor are often critical to overall economic development of cities and nations
* Urban settings can improve access to health services, education, and social and cultural opportunities and, when growth is effectively managed , cities can be part of the solution and not just part of the problem in national growth.
* If well managed, cities can be engines of development for national economies and centers of positive sociopolitical transformation
* The high population density in cities can facilitate delivery of development interventions to large numbers of people We Acknowledge the Risks of Urbanization
* Countries that fail to plan for increasing urbanization place themselves and their citizens at serious health, economic, and security risk.

* The health of slum dwellers is typically well below that in other urban and rural areas, even when stratified by poverty level. These inequities are also observed in other critical development indicators like schooling and affect the health of the entire city.
* Settlements without legal status and services can become focal points for social tensions, conflict and illicit economic activity. As Urban Health Champions, We commit to Promoting the Following Ideals to Improve Health Outcomes and Overall the Effectiveness of Cities and Major Urban Settlements in Our Countries:
* Effective, transparent, accountable, and proactive governance that is broadly inclusive is a critical factor in the growth of healthy cities.
* Solutions to urbanization should be developed within a framework that is inter-sectoral where governments work effectively in partnership with the public, organizations of civil society and the business community.
* Donor agencies and governments must include urban concerns in their strategies as adapted to country circumstances * Interventions and programs to improve the functioning of urban areas and cities should be designed with equity consciousness to ensure that the most vulnerable urban dwellers have input to and benefit from the programs
* An urgent priority is the development of effective strategies that create incentives to health to address the challenges of slum settlements to ensure they are places where the informal sector to thrive, human needs are met, and people can live decent lives.
* Cities must integrate health and urban planning and begin planning for the growth of their cities now. * Links between urban health, sustainable development, and MDG’s must be demonstrated to policy makers
* Cities should respond appropriately to climate change in the interest of protecting and promoting human health * Improved surveillance, evidence, and research from robust evaluations of interventions must be shared and used to identify best approaches for investing in healthy cities.
* Increased capacity is needed to assure the availability of the expertise to provide health impact evaluation and monitoring.
Overall Commitment to the Nairobi Statement We commit to advancing the achievement of these Urban Health Champion Solutions through continued consultation, mutual learning and actions that promote development and evaluation of policies and programs that promote the health and well-being of all urban residents as a path to effective national economic and social development.

Case stories are a window of awareness and action.

In the past, the Mumbai High Court had made a suo moto case on the basis of a case study written by Hemant karnik, our editor-in-chief, on the subject of maternal and neonatal health in Gadchiroli, which had appeared in a Marathi daily. The Court directed the Government of Maharashtra to form a committee to study the problem of malnutrition among children which is still operational and Medha Kulkarni, Sampark trustee, is a member of the committee. Sampark has been publishing and disseminating case studies on various socially important issues and it is our conviction that case studies appearing in media, are a powerful tool in both policy advocacy and advocacy to change public perception / behaviour.
More recently, a series of articles by Sampark facilitator which appeared in a Nagpur newspaper, had the effect of establishment of a new health post in the vicinity of a slum area in the Nagpur city. It was as if a wall of ignorance / apathy had blanketed the dismal reality and the media advocacy done by Sampark facilitator opened a window. Here is a picture presentation of this advocacy!

Bihar to e-Track pregnant women
It will track their health conditions and provide prenatal and postpartum care


In a bid to minimise maternal and infant mortality in the state, the Bihar government has decided to create a database of each pregnant woman and newborn babies at village level to track their health conditions and provide prenatal and postpartum care to mothers

The data base would offer unique named-based searches on mother and children.

The data will include date of vaccination and expected date of delivery of pregnant woman. If the family of the expecting mother has any cell phone, they would be informed through SMS. In all 80,797 anganwadi sevikas across the state have been involved to make the campaign a success.

The decision to create software to track the health conditions of expecting women and infants was taken at a meeting of senior officials of the Health Department.

Executive Director of the State Health Society Sanjay Kumar said, “The idea behind the campaign is to check mortality rate of expecting mothers and infants. The campaign, christened as ‘Mother and Child Protection Campaign’ will be launched in villages next month.”

Under the progamme, the agencies would also take care of nutritional aspects of women and newborns, Health Department Principal Secretary C K Mishra said.

He said the officials deputed at primary health centres would apprise expecting women of benefits of breast feeding.

“The electronic tracking programme has been started due to shortage of manpower in health sector,” he said, adding that other information about the health of women and child would also be provided on demand.

ICDC Director N Vijay Laxmi said that the government was contemplating to enroll 9,000 more anganwadi sevikas. They would be engaged in collecting information about expecting women in remote villages.

She said that Integrated Management of Newborn and Childhood Illness (IMNCI) has been introduced in 24 districts of the state. Special Care Newborn Units have been set up in six districts.