Swabhiman- A Programme on Health and Empowerment of Women

A focused baseline survey was undertaken to access the prevailing situation in the project area pertaining to knowledge, awareness and practice in relation to Reproductive and Child Health (RCH) and Adolescent Reproductive and Sexual Health (ARSH) issues. Keeping in mind the nature of programmatic intervention, two target groups were covered during the baseline survey:
1. Unmarried Adolescent Girls (10-19 Years)
2. Eligible Women (15-49 years)

However, the specific objectives of the survey were as follows;
•To measure the knowledge level of unmarried adolescent girls on ARSH issues.
•To measure the awareness level of eligible women pertaining to Reproductive health and utilization of RCH services viz, ANC, PNC, Immunization and Family planning etc.
•To access the awareness on gender issues e.g.; Violence and discrimination against women etc.
Based on the Baseline survey, impact indicators and project outcomes were decided in the following manner:

Project Outcomes
•Increase in knowledge level of adolescent girls on ARSH issues
•Increase in awareness level of the community stakeholders on health and RH issues
•Increase in awareness on gender issues e.g.; VAW, discrimination against women etc.
•Increase in health seeking behaviour on RCH services.
•Documents brought out for wider dissemination

Project Indicators
•Number of adolescent girls made aware of RH issues by SHVs.
•Number of women and adolescents aware of legal age at marriage.
•Cases of violence against women (incidents related to dowry, rapes,
•Physical and mental abuse) identified by the volunteers and reported.
•Number of success stories of girls enabled in negotiation skills
•Increase in early registration within 12 weeks of pregnancy.
•Increase in full ANCs / PNCs and safe delivery
•Increase in full immunizations.
•Increase in use of modern family planning methods
•Girls seeking out vocational skills training, employments.
•Number of case studies and process documents

Selection of partners:
The project envisaged Smile Foundation initiating the Girl Child Project in rural/urban slums areas in Delhi city in collaboration with 4 partner NGOs. These NGOs at that time were funded by Smile Foundation, India to work on Child Education and Empowerment issues.

Selection and Training of PCs/CHEs:
Each partner NGO recruited One Project Coordinator and One CHE in its community. The CHEs were women who were active members of the same or nearby community. With possessing some educational qualifications, these were women or girls who had passion to work for the empowerment of community women and adolescent girls.

Selection and Training of SHVs:
Health volunteers who are none other than adolescent girls from these communities are constantly groomed under Swabhiman Programme as second generation of leaders. They support the programme in conducting family planning surveys, pregnancy surveys and immunization surveys. Not only this, they have supported mobile van in mobilizing patients for encouraging health seeking behaviour. SHVs were selected from amongst the community members keeping in mind the fact that these girls are going to create percolation effect of empowerment in the community.

Project Management:
Managing 10 CHEs, 40 SHVs and 120 Peer Educators at the same time in varied fields was not that easy, especially retaining the health volunteers who were not salaried workers. After all, Swabhiman Team at Smile rigorously trained them at field as well as institutional level.

Selection and Training of Peer Educators:
The agents of empowerment were executing Swabhiman in full swing but the work could not be stopped here. Each SHV by the second year of implementation of Swabhiman now had to associate 3 peer educators with her to take the programmatic activities further. Thus, in total 120 peer educators prepared a cadre of third generation of community leaders in the form of peer educators.
Media Advocacy was very crucial not just to make the programme appeal and visible to masses but creating awareness generation amongst the privileged masses too that women empowerment is important and should happen. Swabhiman was reflected not just nationally but internationally too and has 4 international coverage to its credit – Washington Post, Hong – Kong Channel, San Francisco and Finnish Broadcasting Corporation.
Service delivery through Mobile van
Furthermore, a fully equipped mobile clinic designed to deliver Reproductive Child Health services in slum population having facilities for examination of women visiting the communities has been very effective.

Liasioning, Networking and Nurturing Stakeholders:
With such a massive programme, it is very important to network with stakeholders associated with the programme. Under the programme, we have been able to nurture stakeholders such as Delhi Police, Directorate of Home Guards & Civil Defense etc.

Advocacy through Community mobilization, Awareness Generation and IEC/BCC (Information Education Communication/Behavioral Change Communication activities:
Various innovative tools like street plays, puppet shows, counseling sessions, one –to – one interactions, etc have been used for community mobilization on RCH and LSE issues. Community educators, Swabhiman Health Volunteers and Peer Educators have been involved in the awareness generation process.

Documentation and Dissemination:
Complete MIS has been maintained based on achievement indicators of the programme. Quarterly Progress Reports nd Expenditures reports have been shared with the PFI. Case studies, success stories and reports have been adequately documented.

Breaking the community mindset was the biggest challenge for the Swabhiman team. It was difficult to convince families to accept and practice Family Planning Methods. Also lack of encouraging health seeking behavior amongst community women and adolescent girls made things difficult during the initial stage of the programme. Involvement of male in the health and empowerment issue of women was almost negligible which again made things worse. The economic dependence of women on their husbands put wives in a subordinate position to their husbands was another major issue.

Population Foundation of India (PFI) partnered with Smile Foundation to implement a 3 year Holistic programme on comprehensive Healthcare and Empowerment of Women.
Grassroot NGOs like Adhaar Society, Sahyogita Samaj Vikas Sansthan, Neb Srishti and Health and Care Society work towards the implementation of Swabhiman programme.
Volunteers from colleges and universities from India and abroad help in campaigning and advocacy related activities.

The major results generated from the initiative are as follows:
•It helped breaking the community mindset (orthodox and rigid)and now they are open to accept positive changes.
•The project raised a cadre of health volunteers
•Swabhiman Centres are fiunctioning as Information Centres for women
•Now people are accepting Family Planning Methods
•The project is encouraging health seeking behavior amongst community women and adolescent girls.
•Networking with stakeholders and like-minded organizations/institutions
•Empowerment of community women and adolescent girls
•Now even the male community have started involving in the matters of women empowerment.

The initiative generated the following impact:
•Selection and capacity building of 10 CHEs, 40 SHVs and 120 peer educators.
•18,045 household visits made for tracking pregnant women, non- immunized children and households adopting various family planning methods.
•11,008 women and adolescent girls encouraged for health seeking behaviour.
•6,622 women and children received mobile health van services.
•2,150 children from (0-2 years) completed full immunization.
•23 major advocacy events organized on women and Girl Child empowerment.
•55 street plays and puppet shows were performed on Reproductive Health and Family Planning Issues as part of IEC/BCC activities.
•314 women and adolescent girls treated for Reproductive Track Infections/Sexually Transmitted Infections.
•547 women facilitated for sterilizations, 2874 community people provisioned with condoms, 120 women went through IUD insertions, 595 women given iron tablets.
•33 print and electronic coverages enabled media advocacy
•Brochure and six monthly newsletters are being circulated amongst stakeholders.