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Minimizing disparity through increasing access to vaccination by the estate communities in Sri Lanka

Participatory, multi-actor partnership strategies and youth engagement for improved immunization among poor and marginalized estate families

Photo of Subhashi Dissanayake
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

FoSE aims to apply inclusive, participatory and multi-actor strategies to address the social and access issue of the estate communities to vaccination in Ratnapura district by promoting youth and the responsible actors engagement with CDF.

Explain the idea (less than 2,000 characters)

Sri Lanka is at the top in Asia with high level of health services. However, families in estates are with lower rates to vaccination compared to the other families in the country due to being marginalized and unrepresented. Malnutrition among children in the estates is at 44%, significantly higher than the national average of 10%. Low birth weight and malnutrition in both mother and baby lead to cognitive disability and physically slow growth. Even though 84% of the mothers in the country, have been visited by the Midwife to provide pre-natal care, it appears that only 42% of mothers in the Estates have reported of Midwife’s visit, although they are the neediest of such services. Full immunization cover, to prevent six dangerous childhood diseases, is recorded as the lowest. The main reasons for this discrepancy will be addressed by the ‘Idea’ with a holistic approach: 1. Unawareness on the need of vaccination by the estate parents leading to neglect of on-time vaccination for their children. Innovative and attractive methodologies (forum theaters, dramas, etc.) will be practiced to increase the awareness through the youths from the same community. 2. Estates are managed by Estate managers (private) with the Plantation Human Development Trust (semi-government), whereas the rest of country is administered by the Divisional Secretariat Divisions and Pradeshiya Sabha through which most of the government services including the health services are channeled. Even though the Welfare Officers have been appointed in the estates, they are not capable in addressing the need of vast number of families in an estate. The selected youth will be capacitated to be the facilitators and connectors between the communities and health officers with provided communication channels/technologies to ensure the reach of the required services to estate families. 3. Health centers will be supported to address the distance issue in accessing the medical facilities by the estate families.

Which part(s) of the world does this idea target?

  • Southern Asia

Geographic Focus (less than 250 Characters)

Ratnapura district of Sabaragamuwa province of Sri Lanka in South Asia is targeted. Ratnapura is a district with high population of tea estates families with acute poverty. It experiences high level of climate disasters (floods, land slides, etc).

Who are your end users and how well do you know them? (750 characters)

Primary end users are the families of the estate communities in Ratnapura district. The selected youth and the public health officers and the estate worker housing cooperative societies (EWHCSs) will also get benefited through the engagement. FoSE will be working closely with the CDF, which is a community-based organization in Ratnapura. The Executive Director (ED) of FoSE and CDF have many years of experience and connection built with these groups in their previous project implementation in the areas of education, health, water & sanitation, livelihood development and gender equality promotion. Therefore, awareness of the issues, hands on experience, connections built, recognition gained, commitments, innovative ideas are some strengths.

How is the idea unique? (750 Characters)

The idea is with the sustainability focus in bringing the young generation in taking responsibility for their communities and increasing the commitment and capacity of the target groups and public officers on the vaccination. This empowerment with the use of holistic and attractive approaches for different groups is unique to this project compared to the others that are more like services projects. The internal strengths (mentioned preciously) with the two organizations with the external funding support will make this a success and a role model for the other organizations and responsible state and estate management actors to be replicated with other estates. Therefore, dissemination of the results of this is also focused with wider groups.

Idea Proposal Stage (Select 1)

  • Pilot: We have started to implement the idea as a whole with a first set of real users. The feasibility of an innovation is tested in a small-scale and real world application (i.e. 3-15% of the target population)

How many months are required for the project idea? (140 characters)

It will take us minimum 14 months to implement the idea and to achieve the 1st level of results -increased awareness and access to services.

Organization Name (less than 140 characters)

Foundation of Solidarity Empowerment (FoSE) will be implementing this idea together with Community Development Foundation (CDF) in Ratnapura

Type of Submitter

  • Other

Organizational Characteristics

  • Female-led organization
  • Women’s health/rights focused
  • Locally/community-led organization
  • FoSE is in the process of registration as a non-for-profit Guaranteed Limited. CDF is registered NGO

Organization Location (less than 140 Characters)

FoSE is based in Colombo in Sri Lanka, but with national level coverage in projects. CDF is registered in Ratnapura district in Sri Lanka

What is the current scale of your organization’s work?

  • National (expansive reach within one country)

Website URL

FoSE hasn't created a website yet. But CDF website is

Tell us more about your organization/company (1-2 sentences)

FoSE vision is: To be the primary support and platform for local organizations working for transforming communities towards economic, social, cultural, health, political and environmental justice. Mission is: Technical and financial empowerment of local organizations to work with underprivileged women, men, girls and boys from different communities with participatory approaches so they may feel belong, contribute and thrive. Accordingly, FoSE bring this idea with CDF for ensuring health justice.

Who will work alongside your organization in the project idea? (750 characters)

FoSE will collaborate with CDF in implementation of this project with the estate families and relevant state and non-state actors related to the health sector using their experience. It is a requirement to work collaboratively with the estate management in order to get the access to the estate families as well as to bring a sustainable solution for them. This will also support to get the estate youths released, to attend the programs, by the management. The previous experience in working with estate families will provide the knowledge to find the best time and best methodologies to attract them for the programs. Working experience with EWHCSs will lead the way to ensure sustainable linkages with the state actors in health service provision.

How many people are on your team?


Tell us more about you and your team

Subhashi Dissanayake, Founder and Executive Director, FoSE - have 18 years of experience in the development field working for the reduction of poverty and injustice, with different communities including that of estate sector. She generated this idea with her previous experience and therefore, will play an advisory role for the implementation, a role to liaise with donor and management of information and project quality. Charles M Ravie, Founder and Chairman, CDF - working for the benefit of the estate communities in Ratnapura district since 2005. He contributed to the development of the idea with provision of information related to the targeted communities and will monitor the implementation closely at the field. He will also facilitate the linkages with other stakeholders. Project coordinator and finance officer will be joined to support the implementation once the project idea is funded. They will be full time paid staff for the implementation with the advice of Subhashi and Ravie.


Join the conversation:

Photo of Marichu Carstensen

Hi Subhashi, I have been working with the youth around me for many years and I think you are on the right track. Yes, they have energy and a great amount of creativity to help in this complicated endeavor. Art is a powerful tool. Youth and art together will yield interesting results.
I hope that you can show concrete examples of your movement and how you can sustain this. Since they are going to school, will they only be there partially? Will you only work with them for big immunization campaigns or all throughout the year?
Thank you!

Photo of Subhashi Dissanayake

Hi Marichu, many thanks for the provided positive message and the helpful tips for the proposed idea. Since the idea presentation has limits in words, I would like to provide more information on the idea with regards to the raised concerns in this message.
As you mentioned, youth are the driving force of many countries with their creativity and energy. We have around one forth of the population as youths in the country and therefore, they are highly potential and required to be involved in the development process of the country. The estate communities are not interested in normal awareness programs held in their estates. But they are attracted for the programs using Creative Arts. Therefore, youth and the Arts will bring high opportunities to create awareness of the need and benefit of the vaccination among the parents and others of the estate families.
Youths are attracted to the new technology especially to the mobiles. Provision of these to youths, as incentives, will be used to collect and share the information of the families with the public health officers. This will bring a system among the estate communities and public officers to bridge the gap in information. The monthly held health clinics will be facilitated by the public health officers together with youth, based on these information and connections built. The youth are provided with small monetary incentive for this facilitation at the clinics. It is suggested to start a health fund with the estate cooperative society to sustain this even after the end of the project intervention. However, the increased awareness and the connection built (between the estate families and public health officers), will sustain for longer period, hence these services of youth will be required only up to that level. The engagement of youths is not required to be throughout the whole period. They can do the training, practices, awareness events, health clinics, sharing of information after school hours or in weekends or during their holidays.

Photo of Marichu Carstensen

Subhashi, I would love to see your ideas get developed and become more concrete.
I am sure the young people will have more creative inputs in the future. If they will be the ones interacting with the caregivers, it is imperative that they become good communicators. There could be a training set for this on a regular basis. I hope you can sustain this program.
Again, the best of luck!

Photo of Marichu Carstensen

Subhashi, I would love to see your ideas get developed and become more concrete.
I am sure the young people will have more creative inputs in the future. If they will be the ones interacting with the caregivers, it is imperative that they become good communicators. There could be a training set for this on a regular basis. I hope you can sustain this program.
Again, the best of luck!

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