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Improving sexual and reproductive health in drought affected communities of Thar Desert, India

The proposed project will address sexual and reproductive health needs of drought affected communities in the Thar Desert in a holistic way

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What specific problem(s) are you trying to address?

Community health care has always been an issue of major concern in the arid and drought-impacted state of Rajasthan. Feudal society, poor socio-economic status of women and prevalence of social evils have been predominant features of the rural communities in the Thar region of Rajasthan over a long time. The above has resulted into widespread neglect of women’s health resulting in high pregnancy rate, high miscarriage rate, premature infant death, high risk of mortality & morbidity during labour and prevalence of infectious and chronic diseases among women and girls. The state of reproductive child health is extremely poor . The extremely-high-figures regarding Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) reflect it.

What are some of your unanswered questions about the problem(s) you are working to address?

The first problem is around low levels of awareness on sexual and reproductive health and extreme levels of sensitivity to impart knowledge particularly to adolescent age groups. The second major problem is lack of health support services and lack of medical supplies at village level to take care of primary needs. The third problem is about lack of basic nutritive foods/supplies at the community level resulting into malnutrition, low immunity and major health issues.

Explain Your Idea

Our proposal/idea will address above three questions in a holistic way: 1. Form a cadre of Village Health Workers (VHWs) in the rural areas, who will provide their services to women and girls in the areas ante natal care, supplementary nutrition, immunization, maternity services and referral services. This intervention will help in increasing the level of health awareness among women and girls. The VHWs will organize adolescent girls training (AGT) and adolescent boys training (ABT). The training to women and girls, and boys, will be provided through a specially designed online curriculum to be imparted with low cost tablets. 2. Mobile Pharmacy - a cadre of mobile pharmacists will be trained and will be provided with a basic pharmacy kits and bikes. They will travel to women and girls within the villages and will provide them nutritive supplies and basic medication (prescribed mainly for Non-Communicable Diseases) to take care of their primary nutrition and medical needs. There will be am affordable cost on these supplies for sustainability. 3. Developing low cost, drought resistant Household Horticulture Units (HHUs) to grow vegetable and fruits providing vitamins and micro-nutrients, and proving training support to household for maintenance of the units. We believe above three pronged approach will make a significant impact and will improve sexual and reproductive health of our target groups.

Name the three most important ways that your idea will address your identified problem(s).

As described earlier, there are three main components in our idea: 1. The cadre of VHWs and newly designed online curriculum will raise health knowledge in women, adolescent girls and adolescent boys. We will use them as knowledge leaders in the community. 2. Mobile pharmacies will provide nutritional supplements and medical supplies at people's doorsteps at an affordable cost. The services will be sustainable with a cost recovery approach. 3. HHUs will provide all important nutrition to women and adolescents. The holistic model will address multiple aspects of sexual and reproductive health and will be a good replicable model in other regions.

How is your idea unique?

The idea is unique for following reasons: 1. It address the sexual and reproductive health needs of drought affected communities impacted by food and water insecurity. 2. The health education component will be taken up with digital technology, which will be easy to learn and will have a long lasting impact. 3. Mobile pharmacy concept taking supplies to people's door steps has not been used in the past in the Thar Desert and will be very helpful. 4. HHUs is a new experiment which will be totally targeted at nutrition needs. 5. Again, the model is holistic and is replicable for other arid zones.

What are some outstanding concerns or questions that you have regarding your idea?

We will need to work on a good quality inline curriculum for which we will partner with technology experts. To run VHW cadre and mobile pharmacy, we will need good human resources. We will also explore best species for HHUs and their optimum technical designs. GRAVIS is an experienced organization to take up these tasks.

Who are your end users?

Our end users will be women and adolescent living in the remote villages of Thar and who are severely impacted due to food and water insecurity as well as due to lack of medical and public health services. They suffer suffer with a wide range of health problems including anemia, malnutrition and vitamin deficiencies. It is estimated that only 30% pregnant women get anemia prophylaxis coverage in the region. The incidence of infectious diseases such as malaria, tuberculosis and gastro intestinal infections is also very high. Our idea will reach out to about 5,000 women and adolescents.

Where will your idea be implemented?

  • India

What is the primary type of emergency setting where your innovation would operate?

  • Extreme drought

Tell us more about the emergency setting that you intend to implement in

The Thar Desert of India, spread across the state of Rajasthan mainly, is one of the most underdeveloped regions in the world. The region is chronically hit by persistent droughts and communities in the rural parts of Thar are forced to live with poverty, illiteracy and poor health. The number of people living below the poverty line is much higher than the national average in the area. Droughts severely impact the health status of communities.

What is your organization's name?

Gramin Vikas Vigyan Samiti (GRAVIS)

Tell us more about you.

GRAVIS, an NGO based in the Thar Desert of Rajasthan, has been working to empower the rural communities for the last 34 years. It takes an integrated approach towards rural development and emphasizes on water security, food security, education and healthcare. GRAVIS covers over 1,500 villages with its activities and interventions and benefits about 1.3 million people living in Thar. Health has been a major area of GRAVIS’ work and the focus has been on improving the health conditions of women, children and elderly living in Thar. It takes a holistic approach to improve the health status of communities. Keeping this in view, GRAVIS has set up a comprehensive, rural hospital in a village of Thar Desert.

Organizational Characteristics

  • Locally/community-led organization

What is the current scale of your proposed innovation?

  • Community - 1+ communities within 1 country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

Jodhpur, India

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Existing Prototype or Pilot: Tested a part of my solution with users and am iterating.

Website

www.gravis.org.in

How has your idea changed based on feedback?

As a result of the feedback - our idea will now consider using mobile phones as a tool to spread the health messages, will gather local feedback as much as possible to design the curriculum and will have a plan for consultation with the community on adapting to changing needs.

Who will implement this idea?

A GRAVIS team will lead the implementation in close collaboration with Village Health Workers and mobile pharmacists. VHWs will be responsible for health education among women ad girls. Pharmacists will supply medical items.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

We always believe in active community contribution in the designing process. The above project will strengthen our belief in the ideology and will provide us new insights on how to hear from all groups, especially the marginalized ones.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

The biggest challenge faced by our end-users on a daily basis at the individual level is lack of knowledge on sexual and reproductive health. On the system level, the challenge is the mindset in the context of sexual and reproductive health related education, which is not very favorable. We will work to overcome these challanges through our proposed idea.

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

Impact - By 2021, to create an atmosphere in which women and girls are allowed to have most optimum levels of sexual and reproductive health in rural India, directly affecting at least 10,000 women and girls. Question - how do we overcome the barrier, battle with the mindsets that come in the way of sexual and reproductive health education to create a long lasting environment for future.

What is it that most attracted you to Amplify instead of a more traditional funding model?

It is a very good way of co-designing and of improving on the original ideas with the peer feedback.

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • Between 1 and 2 years

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Between 5-10 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • Above $1,000,000 USD

What do you need the most support with for your innovation?

  • Communications/Marketing/Graphic Design

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Hi Prakash Tyagi Achieving Food System Vision goals will be easy if me can create a network with you.

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