Unicef Programs

Promoting basic health practices to save young lives in Niger's remote villages

© UNICEF Niger/2008/Bisin

Community facilitator Bassira Rabey illustrates proper handwashing with soap in Oumba village, southern Niger.

In the run-up to the 20th anniversary of the Convention on the Rights of the Child – a landmark international agreement on the basic human rights of all children – UNICEF is featuring a series of stories about progress made and challenges that remain. Here is one of those stories.

By Sandra Bisin

OUMBA VILLAGE, Niger, 21 July 2009 – Bassira Rabey is a community facilitator who goes from door-to-door in her rural village to make sure that families, especially women, are maintaining a proper environment to improve their children’s health.

Ms. Rabey is part of a network of 101 facilitators who have been trained to promote essential family practices for child care within their communities. This initiative is at the forefront of UNICEF’s strategy to contribute to improving child survival rates in Niger by 2013.

Benefits for child health

“Since I started these activities in the village, I have already seen major changes in behaviours," said Ms. Rabey. “When I first visit them and tell them about these practices, they do not always cooperate. But after a couple of visits, they start understanding and seeing the benefits for their children’s health.”

The community facilitators focus on four major health interventions: exclusive breastfeeding up to six months of age; the use of insecticide-treated bed nets by pregnant women, and by children under the age of five; the use of oral rehydration salts to manage diarrhoeal dehydration; and regular handwashing with soap.

The challenges are vast. One in five children in Niger dies before reaching his or her fifth birthday. Only 9 per cent of women practice exclusive breastfeeding for the first six months, most children under five do not sleep under insecticide-treated bed nets and only 7 per cent of households have improved sanitation facilities.

© UNICEF Niger/2008/Bisin

Bassira Rabey demonstrates the proper position for breastfeeding to Zina Hamidou, 20, in Oumba village.

One household at a time

As part of her community work, Ms. Rabey visited the home of 40-year-old Hadiza Hamidou and her two daughters. She looked around the home and pointed out places where the family could practice better hygiene. Then she demonstrated the correct procedure for handwashing with soap to the family as well as neighbours who had gathered around the home.

Pointing at two traditional clay water containers, Ms. Rabey told the family: “You should keep them covered all the time or else dirt and dust will get in there and spoil the water. Unsafe water will, in turn, cause diarrhoea and lots of other diseases among your children.”

Ms. Hamidou’s daughter Zina, 20, was trying to breastfeed her infant daughter, but the baby was constantly crying. Ms. Rabey knelt towards Zina and took the baby in her arms, modelling the correct horizontal position for effective breastfeeding.

“I wish I had known all this before,” said Ms. Hamidou. “Rabey has really opened my eyes on these issues. I want my daughter’s children to be in good health, and I will now pay more attention to keeping our environment hygienic.”

A multi-pronged approach

The health-practices programme is currently being piloted in the region of Maradi, in southern Niger, and will progressively be scaled up to the whole country.

In addition to making door-to-door visits, the facilitators organize group discussions that involve community and religious leaders. Also in place is an itinerant cinema showing films that promote essential family practices.

“Through this approach, which uses interpersonal communication, community mobilization as well as the communication by proximity media – such as community radio stations – and advocacy at the community level, we are aiming to create an environment that encourages the adoption of these essential practices,” said UNICEF Niger Communication Officer Violeta Cojocaru. “Families have an essential role to play if we want to win this battle for child survival.”

Vitamin-A supplementation program in Bihar

JOINT PROGRAM OF STATE HEALTH SOCIETY,BIHAR & UNICEF
Vitamin 'A'
In 1997-98 Vitamin 'A' program had been started with the help of World Health
Organization and Indian Council of Medical Report (ICMR). As per the survey report of
NFHS II the objective was to strengthen both Vitamin 'A' and routine Immunization in
complementary way. Therefore looking at the need of the time it was decided to initiate
the process with UNICEF in the year 2000-2001 under the Netra Jyoti Campaigns. Since
the merger of Vitamin-A and Routine immunization in the State it is still continuing with
the coordination of UNICEF and State Health Society, Bihar.
Objectives of the Programme
As per the Programme policy led by GOI Department of Health, Ministry of Health and
family welfare Department of family Welfare child health Division it has been decided to
administer Vitamin A supplement to all children Nine month to Five Years of age vide
letter no Z.28020/30/2003-CH dated: 2nd November 2006.
State Health Society and Government of Bihar has been successfully undertaking
Vitamin 'A' supplementation Programme for preschool children. It has therefore been
decided to undertake the respective programmes for the children of the age group 9
Months to 5 Years in all the 38 District of state following the biannual fixed day strategy
linked with Routine Immunization. Children of 9 months to 5 Years of age would be
covered with six monthly doses of Vitamin A syrup.
Regular Vaccination Program of Vitamin 'A'
− In all the States in India 'Wednesday' and 'Saturday' is marked as a regular
vaccination day.
− During this schedule Micro plans were cultivated.
− Strengthening this regular vaccination program various meetings were organized
with Primary health centers (PHC), Health Sub Centers (HSC) and Aangan wari
centers (AWC).
− While the way of Jaccha Baccha Card and M.C.H.N register, society
dependent orientation had been started. For the age group of 9m-36m child Jaccha
Baccha Cards were spread upto HSCs.
− District Field Monitors (DFM) were appointed with the help of State Health
Society and UNICEF which included different groups of people, who were
trained at State Level. The roles of DFMS varied from strengthening the program
to assisting the State level employees.
SHSB
Vitamin 'A'

Vitamin 'A' Supplementation Program in Bihar
Vitamin 'A' first and second catch up round was scheduled from 19th to 21st April 06 and
28th Nov to 1st Dec '06 in all the 38 Districts of Bihar as a result of which 77 Lakhs and
79 Lakhs children were benefited by Vitamin 'A' Syrup respectively. The aggregate
percentage of which accounts to 89.94 for first and 95.10 for the second catch up round .
In order to execute the Works related to Vitamin 'A' Program in the District to the grass
root level the services of District Field Monitors (DFM) are being taken, who render their
services on short-term assignment by UNICEF. They have been stationed in the allotted
District to strengthen the program since the very beginning till the finalization of the
Reports and UC and SOE.
Activities before the catch up round
• Different types of IEC materials were developed for Advocacy and propagation of
information regarding the Vitamin 'A' catch up Round.
• The meetings at all the levels were organized ranging from Primary Health Center
to the Health Sub centers with the coordination of District Field Monitors, District
Level Officials and Block Level Officials.
• Special Mobile Drive campaign was launched for covering the children of hard to
reach areas so that no child could be left out.
Following Strategies were followed during the Second Catch Up Round with Mobile
Van approach for Hard-to-Reach areas:
Date Day Centre Approach Mobile Van Approach
28.11.06 Tuesday Advocacy and Communication of
Messages through Mobile Van
-
29.11.06 Wednesday Administering Vitamin Syrup to the
Children with the help of Anganwadi
Workers
Advocacy and
Communication of
Messages through
Mobile Van
30.11.06 Thursday With the help of Door to Door approach
administering the syrup to the left out
children
Administering Vitamin
Syrup to the Children
with the help of Mobile
vans
01.11.06 Friday To go to each and every House with the
help of the workers
Administering Vitamin
Syrup to the Children
with the help of Mobile
vans
SHSB
Vitamin 'A'

Role and Responsibility of (District Field Monitors) DFM
1. Assisting in Conducting Vitamin ‘A’ Catch Up round Biannually in their District.
2. Support in monitoring of PHC’s (Primary Health Center) during the Catch Up
round.
3. Organizing meetings in District, PHCs, HSCs with CS (Civil Surgeon), DIO
(District Immunization Officer), DEO (District Education Officials), MOIC (MO
Incharg), MO (Medical Officers), AWC (Angan Wari Centers), HS (Health
Supervisor), AWW (Angan wari workers) and Others supportive person.
4. Preparation of Coverage Reports on the basis of Census data.
5. Preparing reports on UC (Utilization Certificate) and SOE (Statement of
Expenditure Certificate) of their funds.
6. Monitoring of Population of PHC given by District, Account of Coverage Report.
7. Training and Sensitization.
Importance of Catch Up round Coverage Report:
• Coverage report reflects the radiant beauty of your hard work over the catch
up round.
• Coverage reports of the round are the most important aspect, which shows the
achievement of your district.
• It also shows the percentage coverage of PHC’s as per district.
• It represents, number of targeted beneficiaries covered during the round and
number of children who were administered.

Some points to be viewed while making Coverage Reports of Catch Up
rounds:
• While checking coverage reports given by districts, we found that they made
silly mistakes which make their exceptional coverage reports vulnerable.
• There are variations in calculation of Target Beneficiaries made by various
districts.
• As we know The Target Beneficiaries is fixed as 8.5% for 9m-36m and 5.7%
for 37m-60m of the Total Population of PHC.
• But different district made different calculation for Target Beneficiaries.
• Some says that they would not be able to change the Target Beneficiaries on
8.5% it is fixed as per District.
• Some district gives their Target beneficiaries 2.5% for 9m-12m and 6% for
13m-36m and accounts their percentage of achievement according to them.
• Some other complained that the coverage report made by "Computer Babu"
and the mistake is done by them not by him.
• Some Covering Letters came here with the sign of DFM it self instead signed
by CS (Civil Surgeon).
SHSB
Vitamin 'A'

Achievement

YEAR Percntage of Coverage %
2004 73.93
2005 84.55
2006 95.10

Looking at the previously mentioned table, we say that our Vitamin 'A' Supplementation
has been rising above and now it shows all time highest 95.10% coverage.
Practical Notes
− Preparation of Coverage report must be on the basis of above mentioned points.
− Coverage reports should be accompanied with the covering letter duly signed by
civil surgeon.
− The correct Coverage reports were prepared on the basis of originals only

Homeless People

Banjaras are nomadic tribes found in Andhra Pradesh, Bihar, Madhya Pradesh, Himachal Pradesh, Gujarat, Tamil Nadu, Maharashtra, Karnataka, Orissa and West Bengal. The banjaras are believed to be descendants of the Roma gypsies of Europe who migrated through the rugged mountains of Afghanistan, to settle down in the deserts of Rajasthan in India 2300 years ago. These tribes are related to European gypsies, who probably migrated from India.
Banjaras are known by different names such as Lamani, Lambadi, Bangala, Banjori, Banjuri, Gohar-Herkeri, Goola, Gurmarti, Kora, Labhani Muka, Lambara, Lavani, Lemadi, Lumadale, Sugali, Tanda, Vanjari, Waji, Gormati and Singali. They speak Lamani language.

Their occupations are gathering of forest products and agriculture. Banjara women wear a full length skirt with borders embroidered in mustard and green thread. They also wear pretty silver anklets. Silver, brass, gold, cowries, ivory, animal bone and even plastic are used in making a Banjara wardrobe. These tribes are experts in traditional hand embroidery with mirror works.

They worship Lakshmi, the Goddess of prosperity. The hundreds of cowries that the Banjara tribal women wear are very auspicious as they represent Lakshmi.Banjara tribes of Andhra Pradesh celebrate Holi. A variety of dance forms are performed during this occasion.

Women in the workforce-Importance of Sex

Forget China, India and the internet: economic growth is driven by women

EVEN today in the modern, developed world, surveys show that parents still prefer to have a boy rather than a girl. One longstanding reason why boys have been seen as a greater blessing has been that they are expected to become better economic providers for their parents' old age. Yet it is time for parents to think again. Girls may now be a better investment.

Girls get better grades at school than boys, and in most developed countries more women than men go to university. Women will thus be better equipped for the new jobs of the 21st century, in which brains count a lot more than brawn. In Britain far more women than men are now training to become doctors. And women are more likely to provide sound advice on investing their parents' nest egg: surveys show that women consistently achieve higher financial returns than men do.

Furthermore, the increase in female employment in the rich world has been the main driving force of growth in the past couple of decades. Those women have contributed more to global GDP growth than have either new technology or the new giants, China and India (see article). Add the value of housework and child-rearing, and women probably account for just over half of world output. It is true that women still get paid less and few make it to the top of companies, but, as prejudice fades over coming years, women will have great scope to boost their productivity—and incomes.


Governments, too, should embrace the potential of women. Women complain (rightly) of centuries of exploitation. Yet, to an economist, women are not exploited enough: they are the world's most under-utilised resource; getting more of them into work is part of the solution to many economic woes, including shrinking populations and poverty.

Some people fret that if more women work rather than mind their children, this will boost GDP but create negative social externalities, such as a lower birth rate. Yet developed countries where more women work, such as Sweden and America, actually have higher birth rates than Japan and Italy, where women stay at home. Others fear that women's move into the paid labour force can come at the expense of children. Yet the evidence for this is mixed. For instance, a study by Suzanne Bianchi at Maryland University finds that mothers spent the same time, on average, on childcare in 2003 as in 1965. The increase in work outside the home was offset by less housework—and less spare time and less sleep.

A woman's world
What is clear is that in countries such as Japan, Germany and Italy, which are all troubled by the demographics of shrinking populations, far fewer women work than in America, let alone Sweden. If female labour-force participation in these countries rose to American levels, it would give a helpful boost to these countries' growth rates. Likewise, in developing countries where girls are less likely to go to school than boys, investing in education would deliver huge economic and social returns. Not only will educated women be more productive, but they will also bring up better educated and healthier children. More women in government could also boost economic growth: studies show that women are more likely to spend money on improving health, education, infrastructure and poverty and less likely to waste it on tanks and bombs.

It used to be said that women must do twice as well as men to be thought half as good. Luckily that is not so difficult.


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