In all its projects, Agragami India ensures the reporting of service statistics to measure coverage and outputs. This data is used to monitor project performance and the extent to which specific objectives of projects are being met.
RESULTS OF END-TERM EVALUATIONS:
Three of our projects have had end- term evaluations and the results revealed are presented below.
An important objective of Agragami’s health program is to reduce teenage pregnancies and delay child bearing till the woman is 21 years of age. Multiple benefits accrue from such delay: incidence of low birth-weight is reduced, older mothers are emotionally and psychologically more mature and better able to care for their new-borns, the couple has had time to develop emotional bonds before they welcome a new addition to the family, and the couple is able to earn and save a little before their first child is born. All in all, delaying first birth contributes hugely to family well-being.
Our behaviour change interventions with unmarried adolescent girls aged 15-19 years, teenagers who are engaged to be married, newly-wed teenagers, and pregnant teenagers, focuses on giving the young women an understanding of the benefits of delayed childbearing, and the knowledge and the skills that they need to use contraception to delay the first child. Alongside these inputs, they also receive essential inputs on how to have a safe pregnancy and how to care for the new-born. Care is taken to build confidence in the safety of contraception, and skills of persuasive communication with elders in the family who may put pressure on them to “start a family soon”. Mothers of adolescents are also educated on these issues.
The results of this work are heartening. We analyzed data on the age at first pregnancy of those young women who came to our antenatal care talks/ meetings. Between 2012-2013 and 2016-2017, the percentage of first time pregnant women who are teenagers (15-19 years old) has steadily declined from 26% to 8%, indicating that age at first pregnancy has increased significantly.
INCREASE IN IMMUNIZATION COVERAGE OF CHILDREN AGED 9-12 MONTHS
Since 2012, Agragami has worked closely with the Delhi government’s Health Department and its Integrated Child Development Services department (ICDS) to improve immunization coverage rates in Madanpur Khader. Agragami has provided regular capacity building inputs and supportive supervision to the anganwadi workers in the area. Monthly coordination meetings are held between the ICDS Supervisor and the Medical Officer-in-charge of Shriniwaspuri dispensary, wherein plans are made for holding routine immunization clinics in the area and for mobilizing mothers to bring their children for immunization.
As a result of these efforts, the percentage of children aged 9 months to 1 year who have been completely immunized increased from 18% in 2012-2013 to 79% in 2016-2017.
STORIES OF IMPACT
CHAMPA DEVI: HER SUCCESS STORY IN STOPPING CHILD MARRIAGE
Champa Devi joined Agragami’s Ananya Project as a Discussion leader (DL) and was also a member of the Child Protection Committee (CPC). Agragami organizes various trainings for DLs on issues related to the United Nations Convention on the Rights of the Child (UNCRC), rights of children, ill-effects/consequences of child marriage, a component of sexual and reproductive health called ‘Me and my body’, bullying, gender discrimination etc. Thus DLs become competent in disseminating these issues among adolescents.
Champa Devi gained experience in adolescent issues and was working actively as a DL. So the day that she heard that her sister’s 14-year old daughter Pooja Kumari was being married off, she couldn’t believe it. She called her sister to confirm the news and when her sister confirmed it, Champa Devi rushed to her sister’s house in Tankuppa in Bedala Panchayat in Fatehpur Block, District Gaya.
The family belongs to a marginalized community, which considers a girl child to be a burdensome responsibility, financial and otherwise and best married off as soon as possible. Once the girls in the family are married, the parents consider themselves ‘free’ of the ‘burden’. Though her parents are illiterate, Pooja was studying in class 9 when this decision was made. The parents are poor and earn an annual income of INR 60,000.
Champa Devi was confident she could stop this marriage and knew that she had to prevent child marriage by building the capacity of the village CPC; except this village did not yet have a CPC. So she first met her sister and brother-in-law to find out the reasons behind their wanting to marry Pooja off at such an early age. They told her that they wanted to construct a house and planned to start construction after Pooja’s marriage. If they constructed the house first, then they would not have enough money left to get Pooja married, they said. They also admitted they had not taken Pooja’s consent to the proposed marriage. To them Pooja’s marriage was a burden and a responsibility to get over with as early as possible. They were not at all aware of the negative implications of child marriage.
Having understood the reasoning behind their decision, Champa Devi discussed in detail, all that she had learnt and told her sister all about the training she received under Project Ananya. She also shared information about CPCs and its interest to prevent any child marriage in the village for a better future for all the children. She explained in detail about the ill-effects and consequences of child marriage on a girl’s health. She informed her sister about the legal age of marriage for girls and boys, about the law against child marriage and the punishment for parents and those involved in child marriage.
Once her sister was made aware of all this, she realized that her daughter was not prepared physically and mentally for marriage at 14 years of age. She immediately talked to her husband and decided to stop the marriage and to support Pooja in continuing school. She and her husband also agreed that they would get Pooja married after she turned 18 years old.
Pooja’s mother said, “I want to see my daughter alive, healthy and happy first.” She thanked her sister, DL Champa Devi, and expressed the willingness to go to Mohanpur to attend CPC meetings and the discussion sessions of adolescents, since her own village did not have a CPC. Thus a small effort by Champa Devi to spread knowledge and take immediate action on the same played a vital role in preventing 14-year old Pooja’s marriage.
Pooja is now happy and going to school regularly. She wants to complete Graduation. Champa Devi’s initiative and leadership provides a ray of hope for the community in its endeavours to stop child marriage. Pooja’s mother remains very thankful for the support she received from her sister and the community in saving her lovely daughter’s life. She says, ‘Humne training le liye hai Agragami India se, gaon main committee ban le hal shaadi rukwa we khatir, tuhu 18 saal baad bitiya ke shaadi karwaiya.’ (I have taken training from Agragami, and now we have a committee in the village to stop such marriages. So we’ll get our daughters married only after they turn 18.)
That’s some achievement!
CHANGING A LIFE FOREVER
Eight-year old Aryan Kumar studies in class two in a government school and became a member of his nearest Children’s Activity Centre (CAC) in November 2015. When he came to CAC to get membership, he hesitated to speak and was unable to pronounce words clearly.
Aryan didn’t want to go back to regular school because some children in his class had made fun of him, imitating his pronunciation. His mother was very concerned about how he would complete his education. So Aryan started to attend CAC with other children. Nobody there made fun of him or imitated the way he spoke. Facilitator Sarita Sharma makes sure the children do not imitate others to make fun of them. This was the utmost motivation for Aryan and gradually he started to participate actively in routine activities. He felt that learning was fun for the first time because the activities at CAC included story-reading/telling, drawing, craft-work, dance, games etc., to enhance reading skills and self-expression.
Spending five months at CAC has really made a difference in Aryan’s life. Now he talks with confidence, pronounces words clearly and has even started attending regular school. The CAC facilitator, Sarita Sharma shares that there were many children in CACs who faced similar challenges when they first came in, but later their reading skills and self-expression improved because, “At CAC, we have a way of making the children love learning. We ask them to trace alphabets and pictures, to read/tell stories, do craft-work and drawing; we encourage them to dance and play games. All of this enables children to become interested in studying, inspires them to want to read, and they learn to read and express themselves.”
Aryan’s mother expressed sincere gratitude to Agragami for changing her son’s life and said, “The Children’s Activity Centre has changed his life and now his future will be bright.”
KITCHEN GARDENS: FEEDING FAMILIES, INCREASING INCOME
Promoting kitchen gardens is an important feature of Agragami India’s Khushali Project. In June 2016, the project encouraged 174 families in the 10 intervention villages in Bodhgaya block to set up kitchen gardens. Once they agreed, the project team provided the families with seeds (spinach, lady finger or bhindi, cucumber, pumpkins, jhingi, and bitter gourd or karela), guidance and follow-up.
The team next ensured that all families sowed the seeds as per laid-down scientific guidelines, and provided regular follow-up and guidance in this regard too. Today, these well-maintained gardens produce 3 to 5 kg vegetables daily, thanks to the diligent efforts of the 174 families, supported by the project team.
Reema Devi, who lives in Silaunja village, sowed her kitchen garden about three months ago, receiving technical inputs from an agriculture scientist. She notes, “Now we eat vegetables daily at home, and still have enough to sell. They are an additional source of income. The average productivity of one kitchen garden is 3 to 5 kg, and 1 kg of vegetables sells at Rs. 15 to 20. We don’t need additional land to set up a kitchen garden. It can be grown on a very small piece of land, so the landless can adopt it too. This has ensured the highest level of self-sufficiency.”
Reema Devi feels that all the 174 families have benefitted from Agragami’s efforts, which has led them to invest in kitchen gardens under Project Khushali. Prior to this initiative, she and other families were too poor to even buy vegetables. Growing their own vegetables has helped them in more ways than one:
- the families regularly eat nutritious food, which is improving their nutritional status;
- the intake of an adequate quantity of vegetables is especially significant with regard to improving the health status and balanced growth of children;
- the gardens have provided a new source of income in rural areas where people have limited income-earning opportunities;
- kitchen gardens can be grown on very small pieces of land, and so landless families adopt it easily; and,
- this initiative under the Khushali Project has generated interest among other families too, who now want to have kitchen gardens of their own.
STRENGTHENING MATERNAL AND CHILD HEALTH
Daulti Devi is 35 years old and and lives in the Mushahar tola of Ledhi village, Mohanpur block, Gaya district. Ledhi is a scattered village, surrounded by dense forest and greatly affected by naxal activities. Daulti Devi and her husband Girja Manjhi are a scheduled caste couple with five children — three girls and two boys. They are daily-wage farm labourers. Between them they earn about INR 36,000 a year. Mostly Daulti has to manage her home and care for her children all on her own, as Girja is often engaged in labour work outside the village. She narrates her story in her own words -
‘I was married at 14 and have five children. My first child was born when I was 16. My first four children were born at home. Neither I, nor any of the women in my family wanted to deliver in a hospital. For my fifth pregnancy, Manju didi and Bipin bhaiya counselled me to deliver my baby in a hospital. With their support, I registered my pregnancy at the nearby anganwadi centre (AWC) during a village health and sanitation day celebration. They made me attend group meetings and I got to learn many important things about nutrition, antenatal care, and immunization. Before that, I was completely unaware of these issues. Manju didi helped me get all the antenatal services at the village health and sanitation day meetings. I have been able to follow the right feeding practices for my children. They are healthy, growing well, and have had all their ‘tikas’. My son is now 13 months old and is healthy. I will get him fully immunized.
‘My daughter Manisha was severely malnourished. After I took her to the nutrition rehabilitation centre at Gaya, she got better. I do not want any more children, so I have had a tubectomy. Manju didi helped me in that.’
ASHOK KUMAR SAH: A CHAMPION OF FAMILY PLANNING
Ashok Kumar Sah from Katihar in Bihar, is a businessman and social worker. He owns and operates a successful poultry. At just 34, he is a prominent figure in his community and very active in family planning advocacy- which he undertakes on a purely voluntary basis. Ashok is passionate about the cause of family planning. He believes that everyone should have no more than two children and should maintain space between children. If this is done, every family will be able to take better care of their children and also we would be able to deal with our country’s population problem. He says, “I want people to understand that if we do not do what is right, our karma will punish us.” His advice to the government is to make family planning education mandatory in school, just like yoga. Adolescence is the age at which children need this education. They are growing up and are attracted to the opposite sex and are sometimes liable to act unwisely. Ashok says that if he were given the responsibility, he would go into schools and talk to adolescents about how to avoid risk and use contraceptives to protect themselves from unwanted pregnancy and infection.
Ashok Kumar has 2 children- a boy and a girl. When their first child was born in 2003, he and his wife decided that they wanted to wait for about 4 years for their next child. They achieved this by using the safe day method. After their second child was born, they decided not to have any more children and they continue to use the safe day method to avoid conception. Ashok learned about the safe day method from his study of Ayurveda texts and has found it to be a reliable method.
“Planning my family changed my life,” says Ashok Kumar. He says that he now has ample time to devote to his business and also to serving the community through his family planning advocacy work. This would not have been possible he says, if he and his wife had not spaced their children. They now have a small, healthy, active family. The advantage of the safe day method of family planning is that it requires no medical intervention- he and his wife never had to visit a doctor, nor did they have any problems with contraceptives. However, Ashok is quick to acknowledge that though the safe day method works for him, it may not be to everyone’s preference. He feels that there are so many other good methods of contraception available that people can easily find one that suits their particular requirements.
Ashok Kumar’s community advocacy is aimed at bringing about increased awareness about small families and spacing at the grass roots level in the community. His constant message is, “a small family is a happy family.” He says that he often discusses family planning in the community. He says, “just yesterday there was a shiv charcha and I used the opportunity to speak about the safe day method of avoiding conception. Many women were extremely interested in learning about the method”. Once a Muslim member of his village talked to him about the fact that while he wanted to have no more children, and he and his wife were thinking about adopting tubectomy, members of his family were concerned that tubectomy was a dangerous procedure. Ashok Kumar talked to him, gave him the right information and reassurance, and the wife proceeded to have a tubectomy. That and other similar instances where he has been able to help others, give Ashok great satisfaction.