Health and Sanitation

IIRD aims to create awareness and develop the necessary infrastructure to provide people with healthy and sanitary living conditions.
 

Since the beginnings of its work, IIRD has identified Health And Sanitation as a serious area to be addressed in order to improve living standards of rural people in India. IIRD aims to create awareness and develop the necessary infrastructure to provide people with healthy and sanitary living conditions.

We pursue this goal by providing training sessions and implementing projects and awareness campaigns on sewage treatment, waste and water management, water related diseases prevention and treatment, personal hygienic habits, etc.

Besides acting as an implementing agency, IIRD has been playing an important role as a nodal and consulting agency for governmental and non-governmental institutions by approaching, supporting and engaging the various stakeholders.

By providing access to a safe and adequate water supply and sanitation; training in the improvement of hygiene habits; and training the community to maintain its improved water supply and sanitation facilities through community participation, IIRD has been able to make that much required difference in reduction of water-borne diseases in its areas of intervention

Objectives:


To increase rural people’s access to health services and sanitation providing the infrastructure, know-how and information needed, by creating infrastructure, raising awareness, developing sense of responsibility, building capacity and engaging the stakeholders.

The Program at a Glance

Program

Area and Time

Supporting Agency

No of lives affected (approx)

Rural Sanitation Program

All over Rajasthan 1994- 1997

Rural Development and Panchayati Raj Department (RDPR), Government of Rajasthan

Awareness and training for all NGOs in Rajasthan

Control of Diarrhea Diseases, Water and Sanitation (CDD Watsan)

Alwar District, Rajasthan , 1998- 1999

UNICEF

 

Child’s Environment: Sanitation Hygiene & Water Supply Project

Alwar District, Rajasthan, 1999- 2000

UNICEF

 

Sector Reform Project

Alwar District, Rajasthan, 2000- 2002

UNICEF, Government of Rajasthan

 

Integrated Water, Environment and   Sanitation Programme (IWES)

Alwar and Tonk (Rajasthan)
2000-2006

UNICEF

41.151 Households in 264 villages benefited

Aanchal se Aangan Tak

Jhalrapatan and Khanpur in Jhalawar (Rajasthan, 2006- 2007

UNICEF, Government of India

650 families covered in two blocks

Gram Shakti

Toda Raisingh Block in Tonk district, 2009

UNICEF

About 31 Gram Panchayats, 138 villages and population of 112642

Behaviour Change and Communication

Niwai and Tonk, 2010

UNICEF

1296 people benefited in Tonk, about 860 people benefited in Niwai

Addressing Other Health Issues

Ongoing Process

 

 

Milestones

Rural Sanitation Program

Year: 1994- 1997
Place: All over Rajasthan
Partner Agency: RDPR (GoR)

Objectives:
Provide technical training to state employees and other NGOs

Impact:
IIRD’s involvement in technical training and evaluating programs marked the beginning of its work in this field. The Rural Sanitation Program, supported by the Rural Development and Panchayati Raj Department (RDPR), GoR, was the first of such projects.

From 1994 to 1997 the IIRD was entrusted to provide technical training to state functionaries and other NGOs responsible for the supervision and implementation of sanitation projects all over Rajasthan. Employees from the district to the grass-root level were trained and a favorable environment for the better implementation of sanitation interventions was created.

As a result, a greater number of blocks and villages had sanitary latrines and soak pits put in place and maintained, and a great amount of people, especially women and children, was aware of the importance of personal hygiene, food handling and diarrhea prevention.

From 1997 to 2004, with the support of UNICEF and other partners, IIRD implemented important Water & Sanitation programs with the ultimate purpose of fighting morbidity and mortality mainly caused by water related diseases among women and infant children.

Control of Diarrhea Diseases, Water and Sanitation (CDD Watsan)

Year: 1998- 1999
Partner Agency: UNICEF
Place: Alwar District, Rajasthan

Objectives:
Reduce diarrhea diseases incidence in 430 households of 156 villages of Alwar District by focusing on mother and children hygienic habits and by providing safe drinking water and sanitary facilities.

Impact:
The UNICEF supported project, Control of Diarrhea Diseases, Water and Sanitation (CDD Watsan), implemented from 1998 to 1999 marked IIRD’s turning point to become a field based implementing agency. The project targeted In order to achieve such goals a number of activities were organized including awareness camps, formation of Mahila Mandals (women representatives committees) and Panee Panchayats (water management committees), leaders orientation camps, Village Contact Drive, polio immunization campaign, technical training on hand pump and masonry. The table below depicts the specific interventions and their achievements:

Figures:
Through 17 training sessions for engineers, women hand pump caretakers, local animators and masons, 479 people were trained
34 awareness camps in which 1720 mothers participated were undertaken
Mahila Mandals were formed and monthly meeting to discuss health and sanitation issues were held
One Panee Panchayat was formed in each village to enable women representatives to take responsibility over water management decisions
50 orientation (1813 participants) camps for the Panee Panchayats members were conducted
63 Village Contact Drive were organized, mobilizing 11917 people from the communities benefited
Polio Immunization Campaign - 17.031 children of 0-5 years were given polio double dosage vaccine

Child’s Environment: Sanitation Hygiene & Water Supply Project

Year: 1999- 2000
Partner Agency: UNICEF
Place: Alwar District, Rajasthan

Objectives:
Reduce diarrhea diseases incidence in other villages and blocks of Alwar District by focusing on mother and children hygienic habits and by providing safe drinking water and sanitary facilities.

Impact:
Based on the fruitful efforts and achievements of the CDD Watsan Project, from 1999 to 2000, Child’s Environment: Sanitation Hygiene & Water Supply Project was sanctioned to continue the work in Alwar area.

Figures:
Financed by UNICEF and DFID, the project was initially implemented in 191 villages of the 12 blocks, which had been previously covered; but further extended to cover 205 other Gram Panchayats all over the 14 blocks of Alwar District.

Sector Reform Project

Year: 2000- 2002
Partner Agency: UNICEF
Place: Alwar District, Rajasthan

Objectives:
Provide safe drinking water through the encouragement and reinforcement of local participation in water management processes.

Impact:
Along with the IWES, the Sector Reform Project was also implemented in the blocks of Rambargh and Laxmangargh in Alwar District from 2000 to 2002, sponsored by UNICEF in partnership with the Government of Rajasthan. The necessary infrastructure was given, and shared responsibilities were taken with the creation of Village Water and Sanitation Committees (VWSC). For the full implementation of the project, IIRD was chosen as one of three NGOs to coordinate the implementing agencies in five other blocks of the district.

Integrated Water, Environment and Sanitation Programme (IWES)

Year: 2000- 2006
Partner Agency: UNICEF
Place: Alwar and Tonk District, Rajasthan

Objectives:
Ensure community’s participation and ownership of the initiatives through decentralization of the responsibilities by involving the Panchayats and creating grassroot committees. 

Impact:
Broadening the perspective from the individual level, which focused on women and children, to the community level, involving whole villages, the Integrated Water Environment and Sanitation Project (IWES) started to be implemented in the districts of Alwar and Tonk in 2000. IIRD acted as the implementing agency in the blocks of Ramgarh and Laxmangargh in Alwar, and Todaraisingh, in Tonk. In other 14 blocks of Alwar, IIRD was the nodal agency.

Water User Groups (WUG) were formed to take responsibility over the operation and maintenance of the water supply system in the villages. Some of the WUG members were later linked to SHGs.

The village sanitation plans were implemented with the support of the Gram Panchayats and Panchayat Semites. And water and sanitation committees were formed to develop village sanitation plans water supply, sanitation, health services, school sanitation and other developmental works.

The committee and WUG members were also responsible for raising local contributions to be invested in infrastructure. Training sessions for hand pump mechanics were organized, hand pump repair tool kits were distributed at Panchayat level and rainwater-harvesting systems were constructed. Additionally, a Borehole System for safe disposal of wastewater from the hand pumps was installed.

Figures:
41.151 Households in 264 villages benefited

Aanchal se Aangan Tak, 2006- 2007

Year: 2006- 2007
Partner Agency: UNICEF, Government of India
Place: Jhalrapatan and Khanpur in Jhalawar

Objectives:
Strengthen the ICDS program so as to achieve its goal of improving child survival, growth and development.

Impact:
Through a series of community meetings, orientation programs and mobilizing networks, all were explained the importance of immunization in the eradication of diseases like polio etc, the need for sufficient nutrition for the mother-child for a healthy life, breast feeding, medical check ups at regular intervals, hygienic and sanitary habits formation, etc.

Capacity Building was an integral part of the program, in which the Anganwadi workers and other working professionals committed to the cause of mother child health were taught the following:

  • Ensuring proper feeding among rural children.
  • Entrusting mothers for proper nutrition to themselves as well as their infants and other family members
  • Taking birth control measures
  • Creating a practice of proper nutrition
  • Removing the fear of immunization to pregnant women
  • Creating the spirit of Health is Wealth
  • Abolishing the traditional discrimination of gender and pursuing Gender Equality
  • Avoid the spread of such diseases that can be cured through proper nutrition


Figures:
650 families covered in two blocks

Behavior Change and Communication

Year: 2009
Partner Agency: UNICEF
Place: Toda Raisingh Block in Tonk district

Objectives:
Implement integrated communication strategies to contribute to IMR and malnutrition reduction, a clean environment, HIV prevention, and enrolment and retention of girls in school.

Impact:
Designed for improving awareness among the communities to identify loopholes in the existing poor indicators, village volunteers were trained in undertaking BCC campaigns,-  conducting rallies, having focused group discussions with community, contact drives and such events in the community.
The areas of concern were related to issues like hand washing, exclusive breast-feeding, immunization, infant feeding and weaning, importance of girl child education and role of PRIs, service providers and the community in improving indicators. About 31 Gram Panchayats, 138 villages and population of 112642 were roped in the program for behavior development.

Thus a large scale network of community mobilizers, young people and change agents trained in effective interpersonal communication who engage on a sustained and frequent basis with vulnerable families, was built and communicated with great efficacy around key facts. And so, integrated IEC plans were implemented and monitored in priority districts across key departments.

Figures:
As a result, 80% Families and individuals adopting and maintaining behaviors in four key areas from the starting point of the 2005 baseline to reduce IMR, MMR, child malnutrition, hand washing, girls education, EBF and TCF and HIV/AIDS.

Behavior Change and Communication

Year: 2010
Partner Agency: UNICEF
Place: Niwai Block in Tonk district

Objectives:
Develop strategic communication components of programs in maternal and child health and nutrition, water, sanitation and hygiene, basic education, child protection and HIV/AIDS. The goal was to influence positive behaviors among children, families and communities towards issues in health and sanitation.

Impact:
To orient and inform people on the four indicators i.e. Exclusive breast feeding, Girl child education, knowledge about HIV/AIDS and hand washing, IIRD engaged in capacity building of Gram Panchayat, PRI, VYV and other involved agencies, by bringing them together under one umbrella, reorienting them for counseling sessions , etc. Also, adolescent girls, both literate and semi-literate, were bought together under Meena Manch, to build capacity of these girls to enable them to discuss on four indicators among their peer group.

Figures:
40 Meena Manch were formed and 500 girls joined the program. Programs and activities such as School Children Rallies, Film Show, FGDs, Swasthya Chetna Yatra, Ujale ki Aur awareness initiative, Hand Washing Day, World AIDS Day, were organized and heavy participation was seen. While 1296 people benefited in Tonk, about 860 people benefited in Niwai.

Addressing Other Health Issues

Beyond IIRD’s involvement in sanitation projects, other important issues like hospital waste management, HIV/AIDS, tuberculosis and hepatitis B prevention, and water defluoridation, have also been addressed by our projects.

Hospital Waste Management

The hazardous problems caused by the improper disposal of hospital waste became a matter of concern in India since the enforcement of the Bio Medical Waste Management and Handling law. Established in 1998, it specifies procedures for proper collection, treatment, transport, storage and disposal of hospital waste. Because of that, IIRD started to address the issue by organizing training sessions and workshops to the hospitals community.   

In 1998, in partnership with the Ministry of Medical and Health Services and the World Health Organization (WHO), IIRD organized the National Workshop on Hospital Waste Management. It allowed concerned actors to intensively discuss the issue of waste management and thereby exchange ideas and solutions. And in 2000, IIRD conducted a five-day Orientation Training Program on Waste Management supported by the Ministry of Environment and Forest for doctors, nursing staff, ward boys and safai karmcharis of hospitals in Jaipur.

Avoiding Hepatitis B and Tuberculosis among Female Rag Pickers

In 2000, the DST GOI launched the project Socio Economic Upliftment and Reduction of Occupation of Hazards, Hepatitis B and Tuberculosis among Women Rag Pickers in order to enlist women rag pickers, assess their social and health conditions and provide interventions to their socio and economic upliftment. In Jaipur 273 slums were selected and a total number of 1500 women have been identified. Out of these, 1012 women were trained on overall health and rag picking issues. Twenty medical camps were conducted to identify the heath status of women and children in the community, followed by 50 blood testing camps. Twenty-five awareness-training programs were consequently held to raise awareness on HIV/AIDS prevention, child nutrition and health and immunization. Having identified the positive cases of tuberculosis and hepatitis B, eighty-five follow-up visits were organized to counsel women during the treatment process.

Defluoridation of Water

The excessive consumption of fluoride (more than 0.8 ppm) can cause serious health problems by affecting the calcium retention on human body’s joints, teeth and bones in general. In Rajasthan, high levels of fluoride can be found in the water provided by the public services and because of that young and old people have been suffering from skeletal fluorosis, teeth loss, etc. To educate people about the serious consequences of it and to demonstrate simple defluoridation technologies is found to be the most pragmatic way of solving the problem. Thus, from 2001 to 2003 the IIRD was entrusted by the DPS, GoR to promote domestic defluoridation in Tonk District through awareness raising initiatives, skill training on domestic deflouridation technologies and rainwater harvesting systems. As a result, for example, after three rainfalls the water contained in the five hand pumps that were renovated and connected to the rainwater harvest system in Niwai Block, had their fluoride level decreased from 6.8 ppm to 1.8 ppm.

Identifying the Needs

As a complementary part of its work as a technical and training agency, IIRD has also been involved in research study projects on different subjects concerning health and sanitation.

Between 1995 and 2003 UNICEF and its governmental partners entrusted the IIRD team to conduct a number of Multi Indicator Cluster Surveys (MICS). The primary objective of the MICS is to collect information about the overall health and sanitation condition of a specific target group, with the ultimate goal of drawing policy makers’ and development agencies’ attention towards their plight and thereby accelerating the formulation of effective public policies on social development.

From the several MICS conducted by IIRD’s team in the different geographical areas throughout these years, common recommendations could be formulated concerning the data compiled. They are as follows:
1-  Breast feeding practice, weaning, Ante Natal Care, Post Natal Care and nutritional aspects should be addressed by in-depth IEC activities
2- Awareness camps on HIV/AIDS need to be organized with the involvement of local leaders and other stakeholders;
3- Immunization Cards have to be systematically distributed and updated;
4- The benefits of using ionized salt should be amply explained and promoted;
5- Education of girls needs to be given special attention. Primary education may be supplemented by vocational courses;
6-Muslim religious leaders should be actively involved in raising awareness activities on hand washing practices among the Muslim community;
7- Access to safe drinking water has to be provided.

The involvement of IIRD’s team in these surveys was of significant importance for its understanding about the most deprived urban population’s living conditions. Thus it enhanced its engagement with the concerning bodies by providing them with consisting data, submitting need based project proposals and playing a proactive advocacy role.

 

Success stories


When Santosh realized that her son was grossly underweight, she immediately went to the Anganwadi center in the village. Not only did her son recover in a span of a week, she was also counseled regarding correct feeding practices and care.

Now he has regained significant weight and is recovering fast.  He has a better appetite and weight gain.

-    Santosh, Housewife and Landless Labourer, Khanpur, Jhalawar

Through the Integrated early child development (IECD) Program, Sita, a young girl, committed herself to the welfare of the village. Her initiatives display a good blend of public enthusiasm, community initiatives and family based care for children. It not only demonstrates the perfect life cycle approach, but also many other best practices.

 “I take proper care of health and hygienic aspects of my village. When women come to the AWC, we talk about breastfeeding, child feeding, IFA consumption and even concerns like child spacing. Adolescent girls have also become a part of these groups.

                                                                                                                                                           -  Sita, Anganwadi Worker, Niwai