State Level Jansamvad onCommunity Based Monitoring to Improve Informed Choice and Quality of Care in Family Planning - Bihar
Place: A N Sinha Institute, Patna
Date: 10 July, 2014, between 10.30 am to 6.30 pm. Please do join us there.
On the eve of the World Population Day, Bihar Health Watch Forum along with the National Coalition Against Coercive Population Policies (NC-TCN), Centre for Health and Social Justice (CHSJ) with financial support from OXFAM and AJWS (American Jewish World Service) is organising a Bihar State Level Public Dialogue on July 10, 2014.
Background and the Process
Family planning within the context of health is one of the flagship programmes of the Government of India. India started its national family planning programme in 1951 and has a long and chequered history. First there was an obsessive fear of explosive population growth which led to the introduction of coercive components like targets, incentives and penalties for the community as well as the health worker. The programme was often reduced to provision of female sterilisation in rapidly conducted sterilisation camps where the quality of surgery was very poor. After signing on to the Program of Action of the International Conference on Population and Development (ICPD, 1994), the Government of India made many changes in the way the family planning programme was designed and implemented. Method specific targets were abandoned; standard operating procedures and quality assurance mechanisms were introduced. Today the Government of India has shifted its programme focus from female sterilisation to an approach focusing more on birth spacing and temporary methods. However, India is a large country and manner in which programmes are delivered on the ground can be very different from the policy intentions. There is need to understand whether couples especially women can access high quality family planning services according to their needs and choice which is the true intention of the family planning programme.
Community based monitoring (CBM) methodology has been developed within the auspices of the National Rural Health Mission to understand the communities’ experience of service delivery. It is also seen as an integral component of community participation as well as of accountability mechanisms, and is aimed at improving the quality of services demanded by the community and delivered by the health system. CBM methodology has been used in this initiative since it increases participation of the community and civil society organisations.
In an effort to strengthen people’s access to quality family planning services and build understanding on quality of care in family planning, four Civil Society Organisations undertook community based monitoring on family planning services in selected villages in five districts of Bihar, Bhagalpur, Kishanganj, Nawada, Nalanda and Patna. The CBM exercise included discussions with women where the experience of women who are intended as well as actual beneficiaries of the family planning programme was understood. Interviews were conducted with a selected group of ASHAs in each district and the Medical Officer and ANM of one Block in each district were also interviewed. The district level public dialogues based on the findings of community based monitoring has been undertaken in five districts of Bihar during last two months focussing on informed choice and quality of care in family planning.
In district level Jansamvad, score cards with findings and experiences of family planning users were shared with community, health service providers, Panchayati Raj Institution (PRI) members and media. The service providers accepted that there was lack of counselling from the providers’ side. The service providers also accepted that they only emphasised on female sterilisations in order to meet their target set by State Government and other spacing/family planning methods were not given as a choice to the community. The ASHAs shared their problems as motivators and service providers. ASHAs who were present in the district level Jansamvad told that they were never provided any kit or Information Education and Communication (IEC) materials of different family planning methods to demonstrate among community. The service providers accepted that there was no regular supply of family planning services to the facility.
With the aim of presenting these district level score cards at a state level and discussing the findings from the monitoring process, and issues emerging out of the district level public dialogues with state level senior health officials, politicians, policy makers, lawyers, media and communities, NGO partners, networks, a state level public dialogue is being orgnaised.
In this State Level Public Dialogue, we will have representatives of government, health and human rights advocates, politicians, media, community leaders and community (beneficiaries and users) would share their views and experiences. An expert panel discussion will be held for articulating how the government family planning policies and programmes in India need to address contemporary family planning and quality of care issues and bring in new perspectives into these discussions.
The main objectives are
To share the findings and case studies/testimonials derived from the community based monitoring process in five districts of Bihar
To facilitate open discussion on the issues related to quality of care in family planning with policy makers, family planning experts, politicians, lawyers and with the community
To formulate public policy recommendations and strategy for sustained policy advocacy at state level and National level.
Participants The state level public dialogue is expected to bring together about 100 person which will include women and the community representatives from the five study districts of Bihar, NGO and different networks partners from across the state as well as health department representatives, health and family planning issue experts, media persons, lawyers, and peoples representatives.
We hope that the evidence based findings will serve as a reality check for the community and service providers and bring some positive changes to the family planning services of Bihar State.