In India, only 61% of children between 12-23 months are fully immunised against the six major preventable diseases (Coverage Evaluation Survey 2009). Nearly 70% of children under 5 years of age suffer from anaemia. Only 51% of women undergo at least three ante natal care visits. Less than 40 percent of births take place in health facilities. (NFHS 3, 2005-2006)
As India’s investments in health have been growing over the past decade and the National Health Mission has been seeking to expand availability of healthcare, the main challenge remains to ensure access in service utilisation by all, especially the poor. CINI works at the family, community, institutional and government levels to bridge the gap between service providers and service users. It helps deprived communities acquire information, knowledge and capacity to access healthcare services. In parallel, CINI trains health service providers, such as government frontline community health ASHA workers, to act as effective healthcare agents as mandated by the National Health Mission, which has entrusted CINI to function as the West Bengal State Nodal Agency (SNA).
Trained and motivated local women, organised in Self-Help Groups or acting as community-level workers, interact with families to facilitate access to primary health care services for women and children residing in villages and slum areas. With the help of community mapping and Mother and Child Protection (MCP) Cards, we make sure that no one is left unserved.
We educate communities in issues relating to child health, reproductive and sexual health, including HIV/AIDS, and appropriate hygienic practices to prevent common illnesses at home. We motivate families to seek full immunisation coverage, periodic ante-natal check-ups and diagnostic tests during pregnancy, and early treatment in case of illness. We pay special attention to adolescent health, addressing reproductive and sexual health to prevent sexually transmitted diseases, early and unwanted pregnancy, and Reproductive Tract Infections (RTI). We mainly seek to empower young people with knowledge on the physical, psychological and emotional changes that take place during puberty and adolescence.
At the daily and weekly clinics, such as the Thursday Clinic conducted on our main campus in Daulatpur on the fringes of Kolkata, woman and child clinics are run to provide outpatient care, nutrition and health counselling and treatment of reproductive tract infections. Pregnant women and women with children up to the age of five can consult doctors and health workers about ante-natal care, breastfeeding, nutrition, vaccination and childhood illnesses.
Fighting HIV/AIDS has been a core activity in recent years by the CINI Bhandan Unit. We identify positive cases in the community and in high risk population, and offer voluntary counselling and testing while maintaining confidentiality. We collaborate with HIV/AIDS Positive Networks for training and project implementation to protect orphans and children of HIV-positive patients. The National Aids Control Organisation (NACO) and the West Bengal State Aids Control Society (WBSACS) have entrusted us with training Link Workers responsible for identification, voluntary counselling and testing (VCT) and referral for treatment of HIV cases in the community.
Our community health thrust has been achieved especially through the ‘Community Health through Community Management Initiative’ (CHCMI) funded by the State Government under the National Health Mission, through which we serve 5 districts and 13 million population in West Bengal. CHCMI has given an opportunity to deliver health services through our institutional approach, Child and Woman Friendly Communities, involving the Panchayat, Self-Help Groups (SHGs) and health service providers to map the needs of families and respond through community action, focusing on women and children to improve health and nutrition status during the first 1000 days of the child’s life and pregnancy.