PROGRAMME VISION
Our goal is to evolve and support innovative public healthcare strategies that are accessible and affordable. Our programmes focus on
Health planning and prevention of communicable and non-communicable diseases
Health promotion, empowerment and development with emphasis on primary healthcare, adolescent health and policy-advocacy
PROGRAMME APPROACH
Knowledge and information are essential for people to successfully respond to the opportunities and challenges of social, economic and technological changes. But to be useful, knowledge and information must be effectively communicated to people.
What does effective health communication do?
Effective health communication:
Saves lives
Prevents the spread of diseases
Improves services
Increases social involvement
Cuts costs
Reduces the impact of poverty
Some approaches used in our programme for effective health communication include: information dissemination and education, behavior change, social marketing, social mobilization, media advocacy, communication for social change, participatory development communication, extension education and edutainment.
RAJIV GANDHI WORKFORCE - SOLIDARITY FOR ACTION AGAINST HIV/AIDS
Project Goal: To provide a platform to General Practitioners and Civil Society to use their collective strength for the prevention, control and management of HIV/AIDS in the rights perspective.
Communication Approaches: Extension Education and Societal Action
Area of Operation: Delhi, Mumbai , and the North-Eastern States.
Beneficiaries: General Practitioners and NGOs
Duration of the project: One year to train and operationalise the workforce in an area
Background: With the advent of HIV/AIDS in India in 1986, preventive programmes were started at an early stage to combat the virus. However, the strategies lacked involvement of different stakeholders. The Foundation sees HIV as a multi- dimensional problem with social, cultural, legal, economic and medical aspects, all of which must be tackled through the coordinated efforts of various partners. In its efforts to evolve an effective strategy for the prevention, control and management of HIV/AIDS since 1996, the Foundation has created a mutually supportive network - the Rajiv Gandhi Workforce - of General Practitioners (GPs) and Non-Governmental Organisations (NGOs) to ensure convergence of efforts.
Aspects of social change: Having regard to the esteem in which doctors are held, specially among the poor, the Foundation has given priority to involving them in providing counselling and treatment services on HIV and Sexually Transmitted Infections (STIs). With the high reach and credibility enjoyed by NGOs in the community, this model establishes linkages between NGOs and general practitioners to encourage collective efforts for a social cause.
Description: At the start, training programmes on various aspects of HIV were organised for GPs of allopathic as well as Indian systems of medicine and homeopathy in Delhi, Mumbai and the North-Eastern states of the country. Simultaneously, field-based NGOs were involved and trained through this project. The training programme is linked with post-training networking where the GPs and NGOs develop area action plans and share their experience, skills and strengths to execute the plan and reach the underprivileged and needy.
RAJIV GANDHI WORKFORCE- A DIAGRAMMATIC REPRESENTATION
RAJIV GANDHI MOBILE AIDS COUNSELLING SERVICES (RGMACS)-COMMUNICATION FOR BEHAVIOUR CHANGE
Goal: To evolve and demonstrate a cost effective, culturally appropriate and sustainable strategy for prevention, control and management of HIV/ AIDS.
Communication Approaches: Participatory Community Action, Behaviour Change Communication, and Edutainment
Area of Operation: Delhi and Maharashtra
Beneficiaries: The general community
Duration of the project: One year per slum
Background: Initial HIV prevention programmes in followed the western approach. Our strategies focused on curtailing the virus at source and therefore targeted so called high-risk groups. On reviewing the strategies after 10 years in 1996, the Foundation felt that the targeted interventions were increasing stigma, discrimination and denial in the community. Also, the HIV virus was no longer restricted to urban areas and high-risk groups, but had reached rural areas and the wider community. The Foundation therefore conceptualized the Rajiv Gandhi Mobile AIDS Counselling Services (RGMACS) project in 1997. It targets the general community to foster behaviour change at the societal level by raising awareness, providing services like on the spot testing, preventive and supportive counselling, treatment & referral for STIs & opportunistic infections and builds the capacity of the communities involved.
Aspects of social change: Information dissemination does not necessarily lead to awareness, and increased awareness to behaviour change. Parallel efforts are needed to create an enabling environment, ensure provision of accessible and quality services and build the capacity of the communities involved. The RGMACS project seeks to achieve all these objectives.
DIAGRAMMATIC REPRESENTATION
To convert awareness into action, it is necessary to facilitate the process and encourage people to make responsible choices by providing them with the education, skills and information and simultaneously making those choices accessible, available and affordable.
Engage - share responsibilities to share ownership
Projects cannot achieve the targets without involving and building the capacity of the communities involved. We can offer an array of services but unless the community accepts those services the objectives cannot be achieved.
Exemplify – promoting success stories
Although involving film and sports celebrities to sensitize the community is a proven strategy, its sustainability in community-based projects is poor. The Foundation identifies success stories from within the community and promotes them as an example for others. The results are encouraging and motivate the community to take action.
Encourage – ensuring sustainable behaviour change
External encouragement may work for some time but sustainable behaviour change in respect of HIV/AIDS requires constant encouragement and the reinforcement of positive messages.
Description
"A counseling session underway inside the mobile van
Raising awareness on HIV/AIDS through street play"
A well-equipped mobile van visits an identified slum once in a week. In each area we have two community health workers and 10 community health volunteers who work with the community. During the visit of the van, in the morning sessions, IEC activities such as street plays, audio visual shows, talk shows, magic shows etc are organised. This is followed by a group counselling session by a doctor (member of the Rajiv Gandhi Workforce). Individuals who require personal counselling, treatment of STIs, referrals etc visit the mobile van where a counsellor is available to provide these services. The project team also organises training workshops for capacity building of various stakeholders such as health and anganwadi workers, teachers and youth volunteers. The community health workers do home visits to reach the females who generally do not come out to attend the IEC activities.
SMART PARENTHOOD CAMPAIGN - COMUNICATION FOR SOCIAL CHANGE
Goal: To combat female foeticide by empowering adolescents and young couples with skills and workable options on reproductive and sexual health with a view to improving the sex ratio and stabilizing population.
Communication Approaches: Social Marketing and Edutainment
Area of Operation: Kurukshetra District, Haryana
Beneficiaries: General Community
Duration of the project: Three years to cover a district
Background: Haryana has one of the worst sex ratios in the country, which declined further from 865 in 1991 to 861 in 2001. In order to improve the sex ratio and to achieve net replacement rate, it is necessary to target youth and newly married couples and empower them to take smart decisions. The Smart Parenthood Campaign uses development communication tools and techniques to sensitise, involve and build the capacity of the primary audience (youth & newly married couples) and secondary stakeholders (service providers, NGOs, Panchayats, Government officials, school and university teachers, volunteers, media, and other influential sections to address the specific reproductive and sexual health needs of youth. It focuses on a systematic campaign against female foeticide.
Aspects of social change: Social Marketing helps in promoting and providing rational choices among the people in order to modify their behaviour and practices. It is both scientific as well as cost effective and promotes reciprocal linkages between programme and people.
"A counseling session underway inside the mobile van
Raising awareness on HIV/AIDS through street play"
Description: Conceptualised, planned and designed by the Foundation, the project has been piloted in district Kurukshetra which has the country’s worst girl child sex ratio of 771(as per census 2001). Based on the results of a community need assessment, the project team developed training manuals and a systematic communication campaign to launch the project. Linkages have been established with various government departments like health and family welfare, Directorates of Audio-visual Publicity (DAVP), folk and cultural division, local newspapers, and TV channels.
Village health committees (VHCs) have been formed at the village level with participation of panchayat members, religious leaders and other key stakeholders to strengthen the health delivery system. The VHCs are sensitised and trained to address the issues related to female foeticide and gender discrimination at the village level.
Local folk media artists have been involved and trained on issues related to reproductive health, female foeticide and population control. Intensive IEC activities and systematic print media campaigns have been undertaken.
To provide counselling services and promote youth friendly health services, ten Smart Parenthood Clinics have been established, two each in the five blocks of the district. The clinics provide counselling and referral services to youth and newly married couples on reproductive and sexual health issues.
The initial results of the project have been encouraging. Strong participation of women in village health committees has energised the campaign. These committees have been successful in raising community awareness as well as combating abortion and other gender-related malpractices. Folk media has extensively been used to reinforce the messages in rural areas. To mainstream counselling services on reproductive and sexual health in primary healthcare delivery system, eleven smart parenthood clinics have been established making services more youth friendly. The project is now in its second year. Special emphasis is being given on increasing the involvement of the youth and building the capacity of the local administration and community with a view to handing over the project to the community and the district administration at the end of the second year.
EMPOWERING OUT-OF-SCHOOL ADOLESCENTS THROUGH LIFE SKILLS EDUCATION - EDUTAINMENT FOR INFORMED CHOICE
Goal: To empower out of school adolescents by developing life skills and educating them about reproductive and sexual health to help them make informed choices.
Communication Approaches: Edutainment & Communication for informed decision
Area of Operation: 10 slums of Delhi
Beneficiaries: Out-of-school adolescents
Duration of the project: One year per slum to create a cadre of trained master trainers, peer trainers and peer educators per slum.
"A group of adolescent girls during life skills training session"
Background: It is estimated that there are almost 200 million adolescents in India (aged 15–24), a high proportion of whom are out of school adolescents. Lack of reliable information pertaining to reproductive and sexual health and the desire to experiment increases the vulnerability of this age group to STIs including HIV/AIDS. The World Health Organisation (WHO) defines life skills as “abilities for adaptive and positive behaviour that enable individuals to deal effectively with the demands and challenges of everyday life”.
A group of adolescent girls during life skills training session
Aspects of social change:
"Learning skills- a role play underway during a life skill training session"
Entertainment education or edutainment combines entertainment with educational messages to help educate, inform and encourage behaviour change. The approach works effectively with the younger generation. The highly participatory approach involves the adolescents and encourages them to use skits, slogans, games, audio-visual shows, stories, songs to understand various issues, learn skills and also practice the new skills for their own growth.
Description
STATUS
Area
Number of Peer
Trainers
Educators
Kondli
25
114
Madanpur Khhadar
33
127
Trilokpuri
26
126
Tughlakabad
32
143
Vikaspuri
25
153
Wazirpur
25
139
Kalyanpuri
33
159
Masjid Moth
25
125
Hastsal
28
130
Gandhi Nagar
27
143
The project has been piloted in 10 slums of Delhi. At the start, folk media are used to sensitise and build rapport with the community and the target group. Thereafter, a seven days’ training programme on life skills and sexual health is organised for NGO representatives working in the project area. These become the Master Trainers. A comprehensive five days interactive training curriculum on life skills is developed for providing training to out-of-school adolescents. Using the curriculum, 25 out-of-school adolescents are trained by the Master Trainers as Peer Trainers from each area. Each one of the peer trainers further identifies and trains at least five out-of-school adolescents starting a learning process in each of the project areas and inculcating positive behaviour among the adolescents.
Learning skills- a role play underway during a life skill training session
We are replicating this project in ten areas of Delhi and NCR with Modicare Foundation.
RAJIV GANDHI MOBILE PRIMARY HEALTHCARE SERVICES – REACHING THE UNREACHED
Goal: To develop a sustainable community based primary health care model to achieve the target of “ Health for All” by utilizing the concept and techniques of development communication
Communication Approaches: Development Support Communication, Social Marketing and Social Mobilization
Area of Operation: Harchandarpur Block, Sultanpur
Beneficiaries: General Community
Eight essential components of primary health care
- Education concerning prevailing health problems and the methods of preventing and controlling them.
Background: Achieving the relatively ambitious goal of “Health for All”, as set out by the United Nations and accepted by the Government of India, requires a people-centred and culturally sensitive communication approach on health and development. The eight essential components of primary health care have been accepted by the member countries of WHO including India as the key to achieving the goal of Health for All.
In order to create a demand for primary healthcare services and at the same time strengthen the delivery system, a progressive partnership is required between the community and service providers.
Aspects of social change
The project promotes preventive healthcare by information dissemination using an array of formal and non-formal channels. It involves and builds the capacity of the community, provides curative services through a mobile clinic and focuses on reviving the primary healthcare delivery system and making PHCs more user friendly.
Description
The project is based upon Social Marketing Principles. Development interventions through adoption of social marketing principles is necessary for promoting and providing rational choices among the people in order to modify their behaviour and practices. It is both scientific as well as cost effective and promotes reciprocal linkages between programme and people.
At the start, a rapid situational analysis has been carried out in the project area. Based on the results, communication strategy and media packages have been developed to bring about awareness on primary healthcare. Linkages have been established with key stakeholders including PRI members, government and non-government organisations, opinion leaders, media, corporate etc to create an enabling environment and for providing quality services.
Training programme will be organised for the local folk artistes on primary healthcare issues and communication campaign will be launched with involvement of trained folk artistes and other stakeholders. In view of our successful experience of involving community through village health committees in Smart Parenthood Campaign initiative, such support groups will be formed at the panchayat level with involvement of key stakeholders and community representatives. These groups will be involved and trained to advance the project activities.Training and orientation programme will also be conducted for the primary healthcare workers, volunteers, medical officers, PRI members, media and community based groups.
DENTAL CAMPS- ESSENTIAL ORAL CARE
Goal: To improve the oral health of poor communities by providing quality dental care services with a focus on tobacco prevention.
Communication Approaches: Communication for informed choice
Area of Operation: Different districts of Uttar Pradesh
Beneficiaries: General Community
Duration of the project: Six free camps are organised each year
Background: While awareness on proper dental care is quite low in urban areas, it virtually vanishes as we go down to rural areas. Lack of awareness, unhygienic practices and use of tobacco (in any form) increase the risk of oral problems like tooth decay, plaque, tartar, gum diseases and oral cancers. Raising awareness on proper oral health and prevention of tobacco use are of utmost importance. Communication programmes can help people make informed choices.
"A patient being operated during a free dental camp"
Description: The camps are organised in collaboration with L. Gela Ram Memorial Dental Clinic and Orthodontic Centre, New Delhi. In a camp, approximately 5000 people receive dental care services from a well-equipped Mobile Dental Clinic. Patients are screened and according to requirement dental specialists undertake different dental procedures inside the mobile clinic. Simultaneously, a few trained workers conduct talk shows and group meetings to raise awareness on oral health. The doctors while treating the patients provide counselling on preventive oral health and motivate tobacco users to give it up. For follow-up, the patients are encouraged to visit the District Hospital.
TUBERCULOSIS CONTROL PROGRAMME- HOLISTIC MODEL FOR MANAGEMENT OF TB IN RURAL AREAS
Goal: To evolve a cost-effective model for the prevention, early detection and management of Tuberculosis.
Communication Approaches: Health education and Development support communication
Area of Operation: Kangra District, Himachal Pradesh
Beneficiaries: General Community
Duration of the project: Ongoing
Background: The HIV epidemic has posed heavy challenges in the management of Tuberculosis, one of the common opportunistic infections found in HIV positive people. In India around 5,00,000 people die of TB each year. However, these deaths are preventable by early diagnosis and complete treatment. The Foundation’s TB Control Programme focuses on early detection and complete treatment of patients suffering from the disease.
Aspects of Social Change: Health Education is critical to successful and effective health promotion, especially for the prevention, early detection, prevention and management of TB.
Description: The project is being implemented in Kangra, Himachal Pradesh, in partnership with the World Memorial Fund for Disaster Relief India. Project empowers the community to take responsibility and reach the maximum people. Various communication channels are used to raise awareness on the prevention and treatment of tuberculosis, with special emphasis on the need to improve hygiene and sanitation. For early detection of the disease, the volunteers undertake household surveys in which they discuss the symptoms of TB like persistent cough for three weeks or more, pain in the chest, loss of weight, loss of appetite and coughing up of blood. The symptomatic cases are referred for a sputum test, which is available at the Mobile TB Clinic. If positive, the patient is counselled and treatment is started immediately. The volunteers follow-up with the patients and ensure that they complete the course.
RED RIBBON EXPRESS - COMMUNICATION AND SOCIAL ALLIANCE FOR MANAGEMENT OF HIV/AIDS
Goal: To contribute to the national goal of reducing the rate of new HIV infections by generating awareness on HIV/AIDS in over 30,000 Gram Panchayats in the rural interiors of the country
Communication Approaches: Behaviour Change Communication, Social Alliance & Social Mobilization
Area of Operation: Entire country
Beneficiaries: General Community
Duration of the project: One year
Background: Though according to the latest figures from UNAIDS and WHO there is a substantial reduction in the estimated number of people living with HIV/AIDS in India, yet, there is no room for complacency as HIV/AIDS continues to be a major public health problem- globally and in India. While the country remains at a low prevalence rate (0.7% of the population is estimated to be HIV positive), the size of India’s population means that even a slight increase in the prevalence rate will lead to another million people becoming HIV positive. There is also a growing shift from the highest risk groups to the general population and from urban areas to rural areas.
For India to respond effectively to infection trends and prevent enormous social and economic damage, its prevention efforts need to be accelerated, intensified and expanded. Only a narrow window of opportunity will be available over the next few years to prevent the pandemic from spreading out of control,andwill require the coordinated efforts of different stakeholders at the community.
Description: The Red Ribbon Express (RRE) Project, conceptualized by the Rajiv Gandhi Foundation, is the largest mass mobilization effort on HIV/AIDS undertaken anywhere in the world. The Project is being implemented by the National Aids Control Organisation (NACO) in collaboration with the Ministry of Railways, Nehru Yuva Kendra Sangathan, UNICEF and UNAIDS.
The Project was flagged by Smt. Sonia Gandhi, Chaiperson, Rajiv Gandhi Foundation from Safdarjung Railway Station on World AIDS DAY 2007. Railway Minister Shri Lalu Prasad Yadav, the Minister for Health Dr. A Ramadoss, the Minister for Youth and Sports Shri Mani Shankar Aiyar were also present on the occasion.
In its year-long journey, the RRE will halt at 180 stations and reach more than 50,000 villages across India with comprehensive information on HIV/AIDS. At each halt, six performing teams, each with 10 members, will disembark from the train on a fleet of bicycles to perform in different villages in the interiors of the district. They will stage plays and skits about stopping HIV infection and fighting AIDS stigma and discrimination. Another group of youth campaigners from NYKS travelling in buses will cover an even larger area than the cyclists.
The RRE is a specially designed seven-coach train. There are three education and exhibition coaches with interactive touch screens and 3 D models. It has its own auditorium-cum-training coach for hosting education sessions for doctors, anganwadi workers, PHC workers, SHGs, NGOs, Youth and Women. There is a separate coach with six cabins for counseling and medical services.
