FROM HOSPITALS TO SCHOOLS: Changing the Face of The Country With School Health Programme

Shalu, an 8-year-old, had the privilege of being enrolled into her nearest government school. Though the focus was more on the free food being given, it came with the additional benefit of education as well. But that was not all. Recurrently falling sick made her miss school on a regular basis. And as of today, she has dropped out of school and is sitting at home, deprived of education and a regular source of one meal a day.

School has been the face of not just education, but building a good foundation for the future. If that is the case then what does it bring forth, if it does not have, what is integral to it? I’m talking about the students. India like any other developing country has been working on this matter, along with the rest. And needless to say, it has come a long way.

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Shalu was one of the thousands of children who happened to be affected by anemia even before she started to do things by herself. But thanks to the government, and schemes like National Nutritional Anemia Prophylaxis Program, they had her covered by way of supply of medicine. As mentioned before, with the Midday meal scheme brought in full swing, it was an incentive for her family to put her through school. Having started off being anemic, the impact of medicines was short-lived owing to irregularities in the intake. And so as she grew, more ailments came her way.

Being a developing country, there is a lot that needs to be taken care of. The government for its part has aided in the process by coming up with various schemes and strategies over the course of time in the form of Five-year plans. These can be seen from the various schemes that come have come into place ever since then. However, meeting the planned outcome might still be a milestone yet to be achieved. There are various factors contributing to the same. Having said that, the idea is to bridge the gap. Many more children like Shalu are yet to join the school. So why not bring in the foundation of a healthy lifestyle right where they come seeking the foundation of a better future?

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In fact, one of the publications issued by the WHO on Health Promoting Schools says, ‘The evidence from systematic reviews in high-income countries shows that the HPS approach can contribute to improving children’s health by reducing the risk factors for NCDs. In low- and middle-income countries, school-based interventions have been successfully implemented to prevent communicable diseases and other health problems, such as worm infection, malaria, diarrhea, iron deficiency, malnutrition, and oral diseases, over the past 20 years.’

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Well, our country is not far behind. The most recent addition, School Health Programme an initiative under AYUSHMAN BHARAT looks forward to the same goal. A collaboration of the Ministry of HRD and Ministry of Health and Family Welfare works on the idea of a comprehensive healthcare program. Unlike other programs so far, it builds on the idea of Ownership, Sustainability, Scalability, capacity building and most importantly Convergence. It is exactly what was needed to bridge the gap that was created by previous schemes.

That leaves us with whether we want to make it just another scheme which worked for a while and was never seen or make it THE scheme which changed the face of the country and its outlook. With the idea of Ownership, it puts the ball into the hands of the key stakeholders of the educational institutions. Now we decide the future of these kids. So what do we have for them?

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For a start, Sharp Ngo along with HCL Foundation has taken a small step towards the same. The rest is yet to happen!

 

Written by-

Romina Joseph, SHARP NGO

 

Water, Sanitation & Hygiene: Advocating SDG 6 & Swachh Bharat with Project PUSHTi

The Government Secondary School in Ramgarh is located at an hour’s distance from the Patiala district of Punjab. More than half of the school’s attendees are girls, but over 50% of them drop out by the time they hit puberty. There is one toilet for boys and one for the female faculty, which is shared by over 300 female students of the same school. The structure allocated for the female toilet had turned into quicksand over the years, with roof and walls reeking of termite and lost dreams of hundreds of young girls of attending a decent school.

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Condition of toilets at Government Secondary School, Ramgarh in October 2019

Did you know that over 23 million women in India drop out of school every year when they start menstruating? A majority of these are due to a lack of safely managed sanitation services.

The Joint Monitoring Programme Report 2017 by UNICEF & WHO estimated that 61% of the global population (4.5 billion people) lacked safely managed sanitation services. These people either used basic toilets or latrine (2.1 billion), shared toilets among several households (600 million), used poorly constructed latrines or buckets (856 million), or defecated in the open (892 million). From the 892 million who practiced open defecation, over 524 million people come from India alone – 40% of our total population.

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Sustainable Development Goal 6 and the Swachh Bharat Abhiyan strife towards ODF and promote WASH goals. Despite successful planning and launch, four years into the Abhiyan, India is far from elimination of open defecation. In the three phases of the WASH program launch (Planning, Implementation and Sustainability), the biggest barricade for India has been that of Implementation and Sustainability. Project PUSHTi took a maiden step in Patiala towards contributing to India and the UN’s WASH goals.

  1. Planning Phase: Hearing about the problems of the school and hundreds of girls in Ramgarh, Team PUSHTi performed a need assessment to identify the costs, disparities of equipment and awareness of WASH indicators amongst the school faculty and students. A builder was hired to inspect what of the old structure could be salvaged and what had to be installed. A blueprint of a separate toilet for female students began to come into place.

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  1. Implementation Phase: After procurement of funding, the renovation was kick-started with floor and wall tiling and installation of toilet seat and washbasin. A water tank was installed to ensure unhindered water supply for all the years to come. This was followed by technicalities like plumbing, electrical connectivity, and necessary branding.
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Renovation work in process at Government Secondary School in Ramgarh
  1. Sustainability Phase: Besides water tankers and electrical assistance, a major component of ensuring Sustainability was creating social and behavioral communication change platforms (SBCC). This was achieved through wall paintings on hand washing; importance of sanitation, hygiene and interactive messages for students to comprehend.

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A little more than a month later, the toilet was ready to be used. Using PUSHTi’s interventions as a model, we understand how little effort a massive change requires. Lack of sanitation facilities are in direct relation to the poverty index and malnutrition. By enabling one intervention at a time, we can solve real-time problems of social stratification and nourishment.

Write to us with your story of innovation or contribution towards School Health. Let’s make Bharat truly a Swachh Bharat!

 

Written by-

Mahima Mehra, SHARP NGO

Final Stage
The post-renovation facade of toilets at Government Secondary School in Ramgarh in December 2019.

Promoting Sustainable Development with Project PUSHTi

When the concept of sustainable communities emerged, its ideation was very different from what it is now. Our decade saw a dire need to recognize Sustainable Cities and Communities and the same also found an echo in SDG Goal 11, which was conceptualized at the United Nations Conference back in 2012.

Since then, the components of Sustainable Communities have started to loosely revolve around inclusivity, safety, design, built, connectivity and socio-economic adaptability. But sustainability means more than this. It means building infrastructure that is accessible, uncompromising and safe. It means reducing the gap between resourceful infrastructure and the inclination of community members to access the same.

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With this goal in mind,  Project PUSHTi under GSK’s ‘Mission Health’, SHARP NGO and JSI R&T Foundation as Technical Partner set on a mission to improve the infrastructure and operations of Anganwadi centers across intervention villages of the Nabha block, Punjab. Project PUSHTi supports the Government to improve maternal and child nutrition in the 1000-day period of life.

Ageti Village is a Project intervention village and the Project’s model village located at a distance of 8 kilometers from Nabha town in Punjab. Due to constant wear and tear, the Anganwadi building had become unsuitable for daily activities and an appalling need for revamping was assessed. This was starkly opposite to the promise of a better quality of life, as recognized under SDG Goal 11.

After architectural evaluation, it was charted that the initial infrastructural planning of the Anganwadi situates a generous classroom with an external garden, washing and toilet facilities. After several years in a dilapidated environment, the roof had collapsed and knee-deep water often accumulated in and around the Anganwadi. The base structure thence could be left unhampered.

Another problem was the consequent non-functionality of the AWC during the time span of the renovation. Team PUSHTi arranged a substitute land for the Anganwadi workers with the help of the local governing body to ensure unhindered operations. It then became possible to achieve functionality and sustainable infrastructure simultaneously.

Spread across the period of 6 months, the refurbishment was funded by the village Panchayati Raj and GSK-CH; and facilitated by Project PUSHTi. Intervention activities included plastering, installation of new windows for light and ventilation, sustainable waste stone flooring, new roofing, washroom facilities, and attractive wall paintings.

The Anganwadi has now become a site of innovation, intervention, and information for all members of the community. Though simple and compact, the new AWC is bright, airy and appealing. There are interactive wall paintings for the kids.  The bathroom is well equipped with tiling, electricity as well as primary sanitation facilities. Regular discussions and workshops are organized on issues of Nutrition, Healthcare, and WASH.

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The success of this Anganwadi renovation lies in getting together Community Leaders, Government Officials from ICDS and other departments for a common goal. PUSHTi project sees this as a monumental achievement of the local leadership, block administration, and the project team.

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This will be recognized as a major step by SHARP NGO and Team PUSHTi towards Sustainability and accessibility.

 

Written by: Juhi Arora & Mahima Mehra, SHARP NGO

“AIRPLANES ARE LIKE GIANT SHOES WITH ARMS!”

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It’s raining heavily in a small slum dwelling in Southern Delhi. Under a dilapidated leaking roof, seven years old Priya is shivering while holding her younger sister in arms, making the infant cozy with her body. The eldest of all five siblings, Priya lives with her parents in Safdarjung. Her father is a gardener in a money plant farm and her mother does petty chores like sewing torn clothes roadside. The last time Priya saw the inside of a school was when she was five years old. Months after her fifth birthday, she was asked to discontinue her education due to her inability to pay the school fees. Priya outgrew her only pair of shoes seven months ago, and her mother kept them aside for when her sister turns six. She often looks at the planes in the skies, which look like giant shoes with arms, and thinks about having a new pair all to herself.

She is not alone though. Did you know that over 20 million children in the Sub-Sahara, where temperatures often reach over 100º F, are denied the simple choice such as owning and wearing a shoe, year after year?  A statistic released by Shoes for Souls Organization showed that over 300 million kids worldwide are without shoes and 1.4 Billion people are susceptible to diseases that could easily be prevented by a decent pair of shoes. Something as simple as wearing a shoe prevents hookworm disease, transfer of helminthes infection from the soil, blisters, animal bites, tetanus and tungiasis.

Going without shoes for too long can cause corns, ingrown toenails, fungal nail infections and problems like athlete’s foot. Wearing shoes does not just make walking painless, but shoes have shown to alleviate actual pain. A part of the job of shoes is to absorb impact as we walk, but bad shoes (or no shoes) can throw the whole body out of alignment. If shoes don’t have enough padding, pain is an inevitable side effect. The ankles, knees, hip joints and lower back are all affected by bad shoes. Widespread pain limits mobility, making it difficult to perform normal daily tasks such as walking to the bathroom. This means that simply by jumping in the puddles in rainy weather, Priya may be enjoying her childhood, but her naked feet are susceptible to rashes, infections, tick bites, diabetes; which left unattended can even lead to amputation.

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The problem of shoes just not just raises the problem of economic and social disparity, but also important questions related to the importance of shoes. From physical improvement to being able to participate in the society, shoes can prevent foot injury, heal injuries, improve the quality of life, aid expression of self and expand an individual’s career options by allowing them to work in dire circumstances.

Priya is not the only child facing these dire consequences but she is also not alone. SHARP wanted to preserve both her childhood and her tiny feet. Last September, Priya and her brother Deepak visited a shoe distribution drive by SHARP and BATA. She was given new sneakers, a pair of slippers and a promise to enjoy the rain puddles for all the days to come. Priya never has to look up to the skies again. Her giant airplanes with arms were now in her very own arms!

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SHARP NGO in collaboration with BATA Shoes set on a conquest of challenging this shoe problem with “Stride to Pride” Campaign where we collect used shoes from schools across cities and BATA distributes equal number of new shoes to children. More than 30, 000 shoes have already been collected under this campaign and over 1 lakh shoes have been distributed all over the country. What made our approach unique was not the distribution of shoes, but joining the stories of two children together. We believe that the lifecycle of a shoe resembles that of the child who gives it. For every single smile on a child’s face, there is another child whose soul is uplifted. As the shoe travels, so does the spirit of the little one behind it. Who said foot care cannot be fun?

Priya only worries about flying now,

Because our airplanes are there

To worry about her Foot care!

 

Written by: Mahima Mehra, SHARP NGO

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“THE EARLIER THE BETTER”

How to intervene at a young age?

The Ministry of Health & Family Welfare (MoHFW) has been striving to provide services with universal coverage and equitable distribution for all Indian citizens regardless of income level, social status, gender, caste or religion. With this view in mind, one of the priority areas for action is EARLY DETECTION, EARLY INTERVENTION & EARLY EDUCATION. One way of providing these accessible services will be to utilize already existing infrastructure of community service provisions to cater to the needs of very young children (0-6 years) requiring early intervention services through District Early Intervention Centers (DEIC). We believe that with this provision across the country, India truly has an opportunity to learn and successfully build DEIC models which would impact a greater population. It is then imperative that we look at flourishing models built by other countries and find the components which would be a suitable fit for the Indian society.

A maiden effort was taken by SHARP NGO to analyze the early intervention programmes of five different countries, namely, the United States, New Zealand, UK, Singapore and Sweden. With this data, SHARP was able to infer some primary differences between the models abroad and those in India. Alternatively, we also assessed the gaps in the operation of DEICs in India by visiting centers in and around the Delhi NCR region.

Why is this important? It needs to be noted that in spite of 266 DEIC’s approved in the country only 92 have been established catering to the growing needs of the children requiring early intervention services hence becoming a distant possibility. A major hurdle in the development of these services is lack of trained professionals. To reach out to those un-reached, the vital step is human resource development and the need to develop a cadre of professionals who can provide services even in the rural areas through a single window service delivery system. As in the case of the United Kingdom, the qualifications of trainers are a key factor in their recruitment as a specialist. Moreover, parents can choose from a range of different types of provisions including private, voluntary and independent settings. (Blackburn, C. (2016 https://www.researchgate.net/publication/303777321_Early_Childhood_Inclusion_in_the_United_Kingdom Accessed July 17, 2019). Parents get to decide what is best for their child, depending upon their funding options and their requirements. In India, there is a need to train school teachers & parents in providing primary support and care as they have more frequent contact with the child.

Talking about another major fail is the approach of service delivery with multidisciplinary model, where professionals work independently not fostering integrating and interactive services to the child as a whole, hence, leading to fragmented services for children and confusing or conflicting reports to parents. There is a need to shift this approach to a more Interdisciplinary or trans disciplinary approach, an answer to which can come from the US model. The Centers for Disease Control and Prevention in the United States (https://www.cdc.gov/ncbddd/actearly/milestones/index.html Accessed, July 16 2019) has developed its own Milestones App, which can be used to track the child’s diagnosis, development and next appointment. It provides a summary of a child’s milestones to view, and share it with an email to the child’s doctor and other important care providers. In India, similarly, digital platforms can be used to implement digital early interventions (App based) for health systems strengthening and Universal Health Coverage.

Environmental influences and learning are some of the factors that influence intelligence and human capacities. Handicapping conditions, both physical and environmental, can lead to serious secondary complications. Therefore, there is a need to create awareness and give special assistance to the parents and caregivers (through counselling and family interventions) in providing adequate care, stimulation and learning for their child. As parents have more frequent contact with the child at home, their contribution in eliciting developmental information about their child is essential. The ABC Center in Singapore takes this into consideration and so, parents too are given plenty of guidance by way of a free eight week training program that also includes one home-based session. (https://honeykidsasia.com/early-intervention-centres-singapore-for-children-with-special-needs/ Accessed, July 17, 2019). This model of including parents is also followed in country like New Zealand, where the program is offered in a centre-based model of service, in partnership with parents, and in accordance with international best practice. Parents are as much part of child’s development as the professional trainers. (http://www.championcentre.org.nz/ Accessed July 17, 2019)

There are other interesting models exclusive to countries such as Singapore, Sweden and the US. Singapore, for instance believes in a low therapist-student ratio. There are only over three students per trainer which leads to increased care and attention provided to each child. ((Karnes and Lee, 1978) https://bit.ly/2YRFPrg Accessed, July 17, 2019) This is unlike India, where the care providers are outnumbered by the care receivers.

As in the case of US, all schools in New York City are legally mandated under “Child Find” to find all children who have disabilities and may be entitled to special education services. (https://www.understood.org/en/school-learning/your-childs-rights/basics-about-childs-rights/child-find-what-it-is-and-how-it-works Accessed July 17, 2019) The culmination of education and care of having intervention centers in schools is also common in Sweden. (https://theconversation.com/why-swedish-early-learning-is-so-much-better-than-australias-35033 Accessed July 17, 2019) Sweden’s EDUCARE program imbibes that education and care is build into the system. Early intervention model hence is necessary to be built into the education system in India for better strengthening.

The need for inculcating foreign models is not just based on their success stories. We believe that the functionality of the center would be a mutual, two-way street. Inclusion of parents in their child’s development whether through apps or through formal training would increase the former’s interest in the intervention services provided by the government. Inversely, a greater footfall and balanced ratio of students would help the center in allocation of funds and motivate the working professionals towards skill building. Along with that, following an interdisciplinary model will aid in overcoming the limitations of individual disciplines and will maximize communication, interaction and cooperation among the team members improving on better delivery of services.

The provision has been provided already; it is about time that we ask the questions right, and start accessing our true right!

#EAT LOCAL EAT HEALTHY – PROMOTING THE USE OF UNDERUTILIZED NATIVE CROPS!!

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Agriculture forms an integral part of Indian history, from the days of the Indus Valley civilization to even modern day era, and forms an integral part of Indian lifestyle and culture. Even today, agriculture holds a major role in the Indian economy, contributing 17-18% of the nation’s GDP and in a recent Economic Survey 2017-18 released in the parliament last year, and agriculture employs more than 50% of the total workforce. However today, traditional knowledge about India’s indigenous plants have reduced in the younger generation, mainly due to the influence of urbanization. India is rich in diverse plant species, ranging from food, materials to even medicinal properties. Not only do India’s indigenous plants have economic values, but also have major health benefits equal to those of avocados and other foreign crops.

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Tasteful examples include star fruit, rich in antioxidants, potassium, and vitamin C, okra, a vegetable with a rich source of vitamins and minerals, and the seeds provide quality oil and protein. Phalsa is another fruit similar to blueberries and extremely rich in calcium, iron, magnesium, potassium, phosphorus and vitamin C. It is a super fruit with an effective cooling effect that is perfect for summers. Others also include lemongrass, turmeric, and many other herbs, used to add a little bit of flavor and have medicinal properties.

Today’s integration of connectivity has changed even the food we eat, as now many of the younger generations opt for international ‘superfoods’, often forgetting the value of the crops we grow on our own soil. Foods that we have been cultivating, researching and eating for generations have now lost importance, and it’s important that we bring them back.

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Many people are uncomfortable with market-bought fruits and vegetables, and rightfully so, because it may not be as fresh or reliable as advertised. Therefore we encourage growing locally grown produce right at the comfort of your own home. Options such as terrace farming, kitchen gardening are always ideal, and even if you lack space a smaller balcony farm works just as well.

We at SHARP NGO encourage the use of locally available crops and spread awareness about them under our NUTRITION PROJECTS through awareness campaigns, talk shows, promoting kitchen gardening, educational games in communities &villages to promote dietary diversification of indigenous crops to lead healthy lifestyle, encouraging people from all age group like children, pregnant ladies, adolescents to consume them for a healthy mind & healthy life.

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NASHTA ZAROORI HAI!

“Jaldi khao! Bus aa gayi he!”

These are the words of a typical Indian mother rushing her child in the morning. Little does she know that her child is rushing through the most important meal of the day; sometimes even missing it to catch the bus to school. As children, parents, employees and employers, we often wake up running late in the morning and substitute breakfast with just fruits, carbohydrate and fat filled foodstuff such as cereal, or “rotis” and a dry vegetable sabzi. In rural regions such as the 6,50,000 villages in India, it’s even worse with “chai” and a few biscuits being the staple. This habit is harmful. We neglect the needs of our bodies by doing this repetitively, day after day.

After a long-night’s rest and repair, our bodies’ need the replenishment which breakfast provides. A wholesome breakfast would include carbohydrates along with essential vitamins, minerals, proteins and fibres. Not only does it give you energy, but it helps our minds to power up again and it helps prevent some of the most common diseases in India such as diabetes, high blood pressure, obesity and heart disease. The far reach of these diseases pan-India highlight not only the lack of a balanced breakfast in our country but of a general healthy diet as a whole. We see malnutrition, gout, kwashiorkor, obesity, scurvy and so much more. All the result of a poor diet.

No one should have to do this to themselves and face the consequences because they didn’t know what a proper diet was. This is why we at SHARP want everyone to know. We are organizing nutrition awareness programs across India and educating them about the importance of nutrition in our everyday live. We want to promote and support people to embody a healthier, more nutritious lifestyle, so come join us to make it all a reality!

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