Health Project

Reports and details of this Project will be available from this page.

CRUSADE HEALTH PROJECT REPORT pdf

CRUSADE HEALTH PROJECT 2010/11

1.  Aim

To assess and address the health problems of communities in two blocks with a total population of 25,000 in Tamil Nadu during one year from 1st April 2010.

2.  Profile of the communities

Despite the growth of nearby Chennai city, the villages surrounding Minjur and Sholavaram are backward with agriculture being the mainstay of the population. The distribution of land is highly skewed with a few dominant caste families owning most land. A majority of the households are landless and live in small substandard homes of mud and thatch. Around one fourth of them belong to oppressed dalit community (formerly untouchables).

The Centre for Rural Systems and Development (CRUSADE), a TAMWED partner NGO in Tamil Nadu, has been operating in 150 poorer hamlets in these two blocks since 1992 with the main aim of alleviation of poverty and powerlessness of the marginalised communities. CRUSADE organised more than 8000 poor women into cohesive Self Help Groups around savings and credit and linking all other services with groups.
   
3.  Background
In 2007, CRUSADE carried out a needs assessment survey with 325 sample households in three villages in the one block. Findings revealed that only 11% owned land and 14% of adults had permanent employment. Around 60% lived in thatch houses and only 14% had latrine facilities. 14% suffered health problems. Issues that were prioritised for a response were the high level of preventable diseases; the lack of awarness about health-related topics such as hygiene; the late diagnosis and treatment of health problems; and inaccessibility of health facilities.

The current 12 month pilot health education programme is being implemented in these two blocks through 10 trained health workers who provide health education to 3,500 women who are members of Self Help Groups (SHGs). The project also conducts diagnostic camps at village level for blood sugar and hypertension. People with problems are given counseling and receive follow-up support. The Homeopath Clinic set up at CRUSADE’s Sholavaram Centre for 3 days a week treats patients while referring complicated cases to specialised hospitals. 

A repeat survey conducted in December 2009 with 50 of the 325 households shows that of 20 having health problems, 6 have been cured and 14 are continuing treatment. Of the 50 households, 28 now have sanitation facilities. Interaction with health education providers and trained SHG members suggest a sustainable impact of the programme in terms of reduced communicable diseases, increased awareness on nutrition, early diagnosis and treatment of diseases and reduction in frequency of members and children falling ill. There is a marked Increase in knowledge and confidence of the health providers in tackling health problems. It is therefore proposed to extend and further develop the work in these two blocks to create a lasting impact on the health status of these communities while presenting a model for the improvement in health in other districts.

Problems
During discussions with the women and girls undergoing health training, health workers encountered widespread health problems in their communities and were able to establish underlying causes such as poor nutrition, unhygienic habits and sedentary lifestyles. Chronic diseases such as Diabetes Mellitus, Cervical Cancer, Hypertension, Tuberculosis, Heart Disease and Anemia are widely prevalent in the community. Anemia in young children due to worm-infestation is common. Increased incidence of Polycystic Ovarian Disease, Uterine Fibroid and other Menstrual Irregularities are also noticed. There is inadequate awareness of safe methods to dispose of household waste and used water leading to communicable diseases. The practice of using sanitary toilets is rare due to lack of facilities and attitude. Although some households have this facility, they do not use them due to cultural factors such as a reluctant to defecate inside or nearby the house.

4.  The project

It is proposed to extend the health promotion work to 5,000 families in 40 villages with a total population of 25,000. Each village will have a health volunteer who will be trained by the Medical Officer of CRUSADE. These volunteers will collect information on the health status of the community which will be analysed to record those having health problems who will be counseled by the medical officer for early diagnosis and for treatment. The project will also create sanitary toilet facilities for 40 more households during the year and to hold 4 camps on environmental awareness.

6.  Objectives

• To address the specific health problems of individuals through proper diagnosis and referrals;
• To continue to run the clinic in Homeopathic Medicine to treat diseases at a primary level;
• To conduct mass awareness of the proper disposal of household wastes and the recycling of plastic and other toxic materials;
• To promote household sanitary toilets.

7.  Activities

The following activities are planned to achieve these objectives:

• Complete the 10 modules of training currently in process providing health education to 3,700 women. It is expected that there will be some backlog in covering all the groups and girls in providing health education using the training modules. This will be completed by April end  2010. ?
• To carry out a comprehensive health survey in 40 villages in the two blocks. The information collected will be analysed using IT, listing individuals with chronic health problems.
• Those listed will be reached by a qualified doctor who will prepare a case history of the patient and offer advice on further diagnosis, referral or treatment
• The clinic run at the centre on specific days will deliver low cost alternate medicines for simple diseases.
• To conduct camps at community level for the diagnosis of specific health problems such as Diabetes and Hypertension & anemia.
• To provide technical and financial help to promote sanitary toilets. 
• To conduct awareness camps on the safe disposal of household waste and wastewater.

8.  Targets

The project will focus on SHG members and their familiesin 40 villages. However, the project will not discriminate in favour of SHGs and include others in diagnosis and treatment. Therefore, health surveys will be extended to willing non-members.

• The total population covered will be 25,000.
• Pilot research undertaken in villages indicates that 3.7% of the population have health problems in the project area at any given time. The project is therefore expected to address the health problems of an estimated 1,000 persons, particularly women and children.
• The three day clinic will treat 1,500 persons having treatable ailments at primary level.
• The project will hold 25 diagnostic camps in villages for the diagnosis of persons having symptoms of diabetes, hypertension and anemia.
• The project will offer technical and financial assistance for 40 SHG members to have sanitary toilets.
• It is planned to hold 4 environmental awareness camps in project villages for restricted use of plastics and safe disposal of household wastes and waste water.     

9.  Monitoring and Evaluation

The Medical Officer /Trainer will train the Health Volunteers and will coordinate collection and analysis of health related data. She will conduct health camps in all the 40 villages at least once during the year. The Secretary of CRUSADE will be the overall project manager who will prepare half yearly reports and manage finances. The impact of the project will be internally evaluated in the last quarter through sample surveys, focus group discussions and consolidation of data and the report will be disseminated for the benefit of others.

10.  Sustainability and Exit Strategy

Tamwed and AVI have funded CRUSADE’s health programme for two years. Tamwed contributed to the training, resources and on-going support of 10 Community Health Workers of CRUSADE and also part-funded the Homeopathic Doctor who also trained and supported the Health Workers. The training created a new awareness about  important health issues and was able to contribute to the early diagnosis and treatment of diseases. CRUSADE would like to take this forward by developing a sustainable system for improving the health status of the community through this project.

CRUSADE has already registered an apex level trust for Self Help Groups – Pudumai Pengal Iyakkam (PPI).This trust had already secured income tax exemption for its income and has built up a revolving fund for health and development activities. The Trust is already taking several responsibilities in organising health camps and lending for sanitation units and in monitoring. The Trust will continue whatever activity initiated with needed support and technical guidance.

11.  Programme

	Apr/May/Jun	July/Aug/Sep	Oct/Nov/Dec	Jan/Feb/Mar
Designing survey	X
Collection of data	X	X
Data analysis and output		X	X
Conducting Health camps	X	X	X	X
Running the treatment clinic	X	X	X	X
Sanitation toilet construction	X	X	X	X
Reporting			X	X
Environmental awareness camps	X	X	X	X
Evaluation				X

12.  Finance

This one year project is estimated to cost Rs 450,000. The detailed budget is given. Action Village India, UK will be part funding the project, meeting half of the cost of the Medical Officer and the full cost of   eight Heath Coordinators who are in place to monitor the comprehensive Health Development project that will be implemented by CRUSADE with AVI Funding.

13.  Budget

Expenses                                              

		Rs	£	AVI
1	Doctor - Homeopath /Trainer (P/T includes  travel)	72,000		61,750
2	Cluster Coordinators (8 P/T)			364,000
3	Health workers (10 x honorarium + travel)	180,000		-
4	Management cost ( Accounts, IT & monitoring )	72,000
5	Training (40 women for 5 days) @ Rs100/day/trainee (includes resource person’s cost)	20,000		-
6	Diagnostic Camps (village level)			20,000
7	Data collection and analysis	12,000		-
8	Medicine and cost of diagnosis	20,000		-
9	Transport (for health camps team work)	5,000		-
10	Admin & office costs	12,000		-
11	Grant for 40 sanitation units @ Rs 2500 per unit	50,000		50,000
12	Camera for documentation	7,000		-
	Total	450,000	*6,250	495,750

                                                                                                                      *@ Rs72 to £1

 

Income

	£
AVI	6,885
Tamwed	6,250
Total	13,135

 

Notes

• The environmental awareness camps will be conducted by SHGs and expenses for conducting the camps will be paid internally.
• The total cost of a toilet unit is approximately Rs10,000. The government is expected to provide Rs2,200 per unit for toilet construction and Rs5,000 will be in the form of a loan from the SHG Federation (PPI Trust) which has a Revolving Fund for this purpose).