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IPPI in India 2000- 2001

IPPI in India 2000- 2001. RESEARCH BASED COMMUNICATION MODEL for UNREACHED CHILDREN By Dr K SURESH Project Officer, UNICEF India Country Office. Process Evaluation involves Assessing Knowledge Attitudes/ Beliefs Designing & implementation of appropriate intervention.

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IPPI in India 2000- 2001

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  1. IPPI in India 2000- 2001 RESEARCH BASED COMMUNICATION MODEL for UNREACHED CHILDREN By Dr K SURESH Project Officer, UNICEF India Country Office

  2. Process Evaluation involves Assessing Knowledge Attitudes/ Beliefs Designing & implementation of appropriate intervention Outcome Evaluation Recording behavior Change Reaching the Unreached Communication Model

  3. MONITORS S/NID’s & H-HOUSE GOVERNMENT--DIST/STATE WHO/NPSP / UNICEF ON THE SPOT GUIDANCE END DAY CONSULTATIONS CORRECTIVE ACTIONS

  4. Methods of Data Collection for the IndicatorsProcess Evaluation • Independent observers - NGO, Medical Colleges, IAP members, Students … • Filled-in questionnaire within 10 days of S/NIDs were included for the analysis • Five part questionnaire was developed • 5000-9000 booths/areas observed On booth day and third day for HtH activities

  5. Process Evaluation Indicators • For Immediate intervention • Quality of vaccine in Phase-III • Communities with 2+ Unimmunised children • Subsequent round • Cold chain gap • Awareness regarding date/place • Micro-planning • Next year strategy • Training of service provider • Reasons for not-immunizing children despite HtH for planning IEC/SM

  6. Inclen India (USAID Support)

  7. Methods of Data Collection for the Indicators End Evaluation • Multi pronged approach - • carried in all 35 states/UTs • 1041 clusters (975 normal and 66 high-risk)- • In 218 clusters qualitative research carried out • Quantitative - 41640 children • Structured surveys- Individual one to one interviews to assess Knowledge, its extent, behavioral indicators • Qualitative - 202 FGDs & 467 DIs • FGDs with beneficiaries, family influencers • DIs with service providers, community influencers • Village observation, Transects • Analysis • A holistic approach • Weaving the data from all sources

  8. Awareness - 80% (1995)  99.4%(1997), 99.5%(2001) Indicators for the Communication Model- Knowledge • About the disease • Action Required • About the program • About NID • Use of Mass media • Use of Interpersonal • Training and Orientation Workshops

  9. I Prevention • ‘Medicines required only when ill’ • Concept of Prevention Vs. Cure - Health Vs. Absence of Disease Underlying Issue: • Distrust of Medicines per se and excessive medication • Particularly if free by Govt. & thrust without explanation • Identity of Service Provider Many rounds & Given at home New challenge

  10. Refusal declined on Doctors advice - 6.1% (1995)  Nil (00) II Empathy • ‘Not for me’- Amongst Affluent • because ‘it happens only to the poor’ • Hygiene factors at booth, ‘Look Good’, ‘Feel Good’- New problem • Family doctor advice Underlying Issue: • Lack of exposure, Used to better services, demanding • IAP/IMA/Pvt. Practitioners to immunize at their clinics • Private hospitals to open booths • Medical / Affluent college students to volunteer • Celebrity endorsements

  11. Government Service III Trust • Participation of Volunteers 30%(1995)  60%(01) • Expertise of Service providers ?? • Training Outsourced last year • Free service • ‘No free lunches’ • Issue of dumping medicines • ?? • Readiness to believe negative stories • Sensitization of Journalists and other forums Less negative reporting, % of untrained staff - 26%(99) 5%(01), 91% SP satisfied with the training

  12. III Trust • Appeals from religious leaders/ influencers-Verbal Print • Vedios of Mollavi’s appeal played in UP & WB • Use of celebrities like Shahrukh Khan • Religious lines • Child too young • IPC and Use of SMCs Difference in reach across religions not significant now Coverage in (0-6m)- 75.7%(1996) 91%(2000) In 2000 - <1m - 60%, <3m - 86% were reached

  13. ‘Not aware of need for additional doses’ - 10.4 (1996)  4.5 (2000) (among those refused - 6.7(1996)  1.4% (2000) Empowerment • Fatalistic Attitude • “Whatever is to happen will happen” • How does it matter if we miss? • a few children • a few doses • Repositioning of program as People’s program through Mass media and SM “Every Child, Every Time” theme tune of Audio/ Video spots

  14. COMMUNITIES WITH UNIMMUNIZED CHILDREN DESPITE HOUSE TO HOUSE IMMUNIZATION Among the communities with unimmunized children, % with 2+/100HH such children - 70% (Oct. 99)  18% (Jan. 01)

  15. Issues to Tackle in 2001 • Concept of Health as different from absence of diseases as it becoming rare • Look good, Feel good and match demands (affluent families) • Building knowledge workers amongst service providers • Free Service- ?? • Readiness to believe negative stories- • Anti-fertility • HIV/AIDS

  16. Challenges... • Playing safe’ mentality- double edged sword • Traditionally restricted access to the young child (0-3m) • Social restriction • Exclusive breast feeding • Needs to be tackled as genuine concern • Cultural and religious diversity compound the problem • Fatalistic Attitude - Hardships and uncertainties of life per se • Mental state - Historical suppression within the community • Increase in zero dose children - 0.7(2000) 2.4%(2001)

  17. Thanks for caring

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