The project aimed to cover the above stated four districts considering the factors of high prevalence of diseases, capacity of local community organizations and Non Governmental Organizations (NGOs) and commitment of district health officials. The project objectives will achieve and enhance the capacities of local communities, state public health workers and private health practitioners in managing addressing health issues.

Objective(s):

1. To increase target communities knowledge and role in management of their own health issues.
2. To increase health Awareness among the vulnerable groups, adolescent groups and Marginalized Cast Communities through Behaviour Change Communication
3. To organize health networks of Self Help Groups (SHGs), Community Based Organizations (CBOs), local NGOs, service providers and beneficiaries in detection, referral, treatment and advocacy for services to address prevailing health issues

Activities:

• Creation of strong linkages and network: Establishing network between local NGOs, community based organizations and the govt, service providers will improve case detection, access to services and treatment of the diseases at the community level and the PHC.
• Accessing basic health services: Community based health resources centres will be organised to bring health services to the communities. Community members will also be given information on availability of services and to influence health seeking behaviour. It is aimed that by changing the attitude of health workers people’s confidence in the health system will be enhanced.
• Capacity Building: This project aims to strengthen the knowledge, information and resource mobilization in reducing TB, HIV/AIDS, leishmaniasis, malaria and leprosy in the project area. Providing training to the community based organizations, Panchayat Raj institutions and private practitioners would improve case detection, referral and access to services. Local community based organizations can play a role of change agents to bring sustainable behaviour change among community members.

Project Activities:

Creation of strong linkages and network

Partners’ Meeting

The DCI co-funded BiHAP has picked up momentum at a faster rate. A meeting of all partner NGOs reviewed the progress at the initial stage at a meeting in Begusarai on 23rd May 07. Mr. B Vijayakrishnan, Regional Director and Rajni Kant Singh, State Coordinator moderated the discussions. Alpana Singh (Consultant) presented the Project Implementation Plan and Mr. Farhad Ali, Programme Manager presented the project progress. The partners also shared issues like

A State Level NGO Forum was constituted by the TB division of Bihar State Health Society. Mr. Rajni Kant Singh is a member of this forum, which will have decision making powers on NGO-GO collaborations in the State. This committee will review all the future activities related to TB and will be part of planning for the TB interventions in the state of Bihar.

Strengthening Community Based Organization (CBOs)

Journey towards Community Mobilization

BiHAP has started an innovative movement urging the communities to take health in their own hands. 25 Village Health & Sanitation Committees have been formed in each district of BiHAP area. Every committee has been trained on the five communicable diseases. The committee is taking the responsibility to create health awareness among the villagers, refer the suspected cases to the nearest PHC, and manage the health issues. Accredited Social Health Activists (ASHA) & Anganwadi Workers (AWWs) of the respective villages are members of this committee. There are regular monthly meetings with the committee members.

In Munger the committee was named as “PAHAL” (to take initiation), in Begusarai it is “SWAPNA” (Health for All – A Dream), in Bhagalpur it is named “ASTHA” (faith) and in Samastipur it is just called “Village Health & Sanitation Committee”.

Accessing basic health services

POD Camps in Munger and Samastipur

Making Waves – Working with the GHS

BiHAP works directly with the General Health System (GHS) at the Primary Health Centre (PHC) and community levels, through continuous dialogue with PHC Medical Officers and Accredited Social Health Activists (ASHAs). Some of the accomplishments of this collaboration are as follows:

1. The leprosy eradication programme is strengthened through training of GHS staff.
2. Camps for the Prevention of Disability (POD) is creating positive health consciousness for self-care and reducing stigma surrounding leprosy.
3. Capacity building programmes are improving the ability of the health workers to promptly refer suspected cases of diseases such as leprosy and tuberculosis.
4. Formal and informal interaction with Government Medical Officers is paving a bridge for the provision of better services to underserved communities in the project area.

In July, BiHAP organised seven POD camps. Two of these were held in Begusarai district, two in Samastipur, two in Bhagalpur and one in Munger. Non-Medical Supervisors (NMSs) from PHCs provided assistance in mobilizing known leprosy affected persons, as well as suspected leprosy cases, to attend the camps. As a result of this, camps brought together a mix of existing patients and suspected cases, alongside Government and Community workers, such as PHC Medical Officers, ASHAs and AWWs.
The results of the seven POD camps were as follows:

• Total patients attended – 143 (34 women and 109 men)
• Suspected cases attended – 72
• New cases confirmed – 37
• Patients referred for reconstructive surgery – 6
• POD kits distributed and self-care practiced – 143
• Micro-cellular rubber footwear distributed – 74

An extremely positive element of these POD camps was the active participation of both PHC and community level health workers. PHC Medical Officers contributed by sharing their experience at the camps and expressed their appreciation of LEPRA Society’s activities and the involvement of ASHAs and AWWs in the camps. It was widely felt among participants that the success of these camps was made possible only through collaboration between LEPRA Society, the community and the GHS.

Field test of the Village Health Register

Village Filariasis Intervention – A Success Story    
                        

Training of Trainers (TOT)

Leprosy Training for Anganwadi Workers

Workshops

Lymphatic Filariasis Disability Prevention Workshop

Rajni Kant Singh, State Co-ordinator, Bihar, attended a Lymphatic Filariasis (LF) workshop organised by Handicap International in association with Noguchi Hospital and Research Institute, Ghana. Disability prevention workers from seven countries (in Africa, Asia and the Americas) came together in this forum, to learn and exchange experiences, skills and knowledge in lymphoedema management. In the workshop, participants explored a more integrated public health approach for prevention of disability due to LF and other chronic diseases affecting the lower limbs (such as diabetes, leprosy and Buruli ulcer).

Globally, more than 1 billion people in approximately 80 countries live at risk of contracting LF. More commonly known as elephantitis, LF is a devastating parasitic infection spread by mosquitoes. Over 120 million people are already infected, with more than 40 million permanently disfigured by the disease.
India is the most endemic nation in the world, with 41% of the global disease burden. There are 28 million microfilaria (Mf) carriers, 21 million people with clinical disease and approximately 473 million (348 million in rural and 125 million in urban areas) currently living at risk of infection. The estimated annual economic loss incurred as a result of LF is $1 Billion. Bihar, which carries 20 percent of the LF caseload, is the one most endemic state in India. The National Filaria Control Programme was initiated in 1955 and extended to rural areas in 1982. MDA was launched in 2004. Commemorating malaria and national filarial Observance Day 31st May - National Anti- Filariasis Day  Lymphatic Filariasis (LF) is, after malaria, the second most common vector borne disease globally. The World Health Organization (WHO) estimated the global burden of infection to be 120 million with 1 billion people at risk of infection. LF is the second most important cause of long-term disability worldwide. BiHAP joined the Anti- Filariasis day was observance on 31st May in all four districts the project works.

Observation of Malaria Month

World Breastfeeding Week Celebration

The World Breastfeeding Week was observed in collaboration with our partners in Munger, Samastipur and Begusarai Districts. Many activities were organised to understand and acknowledge the importance of breastfeeding.
In Samastipur, eminent Paediatrician Dr. B. N. Prasad (Former Dir. of Health Services) spoke on the advantages of colostrums for new born baby and the importance of exclusive breastfeeding in the first 6 months of a child’s life.
A rally was flagged off by the Munger Civil Surgeon where a large number of women participated.
In Begusarai, there were community level meetings and a quiz contest on the importance of breastfeeding, initiation of breastfeeding, duration of breastfeeding, time of supplementary nutrition and introduction of complimentary feeding of the babies.  PRI members, private medical personnel, RMPs, AWWs and ASHAs participated in this event.

World AIDS day 2007: Take the lead

A grand function was organized to commemorate world AIDS day 2007 at Gandhi Maidan in Patna, on December 1, 2007 with the support of various organizations working on health issues in the state. Sai Achiever’s Trust took the main lead in organizing the event. Other partners for the event were LEPRA Society. Supramental Foundation, Mobile Theater, Rishab Digital Imaging and Research Centre and Samrat hotel. The function was inaugurated by Dr. C. P. Thakur, former union minister of health, government of India. Other distinguish guest present at the event were Mr. Anil Kumar Singh, minister of science

.The focus of World AIDS Day, this year is clearly engraved in the vision statement – Take the Lead. The event was well attended by government and non-government organizations and school children. These school students participated in skit competition, drawing competition and debate competition. All these activities were around the central theme of this year’s world AIDS day i.e. Take the Lead. The school students distributed the red ribbons and pamphlets to all present in the event

Sravani Mela  - A Special IEC Event

Sravani mela is a month long religious carnival where devotees go to the historic Shiva temple in Deoghar (a district of Jharkhand) after taking the water from the holy ‘utrawahini Ganga’ in Sultanganj. This is an annual event and attracts over three million people. The mass of humanity includes pilgrims from various parts of the country, Bhutan, and Nepal. The pilgrims, known as 'Kanwarias' (pall bearers), walk from Sultanganj to the holy town of Deoghar.

Every year LEPRA Society uses this opportunity to spread the message of good health practises and information on disease management. This year it launched a massive IEC campaigns in association with District health Authority & local Panchayati Raj using two of its IEC Mobile Van and two jeeps fitted with PAS (Public Address System). We also supplied 50,000 leaflets with information on signs and symptoms of diseases. A health camp was organized on the route to Deoghar for 30 days. All supportive medicines were provided in the camp. The Mukhia (Village Leader) supported us by providing a doctor for the camp. ANM, AWW and ASHA where deputed by Districts Health Authority. 

BiHAP which was launched in April 2007 has successfully completed one year of its project period. The project activities were affected by the floods in two districts of its project implementation programme   But we are sure in the days to come by, BiHAP will be able to successfully instil the process of awareness in the field of health that has been planned in this project for community in which it is working.  We sincerely appreciate the government officials and community for all their support rendered to the project.