Summary of PSI / India Child Survival Program
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What is Social Marketing?
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India’s population of one billion is expected to reach 1.26 billion by March 2016. With 28 states, India is one of the most geographically and culturally diverse countries in the world. Health and social indicators also vary, requiring State, District, and even community level focus and prioritization of health programs to address the population’s needs. Maternal mortality remains one of the highest in the world, with an estimated 500 maternal deaths per 100,000 live births, totaling over 100,000 maternal deaths in one year. India ranks second (after Bangladesh) for the highest percentage of low-birth weight infants and forty-ninth for the highest under-five mortality rates1. Over 20% of India’s children under five are malnourished, and 40% of the world’s malnourished children live in India. As a response to this complex and challenging situation, PSI/India proposes a range of complementary social marketing strategies for improving Maternal and Child Health (MCH) in three northern Indian States: Uttaranchal (UR), Uttar Pradesh (UP) and Jharkhand (JH). The purpose of this project is to create positive behavior change in MCH among, and increase the use of essential MCH products by low-income populations of these States. The basket of essential MCH products that is proposed in this project include clean delivery kits (CDKs), iron folic acid tablets (IFA), safe water system (SWS), oral rehydration salts
(ORS), oral contraceptive pills (OCPs) and condoms. Saadhan is positioned in this project as the key to integrating MCH interventions. The word Saadhan means “way” or “means” in Hindi. Its logo, a key, was developed by PSI/India as an umbrella logo for its products. As the “key to family health”, Saadhan integrate various family health issues—management of diarrheal disease, safe motherhood, birth spacing, and STD/HIV/AIDS prevention—under one visible symbol. The project has two components:
- Social marketing of a Saadhan basket of 6 essential MCH products in the three States
- Pilot of a Saadhan referral network of private medical providers in low-income urban centers of Dehradun and Hardwar of Uttaranchal.
In both components, social marketing efforts will adopt distribution and Behavior Change Communication (BCC) strategies that complement one another, and work with a variety of key players who can influence low-income individuals and families. These players include 1) private medical practitioners who serve low-income families, 2) commercial trade representatives, including chemists, grocers, local shop owners, 3) field-level health workers, such as traditional birth attendants (TBAs), auxiliary nurse midwives (ANMs) and community health workers (CHWs) working through NGOs and CBOs, and 4) mothers and fathers of children aged under 5 who belong to low-income settings. The objectives of the social marketing component (Component I) are to: 1) Increase access to the Saadhan basket of essential MCH products, 2) Increase awareness of Saadhan products among low-income families, 3) Improve awareness and collaboration between public, private and NGO regarding integrated MCH, 4) Strengthen PSI/India’s capacity to implement a more sustainable integrated family health program, and 5) Expand PSI’s capacity in integrated MCH. Specific social marketing strategies are implemented according to the requirements of each MCH product: condoms, OCPs and ORS are “over the counter” drugs and use PSI India’s extensive distribution network of commercial channels, whereas IFA tablets are available by prescription only, and distributed through private medical practitioners and licensed chemists licensed. CDKs will be introduced in selected Districts in partnership with NGOs dealing with networks of TBAs and health agents. The marketing of SWS will be piloted using a three-pronged approach, combining trade, community-based interventions, and benefiting from the health providers’ network from component II. For Component II, PSI/India’s methodology adopts features from social franchising to pilot the implementation of a referral network of private medical practitioners in low-income areas of Dehradun and Hardwar cities, UR. The pilot network will bring together 240 private medical providers to competently provide quality products and effective counselling for MCH, and refer to selected sites for those services outside of their area of competence. Training and follow-up will be done through local partners. The Saadhan network will be promoted through local media, and interpersonal communication. Estimated levels of effort by intervention is as follows: nutrition/micronutrients, 20%; control of diarrheal disease, 20%; maternal and newborn care, 15%; child spacing, 30%; immunization and breastfeeding promotion, 15%. For component I, the estimated target population is 6.4 million women of reproductive age, and 5.5 million children under five. For the referral network (Component II), beneficiaries are the clients of 240 private medical providers participating in the network. The project will benefit from GoI subsidies for social marketing products, PSI/India’s matching grant based on sales revenues, and other sources of funding that PSI/India has been able to mobilize, and will coordinate for cost-effective and sustainable impact. web site PSI
1 The State of the World’s Children 2000, UNICEF.