Concept of Call Centre A UNICEF/KSRA Referral Network Project Implemented By: Karra Society For Rural Action, Ranchi, Jharkhand next

The Project Establishing Referral Networks / Call Centers to Reduce MMR and IMR in Six Blocks of Khunti District of Jharkhand. next Blocks Covered: Karra, Khunti, Torpa Arki, Rania and Murhu

Goal Vulnerable families attain sustainable development through access to better and timely health services and information to reduce MMR and IMR.

Specific Project Objectives To establish and provide quality referral services especially related to obstetric and infant health care in all the villages falling under six Blocks Viz: Khunti, Karra, Torpa, Arki, Rania and Murhu of Khunti District, Jharkhand. To establish and provide quality referral services especially related to obstetric and infant health care in all the villages falling under six Blocks Viz: Khunti, Karra, Torpa, Arki, Rania and Murhu of Khunti District, Jharkhand. To create a pool of village health volunteers such as eligible couples, young women from SHG with knowledge on Reproductive Child Health To create a pool of village health volunteers such as eligible couples, young women from SHG with knowledge on Reproductive Child Health To increase safe delivery practices, through increase in – institutional deliveries and deliveries by trained birth attendants. To increase safe delivery practices, through increase in – institutional deliveries and deliveries by trained birth attendants. To establish community ownership by establishing a Call Centre in each of the six Blocks of Khunti District to facilitate fast referral services such as emergency delivery, pre/post pregnancy complications, other serious illnesses. To establish community ownership by establishing a Call Centre in each of the six Blocks of Khunti District to facilitate fast referral services such as emergency delivery, pre/post pregnancy complications, other serious illnesses. To strengthen and create effective tie up with Block, District and State level government health institutions and UNICEF to achieve the desired goal. To strengthen and create effective tie up with Block, District and State level government health institutions and UNICEF to achieve the desired goal.

Why this Project ?  Deliveries are conducted in most unhygienic conditions on unclean surface. Often animal sheds are used to conduct deliveries  Hands and cloths of birth attendant is unclean or not properly cleaned  Objects like arrow, Situha, sickle or any sharp metallic objects are used to cut naval chords  These traditional birth attendants are not skilled enough to identify or handle cases of severe complications  Danger signs before or after the delivery is not identified for referrals  New born are bathed immediately after delivery  Proper breast feeding practices is not followed next

What we Want to Achieve? We Wish to reduce MMR and IMR among 1562 identified pregnant women in all the villages of 6 blocks- Karra, Khunti,Torpa, Arki, Rania and Murhu of Khunti District. next

Expected Outputs Community mobilization for health issues by strengthening SHGs in Karra, Khunti, Murhu and Torpa Blocks in selected villages. Community mobilization for health issues by strengthening SHGs in Karra, Khunti, Murhu and Torpa Blocks in selected villages. Demand generation for govt. health and other schemes and services from communities. Demand generation for govt. health and other schemes and services from communities. Strengthening of referral services through call centres, in coordination with SHGs,Community Level Health Services Providers to help reduce MMR and IMR. Strengthening of referral services through call centres, in coordination with SHGs,Community Level Health Services Providers to help reduce MMR and IMR. Develop systems for effective monitoring through constant interface between different stake holders such as community, government Block and District State health officials, KSRA and UNICEF. Develop systems for effective monitoring through constant interface between different stake holders such as community, government Block and District State health officials, KSRA and UNICEF.

How we want to Achieve? Step 1 By Community Mobilization & Health Awareness through SHGs in all the Villages of Six Blocks under Khunti District. By Community Mobilization & Health Awareness through SHGs in all the Villages of Six Blocks under Khunti District. By Creating Health Fund to be used during emergencies. By Creating Health Fund to be used during emergencies. Step 2 By Identifying and linking available Vehicles around these villages for the benefit of Pregnant Women and others at the time of delivery need. By Identifying and linking available Vehicles around these villages for the benefit of Pregnant Women and others at the time of delivery need. Step 3 By establishing and running 24 X 7, Call Centre, one each in 6 Blocks covering all the villages of 6 Blocks under Khunti District and providing vehicles for quick referral work. By establishing and running 24 X 7, Call Centre, one each in 6 Blocks covering all the villages of 6 Blocks under Khunti District and providing vehicles for quick referral work. next

Activities Performed to achieve the Result Awareness through Community Organization-SHGs : The project understand that the awareness is the key to improve the health status of the villagers, awareness about improving health status of newly born child, awareness on precautions during the pregnancy and safe delivery of the mother. Awareness through Community Organization-SHGs : The project understand that the awareness is the key to improve the health status of the villagers, awareness about improving health status of newly born child, awareness on precautions during the pregnancy and safe delivery of the mother. Awareness through Street Play: The rural population are culturally and traditionally attached with dance, song and plays. So street plays performed in these Blocks are attracting huge rural audience and helping in awareness generation on issues of reproductive and child health and various government health schemes. Awareness through Street Play: The rural population are culturally and traditionally attached with dance, song and plays. So street plays performed in these Blocks are attracting huge rural audience and helping in awareness generation on issues of reproductive and child health and various government health schemes. Training Of Traditional Birth Attendant : The project seeks to identify the unskilled birth attendant to get them trained so that at emergency hour the birth attendant may care properly and can successfully deliver or refer to the nearest Hospitals. Training Of Traditional Birth Attendant : The project seeks to identify the unskilled birth attendant to get them trained so that at emergency hour the birth attendant may care properly and can successfully deliver or refer to the nearest Hospitals. Training Of SHG Leaders And Sahiyya : The Sahiyya is major stake holder in this program and largely helping the supervisors at the field and simultaneously helping out pregnant women. Training Of SHG Leaders And Sahiyya : The Sahiyya is major stake holder in this program and largely helping the supervisors at the field and simultaneously helping out pregnant women. Training Of Master Trainers: Training Of Master Trainers: These Trainers are drawn from PHCs, Project Supervisors and trained as Master Trainers by the Doctors of the PHCs. Follow up training is also organized to help increase their knowledge. These Trainers are drawn from PHCs, Project Supervisors and trained as Master Trainers by the Doctors of the PHCs. Follow up training is also organized to help increase their knowledge.

Activities Performed to achieve the Result Call Centre Worker Training On Call Centre Management: Six Call centers, each in 6 blocks with 18 call center workers are operational 24 hours. Call Centre Worker Training On Call Centre Management: Six Call centers, each in 6 blocks with 18 call center workers are operational 24 hours. Call centre worker computer training: Each of the Call Center is provided with one Desk Top Computer and all the call center operators are provided basic computer operation training to enter information/data. Call centre worker computer training: Each of the Call Center is provided with one Desk Top Computer and all the call center operators are provided basic computer operation training to enter information/data. Meeting With Stake Holders: In order to get support of all the stake holders, government officials and UNICEF officials different meetings were organized and regular quarterly, monthly meeting were performed Meeting With Stake Holders: In order to get support of all the stake holders, government officials and UNICEF officials different meetings were organized and regular quarterly, monthly meeting were performed

HR ARRANGEMENT Coordinator: One District Coordinator Coordinator: One District Coordinator Supervisors: 15 Supervisors in 6 blocks Supervisors: 15 Supervisors in 6 blocks Call Centre Operators: 3 Operators in each Call Center, total 18 in 6 blocks Call Centre Operators: 3 Operators in each Call Center, total 18 in 6 blocks For accountability, the organization has fixed role and responsibility of each of the human resources involved in the program. The clarity in the role and responsibility has made the system stronger and transparent. It is always easy to monitor and evaluate each of the staffs at different hierarchy according to the work defined.

REFERRAL TRANSPORT MODEL The problem of unavailability of vehicles in the remote villages is a big problem for the villagers at emergency period especially at night. The major thrust of the project is to arrange vehicles on time and assure availability at remote villages. To feel the big gap of arrangement of vehicle was a real challenge before the project so to streamline the vehicle arrangement. Vehicle Mapping Vehicle Mapping Meeting with Vehicle Owners/Drivers Vehicle Code were generated Vehicle Code were generated Pvt. Vehicle used Pvt. Vehicle used

Establishing Call Centre The Call Centre is established in at each PHC, or in Block Campus as the space is scarce. The CALL CENTRE is a central place of referral network from where all stake holders are connected through its database and phone nos. The database and phone no in the call centre include list of SHG, vehicle maps with contact number, list of PHC, Doctors, Nurses, Sahiya, ANMs, TBAs, District Doctors, health Officials, their contact and Private Hospitals, Doctors with their contact. Project’s Officials will be in constant touch with Call Centres, District Health Officials, Doctors etc.

Monitoring and Evaluation The monitoring and evaluation is a regular process done by the coordinator and the chief functionary of the organization. The District Project Coordinator has a set methodology to adopt for effective monitoring and evaluation (Given in the Document under Monitoring evaluation section) FORMATS In order to get the data from the field staffs and call centre operators for effective functioning, monitoring and evaluation purpose different formats were used. ( Formats provided in Document under Format Section) In order to get the data from the field staffs and call centre operators for effective functioning, monitoring and evaluation purpose different formats were used. ( Formats provided in Document under Format Section) Weekly, Monthly and quarterly review Meetings : Weekly, monthly and quarterly meeting were also performed for review, evaluation for effective implementation of the project. Weekly, Monthly and quarterly review Meetings : Weekly, monthly and quarterly meeting were also performed for review, evaluation for effective implementation of the project. Random Visit to the field and the Call Centre: The random visit by the Head office officials, chief functionary and the coordinator has mad the monitoring process robust. Random Visit to the field and the Call Centre: The random visit by the Head office officials, chief functionary and the coordinator has mad the monitoring process robust.

MAJOR BREAKTHROUGH The existence of call centre for the villagers has been major breakthrough of this innovative program. The villagers who never thought of such practical arrangement to save the life of pregnant women have access to this service today. The vehicle arrangement at any time any where is something like dream come true for the villagers, there is various villages which is very remote and even the people ignore to visit those villages has been covered by the call centre vehicle arrangement system. The existence of call centre for the villagers has been major breakthrough of this innovative program. The villagers who never thought of such practical arrangement to save the life of pregnant women have access to this service today. The vehicle arrangement at any time any where is something like dream come true for the villagers, there is various villages which is very remote and even the people ignore to visit those villages has been covered by the call centre vehicle arrangement system.

OUTCOME/ IMPACT OF THE PROJECT IN ONE YEAR SHGs and the Call Centre SHGs and the Call Centre SHG Contribution SHG Contribution Sahiyya & Call Centre Sahiyya & Call Centre Community and Call Centre Community and Call Centre Community awareness level increased Community awareness level increased Decrease in IMR/MMR by providing training to birth attendant Decrease in IMR/MMR by providing training to birth attendant Institutional Delivery Increased Institutional Delivery Increased Accessibility of health services and benefits under the Institutional delivery Accessibility of health services and benefits under the Institutional delivery Health Fund generated among SHGs: Health Fund generated among SHGs: Coordination between the Health department /Health workers at village level and with the community Coordination between the Health department /Health workers at village level and with the community

SHGs ON EMERGENCY Call Centre next Blood Emergency Expenses Accompanying Patients KHUNTI SADAR HOSPITAL

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