The year 2012-13 has been a very significant one for us. I am happy to report that our work, on repositioning family planning is bearing fruit. We are making steady progress in bringing family planning back to the centre stage of development discussions, within India and globally. By sharing evidence of its linkages with maternal health, women’s empowerment and development, Governments, Indian and foreign, and the development community are beginning to realize its intrinsic worth.
Well-documented studies reported in a recent special issue of The Lancet clearly establish that family planning saves women’s lives, improves maternal and child health, gives girls a chance to complete their education and find and stay in employment, contributing in significant ways to a country’s development. What could be a more powerful tool than this for progress?
We have actively engaged officials from government and representatives from civil society in several rounds of discussions on family planning, maternal health and public health. The findings of PFI’s systematic review of national and global evidence on best practices in family planning were shared with senior government officers, social activists, demographers, public health researchers, donors and grassroots workers.
Why is it that in spite of India’s Total Fertility Rate declining to 2.5 and many states achieving replacement level fertility, we do not see corresponding declines in maternal and infant mortality? Why has the decline in fertility rates not been even across the states, with some reporting continued high fertility? We continue to engage with these questions.
PFI also contributed to the chapter on health in the Twelfth Five Year Plan. We noticed that the draft chapter had paid very little attention to family planning, the health of the urban poor and community monitoring. PFI advocated for a greater emphasis on family planning as a basic human right, the need to expand contraceptive choices, focus on adolescents and the urban poor and give importance to people’s participation through community monitoring. The Planning Commission accepted our suggestions and incorporated them into the chapter on health.
PFI, in its capacity as the Secretariat of the Advisory Group on Community Action (AGCA), continues to work towards strengthening the capacities for implementation of the community based monitoring and planning and scaling up across the states. This year, after eight years of successful work we wound up one of our major programmes — Promoting Access to Care and Treatment (PACT) — funded by the Global Fund. This programme, which started in April 2005 in six high focus states, sought to improve the survival and quality of life of People Living with HIV and reduce HIV transmission. Over the years the programme has expanded to 18 states and one Union Territory.
PFI faced a major challenge when in August 2010, the Global Fund directed us not to sign the agreement with one of the sub-recipients, pending a fiduciary review. As a result, PFI found itself having to directly implement the programme through over 200 District Level Networks (DLNs) in nine states. Though this was meant to be an interim arrangement, PFI continued to be involved for 32 months, without any additional resources or staff. During this period, PFI enhanced the capacities of the DLNs in the nine states by training their staff and establishing strong operational financial and programmatic systems. The Global Fund has acknowledged PFI’s efforts in achieving targets and ensuring timely reporting despite the many challenges.
Under our Health of the Urban Poor (HUP) program, we continued to assist the Central government, eight state governments and five city governments in designing and implementing urban health programmes. We have also extended technical assistance to the MoHFW for the formulation of the National Urban Health Mission (NUHM), which was approved by the Cabinet on May 1st, 2013 as a sub-mission of the National Health Mission. PFI is now actively supporting the MoHFW in startup activities related to the launch of NUHM at national and state levels. Recognizing the strength of our HUP program, MoHFW has requested PFI to provide technical support to its Urban Health Division. The programme is meant to strengthen community processes, improve planning and monitoring systems to deliver innovative and scalable models of preventive and primary healthcare, especially maternal, neonatal and child health services, and integrate other determinants of health — nutrition, water, sanitation and hygiene — for the urban poor and vulnerable populations living in urban areas.
PFI has been awarded a second grant by Advance Family Planning following the successful implementation of the first phase, which involved building the capacities of staff and partners in advocacy for advancing family planning. The five-year grant is supported by the Bill and Melinda Gates Foundation through the Johns Hopkins Bloomberg School of Public Health.
It has indeed been an action packed and fulfilling year. I would like to thank all our partners who have contributed in making our programmes a success. This would not have been possible without the hard work and commitment of the staff at PFI and guidance from the Governing Board members.
(From our Annual Report 2012-13)