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From the Executive Director's desk

Poonam Muttreja

By all accounts, the year 2015-2016 has been a remarkable one for PFI. A time of endings and unforeseen achievements, it saw a large programme of ours, Health of the Urban Poor, reach completion; it saw the transmedia edutainment initiative, Main Kuch Bhi Kar Sakti Hoon, designed to change social norms and attitudes, scale appreciable heights; it saw a further strengthening of our collaboration with the Ministry of Health and Family Welfare, Government of India and the state governments of Bihar and UP; it saw a heightening of our work with the media; and the emergence of Quality of Care as an area of prime consideration in family planning initiatives. In addition, high quality knowledge products and evidence building continued to enrich and promote PFI’s work.

Organisationally speaking, there are two major developments that I would like to share with you. PFI’s Five-year Strategic Plan (2016-2020) was approved by the Governing Board and is now being executed. The end result of an exhaustive participatory exercise, it builds on our past work and provides a blueprint for action for the next five years. Its driving focus is the repositioning of family planning within the women’s empowerment and human rights framework in national development and in the maternal and child health policies and programmes of the country. Also, for the first time, since PFI’s inception, we have a compelling historical document that traces PFI’s journey from the beginning to the present day, available as a monograph. Prepared by Dr Radhika Ramasubban, it brings together scattered information in an arresting and cohesive manner.

The enabling policy environment makes it possible to continue to take steps towards empowering women and men, so that they are able to take informed decisions related to their fertility, health and well-being. The partnership and understanding between PFI and the Ministry of Health and Family Welfare (MoHFW) have led to significant progress in terms of choice in family planning services. It is noteworthy that the National Family Planning Summit in 2016 focused upon a rights-based approach to family planning. PFI was privileged to be invited as a civil society representative to make a presentation on it at this important event.

The close collaboration between PFI and the Advocating Reproductive Choices (ARC) coalition and the strategic positioning of its secretariat in PFI, made possible sustained advocacy to expand contraceptive choices and improve the Quality of Care, which remains a key and lasting lesson from the Bilaspur tragedy of last year. Equipped with an advocacy strategy, the coalition sought to identify strategies to support the Government of India in the roll-out of injectable contraceptives. It also flagged the Quality of Care in family planning services and the introduction of modern spacing methods as areas requiring priority focus in the family planning programme.

This year saw the completion of the Health of the Urban Poor (HUP) programme and I am pleased to record that it has left behind lasting imprints which will impact the future of urban health in India. Its achievements are many, not the least of which is the design support that it provided to the National Urban Health Mission (2013), which was non-existent at the time that HUP (2009-2010) was initiated. In addition, it brought out the inadequacy of urban community processes for addressing issues, which are peculiar to its setting and vastly different to the rural. The most vulnerable populations and their issues were visibilised and this was no mean accomplishment. The legacy it leaves behind includes, knowledge tools to address this category of population and operational and training manuals that can be used by the states and the Centre. The programme also supported states in preparing programme implementation plans (PIPs) that have helped advance the urban health agenda.

We successfully completed Season One of our flagship programme, Main Kuch Bhi Kar Sakti Hoon (MKBKSH), the entertainment education based transmedia initiative of PFI. The findings of the endline evaluation which sought to assess changes in the Knowledge, Attitude and Practices (KAP) on family planning, child marriage, son preference, gender discrimination, domestic violence and sex selection, have far exceeded our expectations. They distinctly show that the programme has had a measurable and positive impact on the knowledge and perception of the viewers and women’s agency. We are therefore now clearly in a position to endorse the model as one that has been tested and found to be effective. It provides the evidence that MKBKSH has delivered well and is in a position to aspire for a higher reach and impact. With this in view, PFI commissioned a sustainability study to explore its potential in an edutainment universe, define a new aspiration and recommend an appropriate strategy. This was carried out by 9.9 Media under the leadership of Dr Pramath Sinha and Ms Anuradha Das Mathur.

In line with its role as a learning and sharing organisation, the achievements of the television series have been shared at various national and international fora, including the 2016 International Conference on Family Planning. These have helped in shaping an acceptance of the intervention as a tested edutainment model for social change. In a tribute to the scalability of MKBKSH, PFI was given the responsibility of rebranding the Rashtriya Kishor Swasthya Karyakram (RKSK), the National Adolescent Health Programme of the Government as “Saathiya” or companion; and of establishing and promoting an identity for the 800,000 peer educators under it.

A major milestone this year has been the finalisation of the new UP Population Policy (2016-2030). This was a process in which PFI was honoured to be involved at the invitation of the state Government of Uttar Pradesh. I take this opportunity to thank the Government of UP for their confidence in PFI and the distinguished members of the review and drafting committees for their insights and dedication. There is considerable satisfaction in the fact that the objectives of the end product, which are derived from the ground realities and tailored to not only overcome challenges but also meet the aspirations of the people in the state, have been organised by life stage and include gender equality and quality of care, as separate cross-cutting issues.

At the ground level as well, we have a major achievement, which I’m pleased to share with you. Family Planning District Working Groups have been formed in select districts in both UP and Bihar, a clear tes-tament to the partnership enjoyed between PFI and the Mission Directors of the NHM in the respective states. Essentially multi-stakeholder in composition, the DWGs under the Chairmanship of the Chief Medical Officers, have representation from different government departments, which include Panchayati Raj, Education and ICDS along with civil society organisations and other development partners.

In yet another milestone in Uttar Pradesh, PFI has been able to successfully work with the National Health Mission (NHM) to introduce a review mechanism at the divisional level. In addition to facilitating updates on the programme’s progress, this will also provide an opportunity to identify issues and challenges and come up with solutions. It gives me great pleasure to inform you that the National Health Mission of UP has nominated PFI to provide technical support to the 18 divisions in organising these meetings.

At the community level as well, there have been positive developments. The Advisory Group on Community Action (AGCA), constituted by the Ministry of Health and Family Welfare (MoHFW), to provide guidance and support for community action initiatives under the National Health Mission (NHM), focused efforts to strengthen and scale up implementation of the component, across 22 states. Among others, this included capacity development and mentoring of state level institutions to strengthen and scale up implementation and the development of tools and communication materials. It also involved providing inputs in the development of the community action for health component of the State NHM Programme Implementation Plans (PIPs), conducting periodic reviews and strengthening accountability mechanisms. In addition, PFI developed a monograph on grievance redressal, capturing experiences, lessons learnt and challenges encountered in the implementation of other such initiatives in India. Both sharing and learning received an impetus through two regional consultations that were organised on community action for health, bringing together 82 participants from 24 states.

In an another example of the footprints it leaves, PFI left a marked one at the 2016 International Conference on Family Planning in January this year. Through the India Caucus meeting that it organised, it successfully facilitated a fruitful interaction between delegates from India and high level officials of the Government of India led by the Minister of Health and Family Welfare, on key government priorities in family planning.

And this brings me to a partnership that PFI has always considered special. Though the media has always been an important partner for PFI, we took that partnership to another level this year through efforts to increase their understanding on family planning and its linkages with the health of women and children. Attempts were also made to ensure greater media coverage of and attention to stories and articles on the issue of family planning to make it more visible in the development dialogue. Several editorials and articles were written by PFI and placed in the national and regional media.

In line with policy advocacy, the heart of its work, PFI commissioned a study to assess the resource requirements for meeting India’s FP2020 commitments. This has made available a resource that can be useful for stakeholders to plan for bridging the gap in terms of making available contraceptive supplies, outreach services, and trained manpower to address unmet needs.

As always, programmatic changes also lead to the induction of new employees and we are no exception. At PFI, we celebrate new energies and a fresh way of looking at things. After a gap of three years, PFI organised a two-day all-staff retreat, which included the state offices, in February, 2016. This served to bring everyone together and to collectively plan for the way forward, team-wise and organisationally. In addition, all PFI staff were oriented on the sexual harassment policy by Ms Vrinda Grover, a lawyer, researcher, and a human rights and women’s rights activist of repute based in New Delhi.

Within the backdrop of this rich tapestry, what do we plan for the coming year? As of now, efforts are ongoing to facilitate improvements at the policy level for increasing investment and choice in family planning services that meet a certain standard. Our immediate plan is to focus primarily on consolidation in terms of Social and Behaviour Change Communication, Community Action for Health, Urban Health and Advocacy. I see issues related to the continuum of care, quality of family planning services, expansion of the basket of contraceptive choices and male engagement, as areas of priority for us. At the same time we would be ready and willing to respond to any unforeseen challenges or opportunities that may occur.

May I say, that we would not have been able to achieve much of what we have, without our valued partners, viz., the Government of India and state governments, our funding agencies, our implementing partners and civil society and research organisations. I would also like to take this opportunity to express my warmest appreciation to the PFI Governing Board, the Executive Committee and Advisory Council for their unqualified and generous support at all times - without which, achievements would remain a distant dream.