Integrated Program for Community Development (IPCD)

END OF THE FIRST PHASE EVALUATION FINDINGS OF THE INTEGRATED PROGRAM FOR COMMUNITY DEVELOPMENT (IPCD) IN TAMIL NADU, INDIA

Introduction

Indian Red Cross Society Tamil Nadu State Branch (IRCS-TNB) has been implementing the Tsunami Bi-lateral Program in collaboration with Canadian Red Cross (CRC) in six districts (Cuddalore, Nagapattinam, Tiruvarur, Thanjavur, Pudukottai and Kanyakumari) of Tamil Nadu since 2006. The program covers 12,565 households and reaches 62,425 people from 29 tsunami affected coastal villages. This program which started as an immediate humanitarian response to the tsunami disaster, focusing on health and livelihood, has put more focus on the multi-dimensional needs and long-term consequences for the target communities by integrating Disaster Risk Reduction (DRR) and Child Protection (CP) in the schools and community, since 2009 (ref figure 1 for IPCD program components).

The first phase of the Tsunami bilateral program ended in March 2010. In June 2011, IRCS and CRC commissioned the end of first phase evaluation by external consultants. The objective of the study was to understand the progress made so far, processes, modes of implementation used and lessons learned to make appropriate changes and build capacities to facilitate sustainability. The report highlights the methodology and program results from the end of first phase evaluation.

Fig.1. IPCD Program Components

Methodology

The evaluation although largely retrospective / historical in design, was strengthened by the use of comparison groups and baseline data.

Data collected in this evaluation was compared with baseline data completed in 2007 to assess the impact / contribution of the IPCD to the communities. In addition to the relevant baseline data available, two focus group discussions with community members of neighboring non-IPCD villages (as comparison groups) were conducted, to assess the impact / contribution of the IPCD. A mixed-method approach was used not only to gather multiple lines of evidence but also as the best practice to triangulate and validate data / evidence to enhance the credibility of the findings. The key methods used included, desk review, key informant interview, focus groups, case studies, field visits and household survey. Case studies of six villages, one in each district were also done as part of the evaluation to get a holistic perspective of all components of IPCD in the village.

For the household survey a sample of 870 households were selected across 29 villages in six districts using a two-stage cluster sampling. The survey tool with 108 questions was developed in English in consultation with all the stakeholders and was finally translated into Tamil and fine-tuned after a pre-test. In all 48 surveyors, 4 supervisors and 4 data entry persons were trained to conduct and complete the survey between June 16th and June 26th, 2011. A quality control system was put in place to verify the data collected and data were entered every day. The survey team travelled 4400 kms over six districts in 13 days to gather the data.

Overall the IPCD has been very successful in carrying out high volumes of activities to enable knowledge dissemination, and capacity building at the community level.

The crèche program helped in providing additional nutritional food to children and better environment and methods to learn. The children who graduated from the crèche to the primary schools were reported to be better prepared and well behaved compared to those who did not attend the IPCD crèches. This reflected on the quality of training provided to crèche teachers and their ability to put in practice what they learned through resources provided by the IPCD.

The health promoters (HPs), volunteers from the community, each covered about 36 households. They were the key link in the communities for the IPCD and played a vital role as behavioral change agents in the villages. They disseminated information on MCH, First Aid, injury prevention, HIV/AIDS, child development and anemia in adolescent girls and helped to increase access to government health services. The health promoters have evolved as the key link between government services and the community. Their capacities and reach has been utilized by the government health services in informing the communities, distributing polio drops and Iron Folic Acid to communities, organizing heath camps and conducting health censuses among others. This was found to be a strong linkage for the benefit of the community.

The health promoters have also become the first person to go to for 83% of the households in terms of first aid related needs. Overall 23% of the households considered health promoters as the main source of information to go to first for pregnancy complications, next only to nurse / mid-wife / government health worker (46%). This endorsed the fact that the HPs have emerged as key persons to be contacted in the community in terms of health. This was found to be possible due to the eight different training programs on health topics, given to the HPs over the life of the IPCD and ready availability and accessibility of the HPs at no cost to the community.

Overall the effectiveness of the knowledge dissemination could be seen not only from the increase in proportion of households being aware of health information (as compared to the baseline survey in 2007), but also due to the behavioral changes of households, which included:

• 46% of women breast feeding 19 to 24 months compared to only 37% in 2007
• 29% of households maintaining growth charts compared to only 5% in 2007
• 31% of households having vaccination cards as against 18% in 2007
• 92% of the households stored drinking water in a closed container
• 88% of the households used at least one method of purification of water to make it safe to drink (60% in 2007)
• 80% of households boil water before they drink (41% in 2007)
• Washing hands before eating (98%) and food preparation (88%) compared to 56% and 57% respectively in 2007
• 38% of households threw garbage in dust bins (only 5% in 2007) and
• 86% reported that they have been able to reduce day-to-day unintentional injuries and household accident.

The increase in knowledge on health and positive behavioral changes in terms of health and hygiene can be attributed to the work of HPs and the IPCD activities. The 145 health camps conducted during 2009 and 2010 by IPCD enabled IPCD to bring health services closer to the communities reaching 4149 under-five children, 3060 adolescent girls, 5,527 women and 2,703 men (senior citizens).

Overall the 61 Community Development Group for Rebuilding Livelihoods (CDG-RL) was working well with established systems and processes with grants given still secure. The outcomes included, self-confidence of the members, complementing household income, savings habit, readily available loans at lower interest, and community members working together and forming a "we feeling". The success of the CDG-RLs can be attributed to the IPCD. The highlights of the livelihoods component included:

• Increase in resources (funds) in each group due to contribution of monthly savings and interests earned; and
• Formation of the Red Cross Fisherman Federation in Tiruvarur with 32 CDGRLs Federating together to benefit from collective negotiations and savings

The school program in 79 schools has been able to reach more students compared to the JRC model and has added value to the JRC concept. It has also reached students in the primary and middle schools. The selection of 1,085 peer educator to teach the students has been seen as a good concept. The positive outcomes like improved personal hygiene, overall life skills, and knowledge of first aid and or HIV/AIDS have been some of the highlights achieved within the short period. The interest and enthusiasm of the JRC counselor will be a key factor in the success of this component.

Overall it was seen there has been high awareness created on violence prevention against children due to community sensitization through the HPs. 96% of the adults agreed they have the responsibility to keep children safe. Overall gender has been a cross-cutting theme at the beneficiary level and women have been a focus in all the IPCD activities and community structures formed

Some anecdotes from the beneficiaries as recorded during the survey

• Cleanliness and health conditions have improved after they started going to the crèche – (from parents Focus Group Discussion)
• At home they were lazy and alone, now they are active and learn with other kids at an early age – (from parents FGD)
• Now they (children) wash hands and legs and then only eat, without we telling them.......not before – (from Community Development Group for Rebuilding Livelihood)
• Children now wash with soap - they learned in school – (from CMG)
• We can contact the health promoters for any emergencies at any time – (from FGD)
• The VHN has our (telephone) numbers.....she calls us by phone and coordinate whenever she needs us; and We have also been called to attend meetings with the doctor – (from Health Promoters FGD)
• Before we were just housewives, now we can do other things .....no difficulties. I can go to bank now by myself (not before)......now we know what to do in the bank. We now know more "worldly" information – (from CDG-RL FGD)
• There is a support system ("help") now – we can approach health promoters – from Village Disaster Management group
• We are able to meet with government officials....even District Collector – from Community Micro Groups
• Children told us about not to hit them – from CDG-RL
• We do not yell at children now – health promoters FGD
• Now we know how to "handle" children – from VDMT
• We do not hit children now – from CMG

In addition, the survey also threw out areas that need to be strengthened to continue achieving similar or better results in the future, sustain programs with local capacities and resources. The IRCS is taking up those recommendations forward to improve the outcomes further.

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