Tag Archives: training

CK’s Child Development Corner

The child development corner project, which was initiated last year, is almost complete. The corner is now a bright spot in our community center, Ma o Shishu Shiksha Kendra, with yellow colored walls, shelves filled with toys and books, and comfortable foam mats for the children to explore and play. Display boards have been put up to exhibit children’s artwork and important child development messages. Once the curriculum has been finalized for child development sessions—due to be completed this month—child development sessions within the child health community meetings will be initiated. In the meantime, during community meetings (which take place almost every afternoon) the space is being used for play by children whose mothers are attending the meetings.

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In February, Calcutta Kids organized a training workshop on child development to achieve the following goals:

1.) To provide a foundation on child development for Calcutta Kids’ health workers who will be working with mothers and children during the child development sessions. The health workers will use the lessons to teach mothers how to stimulate their children through play.

2.) To solidify curriculum development for the child development sessions to be started in April. This will ensure that the messages and counseling given to Calcutta Kids’ beneficiaries are standardized and evidence-based.

Jane Thompson, a child development and education specialist, and Director of Next Step Early Intervention, conducted the two-day training, “Helping Children Grow” for our health workers. The training started with an overview of ‘secure and nurturing attachment’, and the importance of the emotional bond between the child and the mother (or primary caregiver) which is critical for a child’s growth and development. She also spoke about ‘active learning’, a process by which children develop and learn through interaction with their environment. She emphasized that the most optimum form of multi-sensory learning is achieved through play, which is the major goal of the Calcutta Kids’ child development corner project.

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The rest of the training workshop was divided into age groups: 0-3 months, 3-6 months, 6-9 months, 9-12 months, 12-18 months, 18-24 months, 24-30 months, and 30-36 months. For each age range, Jane discussed key milestones in different areas of development including: cognitive, communicative, social/emotional, adaptive, and physical. She demonstrated activities that could be done during each age range, using materials that she had brought, along with materials that we had procured for the child development corner. A summary of the training and key topics can be viewed on the workshop presentation here.

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We are very appreciative of Jane, for conducting such an informative workshop on child development. The lessons learned will be applied when we hold child development sessions with the beneficiaries (mothers and children) and when we use the space to entertain children while mothers are attending community meetings. —Danya Sarkar

Gov’t-assisted immunization training

In September, Calcutta Kids organized an immunization training program, which served as a refresher training for some of our team and a new experience for others.  The training was carried out by a colleague in the government sector, Dr. Swagata Mukherjee, the Assistant Medical Officer for the Howrah Municipal Corporation (HMC).  Despite his busy schedule, he volunteered his services to Calcutta Kids during his personal time.  During the training, participants learned about vaccine-preventable diseases and related vaccines, the proper vaccination schedule, and how to technically administer each type of vaccine.  The training comprised of two days of observation at the Municipal Health Center during immunization camps, and three days of theory, observation, and practice in the Calcutta Kids clinic.

Training with Dr. Swagata Mukherjee

The training is one of many steps in the process towards implementing a community-based health care model at Calcutta Kids.  Until recently, our curative health, nutrition care, and immunization components have been held in our health center, Swastha Kendra, situated outside of Fakir Bagan.  During immunizations, vaccines were primarily administered by our nurse under the supervision of our doctor.  But this month we are merging the health center into our community center Ma o Shishu Shiksha Kendra, so immunizations are also transitioning to the new space in the heart of Fakir Bagan.  This is part of our effort to bring cost-effective healthcare solutions closer to the community.

The immunization camp will now be carried out in the community by the area in charges (senior community health workers) and the health assistant-counselors who are now qualified in immunizations as a result of the excellent training they received in September.  Where we once relied on one person to conduct immunizations every week (with the doctor as a back-up), we now have four trained staff members who are proficient in administering immunizations.  This will help ensure that immunizations are even more accessible for the families in Fakir Bagan, and provides Calcutta Kids the capacity to extend our immunization program to neighboring areas, thereby targeting more children in need of immunization.

Laxmi administering vaccinations after the training

Around the world, routine immunizations have reduced and even eliminated many childhood illnesses that once killed and debilitated many children.  Although many vaccine preventable diseases (VPDs) have been controlled, children are still dying from diseases that could be prevented by providing the critical vaccinations during the first few years of life.  The World Health Organization estimated that, every year, 1.5 million children die from diseases that could have been prevented by routine vaccination.  That staggering total represents almost one-fifth of all the children who died worldwide before reaching their fifth birthday. (1)

The Indian National Immunization Schedule includes the following six VPDs: Tuberculosis, Diphtheria, Pertussis, Tetanus, Measles, and Polio. For a child to be considered fully immunized, he or she must have received one dose each of BCG and Measles and three doses of DPT and Polio in the first year of life. There is still much more work to be done in terms of immunization coverage in India: Nationally, less than half (43.5%) of children 12-23 months are fully immunized. West Bengal is faring better than the national average, with 64.3% of children 12-23 months fully immunized. (2)

Waiting for immunizations at the Calcutta Kids clinic. Photography by Brett Cole, November 2012

Immunization in India must be sustained, not only to prevent VPDs, but also to reduce the incidence of measles and tetanus, and eradicate poliomyelitis. India, known as one of the greatest challenges for the global polio eradication campaign, has now been polio free for 18 months. (3) The last reported polio case was in Shahapur village in Howrah district, the same district where Calcutta Kids operates. Sustained immunization and coverage will ensure that polio does not make a comeback to this country.

Calcutta Kids is committed to help sustain immunization coverage in Fakir Bagan by ensuring that every young child in Fakir Bagan is fully immunized and therefore protected against vaccine-preventable childhood illnesses.–Danya Sarkar

1.http://www.who.int/immunization_monitoring/diseases/en/
2.NFHS-3, India and West Bengal Factsheets
3.http://www.un.org/millenniumgoals/pdf/UNGA%20Polio%20Event_Press%20Release%20and%20Quote%20Sheet_Final.pdf

C-Section Blog Series (4 of 4)

The third part of our C-section blog series focused on the circumstances leading up to Calcutta Kids’ decision to stop partnering with private clinics for facility based deliveries, and instead (a) offer a Delivery Savings Scheme (DSS) which would provide financial assistance for beneficiaries to deliver wherever they prefer; and (b) up the ante on birth preparedness through a new home counseling curriculum. This week’s blog describes that curriculum, provides data on beneficiaries’ usage rates of the delivery savings scheme, and calls attention to the fact that more community involvement is necessary for the delivery savings program to succeed.

Throughout the pregnancies of our beneficiaries, our CHWs visit their homes at least once a month. During the last few months of pregnancy, the visits have become more standardized and focus on the following themes:

  • Danger signs. What to watch out for—especially pain in the lower abdomen, heavy white discharge or bloody discharge. In such cases, pregnant women are advised to go immediately to the facility with which they are registered, and to call their Area in Charge for support
  • What not to worry about: Many women become worried if the gestational age of their child crosses 37 weeks. The CHW’s counsel the women not to worry about this until around 40 weeks at which time they should visit their facility.
  • Preparation: The family is counseled to assure the availability of transportation to the facility regardless of the time of day or night, and to ensure that money is set aside for transport. They are also told what documentation to have ready to take with them to the facility.
  • To C or not to C: Pregnant women and their families are provided with knowledge about C-sections. They are informed of the recognized and accepted indications for C-sections; the potential risks for the mother after a C-section delivery; the potential risks for the mother during her next pregnancy; the immediate risks for the baby during a C-section delivery; and the potential long term risks for a C-section-delivered child.

The CK staff has gone through an intensive training focusing on these themes. (You can see these materials in the resources section of our website or you can click here for the Labor and Delivery Educational Session and here for the C-Section Education Session.)  They also have received refresher training on the labor and delivery process, fetal development, and complications that can occur during labor. And they are equipped with flip charts and other materials to facilitate their home-based counseling with pregnant women.

Delivery Savings Scheme Data:

  • Scheme began in July 2011
  • Since inception, 68 CK pregnant women out of 162 pregnant women in households registered with CK, have enrolled in DSS
  • Of those 68, 45 remain pregnant
    • Of the 45 who delivered, 2 had miscarriages; 29 had normal deliveries, and 14 had c-sections.
    • Of the 45 who delivered, 24 took place in private facilities and 19 took place in public facilities.
  • Currently (July 2012) there are 55 pregnant women involved with Calcutta Kids and 21 are participating in the DSS.

With a DSS user rate of around 40%, the scheme is not working as well as we would like. And the DSS is not working as a replacement for the services being provided earlier through private facilities.

Next week, Calcutta Kids will be holding a number of focus group discussions to try and figure out why it is that more pregnant women are not taking advantage of this scheme. The discussions will be held separately with those who have used the DSS and those who have not. We look forward to sharing what we learn from these discussions in a future blog.

From this data, however, some questions arise: Does this experience coupled with the micro insurance experience indicate that families (a) don’t have surplus cash on hand or (b) aren’t willing to use surplus cash for such a purpose or (c) that the men in the family are not willing to set such money aside for this or (d) there a is basic fear (based on the reality that there is a lot of huckstering that goes on in the slum) that they might never see their money again?

Clearly we have more work to do in facilitating a good option for safe facility-based delivery among our beneficiaries. We are confident that we will be able to find a solution which benefits our beneficiaries while at the same time protecting them—and also Calcutta Kids. -Sumana Ghosh, Danya Sarkar and Noah Levinson

The Next Generation of Development Workers

While not a primary objective of Calcutta Kids, one of the roles we have found ourselves embracing is that of a mentoring organization for the next generation of western development workers. The organization is, in fact, flooded with applications from students seeking internships with Calcutta Kids (from which, unfortunately, we’re able to accept only a limited number.) Maybe this burst of interest is because Calcutta Kids was itself started by a young Westerner with whom young people can identify, perhaps it’s because Calcutta Kids embodies for some, what Nicholas Kristof refers to as the D.I.Y. (Do It Yourself) Foreign-Aid Revolution , or maybe it’s simply because of our clear objectives and proven track record. Whatever the reasons, we have, in taking on interns, been entrusted with an important responsibility, one we take very seriously.

Since Calcutta Kids Trust commenced its work in 2005, we have had the opportunity to work with over 20 undergraduate, graduate, and post graduate student interns from Europe and the United States, most of them having a public health interest or background. These interns usually spend between 2 and 10 months working on a specific project with clear objectives and an achievable if strict timeline. Projects range from illness-specific training and treatment protocol development to project evaluation to website development. The internships to date have been overwhelmingly positive for both the interns and for Calcutta Kids.

Apart from the value of their projects – which have invariably been valuable to our on-the-ground operations, these students have often opened their networks to Calcutta Kids for fundraising purposes, an unexpected but much appreciated by-product of the internship. When queried about it, they indicate that having seen the inner workings of the organization at close quarters – having participated in such a range of activities, been privy to managerial deliberations and financial records and having seen first hand the effects CK are having on these disadvantaged families, they believe sincerely that this is an organization they’d now like to support financially.

So along with providing an opportunity for this next generation of development workers to put into practice the theories and concepts they’ve learned in school, the Calcutta Kids’ internship program allows young persons to see and experience the workings of an organization guided both by values and by evidence. We hope that through our role in mentoring this next generation we can not only encourage replication of some of CK’s successful models, but, perhaps more importantly, inspire these young people to take the lessons and values gleaned from CK into their future work. – Noah Levinson

Flip-Charts, Training and a Community Center – Oh MY(CHI)!

Originally posted in the Fall 2011 Newsletter

The Maternal and Young Child Health Initiative (MYCHI) staff has been working diligently over the past nine months to make our programs even more effective. Danya and Sumana have been revising the pregnancy care program to reflect changes in international maternal and neonatal health guidelines and to utilize the lessons we have learned over the past 6 years. We now have two excellent flip charts that are culturally appropriate to help counsel families about best practices and the early detection of problems.

In May, we had an in-depth training on the new pregnancy care program with all of our community health workers and other MYCHI staff. In this training, we were able to explain exactly why each type of data is collected; to provide refresher information on the complications that can occur during pregnancy, delivery and the first few months of life; and to talk through specific problems that have arisen in our area. In the course of the training, we also were able to strengthen the bonds that have enabled us to work as a team and to have fun together!

We are also working to revise the child health program to better tackle the non-food related causes of malnutrition as well as to update the program more generally. During the past six months, we worked with a small sample of severely malnourished children to find out with precision the causes of their malnutrition. We found that many of these children were suffering from anemia, a high worm load, several micronutrient deficiencies and stress in the home, all of which hinder the absorption of nutrients and, in turn, impede affect mental and physical development. We now can use this information to inform our protocols as we redesign the child health program. We are very excited about the new community center, located in Fakir Bagan itself, which will be opening in December – a safe, clean and attractive site where we can hold our regular community meetings and gatherings of small support groups – a space for women and children to come together comfortably for support and information.