OXFAM IN ACTION

Mobilising Civil Society towards Right to Free

Public Health and Education in Jharkhand
No. 14 | may 2016

Oxfam India believes that the right to universal access to good population8. A high-level committee, headed by well-known
quality healthcare and education is a practical way of closing academic and Adivasi activist, Virginius Xaxa9 on tribal health
the ever-widening gap between the rich and the poor. Oxfam highlighted Adivasis poor access to maternal health services.
India works in six states1 to empower the community to improve According to the latest-available district level data, District
accountability of public delivery systems of healthcare and Level Health Survey (DLHS)-3 (2007-08), India recorded 47 per
education. While in most states the initiatives on health and cent institutional delivery. Jharkhand, however, was the worst
education are exclusively implemented, in Jharkhand, the two performing state with 17.7 per cent10. The Adivasi women in
strands have come together. Oxfam India supports three non- Jharkhand were worse off with only 7.9 per cent having any
government organisations (NGOs) in Jharkhand Child In Need access to institutional delivery11.
Institute (CINI), Nav Bharat Jagriti Kendra (NBJK) and Society for
Participatory Action and Reflection (SPAR) in three districts Looking at education indices, the states literacy rate improved
since 2011. Oxfam India, along with its partners, works closely from 53.5 per cent (Census 2001) to 66.4 per cent (Census
with community advocates in an effort to strengthen the civil 2011) but it still remains below the national average of 74 per
society movement towards realising the entitlements for health cent12. The literacy rate of the Adivasis in the state is lower at
via the National Rural Health Mission (now National Health 57.1 per cent13. The Xaxa Committee pointed out that even with
Mission) and for education through the Right To Education (RTE) reasonable infrastructure and student enrollment, regular school
Act 2009. attendance remained a problem in the Adivasi belt. Some of the
most educationally backward states in central India like Madhya
Jharkhand was carved out of erstwhile Bihar in 2000. Though Pradesh and Jharkhand have the lowest student attendance rate
endowed with natural resources, it continues to be the fifth least (below 60 per cent). To make matters worse, the old problem of
developed state in the country2. The state has a poverty ratio of teacher absenteeism, that Adivasi areas are known for, persists14.
45.3 per cent as against the national average of 37.2 per cent3.
In 2011, Oxfam India15 partnered with three NGOs in Jharkhand
Despite some improvements, health and education parameters in
to build capacities of the community to demand and ensure
Jharkhand continue to be dismal. Focusing on health outcomes,
delivery of health and education services, provide support to
data from the Sample Registration System, Registrar General
stakeholders to monitor the implementation of plans, and to
of India (RGI-SRS) reveals that national Maternal Mortality
strengthen state and national level networks of NGOs.
Ratio (MMR)4 reduced from 212 to 167 in the period 2007-09 to
2011-13 respectively. Though Jharkhands MMR reduced from 261
Oxfam India, through the three NGOs, works in 60 villages in three
to 208, for the same period, it continued to remain higher than
districts Hazaribagh (NBJK), Gumla (CINI) and West Singhbhum
the national average5. The data on Infant Mortality Rate (IMR)6 is
(SPAR). The project has helped the community track budgets of
marginally better. While the national average declined from 47 in
various schemes under health and education, hold social audits,
2010 to 40 in 2013, Jharkhand registered a change from 42 to 37
and recruit multi lingual part-time teachers in schools. Though
for the same period7.
the three organisations were already working separately in the
While poor maternal health indicators poses a serious challenge respective districts, this project enabled them get together to
nationally (and in the states), data suggests it is worse for mobilise people to demand their health and education rights.
Adivasis. In Jharkhand, Adivasis constitute 26.2 per cent of the

Jharkhand vs india
Jharkhand India

Poverty ratio 45.3 % 37.2 %

Maternal Mortality Ratio (2011-13) (per 100,000 live births) 208 167

Infant Mortality Rate (2013) (per 1000 live births) 37 40

Institutional Delivery (2007-08) 17.7 % 47 %

Literacy (Census 2011) 66.4 % (Adivasis-57.1%) 74 %

Budget tracking of
health and education
(NBJK)
The scholarship money wasnt reaching the students in time.
We found that it was actually being diverted to the Gram Shiksha
Samiti16. The money should have actually come to the School
Management Committee (SMC). The SMCs had replaced the Gram
Shiksha Samiti since the implementation of the RTE Act, says
Prem Kumar Paswan, president of the SMC in Chordaha Gram
Panchayat. The matter was brought up at the SMC meeting and Sahiyyas attend review meeting at Chordaha village in Hazaribagh district
action was taken. The money was finally diverted to the SMC and
the scholarship amount was deposited in the bank account of all tab on the scholarship amounts supposed to be deposited in the
the students. bank accounts.
Earlier, money coming in for the different schemes remained The VHSNC, a community based monitoring committee under
unaccounted for. Hence, NBJK and Oxfam India made budget the National Health Mission (NHM), was formed as well. This was
tracking of health and education schemes and entitlements a done to increase the accountability of the health workers as well
priority. The first stage was putting in place community based as to utilise the untied fund of Rs 10,000 diligently. Accredited
monitoring systems like Village Health Sanitation and Nutrition Social Health Activist (ASHA), Auxiliary Nurse Midwife (ANM), the
Committee (VHSNC) and SMC. These committees were formed to Anganwadi18 Worker (AWW) and other members of the Panchayati
ensure the smooth delivery of health and nutritional services, Raj Institutions (PRIs) were brought together on one platform.
and the compliance to the RTE Act as well as to track the budget They, along with the community members, were trained on the
allocated for them. provisions of different health schemes and entitlements.
For the formation and effective functioning of the SMC, parents, The accountability of ASHAs and ANMs has increased because
teachers and members of the Panchayat were brought together the community is actively involved in the work. Vaccinations
and trained on the provisions of the RTE Act. Parents first had have picked up, wells have been bleached, the uptake of
to be told about the importance of education children were Mamta Vahan19 has improved, and institutional deliveries have
either found grazing their cattle or helping the parents in the increased, says Sujanti Devi, ASHA (Sahiyya), Chordaha village
farm during school hours. Teachers were hardly present in school in Chouparan block.
they were pulled out of school for government duties (like
However, despite a marked improvement in service delivery since
elections, census etc.). The role of the different stakeholders
the budget tracking exercise, there is still a long way to go. There
was defined and responsibilities fixed. Once this process started,
are some teething problems but the community is warming up
it garnered a lot of interest among the parents, explains Prabhu
to the fact that now there is a platform for them to track and
Nath Sharma, project coordinator, NBJK.
participate in the health and education schemes. The members
Para teachers were appointed this ensured that classes became are exclusive to each committee as the work is diverse; the VHSNC
more regular and children could attend classes. Bal Sansad or meets on the 20th of every month while the SMC meets every third
childrens parliament17 were formed the elected students made week or whenever the need arises. To take the work forward now,
sure that students and teachers came to school regularly and SMC federations are being formed at the block and the district
the mid day meals were cooked and served hygienically. The SMC, level. This is the most sustainable way to take forward the work,
comprising parents and teachers, have started keeping a close says Prabhu Nath Sharma.

Social Audits (CINI)

We have regular meetings with SMCs and VHSNCs together. Some The VHSNC members provide support that an ANM needs.
of the community members are part of both the committees and These are far flung areas and when she comes it is important
so the joint meetings are helpful. The meetings are held to ensure that everyone is present. The immunization drives have picked
that the two health and education committees are functioning as up. Earlier, people were a bit wary of getting immunized. The
per the norms, says Cresenshia Kujur. She is the mukhiya20 of VHSNC members have played an important role in convincing the
Janawal village in Gumlas Chainpur block. community to benefit from the health services, says Jyoti Kujur,
VHSNC member.
The village, a predominantly Adivasi village, has a government-
aided school. The school was severely understaffed. Being a Social audit was introduced by CINI and Oxfam India in 20 villages
minority school, the SMC has the mandate to appoint teachers. in Gumla. Ten member audit teams, one each for health and
Facilitated by CINI and Oxfam India, in 2011, the SMC was formed education, from the community carry out the social audits. These
and two additional teachers were appointed to the school. The are the barefoot auditors who have been trained on the NHM
SMC ensured increased enrollment and student retention. It has provisions and the RTE Act respectively. Basic school education
also brought down the pupil teacher ratio (PTR) from 96:1 to 32:1 is the criteria for selection of barefoot auditors. They audit the
up to class V. As in Chouparan, here too, the Bal Sansad is very books and tools maintained by the two committees bi-annually.
active. It keeps a close tab on the attendance of the students. A
fine of Rs 2 per day is imposed on students who bunk classes. Of The community mobilisers, usually selected from within the
course, those who are genuinely sick are exempt, smiles Asmita community and appointed by CINI, are key to the functioning of
Kujur, President, Bal Sansad. the committees. Since most of these villages are in far-flung
2
areas, the community mobilisers train the committees and are a for the services, adds Vijay. For the purpose of social audit, the
source of information for the community. VHSNCs maintain records of utilisation of services, expenditure
of the untied funds as well as a record of the visits and activities
The community, in these 20 villages, have been provided with
of the ANM and ASHA. Records of health indicators like antenatal
community based monitoring tool on RTE. There are school
and postnatal care, institutional delivery and immunization of
report cards enlisting different provisions of the RTE Act. These
children are maintained. Further, according to the social audits,
provisions are color coded to show the actual status of their
these parameters have improved.
implementation. The school report cards and the Bal Sansads
have ensured that all children in the villages, where we work, CINI also conducts Jan Sunwais (public hearings) regularly. The
have been enrolled in age-appropriate classes, explains Vijay public hearings are held at the school, block and district level
Shankar Dubey, project manager, CINI. and then the issues raised during these hearings are taken to
the respective departments for further action, says Vijay. The
These social audits have encouraged participation of the
state government has, in fact, adopted and institutionalized the
community through the year. The community ensures that the
model of social audit system, for VHSNC and SMC, put in place by
VHSNC and SMC meet regularly through the year as per the norms
CINI and Oxfam India21. These audits will be held twice every year.
and also deliver accordingly. This has helped create a demand

Multi Lingual Education (SPAR)

At the Nav Prathmik Vidyalaya in Kolpotka village, in West interest in attending school is also evident. The SMC too
Singhbhums Manoharpur block, it was lunch time. Rice and has played a crucial role in getting children back to school,
dal was served under the mid day meal scheme. The meals says Hiramani Lugun, a MLE part-time teacher. Hiramani, who
are regular and the quality is good, we are told by the SMC herself is in the first year of college, said that the attendance
members who accompanied us during the visit. As the children has improved and is now, on an average, 50 students.
finished their lunch and went to their classes, we noticed
SPAR-Oxfam India revived the VHSNC in these villages. The
ribbons pinned to their shirts. They were of different colours.
difficult terrain of the far-flung blocks of the district and the
The coloured ribbons monitor the attendance of the impact of Naxalism had kept the administration and, to a large
students. This helps us identify the students who are most extent, the schemes away from these tribal villages. The
likely to dropout and need more attention, explains Naval impact is evident. The demand for Mamta Vahan has surged,
Kishore Lugun, a para teacher at the school. The ribbons institutional deliveries have increased and so has the number
are a monitoring tool used under Prayas, an initiative of the of women bringing their children for immunization. The referrals
Jharkhand Education Project Council (JEPC) and UNICEF to to the Community Health Centre have increased, says Binod.
bring back probable dropouts to school22. Prayas was initiated
in 2011. Naval explains that students who have been absent
for less than three days have green ribbons, those who
missed school for three to 11 days in a month had red ribbons.
Students with blue ribbons skipped school for more than 11
days in a month and those who wore the yellow ribbons were
those who were absent for most of the days. SPAR-Oxfam
India help schools implement Prayas, through the SMCs, in 20
villages23.
Students who are irregular at school are often visited by the
teachers. Meetings are held with the parents to understand
the reasons for poor attendance of their children. A couple
of reasons came up. One, the school timings coincided with
when the cattle have to be taken out for grazing or when farm
work has to be done. The other was the language barrier.
Children, who are mostly from the Munda tribes, were taught
in Hindi. Since this is not their mother tongue, it was difficult
for them to grasp what was being taught in schools. This lack
of interest also affected their attendance, says Binod Kumar
Horo, project-in-charge, SPAR.
In order to raise interest among the students, Oxfam India-
SPAR introduced Multi Lingual Education (MLE) in these
schools and appointed part-time teachers in April 2015. These
teachers, after training, started teaching in July 2015. The
MLE part-time teachers are conversant in the tribal language.
They are appointed in addition to the other school teachers. In
Kolpotka, the appointed part-time teachers taught in Mundari
since the village comprises mostly of the Munda community.
We have managed to get students, who had dropped out
of school for various reasons, back into the classes. And
because we are teaching them in their language, their
Part-time teacher appointed by SPAR taking a class at Kolpotka village in
3 West Singhbhum's Manoharpur block
The Way Forward These districts have been long neglected due to geographical
and social reasons. These communities, in the past, have
The simultaneous intervention in healthcare and education neither had the opportunity of a dialogue with the service
supports an all-round development of the community. The providers nor the chance to monitor and audit their work. So
active participation of VHSNCs and SMCs indicate that the these issues need ironing out but the small successes are
community is keen to demand the services, benefit from them very crucial, says Binod.
and plug the loopholes in its implementation. The formation of As a next step, the NGOs plan to train the members of the
these committees has made the PRIs and the service providers VHSNCs and the SMCs on filing requests under the Right to
accountable and transparent, to a large extent. Information (RTI) Act and use the information to approach the
necessary departments to ensure proper service delivery in
There are some hiccups. For instance, in one of the villages
their districts and blocks.
under the NBJK project, the ANM had not mentioned to the
VHSNC that the haemoglobin kit was not provided to her for the The way forward is to make these processes sustainable. For
last few months. Another instance is from one of the project instance, a federation of the committees at the block and
villages of SPAR when it came to light that separate VHSNCs district level planned by NBJK is the key to keep the community
in two hamlets had been merged as one and the committee engaged, informed and empowered. It is a big boost that CINI
was now housed in that part of the village that had a higher has been approached to provide a model of social audit to the
concentration of non-tribals. Information such as these do not state. SPARs work in Jharkhand is likely to get a boost too since
surface naturally, yet. the state government is very keen on introducing an MLE policy.

Notes Tribal-Committee-Report-May-June-2014.pdf
viewed on 17 March, 2016)
(as centrally sponsored scheme in India. It caters to
children in the 0-6 age group. The word means
12 Literacy Census 2011 | http://www.census2011. courtyard shelter in Hindi. They were started by the
1 Uttar Pradesh, Bihar, Jharkhand, Odisha,
co.in/literacy.php (as viewed on 17 March, 2016) Indian government in 1975 as part of the Integrated
Chhattisgarh, and Assam
13 Tribal Profile at a Glance, May 2014 | Child Development Services program to combat child
2 h t t p : / / a r t i c l e s . e c o n o m i c t i m e s . i n d i a t i m e s .
http://tribal.nic.in/WriteReadData/CMS/ hunger and malnutrition
com/2013-09-27/news/42463817_1_ajsu-special-
Documents/201410170116549630578TribalProfile. 19 An ambulance facility for the community from the
status-backward-states (as viewed on 18 March,
2016) pdf (as viewed on 17 March, 2016) village to the health facilities
3 Report of the Expert Group to Review the Methodology 14 Report of the high level committee on socio- economic, 20 Village headwoman
for Measurement of Poverty| Government of health and educational status of tribal communities 21 CINI also studied and reviewed the status of
India Planning Commission June, 2014 | http:// of India http://www.indiaenvironmentportal.org.in/ implementation of GRM (Grievance Redressal
planningcommission.nic.in/reports/genrep/pov_ files/file/Tribal%20Committee%20Report,%20May- Mechanism) of five states (Uttarakhand, UP, Bihar,
rep0707.pdf (as viewed on 17 March, 2016) June%202014.pdf (as viewed on 14 January, 2016) Gujarat and Rajasthan) and submitted a draft
4 Maternal Mortality Ratio is calculated as the number 15. The project was supported by Oxfam Germany from report for GRM to the concerned department. These
of maternal deaths as per 100,000 live births 2011 to 2014 recommendations were submitted to ensure that the
5 http://nrhm.gov.in/nrhm-components/rmnch-a/ 16 The Gram Shiksha Samiti or the Village Education state HRD includes GRM as per the provision of the
maternal-health/background.html (as viewed on Committees were formed under the National Policy RTE Act
May 13, 2016) of Education, 1986. The Policy visualized direct 22 Prayas - an attempt to enhance student attendance
6 Infant Mortality Rate is calculated as the number of community involvement in the form of Village in schools in Jharkhand, Indiaby Binay Pattanayak|
death of infants (under 1 year) per 1000 live births Education Committees (VECs) for management and academia.edu (as accessed on 18 March, 2016)
7 SRS Bulletin | Sample Registration System | Vol. 49 No. improvement in school education at the village level. 23 Prayas is one such attempt by Jharkhand Education
1 | September 2014 These were later replaced by the School Management Project Council (JEPC) and UNICEF to attract
8 Jharkhands Adivasi population is 8.29 per cent of Committees (SMCs) under the RTE Act, 2009. The Act children to schools on a daily basis through mutual
the national Adivasi population recognised the role of local governance in school cooperation among students, teachers, school
9 This committee was constituted by the Prime education by necessitating the formation of a School management committee (SMC) members and other
Ministers Office in August 2013 to look into the Management Committee (SMCs) in each school community members. Focus of this initiative is on
socio-economic, educational and health status of 17 Though it is considered to be a part of SSA, but not children who, due to some cause or, other, remain
the tribals of India mentioned exclusively in the policy documents. absent in school in Elementary Schools (Classes
10 India Report- DLHS 3, pg. 70 | http://rchiips.org/pdf/ However, it is largely dependent on the states to I-VIII) and work with the concerned child, her/his
INDIA_REPORT_DLHS-3.pdf (as viewed on 17 March, form it and make it functional. The five states that family in a systematic manner to enable the child
2016) have Oxfam Indias education project have Bal come back to school. Prayas was initiated on a pilot
11 Report of the High Level Committee on Socio- Sansads in place.http://ssa.nic.in/monitoring- mode in 2011 in around 10 schools of Ranchi district
economic, Health and Educational Status of Tribal documents_old/jrm/JRM/JRM_JHARKHAND_1_.pdf where the interventions demonstrated visible
Communities of India, pg. 236 | http://www. 18 Anganwadi centre is a government sponsored child- achievement, attendance in some schools booming
kractivist.org/wp-content/uploads/2014/12/ care and mother care centre as part of the oldest from a mere 40% to around 90%

Author: Savvy Soumya Misra

Contributors: Pallavi Gupta, Sanjay Suman, Prabhu Nath Sharma (NBJK), Vijay Shankar Dubey (CINI), and Binod Kumar Horo (SPAR)
Inputs: Pooja Parvati, Ranu Kayastha Bhogal, and Mirza Firoz Beg
Editing: Pooja Parvati
Photo Credit: Savvy Soumya Misra
Oxfam India, May 2016
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