AstraZeneca – Young Health Programme



|AstraZeneca Young Health Programme (India) |

|Annual Report |

|November 2010 – October 2011 |

|Project name: |AstraZeneca Young Health Programme – India |

|Project location: |New Delhi in 5 resettlement colonies: Madanpur Khadar, Badarpur, Mangolpuri, Holambi Kalan and Dwarka. |

|Project duration: |Three years (November 2010-October 2013). |

|Beneficiaries: |Over 30,000 households will directly benefit and at least 150,000 people within the communities will indirectly benefit |

| |by the end of the project. |

|Outcomes: |Summary of main achievements: |

| | |

| |In the first year of the project more than 30,000 young people were reached. This included all young people reached |

| |directly and indirectly through peer education programmes, street plays, puppet shows, melas (fairs), group meetings and|

| |awareness sessions at the Health Information Centres (HICs) and rallies. The programme trained a total of 585 peer |

| |educators (299 male and 286 female). These peer educators reached out and sensitized a minimum of 15 other young people |

| |per month. In addition to this 22,523 community members were reached through the programme activities. |

| | |

| |(Please note that the number of direct and indirect beneficiaries provided by the project implementing partners working |

| |in the resettlement colonies is 60,000. This is based on an estimate that the peer educators are additionally reaching |

| |other young people in their community which is the project intervention area and in schools who might be from far off |

| |areas, i.e. non project intervention areas. However, based on discussions between Plan India and the project |

| |implementing partners as well as the peer educators and young people accessing the Health Information Centres (HICs), it|

| |was decided that 30,000 was a conservative approximation of numbers reached, as there are overlaps between those |

| |benefitting from the peer education programmes and those participating and benefitting from the street plays, group |

| |meetings, puppet shows, attending the melas etc and so some of the 60,000 beneficiaries would be double counted). |

| |Objective 1: Capacity building of adolescents by providing relevant information, knowledge on lifestyles and better |

| |choices that will help enhance responsive health seeking behaviour |

| | |

| |The project developed training curriculum comprising of 5 flip books, 5 technical documents and 5 facilitator guides |

| |which are being used for peer education on issues such as water and environmental sanitation, sexual and reproductive |

| |health and infectious diseases including TB, Dengue and Malaria. These training documents are titled as: |

| |Training Kit on ‘Health and Wellbeing’ |

| |Training Kit on ‘Life Style Education’ |

| |Training Kit on ‘Menstrual Hygiene’ |

| |Training kit on ‘Reproductive Health’ |

| |Training kit on ‘Water and Sanitation’ |

| | |

| |Life skills is a cross cutting theme in all the 5 documents. |

| | |

| |Cumulatively in Year one, 1100 young boys and girls were engaged and sensitized on the project in the five project areas|

| |directly through group meetings. Through these meetings, potential peer educators were also identified. During these |

| |meetings, the needs of young people were assessed and basic information was provided on topics such as water and |

| |sanitation, infectious diseases, changes in the body and sexual and reproductive health. The information provided to |

| |these young people was very basic and would be further reinforced through peer education. |

| | |

| |Following the meetings, 585 peer educators (299 male and 286 female) were identified and then trained in twelve groups |

| |on the five thematic areas through intensive peer education training. After completing the training, each peer educator |

| |has been organizing individual and group meetings with young people to raise awareness on the thematic domains such as |

| |sexual reproductive health, general health awareness, water and environmental sanitation, menstrual hygiene. They have |

| |each been reaching out to a minimum of 15 other young people a month. |

| | |

| |Additionally, capacity building on addressing gender norms and how these shape attitudes and behaviours of young people |

| |and influence their health choices was carried out in Mongolpuri. 80 boys and 50 girls participated in this training |

| |which covered issues of masculinity and femininity and some of the gender based underlying health determinants that |

| |influence access and uptake of services. |

| | |

| |Health Information Centres (HICs) have been established in each of the 5 project areas and are reinforcing the peer |

| |education by providing supplementary information through group meetings, video shows, question and answer sessions, and |

| |library resources. The HICs have become popular and have catered to providing information to 2000 young people on their|

| |health and well being directly at 5 centres. The young people enjoy spending time at the HIC rather than idling on the |

| |streets. Young girls are allowed to leave their homes to go to the HIC which they otherwise would not have been able to|

| |do. Parents also feel that their children are channelling their energy into something useful and are observing positive|

| |changes in their children’s personalities and behaviour. |

| | |

| |Through continuous meetings and counselling sessions with young people and their parents, there has been an increase in |

| |young people seeking health services for minor sexual and reproductive health problems. Previously young people were |

| |shy and did not access services due to the stigma attached to these sensitive issues. Young girls interviewed by the |

| |programme highlighted that prior to being trained by the HIC they were apprehensive about discussing their sexual health|

| |queries and problems. However, they now feel comfortable discussing these issues at home and seeking appropriate help. |

| | |

| |The HICs and peer educators have been playing a critical role by making prompt referrals of young people with health |

| |problems (sexual and reproductive health, TB, Dengue, Malaria) to the health facilities. The peer educators on a monthly|

| |basis report on the cases referred by them in a specific reporting format. Peer educators referred 95 cases to the |

| |health facilities, and the HIC/project staff referred 165 cases to the health facilities. In total, 260 cases sought |

| |appropriate medical help at health facilities. |

| |Some tangible results in improved healthy behaviour have been observed through focus group discussions and consultations|

| |with young people. Myths and misconceptions (resorting to quacks (Bengali doctors), following home remedies, using |

| |cloth during periods etc.) are gradually being dispelled by young people. Peer educators reported that 85 young girls |

| |are now resorting to gynaecologists for any ailment related to sexual and reproductive health problems (menstrual, |

| |reproductive track infections etc.). Among young men, 70 reported giving up habits related to some form of substance |

| |abuse (as collected by monitoring reports used by peer educators and project staff). |

| | |

| |“Earlier I used to smoke and eat Tobacco, but since I have got in touch with the HIC I gave up all these bad habits”. |

| |Boy age 14. |

| | |

| |Additionally, the programme has also contributed towards addressing some of the underlying social determinants of health|

| |that act as a barrier to young persons accessing health information and services. The programme has sensitized parents |

| |to the links between livelihood and health seeking behaviour and this has positively contributed towards change in |

| |attitudes and beliefs. This has made some parents think of the need to educate their daughters and become contributing |

| |members of the community as was evidenced by interviews carried out with community members by project staff. Several |

| |parents mentioned the need to delay marriage to avoid sexual and reproductive health problems associated with early |

| |pregnancy that they had learned from the HIC. |

| | |

| |“I was married at the age of 15. However, now after attending the HIC I realize how important it is for my daughter to |

| |know her health needs and also earn a livelihood for herself as it will empower her. I want my daughter to be educated |

| |and work and not get married early. Both my husband and I are supportive and we encourage our daughter to come and learn|

| |from the HIC”. (Mother age 30, daughter age 15). |

| |Objective 2: To establish community based actions on key infection |

| | |

| |The project has established 23 Community Stakeholder Groups (CSGs) which consists of men, women, community leaders and |

| |young people who live and work in the community and they have all been sensitised with the project. Through |

| |consultations, various pertinent health issues in the community such as water and environmental sanitation and |

| |infectious diseases (TB, Dengue and Malaria) and their required actions were discussed. They were also informed of the |

| |key issues that the programme identified in the resettlement areas. These include issues of substance abuse, early |

| |marriage, transportation problems to access services (Holambi Kalan), female health issues and lack of knowledge and |

| |information on sexual and reproductive and general health issues. Eventually, these groups will take a lead role in |

| |guiding the health aspects of their community and to ensure that young people’s health is taken into consideration. |

| | |

| |The project has also carried out 314 community meetings with an objective to sensitize the community on project issues, |

| |which are very critical for young people’s health. During these meetings the emphasis was on the role that community |

| |members could play in improving young people’s health. |

| | |

| |Health prevention and promotion, encouraging treatment seeking behaviours, low cost nutrition interventions and other |

| |health-related information has been provided through mass awareness activities. Some of these activities included |

| |street plays, puppet shows, video shows (on health issues), rallies, health talks and health melas (fairs). 52,523 |

| |Community members (including the 30,000 young people) have been reached and awareness has been raised on issues related|

| |to sexual and reproductive health, HIV and AIDS, gender, substance abuse, infectious diseases (TB, Dengue, Malaria) and |

| |water and environmental sanitation. The peer educators have been actively participating in organizing these mass |

| |awareness events. |

| | |

| |As the project develops further, a formal referral system will be introduced where peer educators and HICs would provide|

| |referral slips to the young people to be referred to a health facility. These will be recorded and cross checked and |

| |verified with the referral slips at the facility level. The referral system will ensure that young people are followed |

| |up on accessing health services thus promoting health seeking behaviour. |

| | |

| | |

| |Objective 3: Raising awareness and knowledge about access to available healthcare systems |

| | |

| |The project has initiated advocacy activities with key decision makers for access and uptake of health services for the |

| |young people. Partners have approached the civic body (Municipal Corporation of Delhi (MCD)) and familiarized them with |

| |the project and the focus on infectious diseases and the sexual and reproductive health needs of young people. Many of |

| |the issues that have come up are related to water and sanitation and include: lack of potable water, waste disposal, |

| |sewage maintenance which fuels infections by acting as a breeding ground for diseases such as Malaria, Dengue and water |

| |borne illnesses. Across the communities, water and sanitation issues are the main causes of infection and these could be|

| |mitigated through cooperative efforts of the community and government. The project is collaborating with the municipal |

| |corporation and carried out community sanitation training for community members, leaders and peer educators, and had |

| |attendance of 52 people. This training was conducted by a water and sanitation expert who informed the participants |

| |about degradable and non-degradable waste, solid waste management. Through a Participatory Rural Appraisal (PRA) this |

| |group developed an understanding on the correlation between community sanitation and health. During the training |

| |participants came up with their action plans on improving water and environmental sanitation conditions in Mangolpuri |

| |resettlement colony. This was followed by the community meetings and a cleanliness drive was planned where the |

| |community youth could set an example for others by collecting the community garbage and cleaning up accordingly. One |

| |block was identified to be a “model block” where young people participated in a cleanliness drive and distributed |

| |pamphlets and stickers to promote better sanitation. |

| | |

| |Stakeholder sensitization and coordination meetings were organized for the 5 communities. The key stakeholders invited |

| |included: the 8 medical officers of the Health Department, 2 Malaria inspectors, 4 TB officers (from DOTS department), 1|

| |Member of Legislative Assembly (MLA), 3 Municipal Councillors (responsibilities with MCD), 5 school principals and |

| |teachers, 1 Deputy Director from the Integrated Child Development Scheme (ICDS), Anganwadi supervisors (nutrition and |

| |pre-school centres run by the Department of Women and Child Development and they also deal with adolescent health), 2 |

| |Presidents of Resident Welfare Association (RWAs) and project partner staff. Pertinent health-related issues affecting |

| |the community were raised and the potential actions to address them were discussed at this forum. The Municipal |

| |Counsellor of Mangolpuri area has become the President of the Health Information Centre (HIC) committee to look into the|

| |issues of young people and ensure his cooperation and guidance for the welfare and development of young people. |

| | |

| |Through coordination meetings, doctors and other stakeholders were sensitized on delivering services to meet the needs |

| |of young people. Some health professionals also engaged young people to help in informing the community on health |

| |issues. For instance, in Mangolpuri, young people with a Malaria Inspector carried out door-to-door awareness on |

| |Malaria and Dengue prevention during the monsoon season. |

| | |

| |These sensitization meetings also serve the purpose of advocating and sharing information with relevant authorities to |

| |build partnerships and engage them on the health challenges of young people. |

| |Objective 4: Addressing the immediate needs of the community in issues related to healthcare, hygiene, and sanitation |

| | |

| |Through the stakeholder sensitization and coordination meetings, as discussed above, pertinent health issues (water and |

| |sanitation, SRH, substance abuse, need for life skills etc.) were identified which the project seeks to address through |

| |working with young people at schools. |

| | |

| |The Principals of at least 20 schools have been contacted in all the five areas and discussions were held on water and |

| |sanitation issues. The peer education module has been finalised, and the project is seeking approval from the Education|

| |Department to be able to run sessions in the schools. Post approval, the project team will be able to take sessions |

| |with the children and teachers in the schools and conduct water and sanitation related activities. |

|Other additional benefits|An Editorial Committee has been formed in the Mangolpuri area. This committee comprises of 6 members (3 young girls and |

|(unanticipated results): |3 young boys). It plans to publish quarterly magazines containing articles and other creative writings of their HIC |

| |attendees. This committee will be primarily responsible for collection, selection and editing of all the material. |

| |Different sessions are being held at the HICs other than the project thematic issues such as gender and violence, |

| |Independence movements, Indian constitution and rights etc. |

| |Additional street plays have taken place prepared by HIC members/young people |

| |5 Girls who had dropped out of school have been motivated to resume their education. Now they have got admission in |

| |distance learning/open school and in order to cover their educational gap they are also taking bridge tuition classes. |

|Project challenges: |Partners faced challenges in recruiting local project staff from the project community. Through perseverance, they |

| |managed to get some staff from these communities or neighbouring communities. Eventually, all staff were on board by |

| |February 2011. The project staff have now established good rapport and trust with the young people and are able to move |

| |forward and influence young people in making healthy choices. In the Plan India Country Office there have been some |

| |staff changes and they are still waiting to fill the vacant post of Young Health Programme Project Manager. In the |

| |interim the project management is being successfully managed by other internal team members and no delays have been |

| |caused due to this. |

| | |

| |There has been extreme heat and power cuts. March and April were very hot making it difficult for outreach activities |

| |and encouraging community participation. Power cuts affected HIC functions as well. The situation during the monsoon |

| |season also brings challenges as it gives rise to all forms of water borne diseases. The project has had to be |

| |flexible and be responsive accordingly and try and ensure that the key activities continue to address the needs of young|

| |people. |

| | |

| |A major challenge has been discussing Sexual and Reproductive Health (SRH) in schools. The Chief Minister of Delhi and |

| |the Education Minister are not in favour of having sexual education in schools and this has made it difficult to discuss|

| |within the health clubs in schools. Hence, the project is addressing this issue by providing information through |

| |community level interventions and Health Information Centres. The project will however continue to advocate for the |

| |inclusion of SRH education in the school curriculum. School level interventions will focus on disease management and |

| |environmental issues. Stand-alone modules have been developed on separate themes such as water and sanitation, menstrual|

| |hygiene, lifestyle education, general health problems and sexual and reproductive health. The school authorities will be|

| |able to decide which modules they could endorse in the schools. It is likely that the school interventions will focus |

| |only on water and environmental sanitation, lifestyle education and general health problems. Sexual and reproductive |

| |health will be discussed at the HICs and through peer educators in the community. Teachers will be sensitized on |

| |adolescent health as well and they may be able to discuss these issues as the project progresses. However, it will |

| |depend upon the permission being granted to the project team to work in schools. |

| | |

| |Talking about sexuality in the Indian context is taboo and poses many challenges. There are many myths and conceptions |

| |about this, as well as reluctance among parents and larger communities to discuss issues around sexuality. Sometimes |

| |parents also have incorrect information and they pass this on to young people, and eventually reinforce myths and |

| |misconceptions. Through community meetings, the project discusses these issues with parents and ensures that young |

| |people get the correct information through HICs and peer education. |

| | |

| |Since the project deals with sensitive issues on sexual and reproductive health, some young people feel inhibited to ask|

| |questions. Therefore as a strategy, a question box has been installed at all HICs where girls and boys can anonymously |

| |drop in their queries, which would be addressed by the project staff during the group sessions on daily basis or through|

| |a Q&A board. |

| | |

| |There is more female participation in comparison to males. These forums provide opportunities to those girls who would |

| |not otherwise be allowed to get out of their homes. Furthermore, these forums also provide access to appropriate and |

| |adequate information which is limited among girls but not among boys. Boys receive this information from magazines, the|

| |internet and peers. Creative and fun activities will have to be integrated in the project to attract young boys. |

| | |

| |All 5 project areas are heavily populated, and lack basic amenities/facilities in relation to health, water, sanitation |

| |and education, which are common features of any slum community in India. The project has engaged young people and |

| |communities and has received an overwhelming response. Whilst this is very positive, the level of popularity in all 5 |

| |project locations is becoming difficult to manage particularly due to the increase in numbers of young people visiting |

| |the HICs. In some areas there is a lack of space or trained staff to cater to them and hence a strategy needs to be |

| |developed to better manage this or to expand the project and increase the number of HICs. To meet the above challenge,|

| |the HICs now have separate timings for boys and girls with monthly meetings for parents. The separate timings for boys |

| |and girls are adjusted according to their school timings. In all the 5 resettlement areas, girls attend school in the |

| |morning shift and the HIC after school and boys attend school in the afternoon shift and the HIC during the morning. |

| |This timing also applies to out-of school youth. |

| | |

| |The project requires that the staff be continuously trained to deal with the emerging health issues raised by young |

| |people. The diversity and range of issues is large – sexual and reproductive health, water and environmental sanitation,|

| |substance abuse, TB, Dengue and Malaria and this requires that the project staff are well informed and updated, and have|

| |adequate resources to address the queries of young people. The project staff have been made familiar with all the |

| |project modules. Resources on the topics have also been made available at the HICs. Where staff are unable to respond to|

| |a specific issue, they research these from other experts and provide the information at a subsequent session or refer |

| |them to other appropriate resources. Further, the project coordinator works closely with the project staff to |

| |continuously build their capacities to address the challenges that the project staff encounter at the project sites. In |

| |addition, the Plan technical health adviser acts as a sounding board and expert on technical issues related to the |

| |health and well being of young people. |

| | |

| |It has been a challenge to reach out to the young people in the 19-24 age group as most of the boys in this age bracket |

| |are engaged in jobs and the young girls are either getting married or they are not coming out of their homes due to |

| |traditional beliefs being of an age ready to marry. To address this challenge, the project is encouraging this age range|

| |to visit on Saturdays or days when they are off work. They are also involving the parents of young people to discuss |

| |adolescent health needs and the importance of engaging the young people in the programme. The project will also reach |

| |out to girls who are younger than 18 to build their capacity and bring about behavioural change on issues of early |

| |marriage and early pregnancy before they reach this age group. |

| | |

| |Bringing convergence with diverse stakeholders is a challenge e.g. Water issues are being dealt with by Department of |

| |Drinking Water Supplies; Sanitation by the Delhi Municipal Corporation; and school sanitation by the Education |

| |Department. There is a need to bring these various departments together through stakeholder workshops in order to foster|

| |better coordination. For example, issues of infectious diseases are related to poor water and environmental sanitation. |

| |These issues could be addressed through infrastructural support and collaboration with the municipal corporation. |

|Sustainability: |In Mongolpuri site, as a pilot which could be rolled out to the other project sites to ensure project sustainability, |

| |the project has formed a HIC committee, headed by the Municipal Councillor, comprising of 9 members who includes young |

| |people, parents and a people’s representative. This committee will play an important role in the planning and monitoring|

| |of the HIC. All decisions related to the HIC are being taken by HIC committee members. For example the HIC members |

| |unanimously decided to keep affordable quarterly fees of 10 Rupees for all HIC users. This fee was introduced to create |

| |a value for the HIC and foster learning on how to run a sustainable institution, which caters to the health and social |

| |development needs of the young people and the community. After the project gets phased out, if there was support from |

| |the whole community and it didn’t deter users, the committee could increase the fee so that they could bear the |

| |expenditures of the centre. This will need to be decided after some evaluation of the user fees. There are even |

| |aspirations to register the HIC committee under the Society Registration Act so that they can in future function |

| |independently and get the grant support from Government and NGOs. In this way, this HIC centre could be developed and |

| |nurtured as a sustainable model so that it could also be replicated elsewhere. |

| | |

| |Engaging the community through Community Stakeholder Groups has been instrumental in instilling ownership. The project |

| |has tried, where possible, to recruit local staff from the community. The 585 peer educators selected and trained are |

| |from the communities themselves and they are taking this learning forward to other young people in the schools and |

| |vicinity. The team of young people have been performing street plays on project themes to increase community awareness. |

| |The project intends to provide some participants with professional training in Year 2 so that they can acquire |

| |professional skills in drama and in future they can use it as a livelihood opportunity for themselves. |

| | |

| |The project will sensitize teachers and health staff based in Government institutions on adolescent health issues. |

| |Through the stakeholder sensitization and coordination meetings, relevant Government authorities and community leaders |

| |have been engaged and will be extending support to the project. The project is also being linked to existing Plan and |

| |partner programmes supported by donors and operating in an integrated way. |

|Quotes and photos: |Quotes |

| | |

| |“My son Praveen has changed a lot after joining the HIC. He has become more responsible and even teaches me regarding |

| |health and sanitation. Today my son has become an example for other children and I feel proud of him. I am thankful to the |

| |YHP.” Mother of Praveen. |

| | |

| |“I daily come to the HIC and I ask Badi Didi (Program Manager) to open the centre on Sunday also. We enjoy more in the HIC |

| |rather in school. ” 16 year old boy. |

| | |

| |“Now my friends know that I am a peer educator so they come to me to discuss their problems.” Suraj, peer educator, 17 |

| |years. |

| | |

| |“The HIC has made me more confident to talk about the reproductive health issues and to seek medical treatment.” Sheetal, |

| |22 years. |

| | |

| |“The HIC is our centre here we not only get information but we can play, dance, can do craft activities also.” Vaishali, 13|

| |years. |

| | |

| |“I discontinued my education after class VII but now I want to complete my education.” Shashi, 16 years. |

| | |

| |[pic] |

| |Cleanliness Drive |

| | |

| | |

| |[pic] |

| | |

| |Community Sanitation Training |

| | |

| | |

| | |

| |[pic] |

| | |

| |HHIC Inauguration |

| | |

| |[pic] |

| | |

| |Puppet Show |

| | |

| | |

| |[pic] |

| |Youth Awareness Rally |

Annex 1: Progress against all indicators (Nov 2010 – Oct 2011)

|Progress against all indicators within logframe |Number current |Total number: Programme|Comments |

| |reporting period |to date | |

|Goal level | | | |

|% increase in knowledge of adolescents on health issues | | |TBD (to be done) at end of project |

|% decrease in reported infection / epidemic | | |TBD at end of project |

|Decrease in reported new TB cases | | |TBD at end of project |

|Decrease in reported water borne diseases | | |TBD at end of project |

|Objective 1: Outcome Level | | | |

|% of adolescents having knowledge on infection, physical changes and available health services | | |TBD at end of project |

|% decrease in myths and misconceptions amongst adolescents on various health issues. | | |TBD at end of project |

|% increase in adolescents accessing services from health clinics and counselling centres from both | | |Year 2, Year 3 |

|in-school and out-of-school set up) | | | |

|Objective 2: Outcome Level | | | |

|Increase in community awareness and support for epidemic preparedness initiatives. |Yes |Yes |It has improved through the peer educators, HICs |

| | | |and various awareness initiatives. Measured in |

| | | |Year 2, 3. |

|Establishing Community groups with youth for epidemic risk reduction & preparedness |25 |25 |Year 1 |

|Increased engagement of teachers in sanitation and hygiene by establishment of functioning school |No |No |We are yet to receive formal permission from |

|sanitation committees. | | |Education Dept. Govt of Delhi to formally enter |

| | | |in the school. As of now, we have been carrying |

| | | |out project interventions in schools on the |

| | | |pretext of personal relationship with school |

| | | |principal and teachers. |

|Objective 3: Outcome Level | | | |

|Increased support from community leadership for health interventions for young people |55 |55 (Yes) |Community leaders have been supportive in all 5 |

| | | |communities (in project related initiatives. |

|Improved access and services to address health needs of young people |260 |260 (Yes) |Peer educators are making referrals and |

| | | |documenting their progress. Additionally, cases |

| | | |are also referred from the HIC. |

|Objective 4: Outcome Level | | | |

|% of schools in the project area will have improved sanitary facilities/practices and all schools will |No |No |Permission has not yet been received from the |

|have active water and sanitation committee | | |Education Department of the Government. |

|All Youth clubs in the project area take actions to promote appropriate health, hygiene and sanitation | | |End of Project. |

|practices and prepare contingency plans for epidemic risk reduction and preparedness | | | |

|Improved supply and maintenance of public hydrants and water bodies in the project area |Yes |Yes |TB strengthened after Year 1. Measurement due in |

| | | |Year 2, 3. |

|Progress against all indicators within log frame |Targets achieved-Current |Targets Achieved-Programme|Comments |

| |Reporting period |to date | |

| |(July’11 to Oct’ 11) | | |

|Objective 1: Output Level | | | |

|Number of peer educators identified and trained (by gender) |Male – 168 |Male -299 |Two partners have completed their target of peer |

| |Female – 128 |Female-286 |educators and other two partners will conduct second |

| | | |phase of training in Dec 2011. |

| | |Total Trained PEs-585 | |

|Number of peer groups formed |Male – 20 |Male – 38 |More groups will be formed as the project progresses.|

| |Female – 13 |Female – 35 | |

|Number and type of IEC materials (pamphlets/posters/books) developed and distributed |1 Pamphlet, 2 Stickers |5 Training Modules, 5 Flip|The Editorial committee comprising of 6 Peer |

| | |Books 1 Pamphlet, 2 |Educators (3 Boys and 3 Girls) has been formed to |

| | |Stickers and a Peer |work on a newsletter/magazine with articles on health|

| | |Educator Newsletter is in |and critical issues collected by young people |

| | |process |associated with the project. |

|Number and type of outreach interventions |13 Events: |22 events: |This will be ongoing throughout the year. |

| |(1 International Youth |(2 World TB Days, | |

| |Day, 1 World Environment |3 International Women’s | |

| |Day, 1 Malaria Day, 1 |Days, 4 World Health Days;| |

| |Cleanliness Drive, 2 Hand | | |

| |Washing Days, 2 Girl Child|1 Water Day, 1 | |

| |Weeks, 1 Breast Feeding |International Youth Day, 1| |

| |Week, 2 Cultural Events, 1|World Environment Day, 1 | |

| |Disaster Management Day) |Malaria Day, 1 Cleanliness| |

| | |Drive, 2 Hand Washing | |

| | |Days, 2 Girl Child Weeks 1| |

| | |Breast Feeding week, 2 | |

| | |Cultural Events, 1 | |

| | |Disaster Management Day) | |

|Estimated number of community members reached through outreach |18543 |22523 Approx. |This figure explains the community members reached |

| | | |out through mass awareness activities such as Street |

| | | |Plays, Puppet Show, Rallies, Camps, Community |

| | | |Meetings and Health Melas. |

|Number of adolescents informed/reached by Peer Education mobilization activities |30000 |More than 30000 (This is a|This figure indicates the number of young people |

| | |very conservative figure |reached through trained peer educators, HIC |

| | |see note on page 1). |attendees, group meeting and mass awareness |

| | | |activities. |

|Number of HIC established |4 |5 |Target achieved. |

|Number of referrals made by HIC and peer educators |260 |260 |Through the monthly reporting format used by PEs and |

| | | |HICs. |

|Objective 2: Output Level | | | |

|Formation of active Community Stakeholder Groups in each community |5 |23 |23 groups have been formed to promote young people’s |

| | | |health. Additionally, 5 HIC committees have also been|

| | | |formed whose role is to ensure that HIC functions |

| | | |effectively. |

|Number of referrals made through community based referral system |0 |N/A |This will be done in the next six months. |

|Number of community meetings carried out |251 |314 |In the meetings, the discussions were around |

| | | |familiarizing the community with the project, health |

| | | |issues and misconceptions associated and how to |

| | | |dispel them all. |

|Number and type of IEC materials (pamphlets/posters/books) developed and distributed |1 Pamphlet |1 Pamphlet |On water, environment and sanitation issues. |

|Number of Melas/ Thematic camps/ street plays/ video shows on sanitation, hygiene, |106 Street Plays, |123 Street Plays, |This is an effective communication medium to increase|

|infection prevention, debates held |18 Film Shows, |31 Video Shows |community awareness as also endorsed by the |

| |6 Rallies, |9 Rallies |community. |

| |13 Health Talks, |15 Health Talks | |

| |28 Puppet Shows, |28 Puppet Shows | |

| |1 Health Melas |1 Health Melas | |

| |3 Health Camps |3 Health Camps | |

|Number of community members sensitized |18543 |22523 Approx. |It is gradually increasing through various |

| | | |communication strategies (One to one meetings, group |

| | | |meetings, meeting at the HICs, and various mass |

| | | |awareness activities). |

|Objective 3: Output Level | | | |

|Number of health providers trained on adolescent health & counselling skills imparted |291 |291 |This includes Medical Officers (MOs), Auxiliary Nurse|

| | | |Midwives (ANMs), Accredited Social Health Activists |

| | | |(ASHA) workers and Anganwadi workers |

|Number of legislators leaders, media persons, police) supportive of health initiatives |3 MLAs |4 MLAs |More will be sensitized as the project progresses. |

|attending workshops. |3 MCs |7 MCs |(Member of Legislative Assembly (MLA); Municipal |

| |2 RWAs |3 RWA Presidents |Councillor (MC) and Resident Welfare Association |

| | | |(RWA). |

|Objective 4: Output Level | | | |

|Number of schools participating in sanitation activities |NA |NA |This will take place after the permission is granted |

| | | |by the Education Dept, Govt of Delhi. |

|Number of Youth clubs involved in sanitation work in the community |0 |0 |This will take place in next six months. |

|Number of sessions facilitated by peer educators under the supervision of teachers |NA |NA |This will take place after the permission is granted |

| | | |by the Education Dept, Govt of Delhi. |

|Number of referral/counselling done by trained teachers |NA |NA |This will take place after the permission is granted |

| | | |by the Education Dept, Govt of Delhi. |

|Number of Community action groups taking part in maintaining public hydrants |0 |0 |This will take place in next six months. |

|Other Additional Programme Activities: | | | |

| Number of events at HIC |International Population |International Population | |

| |Day, Independence Day, |Day, Independence Day, | |

| |Diwali celebration, |Diwali celebration, | |

| |Teachers Day celebration |Teachers Day celebration | |

|Installation of Question Box |10 |10 |These boxes have been installed for boys and girls |

| | | |separately at the HICs so that young people can |

| | | |freely drop in questions which they hesitate to ask |

| | | |directly. |

|Competitions |Drawing, Poster, Slogan, |Drawing, Poster, Slogan, |All these competitions have been organized at the |

| |Essay, Poem, Mehandi and |Essay, Poem, Mehandi and |HICs. |

| |Rangoli |Rangoli | |

|Best peer educator of the month | |144 |A total of 144 awards were given to PEs to |

| | | |acknowledge their spirit of participation and |

| | | |volunteerism for YHP. |

|Street Plays developed by HIC members |3 Street Plays |3 Street Plays |Mangolpuri- Child Labour |

| | | |Dwarka- Girl Education |

| | | |Madan Pur Khadar & Badarpur- Substance abuse and HIC |

| | | |information |

|Wall Painting |1 |1 |Wall writings have been done at MadanPur Khadar & |

| | | |Badar Pur on health issues. |

|Distribution of IEC material |By all 4 partners |By all 4 partners |The IEC material has been distributed at schools, |

| | | |Anganwadi centres and to PEs. |

Annex 2 Progress against Activity Plan (Nov 2010 – Oct 2011)

|Activity |Description |Variance/Deviation |Comment |

| | | | |

|Start-up workshop |A workshop was organized in Delhi, which was |Completed |Partners developed work plans following this |

| |attended by AZ and partner staff. The project was | |workshop. Partners gained clarity on the |

| |reviewed and revised accordingly. A brief overview | |project. |

| |of the baseline was provided and the expectations | | |

| |and requirements of the project were discussed. | | |

| | | | |

|Finalizing the baseline report |The baseline report was finalized, after |Completed |The results of the baseline (and specific |

| |incorporating comments by the programme and | |area-characteristics) were incorporated into |

| |technical team. | |the work plan of various partners. |

| | | | |

|Developing work plans |All the 4 partner organizations developed a detailed|Slightly delayed | |

| |annual work plan for their project including a | | |

| |budget. | | |

| |Project Managers (4) and Project Coordinators (10) | | |

|Recruitment of Staff |were recruited by the partners. |Mostly on schedule |Some partners recruited the project staff on |

| | | |time, while there was delay in one of the |

| | | |partners as they were waiting for a suitable |

| | | |candidate. Plan India is still in the process|

| | | |of replacing the post of YHP Project Manager.|

| |Newly recruited Project Managers and Project | | |

|Orientation of Staff |Coordinators were oriented on the project (goal, |On schedule |This took place immediately after |

| |objectives, strategies, milestones etc.) | |recruitment. |

| | | | |

| | | | |

| | | | |

|Stakeholder sensitization and coordination workshop |Five workshops were organised by each of the local |On schedule |Workshops were organized to garner support |

| |partners for relevant key stakeholders from the | |and endorsement for the project. |

| |respective areas which included: | | |

| |Education Department, Health Department, Municipal | | |

| |Corporation, Water Supply Department and Integrated | | |

| |Child Development Scheme, Members of the Legislative| | |

| |Assembly. | | |

| | | | |

| |A mapping of resources regarding availability of | | |

|Social Mapping |health, education and infrastructure services in the|Additional activity |Carried out by the partners to enhance the |

| |community was done. | |project effectiveness. |

| | | | |

|Community Meeting |At least 314 community meetings have been organized | | |

| |in total in the five communities. Discussions |On schedule |Community meetings have helped in awareness |

| |included around the baseline data and health | |raising, sensitizing young people to be |

| |situation, project goals, objectives, strategies, | |engaged in the project and gaining support |

| |milestones. | |from parents to send their children to attend|

| | | |project activities. |

|Mass Awareness Activity | | | |

| |At least 182 activities have been organized to raise|On schedule |A positive response has been received from |

| |awareness. These include street plays, puppet | |the community and awareness has been raised |

| |shows, video shows and health melas. | |on young people’s health in the community. |

|Peer Educator Selection (Boys & Girls) |Identification of peer educators from in-schools and| | |

| |out of school. In total, 585 peer educators have |On schedule |Two partners have completed their target of |

| |been identified (299 male and 286 female). | |peer educators and other two partners will |

| | | |conduct second phase of training in Dec 2011.|

| | | | |

|IEC material development |Gender sensitive, attractive and easy to understand |On schedule |Plan has engaged a communication organisation|

| |pamphlets (2), 2 Stickers which are age specific and| |that specializes in IEC material development.|

| |gender specific and appropriate materials need to be| |Four modules on: water and environmental |

| |adapted for this project. | |sanitation, lifestyle and life skills, sexual|

| | | |reproductive health, menstrual hygiene and |

| | | |preventive and promotive health. These will |

| | | |be ready by end of June. |

| | | | |

| | | | |

| | | | |

| | | | |

| |The intended cultural activities focused on status | | |

|Events - Culture Activity on International Women’s Day (March|of women, normative behaviour against them, health |Mangolpuri, Holambi Kalan, Madanpr |Two street plays were organized to sensitize |

|8) |and hygiene issues, violence. |Khadar, Badarpur and Dwarka. |young people and their parents on the |

| | | |pertinent issues. |

|HIC Establishment | | | |

| |Establishment of Health Information Centres (HICs) |Completed |HIC’s in 5 communities have been established.|

| |at community level. 5 HICs were established in all | | |

| |five areas. These are being accessed and utilized | | |

| |by young people in the community. Up to now there | | |

| |have been thematic sessions, open discussions, | | |

| |debates, film shows on health and related issues. | | |

| |The HIC also offers fun activities such as dance, | | |

| |drawing, and games and integrates social and health | | |

| |issues into this. | | |

|Event World TB Day (24 March) |World TB day was observed to raise awareness about |It was organized in Badarpur, Holambi |The DOTS centre reported more clients |

| |the disease and provide information to the |Kalan, Mangolpuri and Dwarka. |visiting due to the sensitization during |

| |community. Rallies and street plays were organized.| |these events. |

|Event on World Health Day (7 April) |The World Health Day was observed by organising |Completed |Mass awareness activities were conducted in |

| |talks and consultation on health issues. | |all 5 communities on health issues. |

|Quarterly sharing meeting (end of April) |A meeting was held with all the four partners and |Completed |Good cross-learning took place and partners |

| |Plan staff to share their experiences including | |shared their progress and experiences. All |

| |progress, best practices and challenges. | |partners saw the first functional HIC at |

| | | |Mangolpuri. |

|Other celebrations |International Population Day | |All partners celebrated these events in their|

| |World Environment Day | |project area. |

| |Hand Washing Day | | |

| |Teachers Day | | |

| |International Girl Child Day | | |

| |Independence Day | | |

| |Diwali Celebration | | |

|Community Sanitation Training |4 |Completed |All partners have completed the Sanitation |

| | | |training with Community leaders and HIC |

| | | |members. |

|Capacity Building of Peer Educators |585 |Completed |Most of the partners have completed the peer |

| | | |educator training. The 2 partners will |

| | | |complete their training in Dec 2011. |

Annex 4: AZ Global measures

|Global measures: Community Benefit |

|Guidance: To be completed by all. Data to be entered on Grant Stream |

|Outputs |Targets Achieved-Current |Targets achieved- |Outcomes |

| |reporting period (July’11 to |programme to date | |

| |Sep’11) | | |

|1. |Total number of young people who have received health information through AZ-YHP |30000 |30000 (This is a very |These have been reached through YHP |

| | | |conservative coverage of |project activities directly (group |

| | | |young people through peer |meetings, HIC meetings and PEs |

| | | |educators, young people |trainings) and indirectly through peer |

| | | |attending HICs, Mass |educators in the community and in |

| | | |awareness, rallies and |schools. |

| | | |meetings. The cumulative | |

| | | |figure is approx 60000). | |

|2. |Of which: Number of young people who received information about: | | | |

| |Sexual and reproductive health | | | |

| |Mental health |30000 |30000 | |

| |Substance abuse |0 |0 | |

| |Violence |30000 |30000 | |

| |Nutrition |30000 |30000 | |

| |Infectious diseases |30000 |30000 | |

| |Accidents/injury |30000 |30000 | |

| |Other health issue |0 |0 | |

| |Access to healthcare |30000 |30000 | |

| | |30000 |30000 | |

| | | | | |

| | | |Total: 30,000 | |

|3. |Number of young people directly trained in delivery of interventions |296 |585 |(585/600) Total number of peer |

| | | | |educators. |

|4. |Total number of frontline health providers who successfully completed training programmes |291 |291 |Including MOs, ANMs, ASHA and Anganwadi |

| |in adolescent health | | |workers. |

|5. |Total number of influencers (parents, teachers, and leaders) reached by programme |2 Leaders, 162 Parents |422 Parents, 20 Teachers & |Through community stakeholder meetings |

| | | |8 Leaders |and community stakeholder sensitization |

| | | | |and coordination meetings. |

|6. |Number of awareness raising/advocacy campaigns conducted and estimated population reached |147 Mass Awareness Campaigns |182 Mass Awareness |Mass awareness was on key health issues |

| | |reaching 18543; 251 Community |Campaigns reaching 22523; |such as water and sanitation, health and|

| | |Meetings reaching 6220 |314 Community Meetings |hygiene and infectious diseases. |

| | | |reaching over 6820 directly| |

|Infectious diseases | | | |

|Outputs |Target |Target |Outcome |

| |achieved-current|achieved-program| |

| |reporting period|to date | |

|Number of young people given information about disease prevention |30000 |30000 |An estimated 30000 young people were sensitized. |

|Number of interventions mobilized to prevent spread of identified infections |1 |1 |A community Cleanliness Drive was organized in Mangolpuri. HIC members and |

| | | |PEs spread out awareness on Malaria and Dengue. The PEs and young people |

| | | |cleaned the community and sprinkled DDT powder in the drains. They conducted |

| | | |home visits and distributed pamphlets developed under the YHP project. |

|Number of healthcare workers provided with guidelines on adolescent preventative services|291 |291 |The health service providers were sensitized on the project themes so that |

| | | |efforts can be collaborated to bring about intended change. These have to be |

| | | |done in accordance to Government guidelines. |

|Number of schools/institutions undertaking improved hygiene practices |0 |20 |Discussions have been carried out with 20 schools but this has to be |

| | | |formalized. |

| | | | |

| |

|Sexual and Reproductive Health |

|Outputs |target |target |Outcome |

| |achieved-curren|achieved-program | |

| |t reporting |to date | |

| |period | | |

|Number of young people taught about sexual health (HIV/AIDS and STI prevention and testing) |30000 |30000 (This |Young people have been made aware of the thematic issues. |

| | |includes peer | |

| | |educators and | |

| | |sessions at HIC) | |

|Number of young people educated in sexual and reproductive rights |30000 |30000 |Young people have been made aware of their sexual and |

| | | |reproductive rights. |

|Number of young people given information on body awareness/ sexuality |30000 |30000 | |

|Number of public forums/events focusing on SRH where young people had input to content/event |0 |0 | |

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