Category Archives: Health & Sanitation

Chittorgarh District Community Based Rehabilitation (CBR) Programme

Chittorgarh District Community Based Rehabilitation (CBR) Programme

Introduction

CUTS-Centre for Human Development in partnership with Sightsavers is implementing Chittorgarh District Community Based Rehabilitation (CBR) Programme in Chittorgarh and Nimbahera blocks of Chittorgarh District of Rajasthan.

A brief outline of the project is as follows:

Project Area

Chittorgarh is one of the ancient towns of the state of Rajasthan with rich cultural heritage. Chittorgarh which forms the southern part of the state shares its border with other districts namely Banswara, Udaipur, Rajsamand, Bhilwara, Bundi and Kota and on the eastern side it shares the provincial border with Neemuch district of Madhya Pradesh.

Indicators Rajasthan Chittorgarh
Area (sq. km.) 342240 10,856
Population (2001) in million 56.51 1.8
Density (per square Km) 165 166
Sex ratio (females per thousand male) 921 964
Percent Scheduled Caste 17.15 13.90
Percent Scheduled Tribe 12.56 21.53

Chittorgarh was the capital of former Rajput state “Mewar”, which is remembered for bravery and valor of their rulers. Formerly, Chittorgarh was a fort city. Fort of Chittorgarh is spread in an area of around 2.8 Kms and is the largest fort in the country. Most of the part of the districts is hilly in nature and population is sparsely distributed. Availability of potable drinking water like in most part of Rajasthan remains one of the biggest challenges for the people of the area. About one fourth of the total population of the district is of scheduled tribes. In recent past some cement and zinc production units have come up and district is coming in the industrial map of the state but the resident tribals and rural populations is not getting any benefit from these developments. Migration for labour remains a regular phenomenon as agriculture is not very developed in the district.

Chittorgarh is one of the bottom 8 districts according to Human Development report 2007 with human development index of 0.558 and is one of the priority districts for the community development intervention.

Population

Chittorgarh district is divided into 11 administrative blocks and the project is intended to cover two blocks Nimbahera and rural Chittorgarh through CBR approach and advocacy initiatives will be carried out in the entire district to promote social inclusion of PWDs and increase the coverage of eye care services. A brief profile of Chittorgarh district and of two blocks are as presented in the table below :-

Chittorgarh Rural Nimbahera
Population 167960 188718
Schedule Tribe 21007 19523
Gram Panchayat 39 35
Villages 231 175

Though the project aims at addressing the exclusion of persons with Visual Impairment, special focus shall be on reaching out to poorer and disadvantaged sections of the society and also women and children. The proposed district has 49.1% Below Poverty Line families as per BPL census 1997 who would be given priority benefits.

Current Service Status

Eye Care Services

CSR of district 1394 ( Lowest in State)
No. of surgeries in 2009-2010 4745 ( target:9600)

Achievement : 49%

No. of Surgeries done by Govt. sector 94

Chittorgarh is the district with lowest CSR in the state of Rajasthan; CSR of the district is 1394 against the state average of 3961. In 2009-2010 district has done a total of 4745 cataract surgery against the annual target of 9600. With no NGO hospital based in Chittorgarh, district is dependent on the camps organised by eye hospitals of neighboring districts. Government hospital has done only 94 surgeries in the whole year. Gomabai hospital does over 1000 surgeries from Chittorgarh and is the major service provider. Aditya Birla Group under its CSR activities every year organises mega surgical camp at its general hospital in Chittorgarh in association with DBCS and over 1500 surgeries done every year. Overall district lacks primary and secondary eye care facility and accessibility and affordability remains a challenge for the poor population of the district.

Inclusive Education

Government is the major service provider for the education for the children with specific need in Chittorgarh district. Like many other districts of the state district is not having adequate number of special educators to cover the identified children. District has only 6 resource teachers employed by government to support 4620 children. Clinical assessments have not been undertaken in the district and the numbers shown in the government records are the provisional ones. District has one special school for hearing impaired children giving education to about 60 children. No other NGO in the district is working for the education for the children with specific needs. According to 2009-2010 data district has following details about the children with specific need.

No. of VI children in District : 1450 (provisional numbers; without clinical assessment based on the survey done with checklist by school teachers)

No. of VI children in project blocks: Nimbahera: 284, Chittorgarh : 262

Social Welfare

Government welfare schemes are limited to persons who possesses disability certificate, there are still persons with disabilities in the district waiting for the welfare schemes to benefit them. According to government statistics Chittorgarh is one of district where good number of job cards have been issued to PWDs under MNRGEGA programme. About 10 years back Action Aid had started some activities for the empowerment of PWDs with the support of another NGO of the district but it was for a small period of time and not much work to improve the condition of PWDs in the district could continue.

Persons with disabilities are not organised and they are mostly excluded from the mainstream development initiatives. Programmes of health, education and livelihood being implemented in the district knowingly or unknowingly excludes persons with disabilities.

Goal

No person in Chittorgarh district remains needlessly blind and those with irreversible blindness or low vision should have the same rights and access to services as their sighted counterparts.

Purpose

  • Community of the targeted area become knowledgeable about the eye health and start accessing better eye care services.
  • People with Visual impairment are able to maximise their physical and mental abilities, to access regular services and opportunities, and to become active contributors to the community.

Beneficiaries

As eye care and inclusion needs are spread across all age groups, this project is initially intended to benefit the entire population of the project area. Of all groups, it is intended to be more beneficial to the lesser privileged and marginalised groups such as those from the lower socioeconomic strata, tribal communities and the female population.

Direct service delivery will be given in the demonstration blocks of Nimbahera and Chittorgarh-Rural and CUTS will be working closely with the population of the project block. Advocacy initiatives are intended to benefit the entire district and it is expected that the NGO network partners and government will carry forward few of the approaches.

Specific Objectives

  • To demonstrate an approach of primary care for generating awareness in the project area on prevention, cure and cause of blindness and inclusion by end of the project period.
  • To demonstrate an approach of public private partnership to ensure that identified individuals with treatable eye problems receive appropriate treatment by the end of project period.
  • To build the capacity of Persons with disability and organising them to form a district level network by the end of project period.
  • To strengthen the government initiative of inclusive education by ensuring that all identified children with visual impairment are enrolled in the mainstream education system and receives quality education.
  • To work towards the enhancement of social inclusion of the visually impaired (VI) persons and ensure 70% of the identified VI persons receive timely need based rehabilitation services.
  • To strengthen the capacity of CUTS-CHD on eye health and social inclusion issues to make them a resource agency in south Rajasthan.

Collaborators and Stakeholders

  • Gomabai Netralaya will be the major referral centre for eye care services and regular outreach camps will also be organise in the project area by the Gomabai Netralaya.
  • District Education Department will extend all possible support to the children with specific need in the district under SSA programme.
  • District Health Society will support the programme by providing support for eye care services. School eye health programme will be conducted with the support of DHS.
  • District NGO forum: 38 registered NGOs covering 11 blocks are part of the forum nurtured by CUTS. These organisations are involved in the community development activities. CUTS office is the secretariat of the district forum.
  • Consumer resource centres promoted by CUTS are now registered as societies at each of the 11 block headquarters and they have a strong network at the block level. Consumer rights and other laws in disability framework will be taken forward by these centres.
  • 300 Women Self Help Groups formed by CUTS with NABARD support in Nimahera in will be one of the major stakeholders. SHGs will ensure that PWDs are included and supported by the group. The SHGs will also play a role in prevention and promotion of eye care work.
  • Children Collectives (Bal Panchayat): 56 existing village level collectives spread in 12 gram Panchayat will also be contributing in this project.

Project Duration

  • Three years (August 2010-July 2013)

Sustainability

The core strategy of the project is to strengthen the ongoing government initiatives so as to ensure that persons with disabilities (PWDs), children with specific need and the persons with curable eye diseases have a better access to the services. The project is intended to make PWDs aware about their rights and responsibilities and mobilise them into groups so that collectively they can ensure that their rights are protected. Once the PWDs are identified and provided the basic facilities like disability certification and the mobility training it is expected that their access to the services will be better and the system will also be more acceptable to them.

Project is intended to influence and involve various stakeholders on the issue of social inclusion which will take forward the mainstreaming initiatives forward.

The project intervention of three years will create and awareness and demand of the eye care services in Chittorgarh district and project implementing partner established linkages with eye hospitals like Gomabai or government hospital will help continuing the eye care work in the district.