Sightsavers India – Awareness raising/Behaviour Change
Sunderbans archipelago is made up of 106 small islands out of which 52 are inhabited by people and the rest are covered by mangroves and the reserved forest area. Even among these due to heavy erosions some of the existing islands are being evacuated. Most of these islands are connected only by small rivers making the reach to all the areas difficult. With this background implementing a programme aiming to influence as many people as possible is an uphill task which cannot be successful without the support of the members of the community.
The project has thus engaged with different groups of people at the community level to maximise its reach. These groups include the Rural Medical Practitioners, Health Ambassadors, school teachers and the government health workers along with the influential members of the community like the village head or youth club members. As a part of the project design some of these cadres are provided information and skills through the means of training and exposure visits.
Rural Medical Practitioners (RMPs) are the village doctors who have no formal qualification or training however form the backbone of health services in Sunderbans. By means of working as an assistant to a qualified doctor they learn the skills and then begin their own individual practice. They command respect and have a position of significance within the community, thus their support becomes important for referrals and recommendation. Health ambassadors are volunteers who are selected from the various smaller groups existing within the community like the Women’s Self Help Groups, youth clubs, village heads or those who have received services from the project. These individuals are brought together for trainings and orientation on eye health, its relevance and need further sharing about services available.
The health ambassadors help the community health workers in organising camps, disseminating information about events, accompanying other patients to either the hospital or to the vision centres.
The next group is of the government health workers who work closely with adolescents, pregnant women and infants at the village level. They are the frontline workers for the government health delivery system.
Followed by the school teachers connected to both the children and their parents form another channel of influencer.
In a period of two and a half years the project has trained 1051 RMPs, 1469 health ambassadors, 597 government health workers and 1049 teachers. Training more women from each group is an integral part of the project’s approach as it is always more effective to work with women to reach people at the grassroots.
These individual groups along with the community health workers have expanded the penetration of services, information and make a progress towards bringing about an eye health seeking behaviour. In different areas different groups or a mix of them have supported the activities and implementation of the project. Their acceptance and participation in the project delivery has helped gain credibility and trust amongst the people which is apprehensive and has its own set of fears around surgeries due to bitter experiences with other service providers. The increase in cataract surgeries or the increasing footfall at the vision centres would not have been achieved without their support and belief in the project and its interventions.