Ekjut - Dr. Prasanta Tripathy

Context:

Ekjut’s efforts target health issues faced by tribal communities and other poor people living alongside them in Jharkhand and  Orissa  –two of India’s most impoverished States. Isolated communities like the Ho, Santhal, Bhumij, Munda, Juanga, Oraon, Bhuian, Paharia and Kodh are among the many tribal groups in Jharkand and Orissa who have extremely high rates of infant mortality maternal deaths and undernutrition. 

Critical Insight(s):

  • In the face of high mortality and morbidity communities have a passive acceptance of the belief that all events are predetermined and inevitable. They have stopped questioning health issues faced by them. It is therefore critical to transform this fatalistic perspective of the communities and   instill critical-thinking abilities in the community. To gain legitimacy and effectively promote solutions, there is a need to bring in scientific rigor to evaluate outcomes. 

Strategy: Community participation, women’s empowerment, building problem solving abilities, evaluation

Ekjut capitalizes on the most universal resource - the latent will of the mothers to ensure healthy lives for the children. Tapping into existing self help groups organized by CSOs and expanding them to include poorer women who may have been left out, a randomized control trial involving 36 clusters(10-12 villages per cluster) was set up in Jharkhand and Orissa. The intervention involves selecting local facilitators who structure self – exploratory, participatory learning and action process that help women reflect on their problems and encourage them to reason out the causes of their longstanding problems like deaths of newborn babies, maternal deaths, malaria and malnutrition among children. Techniques such as using pictures and drawings, puppetry, street plays and storytelling are the methods of communication. Problems are prioritized and strategies to tackle the problem are discussed among the tribal women.The trial tested the impact of a “process of change”. It was designed as a “community effectiveness” trial rather than an efficacy trial of a perfectly implemented intervention and to know if it could then be adapted and scaled up in other areas.

Impact:

Ekjut’s approach of community intervention has been a success-after three years of intervention, neonatal mortality and maternal depression has dropped by 45% and 57% respectively, during the last two years of the trial. Encouraged by the effectiveness of the approach, Dr.Tripathy and his team in Ekjut extended the intervention to the Control Areas and replicated success and are now scaling up in underserved areas of several districts. In contrast to the usual service delivery methods that seek impact through linear administration of programmes – from implementers to recipients the Ekjut initiative uses a circular method where the implementers, facilitators, groups of women and community members themselves become planners, designers and recipients of learning. Thus, Ekjut  aims for a long standing impact, on the premise of empowering individuals and the community  to take action for building healthier communities.

To learn more about Ekjut, please click here.