Achievement at a glance: Boat Clinic

August 10, 2010
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Ships

Boat Clinic Programme implemented by C-NES in partnership with NRHM, Assam

C-NES has been providing basic health care services to communities who do not have access to health facilities in the river islands of the Brahmaputra through its Boat Clinic initiatives in a Public Private Partnership (PPP) with the National Rural Health Mission (NRHM), Government of Assam. These specially developed boats are equipped with laboratories on board as well as pharmacies. UNICEF is also supporting the programme in Dibrugarh and Lakhimpur districts where it works with C-NES on health training and skill upgradation as well as a school outreach programme to cover children who have dropped out of school or have never been to school.

Background:

In many river journeys, journalist, author and C-NES Managing Trustee, Sanjoy Hazarika observed the enormous gaps and needs in his home state, Assam especially among those living on the river. The need was to take the service to people, not wait for them, with all their difficulties, to come to the mainland for it. After launching C-NES in 2000 and conducting detailed research, involving local community members and staff on issues relating to livelihoods, floods, erosion and health, the time was appropriate to test the idea through competing in the India Marketplace 2004, organized by the World Bank to draw ideas for meeting rural gaps. Thus, the “Ship of Hope in a Valley of Flood” was born, won an award and with the award funds it was decided to build the ship.

In May 2005, the organization launched the Boat Clinic initiative to deliver health services to people living on the islands of the Brahmaputra in Assam state. C-NES started with one boat and seven staff in Dibrugarh district in 2005, with support from district health and administration as well as modest assistance from Oil India Limited, Assam Oil Ltd and local NGOs and business organizations. The success in the intervention received recognition which attracted UNICEF and later NRHM, Govt. of Assam, which wanted to reach out to a larger population. In the first phase of partnership with NRHM, beginning February 2008, the Boat clinic programme was implemented in 5 districts of Assam- Dibrugarh, Tinsukia, Dhemaji, Morigaon and Dhubri. In the second phase, from March 2009, 5 more districts Lakhimpur , Jorhat, Sonitpur, Nalbari and Barpeta were added. From August 2010, 3 more districts- Kamrup, Goalpara, Bongaigaon along with one more unit each in Barpeta and Dhubri have been brought under the Boat Clinc health initiative.

The goal:

To take sustained health care to lakhs of persons on the islands, for the first time since independence, with a special focus on women and children, who are the most vulnerable in difficult conditions. What drives the organization and its programmes is delivering people their birth right in the sphere of health, education, sanitation among others.

The goal is to reach 10 lakh persons or one third of the state’s vulnerable population who live on islands on the Brahmaputra by 2012.

The health teams, lead by District Programme Officers (DPOs), work extensively on delivering basic health services with priority given to delivery of national immunization programme for children as well as pre and post–natal check ups for women. A series of camps to deliver these services are organized by developing work plans for each district to cover the islands in association with the NRHM, the Joint Directors of Health as well as C-NES’ teams of District Programme Officers (DPOs) and Community Workers; the latter are the organizing core of the outreach. The teams make 5-6 trips per month to selected islands and conduct camps for 10 to 20 days. There are two Medical Officers per boat and the paramedical staff includes two ANMs, a GNM, a pharmacist and one laboratory technician. With the involvement of local communities, the DPOs hold camps in a series of villages.

Awareness meetings are held with the communities on relevant topics in order to educate and inform on issues like reproductive health, population control, sanitation, nutrition and malaria control. Information Education Communication (IEC) materials are extensively used for communication. Doctors follow the feedback system in their treatment for self assessment and quality of treatment. Disease analysis is done by the doctors through records maintained at each camp. Each section of the team maintains records and data which provide material for computation and analysis. Reviews on the above sections are done by experts nominated by the Board of Trustees every 6 months.

Outreach

The district wise breakup of population proposed to be covered and number of river islands where boat clinics are functioning so far are as follows:

District	No. of River Islands/ Bankline areas	No. of River Islands/Bankline areas covered	No. of Villages	No. of Villages Covered	Population Covered
Tinsukia	10	10	41	23	14,967
Dibrugarh	14	14	17	17	12,882
Dhemaji	11	11	14	14	9,271
Morigaon	38	25	38	25	29,190
Dhubri	125	35	480	35	1,30,000

District	Char /Village	Population
Lakhimpur	109	1,43,235
Jorhat	293	2,15,095
Sonitpur	145	1,45,729
Nalbari	32	83,602
Barpeta Kamrup Goalpara Bongaigaon	277 175 179 117	2,68,344 1,54,503 1,86,826 1,35,809

Source: Block, District Health Society and C-NES survey

			C-NES BOAT CLINICS: 10 DISTRICTS (Partnership with NRHM)
			Achievement at a glance: Boat Clinic, 1st April 2010 onwards (monthly)

		TINSUKIA DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

13	April	872	48	23	3	26				972	442
17	May	1728	48	55	1	0				1832	301
15	June	1716	74	42	4	18				1854	421
15	July	1804	131	78	4	0				2017	72
16	August	1275	71	56	13	0				1415	550
76	TOTAL	7395	372	254	25	44	0	0	0	8090	1786

		DHEMAJI DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

16	April	891	45	20	0	11				967	6
16	May	1563	82	65	0	14				1724	29
17	June	1814	98	61	1	21				1995	0
14	July	981	26	46	0	6				1059	0
13	August	820	22	39	3	1				885	0
76	TOTAL	6069	273	231	4	53	0	0	0	6630	35


		DIBRUGARH DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Delivery	Total	Family Planning

5	April	219	44	9	2	30				304	220
9	May	581	45	24	2	23				675	0
8	June	555	46	12	0	28				641	58
7	July	623	44	32	5	0				704	42
12	August	737	68	35	5	34				879	0
41	TOTAL	2715	247	112	14	115	0	0	0	3203	320



		MORIGAON DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

24	April	1363	292	82	37	67				1841	527
27	May	1431	260	252	33	67				2043	1102
27	June	1631	310	249	41	114				2345	1290
14	July	1423	203	193	22	66				1907	47
16	August	1701	286	246	32	117				2382	47
108	TOTAL	7549	1351	1022	165	431	0	0	0	10518	3013


		DHUBRI DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

14	April	1406	133	30	3	16				1588	89
14	May	1626	194	49	6	0				1875	91
15	June	1715	170	67	9	21				1982	30
15	July	1804	131	78	4	0				2017	72
16	August	2030	206	83	10	0				2329	74
74	TOTAL	8581	834	307	32	37	0	0	0	9791	356



		LAKHIMPUR DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

13	April	719	30	41	5	2				797	24
7	May	657	11	16	0	0				684	26
15	june	950	20	46	5	4				1025	105
16	July	890	103	64	11	27				1095	52
12	August	1827	81	93	14	26				2041	65
63	TOTAL	5043	245	260	35	59	0	0	0	5642	272


		JORHAT DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

14	April	511	24	21	1	14				571	100
14	May	733	45	26	2	0				806	10
17	June	893	30	33	4	4				964	110
14	July	776	39	32	3	0				850	160
16	August	845	51	43	3	0				942	100
75	TOTAL	3758	189	155	13	18	0	0	0	4133	480

		SONITPUR DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

16	April	1298	370	65	9	506				2248	138
16	May	1185	300	167	24	300				1976	346
15	June	1219	380	149	25	169				1942	204
15	July	1117	239	95	29	163				1643	416
12	August	815	209	42	18	125				1209	33
74	TOTAL	5634	1498	518	105	1263	0	0	0	9018	1137


		NALBARI DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

14	April	1407	211	28	12	55				1713	160
16	May	1729	223	84	8	60				2104	182
16	June	1597	220	80	16	59				1972	183
15	July	1455	214	70	18	21				1778	190
15	August	1448	184	84	23	0				1739	237
76	TOTAL	7636	1052	346	77	195	0	0	0	9306	952


		BARPETA DISTRICT:
No.of camps	Months	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Inst. Delivery	Total	Family Planning

15	April	1633	255	105	37	314				2344	1918
15	May	1808	341	189	41	125	0	0	0	2504	506
11	June	787	213	150	16	42				1208	1312
10	July	1327	301	119	27	82				1856	2561
15	August	1790	47	189	51	100				2177	445
66	TOTAL	7345	1157	752	172	663	0	0	0	10089	6742

	Boat Clinic under NRHM,(10 District) 1st April 2010 onwards (Total)
Total Camps	Districts	Health Checkup	RI	ANC	PNC	Vit A	Spl.Vaccination	IPPIP	Delivery	Total	Family Planning
76	Tinsukia	7395	372	254	25	26	0	0	0	8090	1786
76	Dhemaji	6069	273	231	4	53	0	0	0	6630	35
41	Dibrugarh	2715	247	112	14	115	0	0	0	3203	320
108	Morigaon	7549	1351	1022	165	431	0	0	0	10518	3013
74	Dhubri	8581	834	307	32	37	0	0	0	9791	356
63	Lakhimpur	5043	245	260	35	59	0	0	0	5642	272
75	Jorhat	3758	189	155	18	18	0	0	0	4133	480
74	Sonitpur	5634	1498	518	105	1263	0	0	0	9018	1137
76	Nalbari	7636	1052	346	77	195	0	0	0	9306	952
66	Barpeta	7345	1157	752	172	663	0	0	0	10089	6742

729		61725	7218	3957	647	2860	0	0	0	76420	15093

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