UPCMP Process Document_Final-1-min

1
UTTAR PRADESH COMMUNITY
MOBILISATION PROJECT
The Proof is in the Process
Innovating the Self-Help Group Model to Impact Large-Scale Health Behavior
Change and Service Delivery

2
CREDITS
Author:
Michaela Partridge
Graphic design & layout: RDD Design
Publisher:
RGMVP
Publication Date: 2016
Thank you to the UPCMP team and partners for sharing helpful insights,
documentation and data. Also, this would not have been possible without the
help of committed RGMVP staff, who organized events and key moments in
the field for reflection and learning. And lastly, to the rural women of Uttar
Pradesh, for whom this document seeks to recognize and benefit – may you
continue to mobilize action with the same unwavering spirit that has inspired
this great movement for change.

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ABOUT RGMVP
Rajiv Gandhi Mahila Vikas Pariyojana (RGMVP) is a community-based flagship
program that aims to reduce poverty and address social issues by activating
the innate potential of women living in rural and marginalized sections of
Uttar Pradesh, India.
RGMVP has been operating in Uttar Pradesh since 2002, organizing women
into Self-Help Groups (SHGs) to enhance their economic and social
inclusion and also encourage them to demand their rights and
entitlements from the government.
RGMVP BELIEVES IN INNOVATION AND
SCALE BY DOING THINGS DIFFERENTLY.
WE ARE TRYING TO INSPIRE PEOPLE TO
CHANGE THEIR MINDSET BY CHANGING
THE TIME HORIZON AND THE DIRECTION
OF THEIR INNATE ENERGY IN ORDER TO
HELP THEM OVERCOME POVERTY AND
EXCLUSION.
Sampath Kumar, CEO
ABOUT THIS DOCUMENT
Going beyond mere micro-finance schemes, RGMVP has innovated the
conventional SHG Model to emerge as a vibrant and inclusive system of
leadership and holistic empowerment.
The following document aims to capture the unique designs and
processes built behind the RGMVP model, as they are made evident
through implementation of the Uttar Pradesh Community Mobilization
Project (UPCMP).
UPCMP is a project funded by the Bill and Melinda Gates Foundation,
in partnership with the Public Health Foundation of India, Population
Council, Community Empowerment Lab and Boston University, Center
for Global Health and Development.
Through the activation of RGMVP’s SHG platforms, UPCMP has
developed and successfully scaled-up a package of interventions to
change health behaviors, improve delivery systems to reduce infant and
maternal mortality rates.
Since 2011, tremendous impacts have been felt across the state, in which
hundreds of women have been able to turn life-saving knowledge into
practice. The insights and data from this document seek to highlight
these impacts, while also serving as a repository of information for
development practitioners, researchers and academics who are
interested in new approaches to large-scale health behavior
change and improved service delivery.

CONTENTS
Introduction......................................................................................................................6
RGMVP Background .......................................................................................................7
UPCM – The Project.......................................................................................................8
Delivering Innovations ...................................................................................................7
Critical Results & Milestones .........................................................................................7
Lessons for the Future ....................................................................................................8
Partner Organizations ....................................................................................................7
Acronyms ..........................................................................................................................8

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INTRODUCTION
Maternal health is closely linked to newborn survival. In India, where it is estimated that one woman dies of childbirth related complications every five minutes,
we are hard-pressed to determine what strategies can actually ensure healthier behaviors and safer deliveries. Although facility births are increasing, the quality
of care at birth, as well as the health information and networks available in rural areas, remains a major challenge. Many women still give birth at home, often in
unsafe and unsanitary conditions, and rarely consult skilled health workers before or after delivery. As a result, many women and newborns needlessly die due
to causes, which are largely preventable and treatable.
EVERY FIVE MINUTES, AT LEAST
ONE INDIAN WOMAN DIES DURING
PREGNANCY AND CHILD BIRTH.
World Health Organization, 2016
Infant Mortality Rate
Maternal Mortality Rate
UP
UP
359
292
India
India
212
178
2010 2012 2007 - 20019 2010 -2012
*Per 1,000 live births; Source: PIB
*Per 100,000 live births; Source: PIB
Health Indicators in Uttar Pradesh
Uttar Pradesh (UP), India’s most populous state, persistently performs
poorly on maternal mortality, reporting the maximum number of maternal
deaths and Kerala the least 1 . A woman in UP has one in 42 lifetime risks of
maternal death, where the probability is just one in 500 in Kerala 2 . Similarly,
in the case of neonatal mortality, UP is among the top five high focus states,
reporting 48 neonatal deaths per 1,000 live births 3 . UP also reports 95
under-five deaths per 1,000 live births 4 , equivalent to one death for every
13 school buses. Even more devastating is the fact that the majority of
causes of death, like tetanus or diarrhoea, are largely preventable through
vaccination or good hygiene.
Limited Innovations Available
Many private sector organizations are experimenting and innovating to
address these challenges. Despite the existence of many proven life-saving
interventions, there is still a dearth of community-based programs, which
can take these interventions to scale rapidly and sustainably. Even where
information is available, health seeking behaviors and barriers can often
prevent women from adopting best practices, forcing many women to
resort to high-risk behaviors 5 . Population Council heavily supported this
reality in a landscape study in 2011 6 , stressing the need for Behavior Change
Communication (BCC) strategies to address rural health barriers and shape
demand for the adoption of preventative practices.

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COMMUNITY MOBILIZATION IS
A CAPACITY BUILDING PROCESS
THROUGH WHICH COMMUNITY
MEMBERS, GROUPS AND
ORGANIZATIONS PLAN, CARRY
OUT AND EVALUATE ACTIVITIES
IN A PARTICIPATORY, SUSTAINED
WAY TO IMPROVE THEIR HEALTH
AND OTHER CONDITIONS, EITHER
THROUGH THEIR OWN INITIATIVE
OR STIMULATED BY OTHERS 7 .
Scope for Community Mobilization
Most efforts to improve maternal and newborn health have focused on
strengthening service delivery. And while improving access to, and quality
of, important health services are essential, reducing maternal and newborn
deaths also requires action at the community level. For this reason,
Community Mobilization is recognized as a key intervention in the Global
consensus on Reproductive, Maternal, Newborn and Child Health (RMNCH).
Community Mobilization differs from, and can be more effective than, health
education, as it aims to empower communities to change their situation. This
involves an investment in people’s innate potential to become leaders, make
decisions and take coordinated action to resolve health issues.
Importance of Self-Help Groups
In many rural communities in India, women have very few opportunities
to improve their health or that of their families. Even where local health
committees exist, they are often dominated by community leaders or men,
which can mean critical health issues affecting women and children falling
to the wayside. Self-Help Groups (SHGs) provide the needed informal space
to build on women’s interest in improving the health of their families and also
have the capability of reaching the poorest and most marginalized women.
Besides income benefits from small savings, SHGs encourage an exchange
of ideas and information to identify problems and innovate as a collective to
find solutions for overcoming economic, social and cultural barriers.

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Addressing The Problem
In this context, RGMVP launched the Uttar Pradesh Community Mobilization
Project (UPCMP) alongside a consortium of development practitioners,
action-oriented researchers and behavior change experts to pilot and evaluate
a unique model through social platforms. Partners include the Public Health
Foundation of India (PHFI), Community Empowerment Lab (CEL), Population
Council (PC) and the Centre for Global Health and Development (CGHD)
at Boston University. With the generous support from the Bill and Melinda
Gates Foundation, the project has revealed a promising, institutionalized and
scalable social platform through which maternal, neonatal and child health
interventions may be built upon.
Process Document Objectives
The present document seeks to capture the design and processes under
UPCMP and articulate the deeper insights and explanations as to why and
how positive results were achieved. It reflects on the various kinds of capacity
building and health mobilization activities carried out, the process underlying
these activities and the roles and responsibilities of individuals and groups to
sustain the process. We hope to educate others about RGMVP and explain
how it has innovated the conventional SHG model to expand and leverage
its scope from mere micro-finance linked groups to vibrant and inclusive
leadership building platforms with strong potential to impact family health
outcomes at scale.
1 UNICEF (2009). The State of the World’s Children:
Maternal and Newborn Health.
2 Ibid
3 Registrar General of India (2016). SRS Survey 2014.
4 Save the Children (2010). A Fair Chance at Life: Why
Equity Matters for Child Mortality.
5 Jenny Ruducha et al (2016). Who’s Advice Should I
take? A Qualitative Study of Community Strengthening
and Health Message Delivery in Rural UP. BU Centre
for Global Health and Development.
6 Population Council. Shaping Demand and Practices
to Improve Family Health Outcomes: Designing a
Behavior Change Communication Strategy in India.
Uttar Pradesh ed. Vol. 1: Sage, 2012. Print.
6 Population Council. Shaping Demand and Practices
to Improve Family Health Outcomes: Designing a
Behavior Change Communication Strategy in India.
Uttar Pradesh ed. Vol. 1: Sage, 2012. Print.
7 Howard-Grabman, Lisa et al. (2007). Demystifying
Community Mobilization: An Effective Strategy to
Improve Maternal and Newborn Health.

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RGMVP BACKGROUND
THE HOLISTIC APPROACH
Rajiv Gandhi Mahila Vikas Pariyojana (RGMVP) is the flagship program of
the Rajiv Gandhi Charitable Trust (RGCT) based in UP. It was established in
2002 to commemorate and take forward the vision of India’s former Prime
Minister for the country’s development. Since its inception, RGMVP has
helped to mobilize 1.4 million women and their families into SHGs. The
edifice of RGMVP rests on the innate collective strength of these SHGs
(consisting of 10-20 rural women) and their federations at village and blocks
levels to act as social platforms to go beyond achieving financial well-being
to address more urgent needs of health security and social awareness.
UP ACCOUNTS FOR AN
ESTIMATED 20% OF THE
NATIONAL POVERTY AND 9%
OF THE POVERTY WORLDWIDE.
Three-Tier Institutional Model
SHG
SHG
SHG
SHG
SHG
VO
VO
VO
BO
SHG
VO
BO
61
53
Self-Help Group
Village Organization
Block Organization
359
292
47 A SHG consists of 10-20212
women living in a neighbourhood who voluntarily
42
choose to form a group.
178
SHGs are federated into VOs, representing 150 to
250 women, and then further federated into BOs, representing 5,000 to
7,000 women.

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Service Delivery System
These community-based institutions provide all marginalized women with a platform to unite
based on gender and mutual concern, cutting across rigid lines of caste and religion, to mobilize
their communities and its resources to better their lives. Serving as systematic platforms to help
bridge the gap between government delivery systems and poor recipients, SHGs, VOs and BOs
enable direct delivery of various services, including: access to health and nutrition entitlements;
linkages with frontline health workers and departments; bank linkages; and various schemes to
improve livelihoods, agriculture and education.
Internal Social Capital
RGMVP believes that the creation of well-being alone is not sufficient. While technical and
sensitive support is provided to ensure SHG functioning for achieving financial inclusion, the
process itself also identifies and nurtures a cadre of community level leaders, trainers and
resource persons. This ever-expanding network of Internal Social Capital (ISC) is the key to
sustaining RGMVP’s unique development model, as it is fully owned and managed by the
community. This ensures a bottom-up and scalable approach, prioritizing local context and
collective ownership as a means to address larger personal and social transformation.
Institution & Capacity Building
Ongoing training, counselling and support allow the community institutions to evolve alongside
the women who manage them. As a continuous process, RGMVP and its partners invest in
community leaders through various capacity building trainings on SHG concepts, as well as
norms and management, which outline their roles and responsibilities. The more training an
individual receives, the more capable she becomes in contributing to mobilization efforts.
Sensitive support for women’s institutions at Village and Block levels help strengthen efforts to
layer and direct the delivery of various services. This enables women’s institutions to strategically
engage with the demand side while also working to make supply systems more accountable.
CORE VALUES
Unite
Unite women in SHGs to collectively break
barriers and plan for their futures
Strengthen
Strengthen SHG members through handholding
support and capacity building
Link
Link SHGs and their families to existing
structures of service delivery and resources
Build
Build social capital harnessing new
information and creating support networks
Grow
Grow the SHG network by encouraging
innovation and embracing volunteerism

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Layering Health Interventions
The layering of health interventions and services in UP is especially critical considering the disproportionate number of neonatal and maternal deaths and
malnutrition. This is compounded by poverty and constant financial burdens, leaving families helpless in the face of health emergencies. Regressive health
practices and insufficient public health infrastructure further exacerbate the situation. In this regard, RGMVP operates as a strategic mechanism to connect
the demand-supply bridge. Communities are seen not merely as recipients of care, but as powerful and informed health seekers, capable of demanding quality
health services and improved access.
RGMVP Expansion Map
RGMVP has consistently expanded its outreach
since its inception. As of December 2016, the
project spans across 49 districts, including
complete coverage of Bundelkund, the most
underdeveloped region in the state.
2006
2011 2016
3 33 49
DISTRICTS DISTRICTS DISTRICTS
Cumulative SHG Formation Progress
Social Coverage
1 5 000 0
120 000
900 0 0
66,790
88,806
110,824
130,167+
1.3%
OTHER 41.8%
8.3%
OTHER BACKWARD CASTE
GENERAL
6.2%
MINORITY
600 0 0
37,217
3 0 000
0
*As of Dec 2016; Source: RGMVP MIS
2012 2013 2014 2015 2016
40.8%
SCHEDULED CASTE
1.7%
SCHEDULED TRIBE

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UPCM – THE PROJECT
Project Goal: To improve Reproductive, Maternal, Neonatal and Child health by strengthening the management of behavior change through women’s social
platforms
Project Objectives:
1. To increase adoption of evidence-based, high impact family health behaviors through SHGs to reach the poor
2. To scale up evidence-based, high impact health behaviors and effective strategies to improve access to health services
The Uttar Pradesh Community Mobilization Project (UPCMP) was launched
as a four-year initiative (2012-2016) to further RGMVP’s commitment to
improve health conditions among the poor. What has emerged is a unique
Health Behavior Change model with strong potential to reduce maternal and
newborn deaths at scale, which could indeed be replicated in some of the
poorest communities in India. The following section, based on the experience
of UPCMP, aims to describe this model at length – taking the reader through
its participatory learning and action cycle, owned and operated by local
women leaders.
The principle objective of UPCMP is to reduce neonatal mortality by
developing and scaling up a package of family health interventions, while
also working to strengthen community management of Behavior Change
Communications (BCC). Utilizing the SHG platform to identify target women
and impart information on Reproductive, Maternal, Neonatal and Child Health
(RMNCH), the project seeks to inculcate knowledge, strengthen skills and
invite families to adopt better behavioral practices for safer pregnancies,
newborn care and child health. Work with SHGs is complemented by efforts
to strengthen health services and improve linkages with health systems.
In line with RGMVP’s main operating strategy, UPCMP embraces a
participatory learning and action cycle to identify and prioritize problems
facing target women, and then mobilize action to address them. The
process depends on SHG functioning, committed mobilisers and local
health workers, active communication between SHGs and VOs and
continuous capacity building and community support for measuring
progress and impact. This section will reveal that the proof is in the process.
When all cogs work together to activate SHGs, the results can indicate
tremendous improvement in family health behaviors and increased access
to life-saving health services.
UPCMP EMBRACES A PARTICIPATORY LEARNING AND ACTION CYCLE TO IDENTIFY AND
PRIORITIZE PROBLEMS...AND THEN MOBILIZE ACTION TO ADDRESS THEM.

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ORIENTATION OF RESULTS & ACTIVITIES
To attain UPCMP objectives, some good results have been identified. These results specifically relate to the activities carried out under the project and can
be stated in the following manner:
RESULT 1
RESULT 2
RESULT 3
RESULT 4
Strengthened capacities of women’s
institutions and individuals to
mobilize rural communities and
its resources to adopt preventative
health practices.
Under this result, various capacity
building trainings and knowledge
transfer activities are carried out
in addition to continued SHG
formation and nurturing.
Increased awareness and knowledge
about RMNCH behaviors and
increased capacity to demand quality
health services and
improved access.
Under this result, various BCC,
awareness-raising and mobilization
activities were carried out in addition
to important linkages with supply
side interventions.
Enhanced coordination,
collaboration and information
exchange for the sustainability of
BCC activities through consultative
and participatory processes and
advice networks for support.
Under this result, the coordination
with community stakeholders,
women’s institutions and local
health care workers are carried out.
Selected community volunteers
assisted in collecting and measuring
outcomes related to knowledge
and practices among the target
population.
Under this result, two rounds of
community-managed Lots Quality
Assurance Sampling (LQAS) was
implemented to track and improve
the quality of the process.
INNOVATIONS
Result 1
Result 2
Result 3
INSTITUTION & CAPACITY BUILDING
BEHAVIOR CHANGE MANAGEMENT PACKAGE
PEER-TO-PEER PROPAGATION CYCLE
Key innovations and activators
for achieving these results at
scale are further explained
on page 20, in the section
‘Delivering Innovations’.
Result 4
COMMUNITY-BASED MONITORING & EVALUATION

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UPCM STRATEGIC FRAMEWORK
VISION
Project Area
To enable transformative health behavior change for safer pregnancies, newborn care and child health
MISSION
why?
how?
for whom?
33
DISTRICTS
UP is among the poorest states in India
and significantly lags behind in maternal,
neonatal and child health care indicators
By utilising existing SHG platforms and
network to identify target women and
disseminate RMNCH information
Pregnant Women, Recently
Delivered Women and Mothers
of Children (age 0-2 years old)
HEALTH PACKAGE
Maternal Health
• Identification of danger signs & referral
• Complication Readiness Plan
• Family planning methods i.e. birth spacing
• Promotion & facilitation of ANC/PNC
Neonatal Health
• Thermal Care
• Exclusive Breastfeeding
• Prevention of infection
• Identification of danger signs & referral
Child Health
• Routine Immunization
• Pneumonia Management
• Diarrhea Management
• Complimentary feeding practices
4,500
VILLAGES
FOCUS AREAS
1
2
3
4
120
BLOCKS
SHG formation
& strengthening
Capacity building
training on RMNCH
Diffusion of
RMNCH knowledge
Linkages with
local health system
Target geographies
STRATIGIES
IDENTIFICATION
OF TARGET
WOMEN
COMMUNITY
MOBILIZATION
& DEMAND
CREATION
INTERACTION
WITH TARGET
WOMEN DURING
MEETINGS
ATTACH A SHG
MEMBER TO
TARGET WOMAN
HOME VISIT
TO RECENTLY
DELIVERED
WOMEN
• 6.8 Million Population
• 1.1 Million Households
• 75,000 SHGs
• 5,100 Villages
• 120 Blocks

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MOBILISING ACTION: KEY ACTORS
Frontline Health Workers
Frontline health workers in India are divided into the three primary groups. These include Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives
(ANMs) and Anganwadi Workers (AWWs). Together, they are known as AAA. The scope of their work may vary across states, depending on community needs
and priorities of the various state governments. However, their roles are deeply intertwined at the community level.
Accredited Social Health Activists
Auxiliary Nurse Midwives
Anganwadi Workers
There are approximately 890,000 ASHAs across
India, primarily making home visits to pregnant
women and women who recently delivered.
These home visits are designed mainly for health
promotion and preventive care on topics such
as nutrition, basic sanitation, birth preparedness,
safe delivery and breast-feeding and essential
newborn care. ASHAs do not receive a salary,
but are financially incentivized to ensure and
maintain records indicating that pregnant women
receive antenatal care, encouraging institutional
deliveries and for supporting healthy behaviors.
This cadre was established under the National
Rural Health Mission (NRHM) of India’s Ministry
of Health and Family Welfare.
ANMs are full-time government employees who
manage the operations and service delivery at
primary health centers or sub-centers 8 . They
also lead home visits of pregnant and recently
delivered women when required. As of March
2011, there were approximately 208,000 ANMs
working in these centers across the country 9 . A
main objective of NRHM is to reduce maternal
and neonatal mortality rates by increasing
the number of skilled providers supporting
institutional deliveries. For this, many efforts
are being made to continuously train ANMs to
become “certified” Skilled Birth Attendants 10 . Like
the ASHAs they supervise, ANMs are managed by
the Ministry of Health and Family Welfare.
The AWWs manage nutrition and early child
development programs in their communities.
They also manage centers as distribution points
for rations for pregnant women, lactating
mothers and families with adolescent girls and
children below age 6 11 . As part of their role,
AWWs weigh each child under the age of 5 at
least once a month, record the results during
either a home visit or at the center, conduct
health check-ups and identify children that
require a referral to a primary health center or
sub-center for immediate medical attention. In
2012, there were 1.3 million AWWs in position 12 .
AWWs work closely with ASHAs and ANMs. The
team of AWWs is managed by the Ministry of
Women and Child Development.
8 Population Council (2012). Providing maternal and newborn health services: Experiences of Auxiliary Nurse Midwives in Rajasthan.
9 Government of India (2011). Manpower at Sub-Centres and Primary Centres. Data Portal India.
10 USAID and New Delhi: Intrahealth International (2012). Improving Skilled Birth Attendance in Jharkhand. Washington.
11 Ibid.
12 Ibid.

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RGMVP Health Mobilizers
RGMVP has deployed a cadre of dedicated community volunteers to mobilize action across UP. The volunteers are regularly trained and educated on existing,
new and upcoming government interventions as well as life-saving RMNCH information and practices. The collective strength of health mobilizers and SHGs
creates an advocacy channel to strengthen supply side interventions and also generate demand for women’s rights and entitlements.
Internal Social Capital
Meeting Sakhis
Community Resource Development Institutions
RGMVP ISC are the key to ensuring RGMVP’s
bottom-up mobilization approach. ISC are
identified and trained to lead health discussions
during SHG meetings, identify target women
at the Village Level and use the ISC tool-kit for
effective implementation at the SHG level. As
part of their tool-kit, ISC fill health registrars to
record and track the progress of target women.
During meetings, ISC show health videos and
also facilitate the use of various communication
materials. Lastly, ISC engage with Panchayati Raj
Institutions and Panchayat health committees
to ensure support in identifying and
disseminating health messages through village
level meetings. To date, 1,200 MS’s have been
trained and mobilized.
In 2014, RGMVP developed the MS strategy
to fill the last mile gap. It was found that
health outcomes were closely linked to group
functioning. Thus, the MS strategy aimed to
deepen the process of vertical expansion by
not only leading health mobilization activities,
but also ensuring active participation in, and
proper functioning of, SHG meetings. The MS
is responsible for attending SHG meetings,
ensuring member contribution and helping
SHGs uphold core principles. In addition,
they impart RMNCH information, co-facilitate
SHGs in identifying target women and ensure
representation of SHG members in VO
meetings. As of December 2016, 5,081 MS’s
have been mobilized.
CRDIs are made up of unique teams of rural
women with first hand SHG experiences and
success stories. Performing the role of leaders,
mentors and co-facilitators, CRDI members are
extremely instrumental in scaling up RGMVP
processes and interventions. Eight Community
Resource Development Centers (CRDCs)
serve as constructive incubation units for CRDI
women to receive training and assimilate key
concepts, ideas and techniques. With necessary
training ranging from MNCH health practices
and identification of issues to data collection
and reporting, CRDI members are equipped with
the relevant skills to internalize, practice and
diffuse critical health messages and empower
their communities.

16
OPERATIONAL STRATEGIES
Identification of
Target Women
The most fundamental
activity for UPCMP is to
continuously work to identify
target women (pregnant,
recently delivered or mothers
of children aged 0-2 years).
The introduction of Dayara
Mapping has been especially
helpful in accelerating this
process. The unique method
encourages SHG members to
visit at least five households
in their neighbourhood to
identify target women and
accordingly report back to the
SHG with a list. After compiling
the collective lists of target
women within the SHG, the
concerned MS then shares it
with AAA at the VO level. With
an average of 10-20 members
per group, the method has
the potential to cover over 50
households.
Community Mobilization
& Demand Creation
1 2 3
In a large-scale project, it is
especially difficult to sustain
outreach to communities
with messages that are
standardized, accurate and
effective. UPCMP has therefore
carried out a range of strategic
mobilization activities, relevant
to every stage of the process.
From initial invitations to
attend general body meetings
and events with local
health workers to periodic
health video screenings
and awareness campaigns,
activities are designed to
provide as many opportunities
to engage target women
as possible. With increased
exposure to interventions, the
aim is inspire collective action
for women to demand quality
health services and improved
access.
Interaction with Target
Women During Meetings
Iterative interactions
with target women take
place during SHG and
VO meetings to increase
awareness and identify
danger signs among the
pregnant women and
newborns. Meetings focus
on sharing messages,
which promote safe health
practices, such as Kangaroo
Mother Care (KMC) or
Skin-to-Skin thermal care,
exclusive breastfeeding and
clean cord care. In addition,
meetings provide immediate
assistance to target women
for preparing a complication
readiness plan. Backed
by SHG and VO support,
women are able to seek
out services and additional
information with confidence
and authority.
Dayara Mapping enables
early identification of target
women within communities
and allows for opportunities
to build relationships with
target women and their
household influencers to
promote healthy behaviors
and improve family health
outcomes. Results indicate
a major consolidation of
efforts, in which the initiation
of Dayara Mapping along
with the MS strategy has
greatly accelerated the
mobilization process.

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Attach a SHG Member
to Target Women
4 5
When a target woman is
identified (either through
Dayara Mapping or
otherwise), designated MS or
ISC simultaneously work to
link her with a SHG member
for continuous support.
This connection aims to
reinforce health messages
as well as provide emotional
and social support to the
women before, during and
after pregnancy. The SHG
member is responsible for
facilitating increased uptake
of antenatal care (ANC) and
postnatal care (PNC) services;
providing basic health and
nutrition advice; and ensuring
that the mother, newborn
and family influencers are
connected to the health
information pipeline.
Home Visit to Recently
Delivered Women
Postnatal home visits to
SHG and non-SHG women
are critical to UPCMP in
reinforcing the use of best
practices in RMNCH. As
a mandate of the project,
home visitations with an
ASHA are conducted on
the first, third and seventh
day after delivery. This
is to order to ensure the
initiation of breastfeeding,
Skin-to-Skin thermal care
and to also offer additional
counselling and sensitive
support. Recorded on a
monthly basis at the VO
level, home visits not only
indicate the efficacy of
health layering, but also
attest to the successful
diffusion of information
beyond the SHG fold.
TRAINING RESOURCES
Posters
Posters on issues help participants to easily understand and
identify issues, such as danger signs during pregnancy
Flash Cards
Flash Cards are extremely useful during group exercises to
help participants clearly identify and collectively discuss
Pocket Chart
Pocket charts offer participants a chance to learn about issues
by sorting ‘good’ and ‘bad’ behaviors displayed on cards
Fact Sheets
Region-specific fact sheets provide detailed information on
SHG membership, maturity and geographic coverage
Mapping Checklist
Check-lists at the VO level encourage members to
collectively identify health facilities in each village
KMC Video
The short narrative of a recently delivered woman highlights
the benefits of Kangaroo Mother Care to enhance knowledge
Visual Mapping
Encourages the use of pictures and embraces an individual’s
memory power to replicate models for imparting knowledge

18
HEALTH MOBILIZATION ACTIVITIES
INVITE
WATCH
MEET
Welcome/Congratulations Letters
As part of the mobilization strategy, official
“Welcome” or “Congratulations” letters (‘Badhai/
Subhkmana Sandesh’) from the VO are handdelivered
to the identified pregnant or recently
delivered women. These letters helps to break the
ice with the women and provides an opportunity to
cordially invite them to attend a SHG meeting for
discussions on health. The gesture not only allows
for an emotional connection, but also encourages
women to ask immediate questions and testifies to
the support from the VO. The letters also contain
valuable heath tips, which benefit the entire family.
Health Video Screenings
Also as part of the strategy, health video screenings
are organized to educate women and their families
about maternal, neonatal and child health. These
screenings have proven to be a powerful medium
for diffusing health messages at scale. Audiovisual
instantly engages one’s curiosity, overcomes
obstacles of illiteracy and most importantly, merges
key messages with a relatable cultural narrative. In
rural areas where oral traditions dominate, health
video screenings show every sign of being able
to enhance community health knowledge and
encourage positive decision-making.
Community Meetings
‘Aam Sabha’, ‘Purva’ (hamlet) and Night meetings
are critical for community mobilization and the
widespread diffusion of health messages. Meetings
are held in every local governing body or Gram
Panchayat (GP), and are organized and facilitated
by RGMVP ISC to ensure and maximize attendance.
Participants include SHG members, non-SHG
members and AAA as well as the village head or
Pradhan. Discussion topics cover core beliefs and
strategies, rights-based entitlements, and various
health messages and information about linkages
with government services and facilities.
Additional leaflets and IEC material, including
the monthly newsletter ‘Samara Sangathan’
is distributed as a way to connect with target
women and bring them under the fold.
Small, easy-to-use and PICO projectors have
enabled smooth operating for ISC, creating a
sustainable method for information sharing
across the project area.
‘Aam Sabha’ (general body SHG meetings) have an
especially high impact, as they offer a collective
learning experience where a maximum number
of people can attend.

19
FOCUS AREAS
CELEBRATE
Village Baby Showers
‘Goadh Bharai’ (Baby Shower) events, traditionally
held among family and friends to celebrate a
woman’s pregnancy, have been transformed under
UPCMP to impact entire communities. MS’s and
other trained community leaders have utilized
these occasions as opportunities to engage directly
with pregnant women and their families to spread
critical health messages and provide access to
vaccination and nutritional information, care and
services. AAA as well as the village Pradhan can
attend the events and collectively work together to
establish linkages and encourage behavior change.
A plate of essential food groups along with iron
tablets is a typical gift for expecting mothers,
setting in motion a chain of healthy habits for
themselves and their baby.
CONNECT
Village Health & Nutrition Day
Village Health and Nutrition Day (VHND) is an
important point of convergence for UPCMP,
interfacing between target women and the health
system. ISC, MS and the VO work in tandem with
AAA and PRIs to organize subsequent events.
This helps to optimize results and ensure the
attendance of target women. On the VHND,
women can interact freely with the AAA and
obtain basic services, like vaccinations and iron
tablets, and important health information. VHNDs
also provide on-site counselling and support for
creating demands for better health services.
The coordination between MS, ISC, AAA and
PRI representatives in arranging VHNDs can
bring about dramatic changes in the way people
perceive health and health care practices.
Maternal Health
• Antenatal Care Practices
• Women’s Contact with AAA & SHG
During Pregnancy
• Complication of Delivery Preparedness
• Institutional Delivery
• Postnatal Stay at Facility
• Knowledge of Pregnancy Danger Signs
• Uptake of IFA Tablets
• Complications During or After Delivery
• Postnatal Care for Mothers
• Family Planning i.e. Birth Spacing
Newborn & Child Health
• Initiation of Breastfeeding
• Kangaroo Mother Care & Delayed Bathing
• Clean Cord Care
• Newborn Danger Signs & Complications
• Exclusive Breastfeeding
• Complimentary Feeding of Children
• Age Appropriate Immunization
• Identification of Pneumonia Symptoms
• Management of Diarrhoea through
ORS/Zinc

20
1.
INSTITUTION
& CAPACITY
BUILDING
DELIVERING
INNOVATIONS
RESULT 1
Strengthened capacities of women’s
institutions and individuals to
mobilize rural communities and
its resources to adopt preventative
health practices.
Under this result, various capacity
building trainings and knowledge
transfer activities are carried out
in addition to continued SHG
formation and nurturing.
-
Achieving better health outcomes
require a boost of resources as
well as adequate local capacity to
use those resources effectively.
Capacity building is critical to
sustaining health outcomes and
encouraging self-reliance/reducing
reliance on external assistance.
Thus, UPCMP seeks to strengthen
individual capacity as well as the
social platforms used to implement
RMNCH initiatives. It is in this dual
focus that the project has been able
to continuously improve processes,
devise new solutions and sustain
outreach among target populations.
KEY ACTIVATORS
SHG Formation & Nurturing
No problem exists in isolation.
While maternal mortality may be
attributed to lack of awareness and
advice networks, lack of economic
resources and sustainable livelihoods
are also major factors. For this
reason, RGMVP is relentless in
its efforts to continuously form
and nurture SHGs to eventually
become institutionalized and selfreliant.
Once emboldened with the
necessary support, SHGs can begin
their own journeys of transformation
through livelihood enhancement,
income generating activities, credit
utilization, and preparation of Family
Investment Plans.
Inclusive Learning: V-Maps
Women’s low educational status
limits their access to health
information. Women also have
fewer opportunities to interact
with sources or providers of
information. In addition, the
gendered socialization of women
and girls discourages learning
about sexuality and reproduction.
Together, these barriers place
women at an extreme disadvantage
in recognizing symptoms of health
problems, and therefore, delaying
health-care seeking. Visual Mapping
or hand-drawn ‘V-Maps’ help to
counter information leakages, ensure
social inclusion and speed up the
mobilization process.
V-Maps include:
• Best maternal, neonatal
and child health practices
• Visions for family’s prosperity
• Rights and entitlements
• Ways to take action and
mobilize others

21
Training Of Trainers
As a continuous effort to roll out new activities and
keep pace with existing activities, various capacity
building training programs are conducted in a
cascading manner. The source of information
or training first passes through the Program
Management Office (PMO). This initiates
the Training of Trainers (TOT) process
enabling messages to flow downward
with the ultimate goal of reaching
target women. While sometimes
specific to the individual’s roles
and responsibilities, training is
designed to equip all mobilizers
with the relevant and
necessary skills to be able
to internalize, practice and
diffuse critical messages
to other members
of the community,
especially non-
SHG members.
INFORMATION SOURCE
PMO
CRDC
BO
VO
SHG
TARGET WOMEN
RPO
CRDI
MS
ISC
SHG
MEMBER
The TOT structure
is a major crux of
information flow for
UPCMP, ensuring
that critical health
messages reach
target women.

22
2.
BEHAVIOR
CHANGE
MANAGEMENT
MODEL
DELIVERING
INNOVATIONS
RESULT 2
Increased awareness and knowledge
about RMNCH behaviors and
increased capacity to demand
quality health services and
improved access.
Under this result, various BCC
awareness-raising and mobilization
activities were carried out in
addition to important linkages
with supply side interventions.
-
UPCMP has emerged as a
unique Health Behavior Change
Management Model. As a fluid
process, health messages are
received through ToT from
CRDI members and then
further disseminated to target
populations through SHGs. Roles
and responsibilities of ISC are
allocated at different levels, while
continuous institution and capacity
building takes place. As a result,
an information pipeline is secured,
important government linkages are
made and a sustained structure for
quality interaction is established.
KEY ACTIVATORS
Pipeline Strategy for Information Flow
As previously described, a number of periodic outreach activities – leaflets on
RMNCH issues, VO letters, etc. – have been conducted to motivate and inform
target women and their family members. As a starting point for diffusion, all
information passes through BO level meetings, where VO representatives and
critical mobilisers first learn of their importance. Information is then shared
during VO meetings, attended by SHG representatives who then impart the
information to their individual SHGs. Thereby, ensuring that the information
reaches target women and households.
INFORMATION
BO
VO
SHG
TARGET WOMEN

23
Demand-Supply Linkages & Interaction
1. BMGF Technical Support Unit
While SHGs are responsible for continuous health layering through regular
awareness and orientation programs, synergy with the BMGF Technical
Support Unit (TSU) provides an added advantage for securing linkages.
TSU is supporting the UP government to improve the quality of services
and supplies at government facilities. Its work overlaps 26 blocks of the
UPCMP area. BO level interface meetings between TSU and UPCMP staff
have helped to provide better access to services and supplies from frontline
workers and also usher support from government officials at Block and
District levels.
2. Overlapping Health Initiatives
Government-sanctioned and pre-existing projects have created much
added value and indirect impacts to UPCMP. For example, the
Thrive Network, formerly known as Embrace, is mandated by the
government to provide baby warmers to rural communities. In
2015, the involvement of GAIN across 50 Blocks was another
major contribution, as it focused on spreading information
about child health practices and nutrition. Another key factor
was the involvement of the IDEAS team from the LSH, who
conducted a study to identify key innovations for scaling up.
3. Village Health Sanitation & Nutrition Committee
One of the key elements of the National Rural Health Mission is the
Village Health, Sanitation and Nutrition Committee (VHSNC). As the name
suggests, this committee is expected to take collective action on issues
related to health and its social determinants at the village level. Since
2005, VHSNCs have been set up at the village level (within the Panchayat)
across states. This has meant considerable convergence between VOs
and supply side interventions, providing the required support for women’s
institutions to emerge as vibrant platforms to improve the health status of
their communities.
3. Village Organization Health & Gender Committees
The Health and Gender Committee (HGC) is one of five important
committees organized within the VO. HGCs works in tandem with
the VHSNC (above) in cross-cutting health issues and strengthening
interventions. Members are co-opted to become a part of the VHSNC within
the Panchayat and are also encouraged to actively participate in Gram Sabha
meetings to push the agenda on health issues raised within the VO, such
as improved functioning of health providers, promotion of VHNDs, greater
support to local health workers and ensuring access and use of quality
equipment and supplies.
INTERFACE MEETINGS HAVE HELPED TO PROVIDE BETTER ACCESS TO SERVICES AND
SUPPLIES FROM FRONTLINE WORKERS AND GOVERNMENT OFFICIALS.

24
3.
PEER-TO-PEER
PROPAGATION
CYCLE
DELIVERING
INNOVATIONS
RESULT 3
Enhanced coordination,
collaboration and information
exchange for the sustainability of
BCC activities through consultative
and participatory processes and
advice networks for support.
Under this result, coordination with
community stakeholders, women’s
institutions and local health care
workers are carried out.
-
The Peer-to-Peer Propagation
Cycle of knowledge diffusion under
UPCMP has developed from an
organic and participatory process
of communicating. Local health
workers, RGMVP ISC, women’s
institutions and various external
stakeholders all act as important
cogs in the wheel to impact family
health outcomes. No role is more
important than another. United by a
common goal, individuals perform
their duties, report conditions to
required Village and Block levels,
and consistently collaborate with
one another to collectively share,
organize and carry out activities.
KEY ACTIVATORS
Bottom-Up Approach
A bottom-up approach help enables
an immediate system of reporting,
in which SHGs can raise issues up
the chain of influence, or itself,
provide the solution. This grassroots
approach is crucial for building trust
and encouraging individuals and
family influencers to adopt healthier
behaviors. Despite even the best of
intentions, some health messages
are rejected due to traditional health
norms and practices. However, as
one study indicated, target women
in SHG areas are more likely to turn
away from traditional beliefs and
listen to local health workers than
target women in non-SHG areas.
Target women
were asked to
advise a woman
in a hypothetical
situation to evaluate
their perceptions on
traditional beliefs.
“I WOULD LISTEN
TO WHAT ASHA SAYS...
MY FAMILY MEMBERS
THOUGHTS ARE VERY
OLD AND OUTDATED.”
(UPCMP/SHG Area)
Facilitating Linkages
Communication between local
health workers and SHGs and VOs
is vital in the facilitation of health
linkages, as well as the continued
exchange of target women lists
and sharing of demand for health
services. A study conducted in
2016 found AAAs to be a main
trusted source of health advice and
information for recently delivered
and lactating women 12 . It also found
that the more engagement AAA
have with other health workers and
the VO and SHG platform, the more
likely target women are to utilize
health facilities for deliveries and
consult others for advice.
“SHE WOULD FACE
PROBLEMS IF SHE
PRACTICED WHAT
ASHA TOLD HER AND
DID NOT LISTEN TO
HER IN-LAWS.”
(Non-UPCMP/SHG Area)
12 Jenny Ruducha et al (2016). Who’s Advice Should I take?

25
Advice Networks
UPCMP has seen a tremendous
increase in the collaboration of SHG
members with AAA in disseminating
health information within the
villages. As SHGs continue these
efforts, AAA work to expand the
horizon even further by engaging
with other stakeholders to secure
health supplies, provide care to
women during emergencies, and
offer guidance to other AAA when
questions arise. Interaction with the
Village Pradhan has also helped in
connecting target women to SHGs
and AAA, and providing assistance
during emergencies.
ANM
TARGET
WOMAN
CRDI
SHG
WOMAN
RGMVP
MS
RGMVP
ISC
ASHA
TARGET
WOMAN
TARGET
WOMAN
ASHA
SHG
WOMAN
AWW
SHG
WOMAN
CRDI
TARGET
WOMAN
Community
Resource
Development
Institutions
Government-
Supported
Local Health
Workers
Existing Self-
Help Group
Members
RGMVP
Internal Social
Capital
Pregnant,
Recently
Delivered
Women or
Mothers with
Children (0-2)
Connectivity Through mHealth
The availability and use of cell phones have created an opportunity to incorporate mHealth platforms to enhance and track communication among
ANM, AWW and ASHA; coordinate with RGMVP MS, ISC and CRDI; effectively report and resolve problems with health supplies; and develop a mobile
social network to connect target women with health workers, other target women and SHG members.

26
4.
COMMUNITY
MONITORING
& EVALUATION
DELIVERING
INNOVATIONS
RESULT 4
Selected community volunteers
assisted in collecting and measuring
outcomes related to knowledge and
practices in the target population.
Under this result, two rounds of
community-managed Lots Quality
Assurance Sampling (LQAS) was
implemented to track and improve
the quality of the process.
-
Among various Monitoring, Learning
and Evaluation (MLE) activities
under UPCMP, two rounds of Lot
Quality Assurance Sampling (LQAS)
surveys were proposed to monitor
project activities so that corrective
measures could be taken, if
necessary. Central to this initiative is
the involvement of CRDI members
to administer the survey and record
quality data. CRDIs are crucial to
MLE and subsequently a direct
reflection of project outcomes.
Thus, many innovative learning
techniques and methods were used
to better equip the women for this
important undertaking.
KEY ACTIVATORS
Ongoing Technical Support
Population Council (PC) has been
essential to UPCMP in providing
technical assistance during
implementation and continuously
working to develop salient
operations research projects. As
a crucial point of departure, PC
conducted the baseline survey
for the learning phase Blocks,
measuring key maternal and
newborn health indicators for
the project. PC
has also played
an especially
important role in
data collection
for LQAS by
working closely
with different
teams of CRDI
women in
the fields and
internal MIS staff
to ensure timely
completion
of work and
data quality.
Assessing Performance
CRDI teams were given rigorous
training through a number of
innovative hands-on techniques
to provide participants with
experiential learning. These include
classroom demonstration, role-play
and mock practices, and simulation
exercises for conducting surveys.
Several strategies were adopted to
ensure the quality of surveys to be
conducted in the fields, including
house listings to
identify eligible
respondents
and trial surveys
to identify
and address
problems in
data collection.
Data quality was
further assured
using on-spot
observation
checks and
back-checks
by PC.

27
Field Learning Visits
UTTAR
PRADESH
RGMVP
Exposure visits were undertaken in
West Bengal, Bihar and Jharkhand
to gain insight into successful
strategies, models and measures
for strengthening the capacities of
community health workers. The
visit to Bandhan (West Bengal) in
2012 stressed the importance of
health forums and home visits, as
well as health kits, linkages and
referrals. Similarly, observing the
Ananya Project (Bihar) in 2015
helped consortium partners to
better understand the project’s
behavior change framework, in
particular the elements, approach,
tools and aids developed and used
by the community. And lastly, the
exposure visit to Ekjut (Jharkhand)
in 2015 provided key insights into
the process of another unique
participatory learning and action
cycle focusing on maternal and
newborn health.
JHARKHAND
Ekjut
BIHAR
Ananya
WEST
BENGAL
Bandhan
THE VISIT TO WEST
BENGAL STRESSED
THE IMPORTANCE
OF HEALTH FORUMS,
HOME VISITS, HEALTH
KITS, LINKAGES AND
REFERRALS.

28
RESULTS & CRITICAL MILESTONES
Target vs. Achieved
POPULATION
71.9
% ACHIEVED
6.8M vs. 4.9M
POOREST HOUSEHOLDS
71.9
% ACHIEVED
1.1M vs. 816,012
SHGS
95
% ACHIEVED
75,000 vs. 71,000
VILLAGES/GPS
96
% ACHIEVED
5,1000 vs 4,900
BLOCKS
100
% ACHIEVED
120 vs. 120
Target Women Identified (% of targets achieved)
Diffusion Inside & Outside SHG Fold
PREGNANT WOMEN
RECENTLY DELIVERED WOMEN
74%
58%
50
40
30
2016
OUTSIDE
Pregnant Women
Recently Delivered Women
Mothers Of Childen (0-2 Years)
INSIDE
Pregnant Women
Recently Delivered Women
Mothers Of Childen (0-2 Years)
MOTHERS OF CHIDREN (0-2)
54%
20
10
0
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEPT
OCT
NOV
DEC
*As of Dec 2016; Source: RGMVP MIS

29
INTERNAL SURVEY: LQAS
Accessed Maternal Health Services
Maternal Danger Signs (Knowledge)
Neonatal Danger Signs (Knowledge)
34.5%
3+ ANC
check up
100+ IFA
Tablets
Institutional
Delivery
PNC visit within
a week of
Delivery
Bleeding Prolonged
During Labour over
Pregnancy 12 hours
Bleeding
after
Delivery
Swelling
of hands &
Feet
Foul
Smelling
Discharge
Convulsion
- Fits
Poor
Suckling
or feeding
Redness
& discharge
around
the cord
Pneumonia Convulsion Fever Diarrhoea
17.2%
72.1%
76.1%
93.9%
37.4%
64.6%
42.4%
80.6%
39.6%
41.5%
56%
71.7%
70.8%
83.6%
23.4%
47.4%
73.6%
65%
47.2%
9.6%
26.3%
80.4%
85.1%
52.9%
44.3%
21.6%
47.5%
20.8%
36.7%
16%
29.1%
32.1%
55.4%
18.7%
46.6%
15.9%
25%
40.2%
16.9%
54.5%
15.6%
83.2%
68.8%
Early Newborn Care (Practise) Delivery Preparedness Plan (Practise) Pneumonia (Knowledge)
44.6%
Jun - 2014
Jul - 2015
KMC
Delayed
Dathing
Clean Cord
Care
Exclusive
breastfeeding
(in last 24 hours
of survey)
Identified
Institution
Arranged for
Transport
Saved
Money
Identified
People to
Accompany
Fast
Breathing
Chest
Indrawing
Grunting
Sound
*As of Dec 2016; Source: RGMVP MIS

30
MATERNAL HEALTH BEHAVIORS
Postnatal Stay at Facility for 24 Hours 100 or More IFA Consumption Institutional Delivery
NEONATAL HEALTH BEHAVIORS
Early Breastfeeding Delayed Bathing For 48 Hours Skin-to-Skin Care
CHILD HEALTH BEHAVIORS
Exclusive Breastfeeding Complimentary Food Initiation At 6 Months Age Appropriate Immunisation
Significance test between Baseline and Endline estimates is based on Z test: p

31
LESSONS FOR THE FUTURE
Health Behavior Change Management is a cross-cutting and complex issue, requiring mobilization of knowledge, capacities and skills. Lessons learned have
offered valuable insight, not only for RGMVP to enhance its work in UP, but also for other development practitioners, academics and researchers to consider
such an approach for affecting other marginalized communities in India and around the globe.
Allow Adequate
Time for the Process
Ensure Community
- Owned Approach
Leverage Existing
Networks & Structures
1 2 3 4
Diversify Meetings
& Strategies
Careful planning is essential.
It is particularly important to allow
enough time to identify communities
where the approach can have
the most impact i.e. among POP
populations and SC/ST communities.
The UPCMP Learning Phase was
critical in achieving objectives, as it
allowed the necessary time to learn
about the local communities, identify
strong and capable mobilizers and
consult within the RGMVP streams
of influences to determine how poor
households could be most receptive
to BCC strategies. The mobilization
cycle is an intensive process that
takes time, but using a systematic
approach allows SHGs to develop
cohesion and mutual support, work
together to identify problems and
solutions and take collective action.
Significant value is attached with the
process of community mobilization in
order to attain UPCMP objectives. To
sustain the efforts, it is very important
that the women’s institutions,
through which activities are carried
out, become self-sufficient and
take ownership in the mobilization
process. SHG members need to be
consulted, involved and integrated
in the decision-making process and
social changes should be driven
from the community itself. In such
cases, community mobilization can
be seen as an approach and tool
that enables people to organize for
collective action by pooling resources
and building the solidarity required
to resolve local problems and work
towards community advancement.
Project implementation at the
local level is especially challenging
among rural populations, as it
requires significant rapport building
activities with community members.
RGMVP was able to counter this on
many fronts by utilizing its existing
networks and structures, and by
also galvanizing the influence it
had already made among the poor.
Recruiting local women with the right
attitudes and skills as facilitators and
mobilizers is also critical to success.
Leveraging the existing network of
ISC and others already familiar with
SHG processes and local context
proved to be especially efficient and
effective. With continued nurturing
and capacity building training, these
local leaders are the life force to in
the mobilization process.
High levels of women’s
participation can be achieved
without financial or other
incentives, especially if meetings
address topics that are extremely
relevant, such as newborn and child
health. Covering a range of topics
and using a range of methods and
BCC communication materials
helps to ensure good participation.
Reach is further extended as
mobilizers share knowledge
with and provide support to
other women in the community.
Encouraging innovation among
the women to adapt strategies and
also develop new is another great
way to expand and grow. Dayara
Mapping, for example, may be a
standardized method for targeting
women, but there are many forms
of implementation to ensure results.

32
WHAT THESE WOMEN LEADERS DO TODAY WILL UNDOUBTEDLY
HAVE TRANSFORMATIVE IMPACTS ON THE NEXT GENERATION.
Target SHG Areas to
Expand Coverage
Complement SHG Work by
Improving Linkages
Recognize Young
Women’s Potential
5 6 7 8
Strategize in Countering
Complex Barriers
Continued formation of SHGs is
essential for sustained mobilization.
However, targeting and coverage
of existing SHG membership can
undoubtedly fast track the process,
especially in terms of achieving
positive health outcomes.
Functioning SHGs provide the
necessary platform to identify
target women and also offer
transformation beyond health.
While many non-SHG women
may initially turn to the processes
for receiving health benefits,
their relationship with mobilisers
and association with women’s
institutions can often lead to wider
forms of empowerment. By virtue
of simply coming forward and
seeking help, women can become
financially independent and
experience increased confidence
in their abilities to take action.
Efforts to mobilize action in order to
address maternal and newborn health
problems must be complemented
by efforts to strengthen health
systems and increase access to
quality maternal, neonatal and child
health care. Community leaders
and local health workers are key
actors in strengthening community
links with health services and
enabling communities to demand
improvement in service provision.
Communication between health
committees situated within the
local governing body and women’s
institutions can also help to ensure
the quality of services, as they have
better knowledge of and access
to government funds intended to
improve health equipment, services
and facilities.
In 2013, RGMVP began organizing
Young Women’s SHGs (YWSHGs) by
leveraging the existing network of
women’s SHGs. The overall aim is to
provide adolescent girls with safe,
social spaces to collectively learn,
discuss and negotiate important
issues that affect their health and
well-being. As more YWSHGs were
formed, it was found that the girls
had a greater willingness to learn
about and adopt healthier and
safer practices. YWSHGs were also
found to be excellent channels to
disseminate health messages, as
the girls are predominately more
educated with greater aptitude to
assimilate ideas around health. To
date, the initiative has formed over
7,700 YWSHGs and has continued
to complement SHGs in efforts
to improve health outcomes and
empower their communities.
Socio-cultural, religious and practical
factors can be a barrier to women’s
participation in SHG meetings.
Strategies needed to address
these include concerted efforts to
accommodate those for which the
meetings are intended to benefit and
secure the support of community and
household influencers – be it taking
advantage of village events, making
regular home visits or communicating
with village heads. Where other forms
of resistance arise, women must
be encouraged to depend on one
another, learn from their experiences
and grow as a unit to challenge
destructive norms. Through a
continuous exchange of information,
ideas and support, what these women
leaders do today will undoubtedly
have transformative impacts on the
next generation.

33
PARTNER ORGANIZATIONS
Bill & Melinda Gates Foundation
BMGF is dedicated to improving the quality of live for individuals around the world. From poverty to health to education, BMGF areas of focus seek to build
partnerships that bring together resources, expertise and vision. BMGF is working with a number of organizations across India to drive change. In Uttar Pradesh,
specifically, the aim of BMGF is to understand options for scaling up community platforms to improve family health outcomes and converging supply and
demand interventions. www.gatesfoundation.org
Public Health Foundation of India
PHFI is committed to working towards a healthier India. PHFI is helping to build public health institutional systems capacity in India for strengthening education,
training, research and policy development in the area of Public Health. Established in 2006 as a public-private initiative, PHFI is an independent foundation
head-quartered in New Delhi and its constituent Indian Institutes of Public Health (IIPH) (Andhra Pradesh), Delhi NCR, Gandhinagar (Gujarat) and Bhubaneswar
(Odisha). www.phfi.org
Population Council
PC is an international NGO conducting promising research and delivering solutions to address critical health and development issues around the world.
Working through a consortium, PC researchers have conducted numerous operations research projects to help develop evidence-based comprehensive
behavior change communications strategies for improving reproductive, maternal, neonatal and child health outcomes in Uttar Pradesh, Bihar and other
northern states. www.populationcouncil.org
Boston University, Center for Global Health & Development
CGHD at BU is a multidisciplinary research center that engages faculty from across the University to conduct and utilize high-quality applied research to impact
the health of under-served populations around the world. Core functions at CGHD include conducting local needs assessments, generating policy and program
relevant evidence through a range of methodologies, and assessing effective strategies, interventions and service delivery models. www.bu.edu/cghd
Community Empowerment Lab
CEL engages with local communities in Uttar Pradesh to help set up ecosystems to create a culture of innovation and address challenges. CEL has conducted
a number of large community-based studies since 2003, including the Shivgarth study on newborn survival, as well as operations research and evaluation of the
CARE INHP II program. The expertise of the CEL team in evidence-guided innovations and behavior change management has led to a significant reduction in
neonatal mortality. www.community.org.in

34
ACRONYMS
AAA
ASHA, ANM, AWW
RMNCH
Reproductive, Maternal, Neonatal and Child Health
ANC
Postnatal Care
MS
Meeting Sakhis
ANM
Auxiliary Nurse Midwife
MLE
Monitoring, Learning and Evaluation
ASHA
Accredited Social Health Activist
ORS
Oral Rehydration Solutions
AWW
Anganwadi Worker
PC
Population Council
BCC
Behavior Change Communication
PHFI
Public Health Foundation of India
BMGF
Bill and Melinda Gates Foundation
PNC
Antenatal Care
BO
Block Organization
POP
Poorest of the Poor
BU
Boston University
PRI
Panchayati Raj Institutions
CEL
Community Empowerment Lab
RGCT
Rajiv Gandhi Charitable Trust
CRDC
Community Resource Development Center
RGMVP
Rajiv Gandhi Mahila Vikas Pariyojana
CRDI
Community Resource Development Institutes
SHG
Self-Help Group
GAIN
Global Alliance for Improved Nutrition
TOT
Training of Trainers
HGC
Health and Gender Committee
TSU
Technical Support Unit
IFA
Iron/Folic Acid
UP
Uttar Pradesh
ISC
Internal Social Capital
UPCMP
Uttar Pradesh Community Mobilization Project
KMC
Kangaroo Mother Care
VHND
Village Health and Nutrition Day
LQAS
Lots Quality Assurance Sampling
VHSNC
Village Health, Sanitation and Nutrition Committee
LSH
London School of Hygiene and Tropical Medicine
VO
Village Organization

“STRENGTH DOES NOT COME FROM
PHYSICAL CAPACITY. IT COMES
FROM AN INDOMITABLE WILL.”
Mahatma Gandhi