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Engaging communities in the Golden 1,000 Days in Nepal

Kaori Oshima's picture
Field survey team in Nepal
A field survey team for the qualitative study holding a focus group discussion with women in one of the SHD project communities. Photo credit: World Bank

In Nepali, “Sunaula Hazar Din” means, “Golden 1000 Days” – which is a critical window of opportunity between conception and the age of two years that, with good health and nutrition, can mitigate the risks of malnutrition that hamper a child’s long-term physical and cognitive development.

Sunaula Hazar Din (SHD) is also the local nickname of the Government of Nepal’s recently completed “Community Action for Nutrition Project”, implemented by the Ministry of Federal Affairs and Local Development and  financially supported by the World Bank from 2012 to 2017. The project aimed to improve practices that contribute to reduced under-nutrition of women of reproductive age and children under the age of two and to provide emergency nutrition and sanitation response to vulnerable populations in earthquake affected areas.

The project used a “Rapid Results Approach (RRA)”, where target communities formed groups of nine members that would collectively select and work on an activity to address malnutrition for 100 days. RRA focused especially on the “1000 days” households– namely, households with children under 2 years and pregnant and/or lactating women and also had community -wide interventions targeted to address malnutrition.  

To better understand the local dynamics around the SHD design and activities, a qualitative study was conducted, with support from the South Asia Food and Nutrition Security Initiative (SAFANSI).

The study team gathered the voices of various stakeholders, including the community members, facilitators, and the village and district-level authorities. Listening to the voices of these stakeholders makes development practitioners and project teams recognize how participatory designs may work as expected – or not – in a specific context.

Providing better healthcare in Afghanistan – A view from the field

Fahimuddin Fahim's picture
Also available in: دری | پښتو


Although I have extensive project management experience in Daykundi Province, the scale and impact of the System Enhancement for Health Action in Transition (SEHAT) Program is truly inspiring—for example, the 39 centers that deliver the Basic Package of Health Services (BPHS) together serve over 77,000 outpatients per month. In October 2016, these centers managed the delivery of 615 babies, with as many as 69 deliveries in Temran Basic Health Center alone.
 
In fact, when it comes to female health, SEHAT has ensured that there is at least one female staff member in every health center. This has partly been possible because of the successful implementation of community-level education programs, such as the Community Midwifery Education (CME) and Community Health Nursing Education (CHNE). The program has also strengthened community-based health care by setting up health Shuras (councils) in all locations covered by SEHAT and implemented specific controls on qualifications and credentials of health workers.
 
SEHAT is a program of the Ministry of Public Health (MoPH), supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors. An NGO, PU-AMI, was contracted by MoPH between 2013 and June 2017 to deliver BPHS in Daykundi, in line with national health goals outlined by the ministry. These goals include reducing mother and child deaths and improving child health and nutrition. Thus, the program focuses on increasing access, building capacity, strengthening coordination, promoting use of monitoring and evaluation data, and enabling better support for pharmaceutical supplies.

Stitching Dreams: In Tamil Nadu, Rural Women Show the Way to Start Up India

Samik Sundar Das's picture
In our travels across rural Tamil Nadu we met many women who had a great deal of experience in working in the large garments factories of the state – in Tiruppur and Chennai. But, after getting married their family responsibilities forced them to leave their jobs and return to their villages. Now these young women have put their years of experience to use and are setting up small enterprises in their home villages, sewing garments for India’s huge domestic market. It is a win-win situation for all. Working out of thatched huts and refurbished cowsheds, the newly-minted women entrepreneurs not only turn in a tidy profit but also create much-needed employment for others. The large garment manufacturing companies, faced with crippling shortages of skilled labor, now outsource orders to these units. Today, these fast-growing women’s enterprises have not only opened up new avenues for rural women to work, boosting female labor force participation, but also added a new grassroots and gender dimension to the idea of Start Up India.   
 
As we entered the small hut of rammed earth thatched with coconut leaves, the sounds we heard belonged to a different world. Amidst the whir of industrial sewing machines, nine young women were busy stitching bolts of fabric into men’s shirts, destined for India’s vast domestic market for low-cost garments.  
 
Once a large cow shed, a garment unit today.

This was Inam Koilpatti village in India’s southern state of Tamil Nadu. Even though many villages in the state were rapidly urbanising, this village still had many huts, and prosperity was yet to arrive.
 
Two young women, Indhurani and Gurupakkiam, ran this tiny unit. Born with an entrepreneurial spirit, these women have unwittingly given a much-needed boost to the idea of ‘Start Up India’ in this poor region.
 
“We were both working at a company in Thalavaipuram,” they began. (Thalavaipuram is an emerging garments hub nearby.) “But, with family responsibilities it was getting hard for us to travel 20 km to work. Three years ago we approached our employer with a proposition. We would set up a unit in our village, if he would give us orders,” they narrated.

National Solidarity Programme Transformed Scores of Lives in Kandahar Province

Abdul Qayum Yousufzai's picture
Also available in: دری | پښتو
 
The National Solidarity Programme (NSP) improved lives of millions of Afghans across rural Afghanistan. NSP's successor, the Citizens’ Charter Afghanistan Project aims to improve the delivery of core infrastructure and social services to participating communities through strengthened development councils. Photo Credit: Rumi Consultancy/World Bank

Not so long ago, 15 years to be exact, I remember when people in the districts of Kandahar used animals to transport their agricultural harvest to the provincial center. There were a few, if any, motorable roads, and we had a limited number of health centers and schools in the province. Most of the infrastructure laid in ruins. But worst of all, the economic condition of the average Afghan was quite bad with little or no access to income, opportunities, and facilities.
 
Things have changed since 2003. While many development projects have been implemented in Kandahar Province, the National Solidarity Programme (NSP) has been one of the most popular and high impact. Running from 2003 to 2016, NSP was implemented in 16 of 17 districts and set up 1,952 Community Development Councils (CDCs), which implemented over 3,300 projects.
 
In Kandahar, communities are very conservative, and, overall, the province is highly traditional. When the program was launched, people in Kandahar were not interested in establishing CDCs through holding elections at the village level.

A path toward better health for India’s women

Parvati Singh's picture
 World Bank
In India, Members of a self-help group (SHG) like this one discuss women’s  health issues with female health workers. Credit: World Bank

A little over six years ago, Neelam Kushwaha’s first daughter was born weighing 900 gm at birth, severely underweight. Neelam went into labor while working at the local construction site in Jori village, Rewa, Madhya Pradesh, India. Many people work at such local construction sites in rural areas for daily wages ranging from INR 150-280 (about $2- 4$) per day. Her daughter Manvi, was preterm, and Neelam spent months recovering from child birth complications.

Three years later, when Neelam was pregnant with her younger daughter, Sakshi, she quit wage labor and sought employment at an incense manufacturing unit established by World Bank’s Madhya Pradesh District Poverty Intervention Project (MPDPIP) in 2011. At her new role, she earned more and did not engage in labor intensive work during the final months of her pregnancy. Sakshi was born a healthy 3 kilos.

In the course of my field work supported by South Asia Food and Nutrition Security Initiative (SAFANSI) in 2015, I came across several similar stories.

MPDPIP’s livelihood based approach offered several opportunities towards income supplementation for women self-help groups (SHGs) and rural households through agriculture, dairy/poultry farming and local enterprises, among others.

As evident by Neelam’s experience, MPDPIP’s benefits went beyond income and spilled over into health improvement as well.

I learnt that prior to MPDPIP, childbirth in hospitals was difficult due to prohibitively high costs of travel and hospital stay. Pre-existing government schemes such as the Janani Suraksha Yojana (JSY) offer about INR 1,400 ($20) to rural women who opt for hospital deliveries. However, this payment occurs post-partum, and pre-delivery costs have to be borne upfront by pregnant women.

Post MPDPIP, women were able to opt for hospital deliveries with greater ease due to access to credit from their SHGs. This is particularly relevant for Madhya Pradesh as it has consistently fared poorly with respect to institutional deliveries.

Afghanistan’s energy sector leads the way for gender equality

World Bank Afghanistan's picture
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 Rumi Consultancy/ World Bank
Afghanistan's power utility (DABS) has recently taken steps necessary to ensure that women are involved in all business operations within the organization. Photo: Rumi Consultancy/ World Bank


In Afghanistan, decades of violence, common discriminatory practices, and cultural barriers, including restrictions on mobility, have denied women job opportunities and left them severely underrepresented in all sectors of society.
 
Despite considerable achievements in the last decade, such as the national Constitution guaranteeing equal rights as well as increased enrollment in public schools and universities, achieving gender equality will require widespread social changes.
 
Yet, change is happening and Da Afghanistan Breshna Sherkat (DABS), Afghanistan’s national power utility, is showing the way.
 
With a workforce of about 7,000, the company employs only 218 women, most of whom at a junior support level. However, under the leadership of its new CEO, DABS management has committed to promoting gender equality.
 
The Planning and Capacity Support Project of the Afghanistan Reconstruction Trust Fund (ARTF), managed by the World Bank, is helping DABS deliver on that commitment. The project organized awareness sessions for DABS staff on gender-related issues and provided specialized training to female employees. DABS has committed to providing internships to female university graduates to ensure women can find job opportunities and fully participate in the energy sector.
 
Realizing that the majority of its female staff lacked the confidence to compete with men, DABS is facilitating access to new job opportunities for women employees and has taken steps to ensure that women are involved in all business operations within the organization.

A roadmap to reintegrate displaced and refugee Afghans

Shubham Chaudhuri's picture
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A displaced family has taken shelter in a ruined house on the outskirts of Kabul. Photo: Rumi Consultancy/ World Bank


As the world marks World Refugee Day on June 20, we must remember that it is not only the refugee crisis that is hampering development efforts in many countries. There is also a silent emerging crisis of people driven from their homes to another part of their own country, people known as internally displaced persons (IDPs). It is a growing issue that several countries are facing, with enormous social and political pressures to address.

In Afghanistan, there are an estimated 1.2 million people who are internally displaced because of insecurity or are being forced to leave their homes due to natural disasters. This is in addition to the nearly 6 million people who have returned to Afghanistan since 2002, making one in five Afghans a returnee. In 2016, more than 620,000 Afghans returned from Pakistan alone.

The massive influx of returnees and IDPs is placing tremendous pressure on Afghanistan’s already fragile social and economic infrastructure and is a threat to regional stability.

When I first took up my position as Country Director of the World Bank for Afghanistan, I was struck by the plight of returnees and IDPs and by how hard-pressed the Afghan government was in dealing with them. During my first days in office, back in November 2016, I visited a United Nations High Commissioner for Refugees (UNHCR) center on the outskirts of Kabul. The center serves as the first entry point for returnees where they can receive assistance—including cash—and attend awareness and safety sessions to help them better integrate in their new communities.  

From subsistence laborer to Amazon seller: A story from Bihar, India

Mio Takada's picture
 JEEViKA
Kuraisa creating traditional lac bangles . Photo Credit: JEEViKA


Kuraisa lives in the Majhaulia village in Muzaffarpur district of Bihar, India. As an artisan, she and her family create  traditional lac bangles – colorful bracelets made of resinous materials and usually molded in hot kilns – in their small home production unit.
 
In early 2016, Kuraisa joined a self-help group made up of other lac bangle producers and supported through the World Bank’s Bihar Rural Livelihoods Project (BRLP), also known locally as JEEViKA.
 
The self-help group taught Kuraisa new design techniques and loaned her $2,300 to start her own business. One year later , Kuraisa has added two more production units to her home, which provide full time jobs to her relatives  and to as many as 6 additional workers during peak season.
 
Kuraisa’s annual business income has now tripled to $10,000. The self-help group has expanded and nearly 50 artisan families in the village have joined, giving rise to a village enterprise cluster with an annual revenue of $450,000.

Pakistan bridges the gender divide by embracing a digital economy

Priya Chopra's picture
Registration at the Digital Youth Summit. DYS is an age and gender-inclusive diversified digital platform.
Photo Credit: Digital Youth Summit


Standing in line to sign up for the Digital Youth Summit in Peshawar this May, I struck up a conversation with a young woman from Peshawar. I was pleasantly surprised by her level of interest and eagerness in participating at the tech conference.  She was keen to develop an app that would allow her to sell home-based food products at a national level.  She had already gathered a group of friends who would work with her on different aspects of task planning and implementation.  Her enthusiasm was palpable and infectious.  Born and raised in South Asia, I understand the constraints local women face in largely male dominated societies.  I was therefore heartened by the large turn-out of women queuing to enroll for the workshops.  

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