Achievement at a glance: Boat Clinic

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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