Risk factors perpetuating vulnerability among under 5 children in Bihar : Pediatricians experience

This blog explores the understanding of ‘Under 5 Mortality’ (U5M) and risk factors present in Bihar. In-depth interviews were conducted with three pediatricians in Patna; two of them are retired government doctors currently practicing in their private clinics running out of their residence, and the other is a medical professor at a government medical institute in Patna who also runs a private clinic. All three pediatricians were interviewed in their private premises.

Mother's waiting with their children outside Dr. Kumar's clinic

Mother’s waiting with their children outside Dr. Kumar’s clinic

An expert guideline was prepared for these interviews, it was an open ended questionnaire aimed to capture perceptions of vulnerability and understand risk factors that perpetuate vulnerability. It further explored the challenges existing in Bihar in terms of providing adequate health services to beneficiaries.

Risk factors that come together to make children vulnerable in Bihar

  • Bihar is one of the most vulnerable states in India for mothers and children. Children in Bihar are suffering from treatable diseases. Cultural and socio-economic barrier are much more evident in Bihar as compared to other states.
  • Poor sanitation practices, impure drinking water and extreme weather conditions contribute to many infectious water borne diseases.
  • Children mostly suffer from infectious diseases that affect the lungs (pneumonia), Brain (meningitis) and cause diarrhea. The lack of basic sanitation facilities and poor hygienic practices could be the causes of these diseases.
  • Availability of proper drinking water and appropriate nutrition within a poor family is a challenge.

Dr. Kumar, who practiced in Begusarai district for a decade stated that

Hygienic practices are lacking in Bihar, uneducated families do not understand the importance of hygiene and proper sanitation. Open defecation is a common sight in villages and even in slums of Patna. Families that do have toilet do not use them on regular basis. There is no proper mechanism for discarding the leach pit toilets, open drains which run inside the houses are very harmful, they are water stagnation points and result in mosquito breeding”.

  • Poor child care practices and lack of education among mothers plays a crucial role in making a child vulnerable.
    Dr. Aggarwal, who is a medical professor stated that

Mothers in poor families are uneducated, they all practice breast feeding but not exclusively. This results in exposure to infections. Mothers who work as daily wage workers, and have more than two children prefer feeding packaged or cow milk over breastfeeding. Elder siblings who themselves have not reached teenage are compelled to look after the youngest child of the family. Imagine the type of care a child receives, left to play in unhygienic conditions”.

  • Improper complementary feeding and poor nutritional practices are prevalent among families in Bihar.

Dr. Nigam talked about the poor nutritional practices followed among families and how it impacts the health of a child.

“In Bihar, malnutrition is very commonly seen among children, they have weak bones, poor height to weight ratio and are prone to illnesses. It is more prevalent among females because they are neglected and not properly cared for. Female children are not adequately fed as compared to male children. Children mostly suffer from malnutrition in poor families that can just about afford two meals a day. They do not receive adequate nutrition and are susceptible to infection since their environmental surroundings are contaminated with human feces, stagnant water etc.” He further added that “once a child is suffering from a combination of malnutrition and infections, he/she is more prone to morbidity and mortality”

Clinical signs of vulnerability

“A child who is Malnourished is a child who is vulnerable” Said Dr. Aggarwal. Malnutrition is the underlying cause of all illnesses prevalent in children. Pneumonia, diarrhea, chikunguniya, malaria, typhoid etc are all opportunistic infections. When a child has a poor immune system, repeated biological insults further deteriorate his/her condition. A child who falls in the growth faltering curve of the Glasgow scale (WHO growth monitoring scale) needs immediate attention. Other dangerous signs that can be observed by a layman are:
· Child is lethargic, dull and not playful and is not taking appropriate feed
· Child has seeked medical help thrice over the last three months due to illnesses
· Presence of persistent diarrhea for more than 20 days in a child
· A poor household that is unable to provide an adequate number of meals in a day
· Fast breathing, child gets tired easily and suffers from continuous cough and cold

Cultural and social barriers influencing health seeking behavior

  • Despite vaccination schedule recommended by the government which is available free of cost at government hospitals, acceptance of vaccination is poor amongst the community.

“When it comes to vaccination, Muslim families are not willing to bring their children, they have been misguided by their religious leaders that vaccinations are a mode of controlling fertility status of Muslim population” said Dr. Nigam.

Another quote from Dr. Kumar on religious barrier influencing health seeking behavior,“Yes, there are religious and cultural beliefs but enhanced parental education will help us overcome these lacunae”. He further added that “More than cultural beliefs it is the pain during vaccination or a minor illness after it, even among the educated, which delays or prevents them from coming back for the next dose”.

Dr. Aggarwal said, “The introduction of vaccines has reduced the incidence of diseases but the numbers of children who have received all the vaccines are a small population of them.” “The government of India allocates funds specifically to maternal and child health and more of it would be appreciated.” “Vaccines for Polio, Tuberculosis, Diphtheria, Pertussis tetanus, Hepatitis B, Measles and meningitis are mandatory and supplied free of cost to all children in the country. The coverage varies between each state and region in the country with an average of 60%.”

Other Challenges faced by medical practitioners

  • There is a large presence of unqualified medical practitioners in rural parts of Bihar, who are unfamiliar with relatively simple life-saving medications, and prescribe antibiotics and other potentially harmful drugs.
  • Rural public health facilities across the state are having a difficult time attracting trained medical professionals. One of the retired government doctors spoke about ‘jungle raj’ i.e. times of poor politics, jeopardized legal system and no safety & security in the state. He said “During our early practicing days doctors were threatened to pay ransom to political parties, and if failed to do so family members were kidnapped and tortured”. Such violent situations have resulted in higher migration of qualified professionals from Bihar to other parts of the country and world.
  • In addition to the shortage of doctors, the system is plagued by poor involvement and participation of those who are employed. There have been several instances of pregnant women being treated by nurses and ward boys, who have very little or no knowledge of handling deliveries.

“Rural health facilities are poorly equipped, with no regular supplies and with high patient load . To work in such difficult conditions one needs a lot of patience and motivation”said Dr. Nigam, “Until and unless the government does not spend adequately in rural health infrastructure and manpower, things will not improve.” “Asking well-qualified doctors to work in such a system not only doesn’t cause any significant improvement in people’s health, but also wastes doctors’ education and skills”. Said Dr. Aggarwal.

  • The Central and State governments make little investments in rural health systems and there are regular stock-outs of medicines, to add to already inadequate infrastructure.

Our interaction with pediatricians raises certain imperative questions which we need to address through our primary research. It is important to gain understanding of how risk factors manifest in Bihar and to explore areas of opportunities for saving children from vulnerability. How social and cultural factors are contributing towards vulnerability? What can be done to address the social evils existing in society? Where and what kind of interventions need to be designed and implemented? It is also necessary to understand the challenges faced by qualified providers and in what capacity they can be resolved?

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Design Research: Creating Collaborative Experiences

The scale of ‘Under 5 Mortality’ (U5M) in Bihar is huge:  58 deaths for every 1000 live births, nearly 45 percent of all under five children are underweight and 49 percent of them are stunted. The disturbing figures of U5M may reflect the poor state of human development indicators but the numbers don’t tell the whole story. The UCDU5M project is funded by the Bill and Melinda Gates Foundation and is being pursued by Vihara Innovation Network (us). It is approaching the problem of child mortality through User Centered Design wherein it aims to identify challenges and create solutions by Interacting with the rural populace; understanding their perspective of the health system and observing behaviours and interactions within the given environment. It has three phases i.e.

  • Building an understanding of vulnerability for children in Bihar
  • Identifying opportunities and design interventions,
  • field testing and prototyping interventions to ensure scalability.

The first phase which is primarily dedicated to knowledge building is currently in progress.

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After two workshops framed around the question of “vulnerability” to develop a framework to systematically understand the word in context of children in Bihar, about a month spent on reviewing literature and after long exhaustive sessions of brainstorming with our partners M4ID (all the way from Helsinki!)- we came up with some tools that would help us identify the underlying problems and causes. These were refined to a set of four intensive activities that would comprise the third workshop.

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Workshop agenda

These activities were built around some pertinent question that emerged from the previous workshop; How does risk manifest in Bihar? What Environmental, Systemic and Cultural factors perpetuate vulnerability and how? How do people make decisions around care seeking? What are the markers of health and vulnerability? The activities were designed such that they would allow the transfer of knowledge from our health partners CARE in Bihar without requiring us to analysis hoards of data that they have collected on field.

We arrived at Patna, on the damp rainy afternoon of 6th September, with templates of the activities and a list of prospective participants but with everyone’s busy schedules it would be impossible to sit all of them down at the same time and place. We soon realised that we would have to conduct the activities with smaller groups.

The first round of the workshop happened at the Vihara office in Patna with three enthusiastic participants from CARE; a State Programme Manager and two of his District Officers.We started off at 11:00 am after brief introductions and casual chit chat over tea.

Activity 1- Distribution of Mortality and Risk

The objective of the first activity was to understand the distribution of mortality through different stages of life up till 5 years of age and to identify the risk factors (mostly clinical) that surface at each stage as well as to recognize the preventable and non-preventable ones among them. For this purpose we provided the participants with a graph that contained one axis for the timeline of upto 5 years against the other one a mortality scale. We then asked them to draw “a mortality curve” on this graph which we had thought they would create off the top off their heads but wait! Our participant, apart from possessing immense knowledge and experience from field, were men of facts and numbers. They pulled out their laptops, opened a gazillion excel sheets and started marking points on the graph. After a jarringly long 20 mins we had a spot on, accurate mortality curve.

Our literature review showed that in Bihar mortality load is highest in the first twenty eight days of life. A child who is born preterm with low birth weight is more susceptible to infections and diseases like pneumonia and neonatal sepsis. The curve that was the product of this activity consolidated that and more.

Mortality curve up to age 2years

Mortality curve up to age 2 years

After this the participants had to list out risk factors that perpetuate mortality at different stages of the curve. The results that emerged from this exercise seemed to be somewhat synchronized with what we had gathered during literature review, while at the same time adding to it a lot more detail. However, at the same time it also failed to address certain themes from the literature all together.

We were able to create a table that contained the risk factors we identified from the literature segregated into 5 categories of risk; Clinical signs, Maternal health history, Child case history, Familial context markers and Socio-demographic markers. This table was not presented to the participants during the activity but we drew a comparison after they were done listing out risk factors under each stage. Most of the factors from the activity matched those on the clinical signs category of our table. Apart from these a few matched those under the socio-demographic category. However factors emerging from maternal health history and familial context were largely left untouched. The participants showed an inclination to discuss clinical and socio-demographic factors owing to the evidential knowledge they have developed at their field of work.

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Part 2 of activity one: Listing out risk factors

Activity 2- Routes of risk

The second activity was designed to form an understanding of how risk manifests in Bihar. We had created four scenarios of children succumbing to mortality and/or stepping into morbidity. The age of the children along with some details of their symptomatology was provided to the participants.They were each asked to map out the journeys of at least two of the four cases by adding details of the child’s socio-economic, cultural and familial background and build on maternal history, delivery and birth, interactions with the health system etc. These journeys were to be created on the basis of their experiences and common observations on field.

About an hour later we had seven elaborate journeys in front of us. Each journey was unique in its own sense but they also shared common strains. For example, the first case provided was…

“A boy child who died at 8 months of age. His clinical symptoms started 72 hours before the time of death. He suffered from very high fever, hiccups and his chest was drawn inwards.”

For this case the following inputs were made to this journey by all three participants individually.

  • Delivery was at a PHC but mother and child left the facility within a few hours.
  • Mother was anaemic
  • No sanitation in household
  • Water source: low bore handpump
  • OBC family
  • Family ignored initial symptoms
  • First point of care seeking: RMP (Rural Medical Practitioner)
  • Repeated treatment from RMPs
  • Delay in care seeking from qualified doctor
  • Referred to PHC (Public Health Center) from RMP as severity increased
  • Referred to DH(District Hospital) from PHC
  • Child was either not taken to DH or taken back home from DH within 24 hours
  • Death occurred at home.

These patterns had also emerged during our analysis of the latest NFHS data where we were looking for indicators of risk at community level. We hope that as we continue to conduct this activity with more participants these common routes of risk will become clearer and stronger.

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Journey map by one of the participants

 

 

Activity 3 –  Care Seeking Pathways

The third activity intended to uncover the practices of rural beneficiaries and the decision making involved that explains their behaviour. This required the participants to collectively add to a list of “actors” that are the people that make (or influence) decisions related to child health care and “factors” that are situations and conditions that in turn affect the decision making. We had provided them with 15 green cards with actors and 8 blue cards with factors (based on secondary research and observations from previous field visits) and some blanks in both colours for them to create various other actors and factors.

One new actor card, three new factor cards were created. They started by mapping the decision making involved in a case where a child survives. It pointed out the strongest actors in the process and the predominant factors affecting decisions also became clear here (some of them were from the set of new cards). Factors like money, transport and distance play a huge role in decision making and some of them have been addressed and worked on by the government (for example 102 ambulance service).

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Actors and factors mapping for a case of survival

 

However, when we wanted to move on to cases where the child succumbs to death or slides into morbidity the participants hesitated. They expressed that the ideal route of decision making that saves a life is simpler to understand but the ones that fail to save lives are extremely varied and that it wouldn’t be fair to generalise. Men of facts and numbers like we said earlier! However they offered to share verbal autopsies from the field that we could use to complete the activity.

 

Activity 4 –  Health System Mapping

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Drawing out the structure of the health system

The fourth activity was designed to understand the health ecosystem through a mapping exercise, particularly to gather knowledge around the interplay and individual characterization of the public and private health systems. This group activity began with the participants mapping out the layers of the public and private systems using a bottom-up approach, from the village level to the state level, including their complex interactions at various stages. The participants were able to thoroughly explain and traverse around the systemic structures of Bihar’s complex health ecosystem.

As an extension to this activity, we had also created a template depicting the SWOT Analysis for the public and private systems. Based on their knowledge and experience, the participants were able to identify the strengths, weaknesses, opportunities and threats in both the systems (public and private). The activities provided meaningful outcomes as all participants contributed willinging to provide a better understanding of the health ecosystem in Bihar. The strengths and weaknesses of the health system stimulated conversations on how the public and private system is perceived by the participants in particular, and the community in general. Brainstorming on opportunities and threats opened possibilities of new interventions and triggered ideas around the existing interventions in the ecosystem.

Conclusion

The results of this workshop with CARE participants resonated with the direction we are pursuing and added perspective to it. Numerous research questions had emerged from the literature review and previous workshops which were continuously addressed through these activities. While some hypotheses were validated, others are being explored as we continue doing these activities with various other participants from CARE and Abt Associates. Every day our minds are buzzing with new questions to explore more innovative ways to examine this problem!

This workshop helped us go beyond the facts and the figures- it helped us to tap into that which is sometimes of even more value- the instinct of these experts. These practitioners who have been on the field for years, they’re instinct is rooted in experience which is indispensable. The new knowledge that was gathered during this workshop was an explicit byproduct of the ‘facts and figures’ that backed the outcomes of most exercises. May it be the mortality curve, the personas or the hesitation behind elaborating on the care-seeking pathways in cases of morbidity and mortality. In addition, this knowledge will enable us to better understand CARE’s existing data and identify possible opportunities of interventions.

As we attempt these activities with different group of experts, the outcomes  will change pertaining to their knowledge, experience and expertise. It is interesting to see the similarities in our data with that of the traditional learnings. Despite the slight differences, the nuances, the gaps, there also exists an underlying understanding of vulnerability, of children under 5, in Bihar. We believe this common knowledge around vulnerability holds scope for exploration and consolidation. Let’s see if we can draw an evident pattern based on our future learnings.

The members from the Vihara Team who conducted the workshop, co-created this blog and are still analyzing and collating outcomes are Bhavya Joshi, Nida Yamin and myself.

 

 

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READing Beyond Decoding

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Stay tuned for many more innovations!

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23 Educationists You Should Definitely Follow on Twitter

Whether you want to learn a bit about early reading or you’re preparing to do something about the appalling reading levels of children, it’s a good idea to have a resource for inspiration and news.

We have compiled a list of education Twitter accounts you should definitely follow.

To make this list useful for you, we have created a short bio for each person on our list to give you more context of who they are, why we included them and what kind of tweets you can expect from them.

What are you waiting for, start reading and following. :)

1. Amber Gove

Dr. Amber Gove is Director of Research within RTI’s International Education Division. Much of her recent work has centered on the development of the Early Grade Reading Assessment (EGRA), a system-level diagnostic for understanding students’ foundation skills in reading. Dr. Gove has nearly two decades of experience collaborating with government education departments in project design and impact evaluation, research and data analysis, and policy dialogue. Her research and policy interests include improvement and measurement of student learning; education finance; conditional cash transfer programs; and factors affecting achievement, enrolment, and attendance. Follow her @AmberGoveamber gove image

  1. Dr. Robert Slavin

Dr. Slavin is currently Director of the Center for Research and Reform in Education at Johns Hopkins University and part-time Professor at the Institute for Effective Education at the University of York. As the Chairman of the Success for All Foundation he has turned basic research into comprehensive programs designed to harness the power of kids, unlocking their potential through cooperative learning. Follow him @RobertSlavinRobert image

  1. Andrea Sherratt

Andrea Sherratt leads the development of the ‘Every Child a Reader’ initiative, working closely with literacy consultants and the inclusion/learning/special educational needs (SEN) support service. Every Child a Reader provides literacy interventions to Year 1 and Year 2 children. The program supports schools to employ Reading Recovery teachers, who deliver daily one to one Reading Recovery teaching for the children with the most severe difficulties. Follow her @AJS21andrea

  1. Margeret (Peggy) Dubeck

Dr. Margaret (Peggy) Dubeck, is a literacy and assessment expert who aims to improve children’s achievement through empirical research. Her interest began examining dyslexic readers learning in multilingual contexts. She has extensive experience with assessments that are instructionally transparent and inform evaluations. She has created, modified, and established the technical adequacy of literacy, math, attention, and affective instruments in multiple languages. Her literacy interventions, designed for schools, community programs, and individualized settings include teacher and student materials, trainings, supportive technology and measures of fidelity. Follow @pegdubeckpeg image

  1. Penelope Bender

Penelope Bender is a Senior Education Advisor on the USAID Basic Education team. She is the Lead for the implementation of Goal 1 of the USAID Education Strategy, which aims to improve the reading skills of 100 million children around the world. She has more than twenty years of experience of instructional design, teacher professional development and support, curriculum, assessment and language of instruction in developing countries, especially in Africa. Prior to joining USAID, she worked with the Hewlett Foundation-Gates Foundation Quality Education in Developing Countries initiative and she also has extensive experience with the World Bank. Follow her @penelopeabenderpenelope image

  1. Arun. C. Mehta

Dr. Mehta is Professor and Head of the Department of Educational Management Information System (EMIS) at the National University of Educational Planning and Administration (NUEPA), India. He has authored books on Education for All in India, Enrolment Projections, Population Projections and Upper Primary Education and contributed a number of research articles in journals and in NUEPA occasional paper series; published a number of reports annually based on DISE data; and has worked as a consultant with World Bank, UNICEF, UNESCO and ACCU (Japan). Currently Prof. Mehta is engaged in strengthening of Educational Management Information System in India at the national level and managing one of the World’s largest information systems i.e. District Information System for Education. http://schoolreportcards.in and www.dise.in  developed under the guidance of Prof. Mehta is the recipient of e-Governance 2010 & eINDIA 2010 National Awards among many other prestigious awards. Follow him @acmehta100ac mehta image

  1. Amy Jo Dowd

Doctorate in Education from Harvard University, Amy is currently serving as the Senior Director, Education Research at Save the Children US. She works extensively on Primary Education focussing on children’s reading abilities, teacher education, and educational assessment and evaluation. She is actively engaged with the organisation’s Literacy Boost program which engages the broader community in helping young children learn to read both inside and outside the classroom. Follow her @amyjodowdamy jo image

  1. Dr. Matthew Kam

Dr. Matthew Kam leads Google for Education’s user experience (UX) research efforts to invent the future of teaching and learning around the world. He is best known as a pioneer in designing mobile phone applications that have improved literacy in developing regions. Prior to Google, Kam was a senior researcher at the American Institutes for Research at Carnegie Mellon University where he started MILLEE (Mobile and Immersive Learning for Literacy in Emerging Economies) project in 2004. He is co-founder and advisor to Learning Yogi, a social enterprise that aims to build sustainable technology solutions for improving 21st century learning among low-income children throughout the world. Follow him @matthewkammatthew image

  1. Michael Trucano

Michael Trucano is the World Bank’s Senior Education & Technology Policy Specialist and Global Lead for Innovation in Education, serving as the organization’s focal point on issues at the intersection of technology use and education in middle- and low-income countries and emerging markets around the world. He provides policy advice, implementation and planning guidance and thought leadership on the strategic uses of information and communication technologies (ICTs) in education around the world. As part of his research activities, Trucano leads the World Bank’s related analytical work under its flagship Systems Approach for Better Education Results initiative as it relates to information and communication technologies (SABER-ICT). Follow him @trucanotrucano image

  1. Steve Higgins

Steve Higgins is Professor of Education at Durham University. His research interests are in the effective use of digital technologies for learning and the use of evidence in the development of professional practice. He is the lead author of the Sutton Trust-EEF Teaching and Learning Toolkit. Follow him @profstigsteve image

11. Karen Brenan

Karen is Associate Professor of Education at Harvard University. Her work focuses on computing, classrooms, and constructionism. Karen’s research is primarily concerned with the ways in which learning environments, both in and out of school, & online and face-to-face, can be designed to support young people’s development as computational creators. She completed her PhD at the MIT Media Lab in 2012, where she was a member of the Lifelong Learning Kindergarten research group. Follow her @karen_brennankaren image11. Bethan Morgan

Dr Morgan is a Teaching Associate in the Faculty of Education at the University of Cambridge. Her research interests lie in early and primary education with a focus on classroom teaching and learning in schools. Her core research has focused on classroom teaching and learning – in particular on pupil engagement, pupil consultation and pupil ‘voice’. She lectures on and is actively involved in Cambridge University’s ‘School-University Partnership for Educational Research’ (SUPER), which aims to create useful educational research within a schools-university partnership and document and explore the partnership.  Follow her @DrBethanMorganbethan morgan

  1. Mitchel Resnick

Dr Resnick is LEGO Papert Professor of Learning Research and head of the Lifelong Kindergarten group at the MIT Media Lab, explores how new technologies can engage people in creative learning experiences.  His research group has developed a new programming language called Scratch that enables children to create their own animated stories, video games, and interactive art therefore providing a stepping stone to the more advanced world of computer programming. Scratch is widely used by students, scholars, teachers, and parents for educational purposes. Follow her @mresmitchel image

  1. Kathy Hirsh-Pasek

Kathy is the Stanley and Deborah Lefkowitz Professor of Psychology at Temple University in Philadelphia. She is the author of 11 books and over 150 professional articles on early childhood development, with a specialty in literacy, reading skills and playful learning. Hirsh-Pasek was one of the investigators on the acclaimed National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. She has co-authored the language and literacy curricula for the State of California Preschools. Follow her @KathyandRo1kathy and ro

  1. Josephine Lumb

Josephine Lumb is a primary school teacher from St Mary’s School in Birmingham who works as a volunteer with Red Earth Education initiative which supports Ugandan teachers and improves the educational opportunities for thousands of children. She provides teacher training in Ugandan rural area primary schools. Follow her @josephine_lumbjosephine image

  1. Dr. Erin Schryer

Dr. Schryer is the Executive Director at Elementary Literacy Inc. and early childhood education researcher consultant. She has been working relentlessly towards ensuring all children learn to read well and tirelessly works towards the issue. As a member of her organisation’s volunteer-based reading program- Elementary Literacy Friends (ELF) Erin has brought a wealth of knowledge related to children’s literacy development and effective intervention approaches for children who are struggling with learning to read. Follow her @ErinSchryererin image

  1. Maya Menon

With over 30 years of experience in the field of education Maya’s professional experience include conceptualizing, designing and implementing a wide range of school and teacher-related projects and services. She is the Founder Director of The Teacher Foundation (TTF), a young dynamic organization that focuses on training teachers and aims at infusing the school education system in India with new energy, enthusiasm and expertise. Follow her @TTFMayamaya image

  1. Sanjay Gupta

Sanjay is the CEO of English Helper Inc. He has several years of experience leading and growing large teams and organizations worldwide. He took on the role of the global CEO at English Helper after a long stint at American Express. Deeply committed to education and related social issues, he writes a blog column for The Economic Times. Sanjay is a leadership coach and faculty at Duke Corporate Education. Follow him @scribblesgeesanjay

  1. Subir Shukla

Former Educational Quality Advisor to MHRD, Government of India; developed the Quality Framework for the implementation of the Right To Education and Sarva Shiksha Abhiyan, India’s EFA programme. Currently he is the Principal Coordinator of Group Ignus, which comprises of IgnusERG, a guild of resource persons working to support teachers and enhance the quality of education, particularly in government schools. Follow him @subirshuklasubir

  1. Sandra Baxter 

Sandra is the Knowledge Manager for the Health and Education Advice & Resource Team (HEART), supporting DFID advisers and other development partners with knowledge and expertise in education, health and nutrition. She is also Knowledge Manager for the Governance and Social Development Resource Centre (GSDRC), working in collaboration with a knowledge services team at the University of Birmingham. She has worked for the Institute of Development Studies since 2000, specialising in editorial capacity development work and repackaging research for different policy audiences. Follow her @Sandra_IDS sandra image

  1. Nita Aggarwal

Nita is working as Programme Manager for Language and Learning Foundation. She has worked with several national and International organizations including READ Alliance, Room to Read, British Council and Absolute Return for Kids (ARK) and has contributed to designing and managing early Grades reading/literacy programs. Her educational background includes a B.El.Ed followed by Master’s Degree in Sociology. Follow her @nitaaggarwalnita image

  1. Ted Fujimoto

Ted is President of Landmark Consulting Group, Inc., a management and investment consultancy for scaling innovations in learning. Ted helped design and create the replication systems and strategies for several of the largest scalable, fastest growing, highest performing public school designs in the country that created over 350 schools, including New Tech Network which has created over 160 public schools and replicating between 20-40 per year. Follow him @tedfujimototed image

  1. Karen Nemeth

Nemeth holds a bachelor’s of arts in psychology, a master’s in education, learning, cognition and development, and is also a certified baby sign language instructor. She is an Author speaker consultant on dual language learners in early childhood. In addition to her many accomplishments, she contributes and consults for Language Castle, a website focused on building appropriate preschool services to meet the needs of children who speak English as a second language. Follow her @KarenNemethEdMkaren nementh  image

  1. Ramya Venkataraman

An IIT Delhi and IIM Calcutta alumna, Ramya has been passionately involved with education in India. She is the founder and CEO of Center for Teacher Accreditation (CENTA). CENTA has the purpose of empowering teachers and catalysing their professional development, through an assessment and certification service that will connect outstanding teachers and teacher candidates to great opportunities, by being well-aligned with what schools and others look for. Through this, CENTA hopes to motivate teachers more broadly to take full ownership of their own professional development and therefore catalyse demand for high quality teacher development (without directly getting into it). Follow her @RamyaVRamanramya image

Know of any other educationists we should definitely follow to get news and inspiration, tweet to us @READ_Alliance

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7 Digital Reading Interventions Leading the Future of EdTech

Research has time and again highlighted how meaningful learning starts with strong reading skills. Children who do not learn to read at an early age find it increasingly difficult to “absorb printed information, follow written instructions, or communicate well in writing” which impedes their performance in higher grades, often culminating in early dropout from schools (Gove & Wetterberg, 2011: 1). This makes it imperative for any effort at ameliorating the quality of education to address the development of good reading skills among the children.

There is enormous interest and investment in the potential of educational technology (EdTech) to improve the quality of teaching and learning in developing countries. The primary aim of this article is to highlight the various EdTech interventions with a focus on early grade reading.

EdTech Interventions

As India shifts its attention from school enrolment to quality learning it recognises the role ICTs can play in opening up a vista of opportunities for exploring and employing empirical science and innovation in children’s learning in general, and reading in particular.

While the various Central and State government EdTech initiatives have found some success amongst the target beneficiaries they have been criticised for their lop-sided focus on technology, with lesser emphasis on learning outcomes. Primary level education lays the foundation for developing reasoning, critical thinking and cognitive skills. Therefore, several non-governmental EdTech initiatives in India are focussing on young children and basic learning.

PlanetReadplanetread photoLeveraging technology to deliver quality education is at the heart of the work at PlanetRead. Imagine looking for just one children’s book in an entire village and not coming up with any. That is a reality, which has been experienced frequently in rural India. But since over 700 million Indians already watch Television and there are close to about 200 million smartphone users, can “books” or the “reading experience” be disseminated on media that are already in people’s lives? For 20 years, PlanetRead has been using the idea of Same Language Subtitles (SLS) on Television for mass literacy.

One of their SLS project involves integrating AniBooks (animated books) into the schools and lives of children in Grades 1-3, or ages 6-10, to support the development of reading skills. They will try and leverage: 1) Pico and other low-cost, low-energy projectors 2) Computers already in schools 3) Personally owned mobile phones and potential smartphone users 4) Television at homes to deploy content in schools and homes. They will track the child’s reading progress through an app which will be easily accessible on mobile phones and tablets.

Educational Initiatives Pvt. Ltd.Educational initiativesEstablished in 2001, Educational Initiatives (EI) believes in making a difference in education through personalized learning and ensuring that students learn with understanding. A common focus throughout EI’s 12 years has been on systematically researching aspects of learning, especially assessment. They follow rigorous methods to develop the assessment tools which include in-depth textbook analysis and curriculum mapping, developing and pre-testing test items, getting external experts from the field to comment on the tools before finalizing and implementing the tests through their other interactive tools like Mindspark (digital self-learning program), ASSET, Detailed Assessment, CCE Certificate Course, Teacher Evaluation Program, Teacher Sheets and more.

EI’s adaptive e- learning program for languages called Mindspark (for Hindi, Gujarati and English) allows students to learn languages by employing a constructivist theory of learning by answering questions that are appropriate to their current understanding on either tablets, desktops or laptops. It remediates misconceptions and supports teachers in schools to teach where the need is as opposed to a regular rehearsal based on his/her own intuition on what kids don’t know.

Karadi Path Education Company KPEC magic englishKaradi Path methodology is an indigenously developed language learning process that is revolutionizing the way language proficiency is achieved in schools. It is the product of over a decade’s research into language acquisitions.

Their Magic English-SLL is a 2-year, 2-levelled program specifically designed for students coming from English-deprived environment. This project is being implemented in Tamil Nadu currently. Each level consists of 72 sessions of 40 minutes each (96 hours total). The sessions are included in the school’s regular timetables, typically running three sessions each week. The school kit consists Karadi Rhymes books, DVDs, Phonetic DVD and flip charts for Reading Path activities.

The audio visual mode of program delivers a rich English learning environment in the classrooms. Through a series of videos, the children recognize that each letter has at least one sound and understand how letter sounds can combine to form the words we speak. They start associating sounds they hear from audio-books with the print they are exposed to in the physical books. This leads to a rapid transformation from a phonic-reading approach to a sight-reading approach. The words progress from simple to difficult, and the sessions progress from reading individual words to reading phrases and sentences.

BridgeIT Bridge-IT-2 imageThe program, launched in India in the year 2010, is a replication of Text2Teach, an EdTech project running in the Philippines since 2003. BridgeIT, like Text2Teach, enables video distribution of study content over mobile phones directly into fifth and sixth-grade classrooms, using a combination of SMS and satellite video. Classrooms are equipped with a television and teachers are given a mobile phone and access to a central depository of educational videos, along with teaching guides. Teachers can request for specific videos by sending an SMS from their phones. The success of the Text2Teach project prompted its adaptation in several developing nations including India (Velamuri, 2015).

BridgeIT was implemented in 86 state-government schools in Andhra Pradesh and Tamil Nadu in 2013. Two subjects, English and Science, were chosen for the project, as it was found that the teachers’ need greatest support in these subjects (Velamuri, 2015).

An evaluation of the project using Randomised Control Trial found that program has successfully improved the students’ reading and comprehension skills in English. Since the students are from rural background they used to find it difficult to understand even simple sentences in English in the pre-intervention period. The evaluation showed a remarkable improvement in understanding lessons in English after watching the lesson videos.

Zaya Learning LabsZaya cover imageZaya Learning implements affordable, scalable e-learning technology to increase access to high-quality education and bridge the achievement gap. Zaya wants to empower students all over the world to receive personalized instruction, in and outside of school.

Schools and after-school centers use their digital learning platform and content via tablets and their patented ClassCloud, a hardware device that enables the full e-learning experience offline, especially in schools which don’t have internet or stable electricity. Zaya labs are currently impacting over 30,000 students in India.

Zaya’s “English Duniya” is a mobile Android app which aims to teach children aged 8-12 basic vocabulary, grammar, listening and reading comprehension. The child is led through its personalized learning journey by a map and an avatar, earning points and unlocking new words in the process. The app uses the child’s mother tongue to teach English. The app works online and offline and aims to be accessible to the masses, especially parents and students from low-income groups who are unable to afford high quality English tutors.

MGurumguru picmGuru builds mobile learning apps for students in grades K to 5, focusing on English and Mathematics. mGuru app provides an interactive journey for children, with an explicit aim of accelerating learning outcomes in an engaging way. The vision of mGuru is to package the best learning practices and research into a platform for the masses, so that any child can have tools to gain basic literacy and numeracy skills.

mGuru English is a mobile learning app for K-5 students, aimed at accelerating the acquisition of English literacy for the average Indian student. From basic phonics to grammar, the app provides an interactive journey for student’s learning that engages them and ultimately provides them with tools to read and understand Basic English. The app works without the Internet and is available in Hindi, Marathi, and Gujarati.

Worldreaderworldreader photoWorldreader is a global non-profit that believes everyone can be a reader. Worldreader provides children, students, and their families’ free access to its vast digital library via e-readers and mobile phones. With Read to Kids program, Worldreader is broadening its reach beyond Africa to India and beyond reading in schools and libraries to reading at homes.

All of Worldreader’s research highlights an opportunity to leverage mobile phones to drive literacy among young children through parents and teachers. Today, Worldreader is helping improve global literacy levels and narrow the digital divide, with associated long-term impacts on poverty, education, health and social-well being.

Through the Read to Kids app, the goal is to improve literacy rates by educating parents on their role in developing children’s literacy skills and by increasing access to a digital library of books and other educational resources via mobile phones. This pilot project is being run in Delhi at present.

Conclusion

With the launch of the Digital India campaign in July 2015, the Central government has been emphasizing on e-learning to be introduced in all schools in its effort to digitally empower the nation. While this is a promising opportunity for the nation, a well-coordinated and targeted approach to integrate technology into our vast and complex school system is the need of the hour.

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The best of READtalks 2016 – Key highlights

READ Alliance, a project that aims at nurturing and promoting early grade reading in India by supporting promising  innovations hosted its first ever READtalks, a discussion platform to share thoughts, solutions and spark conversations around early grade reading.

The landscape of education in India is changing very dramatically. If only a decade ago we were struggling to get all of our children into schools, the challenge of primary education today is to understand what reading will mean to people over the course of this century, as we completely abandon hardcopy print in favor of electronic print.

To truly transform education through technology, we need to learn from experts, solution providers and each other. READtalks, a unique experience with engaging sessions, exhibitions, and an evening networking session, is where this discovery took place.

The first READtalks on 14th July began with a simple question: “How can technology be leveraged to transform early reading?”

USAID Mission Director for India, Ambassador Jonathan Addleton launched the READtalks series.DSC_6144The following are a few key takeaways from the event:

  1. To kick off the event, Aditya Dev Sood, Founder and CEO, CKS asked the audience some very pertinent questions; “how will our higher order cognitive abilities shift as we use text more swiftly, interactively, dynamically? How will regional language publication and distribution impact the quality of literary thought for young people in our society?”
  2. Bhanu Potta, Board member to Worldreader India, presented ideas on how technology can be used to foster a culture of reading in schools and libraries. Culturally relevant local language books, transmitted via lowest available connectivity can be delivered to any connected mobile device
  3. According to a UNESCO 2014 report, 90% of the world’s population aged over 6 will have a mobile phone by 2020, we need to shift gears and ensure that technology is easy to use, invisible, manageable and scalable
  4. Bhanu Potta also highlighted some key trends related to mobile reading;mobil reading trends
  5. “Get caregivers to Read to kids”, said Annya Crane Program manager Read to Kids Worldreader. Children who have experienced an abundance of language in the form of talk and read-alouds will have heard 32 million more words by the time they are four than children who haven’t had a language-rich environment
  6. During the one-minute pitch sessions, educators and technology providers presented the audience with their up and coming Ed-Tech solutions. Given below are snapshots of their pitch:DSC_6232mGuru English, a mobile learning app for K-5 students, aimed at accelerating the acquisition of English literacy for the average Indian student. The app works without the Internet and is available in Hindi, Marathi, and Gujarati DSC_6246Read to Kids by Worldreader is a free and vast online library housing thousands of English and Hindi books. The goal of the pilot project is to educate caregivers on their role in developing children’s literacy skillsDSC_6257Zaya’s English Duniya”, a mobile Android app aims to teach children aged 8-12 basic vocabulary, grammar, listening and reading comprehension through a personalized learning journey. The app uses the child’s mother tongue to teach EnglishDSC_6235 The Karadi Path Magic English-SLL uses audio visual to help children progress from a phonic-reading approach to a sight-reading approachDSC_6243EI’s adaptive e- learning program for languages called Mindspark allows students to learn languages by employing a constructivist theory of learning by answering questions that are appropriate to their current understandingDSC_6242With close to 200 million smartphone users, can “books” or the “reading experience” be disseminated on media that are already in people’s lives? PlanetRead uses the idea of Same Language Subtitles (SLS) on Television for mass literacy

The experience for delegates was wide and far ranging with latest thinking from Ed-Tech players, insightful Ed-Tech session by Worldreader, and an opportunity to meet up with key technology suppliers and developers, and to see their up–and-coming products face to face.

DSC_6027 DSC_6054 DSC_6281Not only did delegates leave the conference with new ideas and concepts to implement in the classroom, but they also gained a real insight into how education relates to real-world issues and how we can inspire learners to become fully engaged with the latest technology.

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Saksham, a literacy remediation program in Maharashtra helps Vinod READ

vinod_quest case study kidMeet Vinod Madhukar Dole, a class seven student of an Ashram school in Maharashtra (Gargaon Ashram School) who has been studying here since class 1. Both his siblings, an elder brother and younger sister are studying in the same school. These three kids, originally from a village 15 kms away, are residents at this school. They only get to meet their parents during Diwali, Ganpati or other festivals.

Their parents have very little formal education; mother is a class 8 graduate and father, a 5th standard pass out. They don’t own land because of which both parents are labourers working on farms owned by other people. Every month is a struggle to make ends meet and put food on the table. On days when they cannot find any labour work, Vinod’s parents are forced to stay home.

Even though these children hardly have access to newspapers, story books and other reading materials, they really enjoy coming to school.

Always the first to be in the classroom during special Saksham classes, a literacy remediation programme run by QUEST for children in grades 4-7, Vinod quietly goes and sits in the last row in the class. He is a quiet student and does not speak unless addressed directly.

Saksham programme was started at Gargaon Ashram School towards the end of August 2015. Before the programme started, QUEST conducted a pre-test for all students studying in grades 4 to 7. Typically, results of this test are used to classify students into 3 groups A, B and C, with C being a group of the brightest students in the class.

21Kids enrolled in the Saksham program at an Ashram School in Sonale district undergoing a baseline test

Vinod scored 22.67% in the baseline test and hence was in A group. He took little time in becoming familiar with accent notation and could recognise all letters. Although he struggled when reading and writing ‘र’ related notations and words related to अ‍ॅ,ऑ,ऋ. He also had immense trouble in writing. Even though he could identify all letters, he would make mistakes while writing words with accent notations.

When checking dictation assignments, teachers would ask him to read out the passage he had written. Vinod was then able to recognise the errors in his own writing. Gradually, over time, he has now become familiar with the teachers; and interacts with them freely. With regular dictation, the number of errors committed by Vinod has dropped drastically.

Vinod has gained some confidence about his reading and writing skills and now insists that teachers check his note book first. He has started visiting the library and is often found sitting in a corner engrossed in a story book.

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Teacher reads aloud to a Saksham class. These kids really enjoy when someone reads out to them

Saksham programme was run at this school for 6 months and during these 60 days, Vinod finished reading almost 3 books. At the end of January, during the end line test, he scored 53.33 marks. He showed the maximum improvements and crossed both B1 and B2 groups and has now finally moved to the C group.


 

About Saksham Programme

All three groups; A, B, & C are divided into two sub-groups. Students from both sub-groups sit in the same classroom. This decision is taken based on the students to teacher ratio. As the students in this group have two different levels, slightly weaker students are in 1 sub-group and the slightly better ones are in 2 sub-group. As both sub-groups are accommodated in the same classrooms, the teachers have to teach same content at different levels. The students in A group have problems with alphabet recognition and hence struggle with both reading and writing.

Students in B group face problems in identifying “jod-akshar” (joined letters) and in writing by themselves. Some students also have problem with accent notations and reading. When given a task to write their experience about something, there is no chronological order in the narration.

Students in C group don’t have problems in reading or identifying “jod-akshar” but struggle with notations related to the letter “र”. They also encounter problems during writing. The students have significant issues in handling different types and styles of writing. However, these students are much more likely to progress faster than other groups.

For more details on the Saksham program and its impact on reading skills, check here.

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This Organization is Changing the Fate of Tribals One Child at a Time

The READ Alliance team has been travelling to explore innovative organizations working in the field of Early Grade Reading in India. During one of our recent visits, we met with Vidhya Das, who along with her husband Mr. Achyut Das is running Agragamee, an organization for tribal development in Odisha. Read excerpts from our conversation with her-

There was a recent report on the Sri Lankan government taking tips on quality education from Odisha, which is such great news. What are your thoughts on this?

Yes, I also read it. The team from Sri Lanka visited Puri and Khurda districts, which are the most developed districts in Odisha. Most of the efforts in qualitative education are going on in these districts, as people are very eager to improve their lives and get better education. In the tribal districts however, education is a big challenge, because local tribal communities still do not send their children to school.

Can you give us a brief overview of the status of primary education in Odisha?

Primary education in Odisha has a huge urban rural divide. Most children in the urban areas go to private schools. In the rural areas, there are very few private schools, and children especially from poorer communities have no option but to attend government schools. Faced with resource crunch and lack of qualified teachers, these government primary schools can’t ever provide quality education.

The situation is worse in the tribal districts, where the average number of teachers in a primary school is 3 or less. For upper primary schools, the average number of teachers is around 4. Moreover, many of these teachers are not trained or qualified for handling multi-grade teaching.  This has a direct impact on the learning levels of children.

Grade I with their 1st Book Kau Dake KaGrade 1 students with their book ‘Kau Dake Ka’

By shutting down schools with very few children and increasing the number of residential schools in these areas, the government plans to address this problem. However, the resources required to run residential schools are much higher than those required for a primary school. Shutting down primary schools and shifting all students to residential schools in the tribal regions, might create more problems, as children who cannot go to a residential school for one reason or the other, will be deprived of education completely. It remains to be seen, whether the government will spend enough resources to ensure quality education and facilities in these schools.

What is the educational status of tribals vis-a-vis their non-tribal counterparts in terms of education?

There are multiple reasons for the low literacy levels in tribal regions. The most important reason is that the tribal community still has not realized the need for school education. These people have a right to be skeptical as school education has not really made a significant difference to quality of life in the tribal regions. Tribal communities by and large still have not been able to have the benefits of a literate generation. This impedes the parents from monitoring their children’s learning in school, demanding better teaching, or even supporting their child’s learning at home.

Another reason is the lack of quality government school teachers who are equipped to deliver qualitative education in the tribal regions. A lot of these teachers do not comprehend the innovative methods outlined in recently developed textbooks. These teachers also don’t have proper training to deal with multi-lingual classes, as is often the case in tribal villages.

Teachers' Training in Agragamee School By Prof Kundu_2Professor Kundu during one of the teacher training session in an Agragamee School

Hence the tribal literacy and educational levels are disturbingly low. Many students who have given their 10th exams can’t read fluently. In the villages, actual literacy levels, and simple tasks like reading for information, and doing basic arithmetic calculation are significantly below the ‘literacy rates’ as indicated by the census figures. For tribal girls, the situation is much worse, as patriarchal values attribute least priority to education of tribal girls.

Tell us about the work you do at Agragamee?

Agragamee addresses various aspects of tribal development and tribal poverty. The details of our work in different sectors can be accessed from the website.

Agragamee has been involved in the implementation of programs of primary education in the tribal regions for the last 25 years. In these programs, it has been supported by the Ministry of Human Resource Development for Programs of Non-formal and Innovative Education, covering 200 villages, in 5 tribal districts, Ministry of Tribal Welfare for a Residential Complex for Tribal Girls, and International Funding agencies including Action Aid, and Terre Des Homes.

These efforts in education were essentially through single teacher learning centers, which aimed to provide education in some of the remote tribal regions, where schools did not run or even exist. They have been part of Agragamee’s holistic and integrated development efforts.

From just small rooms in the center of villages lit with a lantern, these schools blossomed into lively dynamic centers of collective growth with shared learning’s where the development history of the village unfolded. The attendance in these centers is not just limited to children, as many adults and adolescents regularly visit the center with interest and enthusiasm. Some are regulars, interested in learning the secrets of alphabets and number; others not so regular in the beginning, as they usually come out of curiosity but gradually become more regular.

Achievements:

  • The Program has enabled a learner achievement at the primary level much more than that facilitated by qualified teachers in formal Government Schools.
  • It has helped children develop a critical understanding of the socio-economic situation in the villages and made them inquisitive citizens who question adults on wrongdoings
  • The Program has also been able to mainstream tribal children 

Grade IV&V Wall Magazine

Children’s monthly wall magazines with illustrated stories, essays and art by the children 

Mukta Gyana Kutira

Seeking to build up and consolidate its past experience in education, Agragamee started a series of schools called “Mukta Gyana Kutira” or ‘Centers for Learning with Freedom’, in some of the remotest tribal regions in Odisha. The interventions include primary schools for tribal girls, primers and guides for easy and fun language development and teacher training.

Over the decade of their existence, these schools have been able to prove their worth, and develop a keen interest for education in the villages. Taking into consideration, the extremely low level of education of girls and women in the tribal districts of Odisha, the Agragamee Schools have been able to break the taboos and barriers to girl’s education in the tribal villages.

This initiative has generated a sense of right to education that has started a process of reforming the state school system. Children have become more regular in attending school which has resulted in some enhancement of attendance of the children.

Apart from exerting a direct impact on the overall education scenario of the area Agragamee Schools have created a sense of empowerment among the students. Children have been instrumental in checking the muster rolls for MNREGA (Mahatma Gandhi National Rural Employment Act), generating awareness about the right wage rate and benefits involved in the programs like public distribution system, the ICDS (Integrated Child Development Scheme), etc.

Since most of these children are first generation learners and have least scope of support and help from parents and relatives, the role of teacher becomes very important. How does Agragamee involve teachers and ensure that they remain motivated and committed to the cause?

Agragamee’s Mukta Gyana Kutir Schools have developed as ‘Experimental Model Schools’, where teachers and teaching is monitored closely, and supportive inputs are provided regularly to the teachers, through informal interactions, training programs and demonstration classes by experts. The teachers have thus gotten a much better understanding of the whole process of teaching. To further support their work, Agragamee has developed innovative work books, and teaching learning material, that acts like a guide for day to day activities in the class.

Presenting Our textbooks to DC Rayagada During his visit to Agragamee SchoolVidhya & Achyut Das presenting Agragamee textbooks to District Collector of Rayagada (Odisha)

The core approach is basically a reversal of the traditional methods of language teaching, which begins with emphasis on the alphabets. In the Agragamee method, the emphasis is on helping the child learn words first, words which have meaning and connections for the child, then learning to write names of familiar objects and things, like animals, vegetables and flowers around the house, etc. There is no effort whatsoever to make the child rote learn any alphabets or spellings. On the contrary, the teacher takes the child through a series of steps, such as writing words, then sentences, and funny rhymes, and so on, which helps the child connect with the phonetics naturally.

There are many students coming from various linguistic minority groups, which make it difficult for them to cope in school due to linguistic differences. What are some innovative ways in which you are overcoming this problem?

This problem can only be overcome with the help of teachers with the same mother tongue as the children. The teacher should be provided training in dealing with multi-lingual class groups. In our schools, the teachers teach the same rhyme in two languages, providing translations for both groups of children.

What is the role of governance in development of education of the tribals?

Governance is a key issue in educational development, as it is with any development administration of any welfare scheme. However, it is the one key intervention that can help any community take the quantum leap from being marginalized to being developed. At the moment the government has many features for the decentralized governance of schools like School Management Committee, Parent Teacher Association, Panchayat Level Standing committee etc.  However, as the people themselves are uneducated, they are unable to exercise the powers conferred on these committees. In such cases, it is imperative to make extra efforts to educate the village community about the various programs and its proper governance and management.

Presenting ADEO Nabrangpur AgragameeSchool TextBooks

Presenting Assistant District Election Officer with the Agragamee Teacher Learning Materials

Thank you Vidhya, it was wonderful chatting with you. Before wrapping up, why don’t you tell us a bit about yourself?

  • What’s your background?

I have done my masters in Anthropology

  • What was the motivation behind starting Agragamee?

Agragamee was started by Mr. Achyut Das, who had experience of poverty and underdevelopment in Western and Southern Odisha, first hand as a project officer in the OXFAM West Orissa Program. I joined 3 years later, seeking to address tribal poverty and underdevelopment. Having a background in Social Anthropology, and been born and brought up in Jharkhand, which was then Bihar, I was keen to work in the tribal regions for their development and rights.

In Agragamee, we sought to address all issues affecting the tribal communities with the ideology of “food and voice”. This included gross violation of basic human rights of tribals (especially tribal women), extreme hunger and poverty, exploitation and lack of education. This is hugely challenging, given the limited resources, the forces of exploitation and the vested interests of different stakeholders.

Along with the tribal communities, Agragamee, and its members have also suffered huge attacks on its leadership, including violence, false cases, imprisonment, threats of de-registration etc. All this has made it very difficult to carry on. Now, we have narrowed down our efforts to a focus only on education, and agricultural development

  • How has the journey been so far?

Tremendously challenging!

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Karadi Path and QUEST transform the Early Reading Landscape in India

Studies have shown the vital importance of reading ability on a child’s future and a country’s economic development. A 2011 UNESCO report found that if all students in low-income countries left primary school with basic reading skills, 171 million people could be lifted out of poverty — that’s the equivalent of a 12 percent drop globally.

READ Alliance partners Karadi Path Education Company (KPEC) and QUEST have been bringing about a change in the reading levels of children in parts of Tamil Nadu and Maharashtra.

KPEC utilizes a tested curriculum that introduces audio/visual technology and language development materials in technologically deprived classrooms across Tamil Nadu. QUEST is building the skills of teachers through rigorous and long-term training and support. They are doing this through LIPI, a comprehensive Marathi literacy program for children in early grades at Ashram schools and SAKSHAM, a literacy remediation program for children who have not mastered basics of reading.

Check out how Karadi Path (KPEC) & QUEST are revolutionizing the early reading space in India.

After every lesson or activity children are given a special assignment based on the Shikshak Mitra’s (Mentors for teachers) lesson plan. Children always welcome innovative assignments which creates an enjoyable learning environment

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(Source: Ashram Shala in Maharashtra where QUEST programs are being run)

The children from Ashram schools who don’t come from backgrounds with zero to now literacy and struggle while reading, always enjoy when someone reads aloud for them

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(Source: Children at an Ashram Shala in a QUEST class)

QUEST uses a lot of games as part of their curriculum. The aim of such games is to promote usage of libraries. These library games are developed by Shikshak Mitra’s. Such games create awareness in children about the variety of books in there library and the diverse content they have. An example of a game- Find a book by clues

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(Source: Children at an Ashram Shala in a QUEST class)

Students enjoying the story path, one of the techniques employed by Karadi Path to teach children how to Read

Mime 2 - Story Path - Panchayath Union Primay School, Amman Nagar Tirisoolam

(Source: KPEC Children at Panchayath Union Primay School, Amman Nagar, Chennai, Tamil Nadu)

Children learning how to READ as the teacher holds up a board with letters and words written on it. This is called the Reading Path, another technique employed by Karadi Path

Monitoring Visit - Reading Path - Panchayath Union Middle School, Chinna Sekkadu

(Source: KPEC Children at Panchayath Union Middle School, Chinna Sekkadu, Chennai, Tamil Nadu)

Happy READing!

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National Rural Health Mission – An Employment Generation Scheme for Women?

Last week I spent time with female health workers in Kurhani, a block in the Muzaffarpur district of Bihar, India. Coincidentally, Kurhani also happens to be the most populous block in India, boasting of a population of almost half a million. When one public health facility caters to that large a population, the load on each health worker is a lot more than usual. The female literacy rate of a mere 35.8%, in Muzaffarpur district, hasn’t done anyone any good either.

Female health workers at the health facility in the Kurhani block of Muzaffarpur, in Bihar (India)

As I sat in the meeting hall of the local health facility with about a hundred of the most over-worked ASHAs (Accredited Social Health Activists), I got talking to a few of them. “Sure, I like being a health worker. At the same time, being a woman, what other options do I have here?” exclaimed one of them. In a state where the agricultural sector is still the largest employer of women with 92% of them working in it, has the ASHA instituting health program come as a more lucrative option?

According to a report by the Institute for Human Development, in Bihar, 36.42 lakh person-days of employment have been provided to households so far, whereby women have received a mere 28.8% of this employment through Mahatma Gandhi National Rural Employment Guarantee Scheme (NREGS). Has the National Rural Health Mission been a better National Rural Employment Guarantee Scheme for the 70,000 plus women that it has employed?

The job of an ASHA is to deliver first-contact health care and be the contact person for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services. The ASHA mobilizes mothers and children for deliveries and immunization rounds, in addition to filling up child-high piles of monitoring registers (which, since a lot of them are illiterate, is done by their husbands or kids). Even as an ‘activist’, an ASHA receives outcome-based remuneration and financial compensation for training days. Facilitating an institutional delivery gets her Rs. 600 ($9.03); Rs.150 ($2.26) for getting a child to complete an immunization session; and Rs. 150 ($2.26) for each individual who undergoes family planning procedures. (Source: http://www.pbnrhm.org/docs/asha/incentives_to_asha_2015_16.pdf)

During another visit, last month, I met a health worker in Goroul block of the Vaishali district who was running for panchayat elections. Being an ASHA, she said, had given her the courage to fight for the local elections. “I have constructed a sphere of influence within my jurisdiction as an ASHA. I hope for these women to vote for me.”, she added.

With an acute lack of opportunities and innumerable socio-cultural restrictions, the National Rural Health Mission has no doubt been an extremely effective employment generation program for women in rural Bihar. A policy with such well-defined success parameters, of reducing infant and maternal mortality rates, has also resulted in ensuring job security for women giving them a sense of dignity, respect, and pride.

Here’s wishing the hardworking fleet of 70,000 ASHAs in Bihar a happy International #LabourDay!

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