- J R D Tata

The India chapter of the Cooperative for Assistance and Relief Everywhere (CARE) is joining two corporate sector NGOs, affiliated with the TATA group, for a project to improve child survival. Another objective of the project is to mobilise other industries to adopt similar models of corporate citizenship to advance ``health for all'' in India. These efforts will complement existing government services and advance the Government of India national goals for reproductive and child health in Bihar.

Bihar is one of the poorest and least developed of Indian states. With a population of 8.6 crore, according to the 1991 census, it is the second most populous state in the country. It also has the lowest literacy rate and per capita income, besides the dubiousdistinction of having the highest mortality rate in the country. In rural Bihar, the infant mortality rate is 94 deaths per 1,000 live births, the under 5 mortality rate is 133 and the maternal mortality ratio is 1,490 deaths per 1 lakh live births.

Approximately 87 per cent of the state's population resides in rural and tribal areas, isolated from information, services, and supplies which support survival. This explains why the state is on the priority list of the central government, CARE India and the Tata group.

``Our goal is to get as many people and organisations as we can to invest into the development of the community. To do that we have to motivate people. Some organisations may be motivated by charity. We want to identify the motivations which a corporate house may have. It could make good business sense to them, for instance. There is also an inherent public relations benefit in helping the community where they operate,'' says Geeta Pillai, sector head, Nutrition and Health, CARE India.

Theproject began in two blocks of Bihar's East Singhbhum district, six months back. Besides providing half of the monetary resources (the other half is sponsored by Tata), CARE did the initial design of the project, hired staff and conducted a base-line study. The Tata group provided 50 per cent of the project resources -- salaries, supplies and the community contribution.

The focus areas of the project are ante-natal and safe delivery, infant f eeding and childhood immunisation. The Tata Steel Rural Development Society (TSRDS) and the Parivar Kalyan Sansthan (PKS) are the two NGOs who are implementing the project. ``TSRDS is providing the delivery mechanism in the Rs 3-crore project.

We will be working in 162 villages in the Patanda block of Singhboom to reduce the mortality rate in the age group 0-2 years through 18 clinics. We are registering the names of pregnant women and mothers with children in the target age group, at present. We are also undertaking capacity building programmes for mothers as wellas health workers,'' says Shakti Sharma, honorary secretary, Patanda Rural Development Society, TSRDS.

CARE has innovated with two new schemes in a state where the state services are far from reliable. The most important is trying to persuade the Mahila Mandals to save small amounts of money every week. This money can be used for health emergencies in the community. ``The money is loaned to people who need it and the interest rate is lower than that charged by local money lenders. We want to form at least one group comprising 10-12 women in each of the 262 villages. This exercise will make community groups financially viable,'' says Pillai.

The loans are used for consumption and not for generating incomes. This way, they help create monetary liquidity for small emergencies, within the community. For example, they could help the family of a woman who goes into complicated labour. Funds for her immediate transfer to a hospital would have come from the village money-lender in the past, at very highrates.

Now, they can just borrow from the Mahila Mandal. The second step is organising Health Day where the villagers are provided with supplies like ORS packages, contraceptives, immunisations, iron tablets, de-worming medicine and basic essential ration drugs, on a monthly basis. ``Being a fixed day, it becomes convenient not only for people to access health services but also to the provider to provide them,'' says Ronal Bhagat, a consultant with CARE India.