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Designing Healthier Urban Environments for a Healthier Urban World March 5, 2013 Sandra Plaza

SNEHA Project Overview

Š Design Impact 2013


Project Summary •

Our initial proposal was to look at developing a sustainable business model in which new services would offset the costs to deliver existing SNEHA service

We soon realized the costs to deliver SNEHA services was high

We decided to alter our focus on the improvement of the delivery of existing services

We began by conducting interviews with all the Program Directors to understand the different strategies and processes used to delivery SNEHA services

We created a SNEHA strategy matrix

SNEHA Project Overview

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CHN = CHILD HEALTH AND NUTRITION PVWC = PREVENTION OF VIOLENCE AGAINST WOMEN AND CHILDREN

SNEHA Strategy Matrix

MNH = MATERNAL AND NEWBORN HEALTH SRH = SEXUAL AND REPRODUCTIVE HEALTH © Design Impact 2013


SNEHA Strategy Matrix

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SNEHA Strategy Matrix

Š Design Impact 2013


SNEHA Strategy Matrix

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WHAT SNEHA PERCEIVES AS BEING EFFECTIVE

Cross Comparative Study of SNEHA Services

WHAT BENEFICIARIES ACTUALLY FIND EFFECTIVE

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SRH

CHN SNEHA CENTRE MODEL CO

MNH

SNEHA Centre Model

PVWC

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Breakup of Cost per Centre (INR in lacs) Cost Heads Personnel cost for Program Staff Personnel cost for Common Operations Staff Training Cost Monitoring & Evalaution cost(including data team) Running Cost for Centre Food, Medicines, Educational Materials for DCC kids Other Program Cost Set up Cost for Centre Overhead Cost for Staff Capital Cost Administrative Cost

Total Cost SNEHA Centre Project Overview

Amount 6.33 0.52 0.14 0.38 2.10 2.72 0.21 0.30 0.51 0.82 1.40

15.42 Š Design Impact 2013


Percentage Breakup of SNEHA Centre

SNEHA Centre Project Overview

Š Design Impact 2013


SNEHA Centre Project •

Total of 20 centres participating in the trial, conducted in three phases in M/East ward

M/East ward has the poorest human development ranking and a high proportion of slum settlements as per the Human Development Index 2009

Lowest literacy rate (66%)

Highest infant mortality rate (66.4%)

Target beneficiaries are women of reproductive age (15-49 yrs) and children < 5

SNEHA Centre Project Overview

© Design Impact 2013


* Sanjay Nagar Phase I

Phase II

Phase I Phase II Phase III

Catchment Area Per Centre • 600-650 Households • 400-450 Families • 2250 Population

Feb 2012 Aug 2012 Feb 2013

SNEHA Centre locations

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UNDERSTAND CHALLENGES AND BARRIERS IN DELIVERING HEALTH CARE SERVICES

HOW CAN WE IMPROVE THE DELIVERY AND QUALITY OF HOME BASED INTERVENTIONS?

WHICH STRATEGIES EMPLOYED RESULT IN POSITIVE HUMAN BEHAVIOR


Value Exercise Workshop #1 Met with the beneficiaries of Prevention of Violence Against Women and Children to understand their aspirations for the future

Community Workshop Overview

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Desire to own her own home

Education is a must

Community Workshop Overview: Womenâ&#x20AC;&#x2122;s responses

Honest doctors

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PVWC Responses – Using Wordle

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Value Exercise Workshop #2 Met with the beneficiaries of Sexual and Reproductive Healthâ&#x20AC;&#x2122;s Adolescents Gaining Ground program

Community Workshop Overview

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Community Workshop Overview

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Reduce child labour

Education helps build a career

Community Workshop: Adolescentâ&#x20AC;&#x2122;s responses

Doctors are important, villages have less doctors

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Community Workshop Overview

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SRH Responses – Using Wordle

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Conducted interviews with SNEHA staff Discussed the basic concept of Home Based Interventions to understandthe process and strategies used to deliver the service

SNEHA Centre Overview: Shastri Nagar & Sanjay Nagar

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SNEHA CENTRE STRUCTURE PD 1 PROGRAM DIRECTOR OVERSEES

PC 1 PROGRAM COORDINATOR MANAGES

1 PROGRAM OFFICER RESPONSIBLE FOR

PO

2 COMMUNITY CENTRES EACH

CO 3 COMMUNITY ORGANIZERS ASSIGNED PER CENTRE

SNEHA Centre Organization Structure

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SNEHA Centre Overview

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Centre #1 located on main street, highly visible

View of centre space

SNEHA Centre Overview: Sanjay Nagar

View of community inside lane

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Centre #2 located on main street, highly visible

View of inside lane

SNEHA Centre Overview: Shastri Nagar

Street life

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Shadowed the work of Community Organizers Conducted individual home visits to understand the strategies used in delivering home based interventions

SNEHA Centre Overview

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Children very much enjoyed the Behavior Change Communication images

Pregnant mother, 22 years old

SNEHA Centre Overview: Individual home visits

Mother, 25 years old, 4 children

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Shadowed the work of Community Organizers Community Organizer reviewing sonogram from doctorâ&#x20AC;&#x2122;s visit

SNEHA Centre Overview

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Next •

Conducted a Cognitive Walkthrough Exercise to better understand the process, attitudes, and challenges of administering SNEHA’s home-based intervention program

Goal is to visualize the entire process and steps in one map

Identify “clusters and gaps” as places for potential ideation

Form new conclusions and hypotheses about how to improve the system’s design

SNEHA Centre Project Overview

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Cognitive Walkthrough Exercise Conducted internally

Home Based Intervention Process Overview

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Home Based Intervention Process Overview

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Cognitive Walkthrough Exercise Conducted with COs Process and strategies reviewed

Home Based Intervention Process Overview

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Home Based Intervention Process Overview

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Cognitive Walkthrough Exercise Exercise to be reviewed with other staff members including the PD and PC

SNEHA Centre Overview

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Next •

Review research and findings with Executive and Program Director

Validate cognitive walkthrough exercise with the beneficiaries of SNEHA services

Conduct workshops with beneficiaries of home based interventions

Ideate and co-create solutions with the community

SNEHA Centre Overview

© Design Impact 2013


Thank You Contact: Sandra Plaza sandra.plaza@d-impact.org www.d-impact.org

Š Design Impact 2012


SNEHA Center Development: March 2013 Update