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14092021 KadamIt was 2017. I had taken over as Secretary, School Education, Government of India a few months ago. I was on a visit to a Government primary school in Haryana. The sight was an incredible one. This was not a typical set of children in a school. They were neither of similar age nor in school uniform but appeared extremely keen and eager. A couple of adults in the room were also not the usual teachers as I walked into the room along with Snorre Westgaard and B R Sinha, who were tasked to manage the work of Humana People to People in India. I was subsequently informed that these were out-of-school children (OOSC). An attempt was now being made to mainstream them. Each child in the room had dropped out and each had a different reason for doing so.
 
In 2005, Humana People to People India decided to address the plight of the OOSC, especially the children living in slums in urban and semi-urban areas. The project was coined Academies for Working Children and varied from handful of children seated on a dhurrie (mat) to proper classrooms in rented buildings. From 2005 to 2015, around 15,000 children benefited from these "academies". While around 50% of the children were mainstream in government primary schools at some time during their education, the project was "independent" of governmental support and was dependent on full funding from private sources, which limited the scale of the programme.
 
With the Right to Education Act in 2010, an idea emerged for developing a pedagogical and operational model that was aligned with the RTE Act and the specific MHRD programme for OOSC under Sarva Shiksha Abhiyan. Attempt now was to develop a strategy based on public-private partnership (PPP). From around 2013 to 2015, the teaching learning materials, tools and models were developed and designed, and piloted at a very small scale in different CSR funded projects.
 
The first larger programme with 2,000 children was implemented in cooperation with Bharti Foundation and RSK Madhya Pradesh in the session 2015-2016 in two of the State's tribal districts, Bharwani and Jhabua. After the initial success in Madhya Pradesh, in July 2016 an agreement was signed with Educate a Child - a programme under the Education Above All Foundation, for mainstreaming 30,000 children in Haryana over a period of 3 years. In October, the same year, an MOU was signed with the State Project Office of the Department of School Education (DeSE) in Haryana. The Department committed to pay for the Kadam teachers (Education Volunteers) and the printing of the Kadam toolkits for each child. These contributions by the State took off in the second year of the project. By July 2019, the project had enrolled over 40,000 children and successfully mainstreamed over 34,000 children, after closing their learning gaps. An assessment of the mainstreamed children showed that over 90% stayed in school, and performed on average at par with the other children. Based on the success of the programme, the MOU between HPPI and Haryana was extended for another three years. During the last session 2020/21, the Kadam Centres were conducted in small groups near the children's home observing Covid-19 appropriate behaviour. In this way, 16,798 OOSC received bridge education despite schools being closed. In total, from 2016 to July 2021, the Kadam Project has worked with 84,524 children, whereof 59,252 have been successfully mainstreamed into the age-appropriate grades.
 
It is worth noting that while HPPI started with over 200 employees in the Kadam Project Haryana in 2016, this has under the extended I MOU been reduced to 11. Most of the work is done by the Education Volunteers deployed by the State Project Office guided and monitored by State Officers on School, Cluster, Block and District level. HPPI provides support through these structures. The Kadam Haryana Project is a good example on a sustainable model for PPP between the government and civil society.
 
In 2017 and 2018, the regional workshop organized by Ministry of Education, enabled HPPI to present the Kadam model at 4 of the 5 regional workshops and discuss extensively with States. This gave a boost to the PPP model and resulted in MOUs with Chhattisgarh, Maharashtra, Uttar Pradesh and Jammu and Kashmir. A model for bridge education was also developed under the name Kadam+. This approach for remedial learning and bridge education for in-school children has reached out to 78,357 children in Madhya Pradesh, Uttar Pradesh, Bihar and Jharkhand.
 
The children spend 70% of their time on working in groups of three - Trios, doing exercises that are directly linked to NCERT defined learning competencies. In all, the programme is significantly based on 540 competencies and 10 steps, across 5 grades and 4 subjects. The competencies and the corresponding exercises are organised in a logically progressive manner so that the children learn by constructing new knowledge based on the previous one, and moving at their own pace through the desired competencies and the steps.
 
A baseline assessment determines the entry step for the children, and their age determines the end goal for the exit step. Each child has an assessment card called TMP card - Tracking My Progress Card, so the progress is visible for the child. For 30% of the remaining time, the teacher leads the programme by engaging children in activities under monthly themes. Once a month the parents are invited for Parent Teacher meeting. Engagements with parents is an important component of the programme.
 
Identification of OOSC is where it all begins. It is perhaps the most difficult part as well. Areas with a number of OOSC is identified in the catchment area of the GPS in that area is defined. The Kadam teacher starts with a door-to-door household survey mapping all OOSC in the catchment area of the school. The teacher mobilizes the children and the parents to enroll. The school allocates a class-room, a veranda or a corridor for the Kadam Centre. The Centre ideally runs for 11 months, but often only 6-9 months as per the State's allocation of Kadam teachers. The GPS is involved in the programme, the Head Teacher supervises and supports the Kadam teacher and the activities. The Kadam Teachers are organised in groups of 10, who meet weekly and share experiences and collect data for the online MIS. Once a month a bigger meeting with all Kadam Teachers in a district is organized. An HPPI District Coordinator leads the operation in a District in cooperation with the District Project Office for SSA.
 
The Covid-19 pandemic brought a new challenge to the school-going children of India - how to learn when schools are closed. Why children from families with sufficient resources could move the learning online, millions of children do not have access to technology. The Kadam methodology has proven a good solution for these children as the simple workbooks and logical step system of learning is ideal for self-learning and peer-learning. So while the schools are closed the children can continue learning together with their peers in smaller groups with the teacher visit 2-3 times per week to check up on the work, provide explanations and instructions for further work.
 
OOSC continues to be one of the major challenges that beset school education in the country. This aspect has been recognised in the National Education Policy 2020 as well. NGOs like Humana People to People India demonstrate that issues relating to OOSC can be addressed substantially through public-private partnerships. They made it happen on account of visionary leadership of persons like Snorre Westgaard and B R Sinha and the practical approach they adopted on the ground.
 
Anil Swarup has served as the head of the Project Monitoring Group, which is currently under the Prime Minister's Office. He has also served as Secretary, Ministry of Coal and Secretary, Ministry of School Education. 
 
This article first appeared on September 7, 2021, on thedailyguardian.com

COVID-19 passes the 4 million death mark and there are no signs of it stopping anytime soon. Inequality, lack of political will and non-committal to mass production of COVID-19 vaccines by wealthy nations fuels the rich and poor divide.

The rate at which COVID-19 is taking people’s lives is shocking. Less than three months ago 30,00,000 people were reported to have died from the pandemic according to data from John Hopkins University. We are seeing new tougher strains of the coronavirus killing people in a short space of time.

"The world is at a perilous point in this pandemic. We have just passed the tragic milestone of four million recorded COVID-19 deaths, which likely underestimates the overall toll," World Health Organisation (WHO) chief Tedros Adhanom Ghebreyesus told a press conference at WHO headquarters in Geneva.

vaccine

WHO has blasted wealthy nations for‘COVID-19 vaccine nationalism" as the global death toll passes 4 million.

"Vaccine nationalism, where a handful of nations have taken the lion's share, is morally indefensible. At this stage in the pandemic, the fact that millions of health and care workers have still not been vaccinated is abhorrent," says the WHO Director.

Tedros said variants were currently outpacing vaccines due to the inequitable distribution of available doses, which he said was also threatening the global economic recovery from the COVID-19 crisis.

The tally is equal to the number of people killed in battle during all of the world’s wars since 1982, according to USA Today, as well as three times the number of people killed in traffic accidents around the world each year. Officials believe the total is an undercount in many countries due to unidentified COVID-19 cases in various countries.

“People are dying in large numbers in countries without enough health workers or ventilators to save them and vaccine stocks have run dry. We will see many more needless deaths, especially in developing countries, which are being hit by a third, wave of the deadly disease, unless vaccines are produced on a much bigger scale, more quickly and at much lower prices’ says Anna Marriott, Oxfam’s health Policy Manager and spokesperson for the People’s Vaccine Alliance, said.

What is clear is many of these deaths could have been prevented had the successful vaccine science been shared and the production of doses ramped up by more manufacturers across the world.

The second wave of COVID-19 infections in India has caused unprecedented stress on the existing public health infrastructure in the country, inflicting grave human and economic costs. This experience serves as a critical reminder for Governments and policymakers around the world to exponentially scale up vaccination efforts and help provide universal access to vaccines to stem the spread of the infection further.

To better understand the current situation in India, HPPI posed some questions to Dr. Lalit Kant, former Sr. Deputy Director General of Indian Council of Medical Research (ICMR), India’s nodal health research body.

Dr. Kant’s responses are listed below:

Lalitkant 07012021 1HPPI: The second wave of infections has made India the epicentre of the global Covid-19 pandemic. What do you think were the main contributing factors that caused this situation?

Dr. Kant: It was a combination of factors that resulted in a huge spike of cases and deaths in the second wave:

I.  A false sense of victory over the coronavirus in January/February 2021

II.  Everybody, including the Government, lowered their guards, almost all restrictions were over,  COVID-appropriate behaviour was not being followed

III.  Several strains of SARS CoV-2 virus emerged in India and (the authorities) failed to appreciate the gravity of the mutations and prepare appropriately

IV.  State level and local elections were held in some States, that brought a large number of people together  without practising preventive measures

V.  Large religious gatherings happened; in one of them about 9 million people participated  

HPPI: While what we see in the news is mostly stories of public health challenges and shortages of medical supplies, what is your take on the response by the Indian Health system as such, and its Doctors, Nurses and other frontline workers?

Dr. Kant: That is very true. We can create extra beds, get additional supplies of oxygen and medications. But they cannot manage patients. We need trained people behind the machines, next to the bed, to take care of the patients. The doctor to patient, and nurse to patient ratio gets worse. Getting trained people is a bigger challenge.

HPPI: Now it seems the wave is turning (or at least plateauing). What in your opinion has enabled this to happen?

Dr. Kant: Plateauing of the wave and subsequent decline is a function of the immunity (developed in people who got infected including asymptomatic and  mild) coupled with the non-pharmacological measures like the lockdowns and wearing of mask. Both  have contributed to the decline.   

HPPI: What can India and Indian public do to avoid or prepare itself for a potential third wave?

Dr. Kant: The pandemic will only cease when all of us have developed immunity to SARS CoV-2. This could be as a result of the illness or acquired after vaccination. As long as there are susceptible people in the population, the waves will continue to come. For a wave to come three things are important. First, the virus, perhaps a mutant variant. Second, susceptible population. And third, infected persons intermixing with the susceptible population and making them sick. Our actions have to be also on these. Don’t take your eyes off the virus, keep checking for mutations. If this happens we should look for the effect of the mutation. Does it become more transmissible, or the illness is more severe, does the vaccine work against it? The next thing to do is to convert the susceptible population into non-susceptible by increasing vaccinations against the SARS CoV-2 virus.  Finally, to prevent infection transmission from an infected person to a susceptible person we must practice  COVID-appropriate behaviour like using a mask, keeping a safe distance, and washing hands frequently. For people who get infected and need hospitalisation, we should plan for an adequate number of beds, supplies like oxygen and medicines, and mechanical ventilators. And not to forget the trained doctors, nurses, and frontline workers who will be needed.  

HPPI: In order to overcome the pandemic globally, public health experts around the world, including the WHO, point to mass vaccination. What is our opinion of India’s planning for vaccinating its people? 

Dr. Kant: The Government’s planning was very good. Priority groups were identified like the healthcare workers, frontline workers, people over 60 years and those over 45yrs  with underlying health conditions, and then all 45 and over. The Government also had an adequate number of vaccines doses for all of these groups. The concern was the slow pace at which the vaccination was being done. Under pressure, the Government made everybody above 18 years eligible for the vaccination. That created problem of vaccine supplies. It would take time for the resultant issues to get resolved. 

HPPI: What is needed to obtain general (if we can call it that) immunity in the population and reduce the spread of the Novel Coronavirus to a minimum?

Dr. Kant: For the development of immunity taking the vaccine is the only solution. To reduce the spread it is the Covid-appropriate behaviour (as mentioned above) is best. As of now, there are no approved immunity boosters. A healthy and balanced diet is best.  

HPPI: How can India produce/obtain sufficient vaccines? What are the various factors contributing to this?

Dr. Kant: My opinion is that India would have to rely on vaccines manufactured/produced in the country. Of all the vaccines which have received emergency use authorisation (EUA) and produced in foreign countries, none may be available to India as countries have made advance purchase commitments and they total more than the manufacturing capacity of the companies. These commitments would have to be honoured first. However, some manufacturers are making efforts to increase their production capacity.  The vaccine manufacturers in India are also increasing their capacity either in the existing plant or transferring technology to other companies to manufacture. Some of the newer vaccines like Sputnik V will become available as it is also being manufactured by more than one company. Novavax has also completed the Phase 3 trial, India was also one of the sites, application for emergency use authorisation is being examined by the European regulators (EMA). This vaccine will also be produced by the Serum Institute of India.  Thirdly, some new vaccines developed in India might also become available by the end of 2021.

HPPI: The mechanism for providing vaccines to poorer countries is COVAX. How many vaccines have been distributed so far under COVAX and what is expected by the end of 2021? 

Dr. Kant: As of 25th May 2021,  the COVAX has shipped over 71 million doses of COVID-19 vaccine to 125 countries. The initial aim is to have 2 billion doses available by end of 2021.

“It is critical that everyone is vaccinated since it minimises the fatality rate caused by COVID-19,” says Ratnamma, 49, of Shadnagar Village in Telangana's Ranga Reddy district. Ratnamma, on the other hand, wasn't always so aware of and confident in the immunisation process.
When the Government announced free vaccinations for citizens above 45 years of age, Ratnamma faced two issues. One issue was access - long lines and a cumbersome registration process made the procedure risky. The second, and perhaps most important, the concern of vaccination arose from the fact that neither she nor her husband, David, had correct knowledge about the vaccine. She believed the rumour mill churning fake news of fatality linked to the vaccination. “Some people warned me that if you get the vaccine, you will die, while a few others said you would get fever and headache,” she says.

VenkataratnammaRatnamma

It was during a door-to-door awareness campaign by HPPI’s Community Development Project (CDP) in Ranga Reddy when the team visited Ratnamma. She says, “Knowing my apprehensions, team members from HPPI explained to me the entire process, took me to the vaccination centre and got my name registered to get the first dose of the vaccine.” Ratnamma was also prescribed by the doctor to take Paracetamol in case of fever and headache which are common side-effects of the vaccine.

In a similar case, 51-year-old Kottali Sudhakar Goud from Mahabubnagar was visiting his daughter’s village in Nandigama Mandal, Ranga Reddy when he heard about HPPI’s initiatives. When the team visited his daughter’s home, Sudhakar cleared all his doubts and took the team’s help to get the first dose of the vaccine for him and his wife. He says, “I had heard a lot of fake news. Some people around me said that I could die of blood clotting if I took the vaccine. But none of this is true. Apart from a slight fever and headache, the vaccine only protects us from high-level COVID-19 infections.”

Sudhakar Goud and VedavathiKottali Sudhakar Goud and his wife

Qualified nurses under HPPI’s CDP Ranga Reddy followed up with Kottali and ensured that all his family members got vaccinated. Today, they continue to help the Primary Health Centres (PHC) in online registrations, following up on COVID-19 positive cases and sharing correct information and awareness on behalf of the PHCs. Project team members are also mobilising the community with information and technological aid while training the youth in the registration process.

It is very crucial at this time that everyone gets vaccinated as it will help reduce the risks and make a person help fight the virus if exposed. The Government of India is working with the state governments and civil society organisations to ensure that all people in the 45+ age group get vaccinated, followed by people in the 18-44 age group. World Health Organization states, “the COVID-19 vaccines produce protection against the disease, as a result of developing an immune response to the SARS-Cov-2 virus.  Developing immunity through vaccination means there is a reduced risk of developing the illness and its consequences.”

Aiding this idea is a global movement called the People’s Vaccine Alliance which supports the idea that vaccines should be made accessible for all. The People’s Vaccine Alliance is a movement of health, spearheaded by global humanitarian and human rights organisations, past and present world leaders, health experts, and many others, advocating that COVID-19 vaccines be manufactured rapidly and at scale, as a global common good, free of intellectual property protections and made available to all people, in all countries, free of charge. To know more about the movement, visit https://peoplesvaccine.org/.

While the COVID-19 vaccine will protect us from serious illness or fatality, it is always important that we continue wearing masks, practice safe hygiene and maintain physical distancing.

Since he joined as a headmaster in the government primary school (GPS) Barki Kheri, in the impoverished Shravasti district of Uttar Pradesh 6 years ago, Aftab Ahmed has always been striving to innovate new methods in his classrooms to improve the learning levels of his students. And the examples of his efforts are aplenty.

In July 2019, a road was built near the school. However, as is often the case, come the rainy season and the newly built road would get completely inundated and make access to the school impossible. Waiting for the fault to be corrected would have taken time and cause the loss of children’s education and possibly also cause some of the students to drop out. Therefore, as a temporary solution, Aftab immediately decided to use some bricks to make a makeshift path for the children to access the school building.

aftab teacher

These efforts were highly well-received by the local community and the parents, who could see that the school staff are working beyond their call of duty to ensure that their children don’t miss out on education. Soon, some of the community members joined in the efforts of laying the path and secured access to school for the local children.

In the village where the school is located, most of the parents are illiterate and the children attending the school are first-generation learners. Knowing well that quality education is the only opportunity for these children to emerge from the intergenerational cycle of poverty, Aftab has started to provide extra support to some selected children to have the option to enrol in the residential Navodaya schools. He has also created a google sheet with the contact details of all the children to track how far have they achieved their age-appropriate learning. With this, he aims to support those who lag behind and encourage them to progress ahead.

In March 2020, after the onset of the COVID-19 pandemic and the declaration of the national lockdown, the situation for the children worsened. Earlier, under the government’s midday meal scheme, one meal was always ensured at the school, but with the schools closed and no work for their parents, even the next meal became uncertain. Anticipating these hardships, Aftab started an initiative to mobilize the community members to support each other. He involved the local leader (the village pradhan) and supported the families in receiving benefits from the government schemes.

water

Further, he re-formed the School Management Committee and started conducting basic literacy classes for the parents, with the idea to conduct mohalla classes and reach the children through the WhatsApp groups.

Having conducted Humana People to People India’s Kadam accelerated learning programme in his school the previous year, and still receiving their support, helped Aftab immensely in his endeavour. With support from the HPPI team, he was also able to distribute essentials such as masks and sanitiser to the local community members. Further, the HPPI team also helped him implement pedagogical ideas like ‘My home, my school’, which promotes children getting educated at their homes with the support of education volunteers.

The true hallmark of a quality teacher is their ability to go that extra mile beyond surmounting the challenge they face. And teachers such as Aftab Ahmed are leading by example for the next generation of teachers as we enter the era of the new normal with its own unique challenges.

About HPPI

Humana People to People India is a development organization registered as a not-for-profit company under section 25 of the Companies Act, 1956 as of 21st May 1998. It is a non-political, non-religious organization. Its mission is to unite with people in India in order to create development in the broadest sense through the implementation of the projects that aim at transferring knowledge, skills and capacity to individuals and communities who need assistance to come out of poverty and other dehumanizing conditions.

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