Project Title:
IT mediated rural women education and dissemination of health information - A pilot

Principal investigator / institution Partner investigator / institution

Dr. V. S. Venkatesan Dr Jani Bai
Graduate School of Management Principal
University of Western Australia Seethalakshmi Ramaswamy College
Perth, WA, Australia 6009 Trichirapalli, Tamilnadu, India

Location where the project is in progress:
Area : Thiruchirapalli district,
State : Tamilnadu,
Country : India

Date of reporting: 20 November 2003

Table of contents

Acknowledgements 3
1.0 Synthesis 4
2.0 Research problem 5
3.0 Research methodology 5
4.0 Initial Research findings 6
4.1 Awareness of importance of education 6
4.1.1 Socio-Economic Conditions of school dropouts
4.1.2 Key reasons for school dropouts
4.2 Awareness level of the village folk before the use of ICT among school dropouts 7

4.3 Awareness level of the village folk after the use of ICT among school dropouts 7

4.4 AIDS awareness 7
4.4.1 Awareness level of the village folk before the use of ICT

4.4.2 Awareness level and feedback of the village folk after the use of ICT

4.5 Pre-natal care 8
4.5.1 Awareness level of village folk before
the use of ICT
4.6 Post-natal care 8
4.6.1 Findings in the preliminary survey
4.6.2 Awareness level of village folk after the use of ICT
5.0 Project outputs and dissemination 9
6.0 Capacity building 10
7.0 Project Management 10
8.0 Impact 10
9.0 Overall Assessment 10
10.0 Recommendations 11

Acknowledgements

On behalf of the research team, the principal investigator wishes to acknowledge the contributions made by the following individuals to the project.

First and foremost, mention should be made of Mr. Panchapakesan, Managing Trustee of the Seethalakshmi Ramaswamy College (SRC). Coming from a tradition of philanthropy, and as head of SRC, Mr Panchapakesan made available substantial infrastructure of this institution for the project. His support and encouragement of the researchers and commitment to the uplift of women has been phenomenal.

Mr. P Subramaniam - As a consultant to the project, Mr Subramaniam and his team of trainers provided excellent training on healthcare issues to students and staff participating in the project raising their level of awareness and making them understand the underlying issues. Their role and commitment to this project is acknowledged.

Several staff members and students of SRC have gone out of their normal duties and responsibilities and taken a keen interest in the project. Such widespread interest in the institution facilitates the diffusion of the project's message into the general community. The computing department of the SRC, headed by Mr Alex has also played a key role in applying information technology to this project. Each of their contributions is acknowledged.

Intentions don't translate into actions unless supported financially. This is the reality of the modern world and this applies to this project also. But for funding from the Pan Asia Grant Scheme, its participating institutions, and ongoing administrative support from AMIC, this project wouldn't be making a smooth progress. The support of all these institutions is gratefully acknowledged.

Dr. S. Venkatraman from AMIC, apart from his role as the research monitor, has also shown a deep commitment to the core cause of project and provided valuable research input to the project. His contribution and support are very much appreciated.

Dr V S Venkatesan
Principal researcher
University of Western Australia

20th November 2003

1.0 Synthesis

School dropout of young females and lack of awareness of health issues are major social problems in India as well as in many other developing / underdeveloped countries. Young females is an important and vulnerable segment of the population and encouraging them to continue education and improving their awareness of health issues can have a significant impact on the future well being of themselves and the future generation. This could also reduce health risks such as AIDS in future, the underlying logic being that a well informed population would make a better decision.

In this project, the focus was on understanding the factors that resulted in the dropout of young females from schools. Further, the project also aimed at examining the level of awareness of specific health issues among rural women and to pilot an ICT based solution that improves dissemination of information.

Five months into the project, it can be confidently said that the project is well on track to meeting its objectives. As originally proposed in the grant application, the pilot is already creating and raising awareness among young female students and rural women in target areas. Seethalakshmi Ramaswamy College (SRC), the partner institution has a group of approximately 100 first generation girl students who come from a rural background with traditional village based parents without a high level of formal education. Details are provided in subsequent sections of the report.

The researchers conducted field studies in 14 rural villages and two urban areas in and around the town of Trichy in Tamilnadu. Through qualitative interviews and focus groups and talking to villagers about their healthcare information needs, student researchers examined the socio economic, religious factors that impacted on rural women. The preliminary survey identified a number of health care issues faced by rural women and identified socioeconomic and religious / social factors as the one that impact on young girls forcing them to drop out of school.

This research identified Pre and Postnatal care and AIDS as the important heath issues faced by rural women. Two ICT based information modules that were developed during the project met with a significantly positive feedback from rural participants and a follow up showed that their level of awareness was better. Further work is in progress.

2.0 Research Problem

The Broad aim of this proposal was to design, test and implement an ICT based Women Education / Health Information Dissemination Pilot targeting women in rural Tamilnadu, India. Further, the project focused on using the infrastructure at SRC, the partner institution, to demonstrate the long-term economic viability and the social benefits of such a programme in a developing country such as India, with complex social and religious interrelationships.

The objectives were:

1. To understand factors that forced young female students to drop out of schools.
2. To understand the health information needs of young women in rural areas of Thiruchirapalli District, Tamilnadu where SRC is located.
3. To examine ways of disseminating health information that is needed in the rural community.
4. To train the first generation rural students studying at SRC to become the core torchbearers for this pilot and use them as nodes to promote health and educational messages in their respective rural communities.
5. To examine the value of a ICT based system to disseminate information to villages.

3.0 Research Methodology

The principal investigator at the University of Western Australia initially designed a survey instrument and submitted it to SRC for their fieldwork. Staff and students from four departments of SRC - i.e. Economics, Home Science, Nutrition and Dietetics and Health Care and Hospital Management were involved in the study that covered 14 villages and 2 urban areas in Thiruchirapalli district. SRC is located in the heart of the Town of Trichy and meets the educational needs of young women from surrounding areas.

Trichy town, Samayapuram and the 14 villages were chosen primarily because of their proximity to the college. Choice of these areas meant that the project could be done with minimal travel budget and students from these areas that are already studying at the college could be used to disseminate healthcare information in their local areas. Such students could act as nodal points to disseminate information in the long run and this would ensure the long-term sustainability of the effort in the post project period. The villages chosen were Anthanullur, Jeeyapuram, Kulumani, Ettarai, Muthalaipatty, Posampatti, Esanakorai, Kattur, Pappakuruchi, Arasankudi, Velthivalam, Pudhukudi, Sempalani, Melavladi. The two urban areas were - Trichy Town and Samayapuram.

Initially, in the month of July 2003, a preliminary survey was conducted in these areas and data on their economic and social status were collected.

The project took the assistance of an experienced health consultant Mr. Subramaniam of Centre for Development Research & Training (CFDRT), Chennai, India to train students and staff of the SRC. Mr Subramaniam and other staff from CFDRT conducted a three day workshop at SRC for the staff and students involved in this project and educated them on the modalities of conducting the health related pilot study. Mr. Subramaniam also had a discussion with Mr. Alex, the system Analyst of the college who is in charge of preparing the necessary software. In the past, CFDRT has done extensive studies in projects relating to AIDs and other health issues in rural areas and hence the choice of the organization to assist SRC in this effort.

Over the next two months, a training and information (software) package was developed, tested in the field and intermittent feedback obtained from the target group through the students involved in the project. A training and information dissemination software package was ready by mid September and, in the subsequent two weeks, the students and staff at SRC were trained to handle the software through workshop and demonstrations.

From October 6th to 9th 2003 the staff and students visited different villages and spread the messages to the villagers using the software and a feedback was collected. During the interaction the whole proceedings were recorded using photo camera, web camera, tape recorder and individual notes.

In the project, the areas chosen for the preparation of software were

• Importance of education
• AIDS Awareness
• Prenatal care
• Postnatal care

Of these four software packages, only the first two could be tested in the present field study because of time limitations. During the interaction session the researchers could find very good response and it was obvious that the visual learning has helped rural women to understand the concepts better. It is only a preliminary study and we propose to modify and update the software using the information we have gathered from the feedback and a more though field study will be undertaken in the month of January.

4.0 Initial Research Findings

4.1 Awareness of importance of education

4.1.1 Socio-Economic Conditions of School dropouts

• The sample dropouts are only from BC, MBC and SC communities
• All belong to nuclear families.
• The parents of the sample dropouts are illiterates.
• All of them are Below Poverty Line.
• They are employed in petty jobs in unorganized sector.
• They all get piece wage rate.

4.1.2 Key reasons for school dropouts.

• Low income
• Failure in their class exam.
• They find English very difficult.
• Transport problem.
• Tradition bound, Prevented from attending school after attaining puberty.
• Lack of self confidence.

4.2 Awareness level of the village folk before the use of ICT among school dropouts

• Not interested in studies.
• Not aware of importance of Education.
• Interested in rearing the family only.
• Not aware of the existence of employment exchange.
• Parents are also not aware of the significance of education.
• Shy, reserved and traditional.
• Lacking self confidence.
• Not aware of the importance of higher education in creating better opportunities.
• Not aware of open school system, correspondence schools & private studies.
• Not aware of the facilities offered by the Government in providing higher education.
• Not aware of Non Governmental Organisations - running training centres or job centres.
• Not ambitious.
• Highly pessimistic about the Exams and their family backgrounds.

4.3 Awareness level of the village folk after the use of ICT among school dropouts

• Came out of shyness.
• Positive attitudes towards Exams.
• Interested to continue their studies.
• Awareness of the importance of Education.
• Awareness of better job prospects
• Awareness of the open school system & child labour school.
• Showed keen interest to know about the facilities offered by the Government.
• Showed interest to know about SHG (Self Help Groups) and child labour school.
• Increased self-confidence.
• Change in attitude towards families and education.
• Awareness about Employment Exchange.
• Seeking guidance regarding time management.

4.4 AIDS awareness

4.4.1 Awareness level of the village folk before the use of ICT

• 25% of the sample were not fully aware of the disease AIDS.
• 55% of the respondents had received information about AIDS through the powerful mass media viz., T.V and radio.
• 94% of the respondents knew the fact that AIDS was a dreadful disease.
• 96% of the sample felt that individual morality was the best preventive measure.
• No case of AIDS patient was reported in the village surveyed.
• It was found that 3 patients had died of AIDS a few months ago.

4.4.2 Awareness level and feedback of the village folk after the use of ICT

• The total sample surveyed earlier expressed their happiness for having received knowledge about the dreadful disease AIDS through ICT.
• The respondents opined that ICT mode of disseminating vital information is more powerful.
• The reasons pointed out were the combination of visual and verbal communication along with interaction.
• The doubts were immediately clarified.
• Simple information that was effective.
• Better understanding even for the illiterates
• No cure for AIDS was better understood.
• Wrong ideas like AIDS being transmitted through mosquitoes, oral mouth discharge were clarified.
• The concept of AIDS being a communicable disease was clarified.
• Advertisement in mass media like T.V need to be more direct than creating misconception (E.g. Pulli Raja)
• Some of the respondent had the experience of having witnessed AIDS patients and matter was discussed among the audience and the response was overwhelming in creating positive awareness.
• It was expressed by the respondents that these information should be given to men.
• Few respondents also condemned the advertisements in mass media like "use condom when you have sex with others" and instead they emphasized individual morality.

4.5 Pre-natal care

4.5.1 Awareness level of village folk before the use of ICT

• Majority of the women are illiterate.
• During Pre-Natal period most of the women suffer from morning sickness
  and minor ailments.
• Most of the women consult their elders for their ailments.
• Majority of the women are taking herbal water during labour time.
• Majority of the women are not gaining required weight during pre-natal
  period.
• During pre-natal period the women are doing normal work.
• In the villages limited facilities are available in the Primary Health centers.
• Majority of the respondents are taking vaccination during pre-natal period
  and less number of women are not having awareness about vaccination.
• Majority of the women are not taking nutritious food during pre-natal period.
• They do not have awareness about nutritious food.
• Most of the women consult only private doctors due to non-availability of
  facilities in P.H.C
• Only for emergency they visit primary Health Centers.
• Majority of the women prefer home delivery.
• Most of the women are taking regular check-up by taking scanning.
• Most of the women like to have healthy babies.
• Most of the women like to have advise for want of healthy babies.
• In general respondents are not having awareness about pre natal care.

The awareness level of village folk after the use of ICT - Yet to be conducted.

4.6 Post-natal care

4.6.1 Findings in the preliminary survey

• Most of the village folk are illiterates.
• Mostly the type of family is nuclear.
• Mostly normal delivery has taken place.
• The people prefer home delivery but majority of the deliveries have taken place at hospital.
• The awareness about birth spacing is enormous in number.
• Practice of birth spacing is low and poor.
• Most of the people are giving cow's milk for their babies.
• The duration of breast-feeding is one-two years in majority of the samples.
• Majority has knowledge about permanent method of family planning.
• The people are regularly following the immunization schedule for the babies.
• A limited babies suffer congenital defects.
• Less number of mothers have delivered low birth weights babies.
• Still the people have preference for male babies.
• The preference because of social status.
• Most of the women are unemployed after conception.
• Only a few continue to work after delivery.
• Majority of the people follow normal diet after delivery.
• A least number of the village folk take nutritious food during post-natal period.

4.6.2 Awareness level of village folk after the use of ICT

This survey is yet to be conducted.

5.0 Project outputs and dissemination

The project is only half way through. At present, the focus is on the social outcomes and collecting data from the grass root level and providing practical information to rural public. Detailed reporting and possibly peer reviewed publications will emerge at the end of the project. Similarly, we are not yet at a stage where there is a need to put the information on the web.

As a result of the project, about hundred students and staff members from various disciplines of SRC have been trained by the consultant and others. A three day workshop, conducted at SRC, discussed the health issues and modalities of collecting information from villages and disseminating information.

The principal researcher is visiting the partner institution in December and further training sessions for students are being planned. Further field visits are planned in early 2004.

Four information packages have been developed by SRC and these will be fine tuned in the second half of the project.

At later stages of the project, all the information is also likely to be presented on a web site. On going costs of maintaining and updating such a website beyond the life of the project are being examined.
In order to ensure long-term sustainability of the project, SRC has integrated this research into their regular teaching / research program. As a result, several academic and policy oriented reports are likely. This will be examined further when the researchers meet in December.

6.0 Capacity building

SRC, as an institution, was founded for the very purpose of capacity building among women. Already several programs are in place in the institution to train marginalized women. The present project adds another dimension to the ongoing effort and focuses on two segments - school dropouts and health information dissemination and builds additional knowledge and infrastructure capacity in this direction.
As mentioned earlier, a group of marginalized first generation students from rural areas, studying in the college, is targeted by this program so that they can carry the message to their homes and spread it in their villages.

7.0 Project Management

The technical and scientific and financial aspects of the project are being managed by the two principal researchers who are in constant touch through email, phone and fax, email being the core medium of communication.
At the beginning of the project, the principal researcher visited the partner institution and the two researchers together with the project consultant and with advise from AMIC research director planned the project in detail.
The two principal applicants are planning to meet in December at SRC and will also meet with the project consultant at Chennai.

8.0 Impact

On the reach of the project, the initial effort has reached 14 villages and two suburban areas in and around Trichy and because of the voluntary participation of many staff members, it can only expand.

As the results presented earlier will point out, there is clear evidence that the project is having a significant impact on womenfolk in these villages, raising their awareness. Comments such as 'men should also be given such messages' shows that women are able to understand the message the project is trying to convey and think through the problems. All the results presented earlier are from rural women groups.

9.0 Overall Assessment

The investigator's view is that the project is progressing well and participation is high both in terms of number and quality. Apart from direct participants in the projects, others have also provided substantial encouragement thus adding synergy to the project.

For the modest investment that is being made in this pilot project, it is already starting to show results. However, because of the very nature of the problem, it is difficult to quantify the impact it has on various people. The impact can only be qualitatively assessed from the response of the participants.

The project is also proving to be a learning exercise for researchers and students about disseminating information among rural women. This will help the researchers evolve future strategies.

While there may some findings that may have policy implications, these will be known only at the end of the pilot. Even then such findings should be placed in a broader context and their applicability to the general population and financial implications should be examined. This can happen only at the end of the pilot.

10.0 Recommendations

None at present, except for a word of appreciation about the administrative support from AMIC. It has been prompt and of excellent quality. Research feedback has also been excellent. Recommendations and feedback will be provided at the end of the project. This will give adequate time to the researchers to formulate ideas and test them.