Work Plan for Development of Tobacco Free Village _ Indore Model
Introduction:
As per the assessment of World Health Organization (WHO), tobacco chewing leads to about 49 lakh deaths every year. Around 10 crore people in the 20th century have lost their lives owing to tobacco consumption. If this consumption rate continues unabated, the figure could rise to an alarming 100 crore. Hence in the 21st century, about a section of the world’s population equivalent in size to the population of India will be wiped out by tobacco. These figures reveal the threatening consequences of tobacco chewing. If effective preventive measures to curb the same are not taken, this could well become the most concerning and alarming life threat for the future generations and the economies of nations. However, this disaster can be prevented.
Also in India tobacco is a major threat to its human resource. As per NFHS-2, (1998-99) the prevalence of tobacco consumption is at 46.5% males and 13.8% females. The provisional estimates from the latest round of NFHS-3 2006-07 indicates an increasing prevalence of tobacco consumption in India, with 57% males and 10.9% females reportedly consuming tobacco in some form. The Global Youth Tobacco Survey (GYTS), 2006 also indicates a decrease in the age of onset of tobacco consumption in the age group of 13-15 years. As per report of the Tobacco Control of India 2004, more than 0.8 million people die due to tobacco consumption every year. There are studies to indicate that approximately 40% of the disease burdens in the country are associated with some form of tobacco or other. Approximately 50% of all cancer deaths in the country are due to tobacco consumption. The majority of the cardio vascular diseases and lung disorders are directly attributable to tobacco consumption. As per National Family Health Survey (NFHS) - 20006-2007 in Madhya Pradesh the prevalence of Smoking among male population is 40.2% and female is 0.5%. Similarly for Smoke-less tobacco usage among male it is 68.5% and female is 16.0%.
In the rural India the burden of tobacco is more due to low per capita income of the rural people. Despite low income these rural people spend a big portion nearly 15 to 20% for buying tobacco product due to less awareness regarding health hazards of the tobacco. Unavailability of adequate health services multiply burden of the tobacco for rural people because they have to move to other places for the treatment of tobacco related diseases. Nobel Prize winner Dr. Amartya Sen has identified this multiplication of the tobacco burden and suggested the world community that it’s necessary to control the tobacco for eradication of poverty from this world, during his address to 13th World Conference on Tobacco or Health, Washington, USA in 2006.
Hence it is the need of today to control the epidemic of the tobacco at not only at international and national level but also at rural areas. This needs not only a strong will power, proper awareness creation but also a planned strategy and effective participation of all stakeholders.
Role Model:
Success story of Community Initiative at Chinchgohan village of district Khandwa is the inspiration behind this proposal. Three years ago a women aged 35 died due to oral cancer in this village. This incident has brought a positive change among the village people and they identified tobacco as the main cause behind this painful death and decided to ban the selling of tobacco product in their village. Today tobacco use is totally banned in this village. This initiative is appreciated worldwide. World Health Organization has given place for this success story of community initiative in its publications. WHO and other health institutions believe that such self motivated community initiatives will help in decreasing the demand of tobacco. Due to decrease in demand will ultimately be translated in control of tobacco. To control such a deep penetrated product in the society is not possible through force and policing but only through these community initiatives.
In Indore city the people have started movement against wine shops and forced these to move out of community area and residential colonies. Presence of these wine shops in the residential colonies were a possible threat to the future of the children living nearby because they were more exposed to risk of alcohol. This community action for saving the children from the evil of alcohol is also very inspiring.
Success Story Published in WHO News Letter
State Tobacco Control Cell has proposed a detailed plan of action for developing villages as Tobacco Free villages. Alcohol is also very inspiring.
Objectives:
1. To bring step by step decrease in the consumption of tobacco in rural areas.
2. To motivate rural shop keepers and village panchayat to control the tobacco epidemic.
3. To link tobacco control with rural development.
Need for the Project:
Development cannot be achieved without improving the quality of available human resource. Every villager is the main factor of human resource of that village. Consuming tobacco is not only a treat of or his family members but also to the human resource of that village where he is living. This treat can only be combated if the village people start a movement against the evil of tobacco and administration not only support but also encourage such movements.
There are many villages where people are suffering from oral cancer but initiative like Chinchgohan are not taken by these. For example 15 deaths from cancer are recorded at Bhichouli Hapsi village nearby Indore city. We, as a part of tobacco control movement; should take initiative and should motivate villagers to save themselves from this tobacco epidemic.
Further it is necessary to link tobacco control with finance for development. This will not only boost the rural health movement but also give a positive direction to integrated rural development.
Work Plan:
Following steps will be taken to achieve the goal of Tobacco Free Village:
1. Environment Formation:
1- In the very first step of environment formation members of different departments like Health, Education, Panchayat etc will visit the village and aware the people of the village about the evil of tobacco.
2- Gram Swasthya Karyakarta, Panchayat officials, Teachers etc of the village will be given training on tobacco control.
3- Community mobilization through awareness will be the objective of environment formation.
4- Door to door and shop to shop survey will be conducted to assess the baseline for the tobacco problem in the village. Garbage analysis may be also a tool for assessing the tobacco consumption in the village.
5- 50% reservation for women may support the movement of tobacco control as women in general are non user of tobacco and also give priority to health, education and other social issues over civil work issues in panchayat.
2. Controlling the Sell:
1- This step is related to community resolution. After environment formation and awareness generation there will be one stage that shopkeepers of the village will be able to pass the resolution that they will not sell the tobacco products. The day when village panchayat and shopkeepers will pass the resolution publically will be celebrated as “Sankalp Divas”. Village panchayat will also announce ban and monitory fine on sell of the tobacco products by this day.
2- Following facilities will be given to the village achieving the state of “Sankalp Divas”:
a. The village panchayat will be provided additional development fund of Rs Fifty thousand as reward.
b. Village shopkeepers will be given Rs 100/- per month as compensation for loss of revenue due to ban on tobacco sell.
c. Special tobacco secession facility will be run for the villagers.
d. Children and women will be informed and make aware about the evil of tobacco so that they can be work as pressure group against tobacco.
Monitoring: Monitoring of the progress of the development of tobacco free village will be done on the basis of base line survey. Counter checks will be done from time to time to monitor the progress and a interim review of overall progress will be done after six month of the inception of the work plan.
3. Beating the Addiction:
After interim review if it is found that there is 50% reduction in the tobacco consumption in the particular village, following facilities will be provided to the village:
1- District Collector will present the “Mukti Award” to the village.
2- The village will be provided additional development fund of Rs One Lakh.
3- The village people who quitted the tobacco use, will be provided additional days of employment under National Rojgar Guaranty Scheme. (Beneficiaries’ Blood test and Urine test may be conducted for assessing the amount of nicotine).
4- Incentive up to Rs. One thousand will be given to the persons involved in tobacco control movement based on their performance.
Monitoring: Monitoring of the progress of the development of tobacco free village will be done on the basis of base line survey. Social Audits will also be conducted. Counter checks will be done from time to time to monitor the progress and a interim review of overall progress will be done after six month of the inception of the work plan.
4. Convergence:
1- If tobacco consumption reduced to 99% of the baseline in particular village the village will be called a “Tambaku Mukt Adarsh Gram” (Tobacco free model village).
2- Following facilities will be given to the village:
a. The village will be honored by Chief Minister.
b. The village will be provided additional development fund of Rs Five Lakh.
c. Incentive up to Rs. One thousand will be given to the persons involved in tobacco control movement based on their performance.
Selection of Village:
Following will be used as base for selection of the village for developing these as tobacco free village:
1. Villages having history of cases of oral and lung cancers. Data will be collected from the cancers and other hospitals.
2. The village recognized as Nirmal Gram may also be selected for the work plan.
Human Resource:
One Social Worker will be appointed at block level as fulltime worker for smooth implementation of the work plan. Other people will be involved from the existing human resource of district, Block and Panchayat administration. They may be:
1. Panchayat Employees
2. Officials and employees of Primary Health Centers
3. Anganbadi Workers
4. ASHA under NRHM
5. Teachers of Primary Schools.
6. NGOs and other religious and social organization will also be involved.
District panchayat Officer will coordinate the work plan at district level while other department will ensure their active participation and support in the implementation of this workplan. Technical guidance for implementation of the work plan will be provided by State Tobacco Control Cell.
