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India
FY 2001 Program Description and Activity Data Sheets
>> Regional Overview >> India Overview
FY 2001 Program
USAID/India requests $46,550,000 of DA, $20,676,000 of CS/D, $5,000,000 ESF, and $92,485,000 of P.L.480 Title II for the FY 2001 program of assistance to India. The program will continue to stabilize population growth, cut pollution in power generation and cities, reduce transmission of HIV/AIDS and other infectious diseases, empower women, and meet food needs of India's poorest populations.
ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Reduced Fertility and Improved Reproductive Health in North India, 386-002
STATUS: Continuing
PLANNED FY 2000 OBLIGATION AND FUNDING SOURCE: $14,500,000 DA; $3,500,000 CSD
PROPOSED FY 2001 OBLIGATION AND FUNDING SOURCE: $26,000,000 DA
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2004Summary: This strategic objective (SO) responds to the global issue of stabilizing population growth under the Mission Performance Plan. With nearly a billion people, India accounts for 16% of the world's population, and adds a further 18 million people a year - one fifth of global population growth. The purpose of this SO is to reduce the current high level of fertility and improve women's reproductive health in North India. The direct beneficiaries are women of childbearing age (15-49) in Uttar Pradesh (UP), totaling approximately 30 million women. Couples of reproductive age throughout India will benefit from the broader commercial availability of family planning and other reproductive health products. Secondary beneficiaries are children under age five, in particular, female children whose survival will be enhanced by the program. The major intervention under this SO is the Innovations in Family Planning Services (IFPS) activity implemented in UP, India's most populous state (166 million). FY 2000 and FY 2001 resources will continue to support this critical intervention.
Complementary to IFPS is the Program for the Advancement of Commercial Technology/Child and Reproductive Health (PACT/CRH) activity, designed to stimulate private sector participation and commercial partnerships for the development, promotion and availability of reproductive health and child survival technologies.
Under the IFPS activity most program interventions are focussed within 29 selected districts of UP (initially there were 28 districts and a new district was added recently). The statewide efforts include training of medical personnel, contraceptive social marketing, logistics and Information, Education and Communication (IEC). Each intervention is tried on a small scale in select areas/districts and if sound potential is demonstrated, it is scaled up in a phased manner to cover additional districts. Therefore, activities such as reproductive health camps and service site improvement cover all 29 districts, but detailed district planning efforts, which are fairly complex, are currently operational on a pilot basis in only six districts. However, the aggregated impact of the activities is significant and will apply to all 29 districts in the future. Another innovative feature of the IFPS activity is that it is programmatically driven by a performance based disbursement system wherein funds are only disbursed to GOI against achievement of specific benchmarks.
Key Results: This strategic objective (SO) is expected to significantly contribute to reducing fertility and improving reproductive and child health in north India. The intermediate results are: (1) increased use of reproductive health services; (2) increased quality of family planning services; and (3) increased use of family planning services. A comprehensive set of three annual indicators was established in FY 1999.
A moderate amount of CSD funds are used to increase access to integrated reproductive and child health care through public and private health delivery systems. The Traditional Birth Attendants (TBAs) training program on safe delivery practices and Maternal and Child Health care will be expanded in 29 districts of UP to reduce maternal and neonatal deaths. Maternal iron-folate, tetanus immunization status and child immunization coverage will be improved through community-based outreach programs and Reproductive and Child Health (RCH) Camps. USAID promotes improved birth spacing as a key child survival intervention. Spacing methods increased 25% in the project area. The percentage of deliveries attended by trained providers has increased 74% since 1995. Iron-folic acid (IFA) status for mothers has marginally increased due to the lack of GOI IFA supply nationwide. The percentage of pregnant women who have received two doses of tetanus toxoid has increased by almost 50% since1993. Finally, over the last year over 6,500 providers have been trained to deliver quality RCH services.
Recent population-based surveys indicate that average number of children per woman has declined by 20% in the past seven years in UP. The Contraceptive Prevalence Rate (CPR) increased from 21% to 24.5% in the past three and half years, an over all increase of 17% in the 28 districts of UP. A substantial portion of this increase can be attributed to an increase in the use of spacing methods; for example, pill use increased by 25% and condom use by 32% during this period. More than 11,000 RCH camps have been conducted to increase the reach of antenatal and child immunization coverage in IFPS districts of UP during past three years.
Performance and Prospects: USAID continues to play a major role in introducing new service approaches and technologies to improve quality, increase access and stimulate demand for reproductive health and family planning services. Considerable progress has been made and the program is rapidly expanding in 29 districts of UP, covering a population of 72 million. Since the inception of the IFPS project, over 380 grants, which include nearly 210 grants to non-government groups have been made in UP. About 170 grants have also been provided to the public sector to improve provider training, skill services and counseling.
To improve the access to quality reproductive health services an integrated public/private sector programming approach was initially tried in six districts. This has proved to be very successful in providing integrated care for mothers, children and fathers. It is being expanded to six more districts and will serve as a model for the entire state in the future. In addition to this a statewide communications campaign in UP was launched, in which 10,000 health workers were trained and provided counseling materials. Additionally, the demand for family planning is being increased through local folk performances and radio and television spots. Further, a four-state generic campaign "Goli Ke Hamjoli" to promote acceptance and use of oral contraceptives in urban areas of north India has also been launched. Recently, the Asian "PR" News judged this campaign as the best Healthcare Campaign of the Year. Complementary to these demand generation activities, a statewide contraceptive social marketing project will soon be implemented for the promotion and distribution of condoms and oral contraceptives. These activities will broaden access to temporary contraceptive methods, allowing couples more choice in planning their family.
The fieldwork for the second National Family Health Survey (NFHS) has been completed in all states except 3 states in the northeast. Preliminary data for four North Indian states covered under this SO and four other large states is already available and all India estimates on key health indicators will be available by mid-2000. The NFHS-2 data is extremely valuable as it helps to track health trends over time.
Possible Adjustments to Plans: The options for integrating select child survival, sexually transmitted disease prevention and HIV/AIDS interventions in the IFPS activity in UP will be explored. The option of implementing a new maternal/neonatal health activity will also be considered.
Other Donor Programs: The World Bank, United Nations Population Fund, United Nations Children's Fund and the British Department for International Development program provide complementary donor support in reproductive health, safe motherhood and child survival. USAID's program has introduced a number of innovative approaches to supporting both public and private sector efforts, some of which have been incorporated into a major new initiative in reproductive health being launched by the World Bank.
Principal Contractors, Grantees or Agencies: The major grantees are the State Innovations in Family Planning Services Agency and ICICI Limited. Technical cooperating agencies include: AVSC International, Cooperation for Assistance and Relief Everywhere, Center for Development and Population Activities, Johns Hopkins University/Population Communication Services, Deloitte Touche Tohmatsu, University of North Carolina, International Training in Health - PRIME Project, MACRO International Inc., Program for Appropriate Technologies in Health, Population Reference Bureau, Population Council, Bureau of Census, and John Snow, Inc.
Selected Performance Measures: Baseline
(1997)Target
(1999)Target
(2000)Target
(2001)Number of IFPS-trained public sector providers performing to standards as defined by standardized clinical protocols. 69
(1997)2,336 3,933 4,343 Contraceptive Prevalence Rate. 20.9%
(1995)25% 27% 29% Percentage of deliveries attended by a trained provider. 17%
(1993)34% 35% 36%
Note: Indicators are for the 28 PERFORM districts of Uttar PradeshU.S. Finance Table (Microsoft Excel)
ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Improved Child Survival and Nutrition in Selected Areas of India, 386-003
STATUS: Continuing
PLANNED FY 2000 OBLIGATION AND FUNDING SOURCE: $3,000,000 CSD; $82,372,000 PL 480 Title II
PROPOSED FY 2001 OBLIGATION AND FUNDING SOURCE: $3,000,000 CSD; $92,485,000 PL 480 Title II
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2006Summary: This strategic objective (SO) responds to the U.S. national interest of poverty reduction and improving health under the Mission Performance Plan. One-third of India's one billion people lack adequate food. More than half of India's young children (73 million) are underweight (more than two and a half times the number of malnourished children in Africa) and chronic maternal malnutrition is high, one of every nine children die before the age of five. Poor access to health care, high illiteracy rates and poor nutrition and health practices contribute to the high mortality and malnutrition. Poor women and children, particularly in remote rural and tribal areas, have the greatest mortality risks. The purpose of this SO is to reduce the high levels of child mortality and malnutrition. The major activity that contributes to this SO is the P.L.480 Title II program under which food aid is integrated with Government of India (GOI) and non-governmental resources to improve key child survival interventions such as immunization, breast feeding and timely complementary feeding. The Title II program is being implemented by two major non-governmental organizations (NGOs) namely Cooperative for Assistance and Relief Everywhere (CARE) and Catholic Relief Services (CRS) and reaches more than seven million women and children. Through the GOI's Integrated Child Development Services (ICDS) program, CARE supports a network of over 100,000 village centers. CRS, working through private registered social service societies, including programs managed by Mother Teresa's and the Dalai Lama's organizations, reaches women and children who are not served by the GOI's ICDS.
A bilateral activity, the Program for Advancement of Commercial Technology/Child and Reproductive Health (PACT/CRH), complements the Title II program. It provides support at the national level for child survival technologies aimed at increasing commercial marketing and distribution of quality child survival products and services such as Oral Rehydration Salts (ORS) and vaccines.
In FY 2001, USAID/India plans to initiate a new activity that would strengthen the child survival impact of the food aid program, as described in the section below on Possible Adjustments to Plans.
Key Results: Among the multiple factors influencing child survival and nutrition, three key intermediate results were identified by USAID as critical to achieve this objective: (1) increased use of key child survival interventions; (2) improved maternal and child nutrition; and (3) improved targeting of at-risk populations.
Performance and Prospects: Recent mid-term reviews (MTRs) of the CARE and CRS Title II programs validate that the program strategy of using food to draw children and mothers into programs where they can receive health care services is sound and it works. Overall progress achieved by the programs is encouraging. The CARE MTR has found the program to be successful in testing models and field implementation strategies to improve child survival and health; energizing the essential collaboration between the two key GOI departments involved in the program - Women and Child Development and Health; and in engaging and empowering communities for better child survival and nutrition. Also the MTR pointed out key areas that need strengthening. The NGOs and Mission are working towards implementing the key recommendations. The MTR also noted that greater focus is required on maternal health issues such as quality antenatal care, distribution of iron-folate tablets and safe delivery. Since maternal/child, nutrition and health issues are inextricably linked to low birth weight (one of every three children born), USAID will specifically focus, within its overall child survival strategy, on strengthening the delivery of interventions for improving maternal health under the existing Title II portfolio.
Almost 600,000 Indian children die each year from diarrheal dehydration. Under the PACT/CRH activity, ICICI Limited launched a promotion campaign to position ORS as the scientific, doctor-recommended, first-line product for all cases of childhood diarrhea. In order to support the increased demand, three commercial firms entered a Memorandum of Understanding to make the World Health Organization's (WHO) composition of ORS widely available in retail outlets. Other PACT/CRH interventions aim to improve the knowledge of health providers of key child health services such as breast-feeding, diarrheal disease management and immunization through continuing education, distance education programs and on-line information networks.
A large USAID-World Bank funded Deworming and Enhanced Vitamin A (DEVTA) trial covers 8,000 villages and about one million children. It will validate the impact of enhanced Vitamin A coverage and deworming on mortality and growth of children and provide a sustainable model for improved delivery of micronutrients, including Vitamin A. The study will be completed during 2003. Also, a feasibility study of working with the commercial sector to expand access to micronutrients is being currently conducted. Finally, operations research opportunities with the Indian Council of Medical Research (ICMR) and the U.S. National Institute of Child Health and Human Development (NICHD) are being explored.
Possible Adjustments to Plans: During FY 2000, USAID will define options and activities to further strengthen the child survival impact of its food aid program and selected reproductive health activities, as well as, include other activities such as micronutrient interventions to improve child survival in India. While recent evaluations of the Title II programs indicate good results, it is increasingly apparent that USAID and its partners could significantly expand the child survival impact of the program with cash resources beyond the section 202(e) funds and minimal monetization levels. Child Survival funding will be required to enhance the quality, coverage and number of maternal and child survival interventions such as vitamin A delivery, immunization and antenatal care.
Other Donor Programs: Other donors working in the nutrition and health sector include the United Nations International Children Emergency Fund (UNICEF), the World Bank, the Swedish International Development Agency, and the World Food Program. The GOI funds all ICDS services, program personnel and infrastructure for the CARE program, as well as in-country transportation and storage costs for all P.L.480 Title II commodities.
Principal Contractors, Grantees or Agencies: USAID implements the P.L.480 Title II India program through two U.S. NGOs namely CARE and CRS. The PACT/CRH is implemented through ICICI Limited, with U.S. technical assistance from Program for Appropriate Technology in Health (PATH), NICHD and ICMR.
Selected Performance Measures: Baseline
(1996)Target
(1999)Target
(2000)Target
(2001)Percent of children fully immunized by age one 28 37 40 44 Percent of pregnant women who received 90-100 iron-folate tablets 13 27 30 35 Percent of infants who received breast-milk And solid-mushy foods at 6-9 months of age 46 58 62 65 Percent of children under-two enrolled in the supplemental feeding program 40 52 56 60
Note: Data and targets are from CARE programU.S. Finance Table (Microsoft Excel)
ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Increased Environmental Protection in Energy, Industry and Cities, 386-004
STATUS: Continuing
PLANNED FY 2000 OBLIGATION AND FUNDING SOURCE: $9,400,000 DA
PROPOSED FY 2001 OBLIGATION AND FUNDING SOURCE: $9,250,000 DA
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2007Summary: This strategic objective (SO) responds to the global issue of environmental protection under the Mission Performance Plan. This SO increases efficiency and reduces greenhouse gas (GHG) emissions in the electric power and industrial sectors and provides commercially viable water and sanitation services for the urban poor. Urban solid waste management activities also contribute to a reduction in GHG. India is the sixth largest and second fastest growing producer of GHG in the world. Electric power generation is the major source of GHG emissions in India, accounting for 48% (or 71 million tons annually) of India's carbon emissions from fossil fuels.
The rapid growth in India's urban population has put tremendous strain on urban environmental infrastructure, including water supply, sanitation, and sewerage systems. Close to 40% of the urban population live in slums and squatter settlements with poor or no access to these basic services, causing severe health problems to the most vulnerable group of the population.
In FY 2000 and FY 2001, USAID will continue to fund the following four on-going activities: Trade in Environmental Services and Technologies which assists Indian industries to adopt energy efficient practices that are cost effective, productivity enhancing, and reduce GHG emissions; the Greenhouse Gas Pollution Project which aims to mitigate the increase in GHG emissions through increased efficiency in electricity generation and promotion of non-conventional energy sources; the Energy Conservation and Commercialization activity which promotes reduction in the rate of growth of GHG through the widespread commercialization of energy efficient technologies and services in India; and the Financial Institutions Reform and Expansion (FIRE) activity which works with local and state governments to develop, package and implement urban environmental infrastructure projects that improve access to basic services by the poorest and the most vulnerable groups of the population.
Key Results: Achievement of three key results by 2002 will indicate the success of this SO: (1) increased avoidance of carbon dioxide emissions; (2) increased number of firms that meet international environmental quality standards in selected industrial sectors, and (3) increased number of local governments/authorities with urban environmental management tools available to them.
Performance and Prospects: USAID's energy portfolio is designed to reduce GHG emissions by increasing both supply- and demand-side energy efficiency and increase overall power sector efficiency through improved regulatory institutions. USAID technical assistance resulted in the first international partnership by our Federal Energy Regulatory Commission with the Indian Central Electricity Regulatory Commission. The design and adoption by the Bureau of Indian Standards of an Indian energy label was another first made possible with USAID assistance. USAID continued its successful energy training program with a focus on power sector regulatory reform and restructuring.
Six USAID-supported sugar co-generation power plants have been commissioned resulting in nearly 400 million kilowatt hours of clean power generation capacity. USAID support for renewable energy has resulted in domestic lighting of nearly 3,000 rural homes and 100 water pumping installations for poor tribal farmers using solar photovoltaic technology. USAID facilitated financial assistance totaling $2.7 million in loan funds to two renewable energy projects (mustard husk briquettes to be used as fuel for power plants and commercialization of a totally battery powered electric car 'REVA') from previous USAID-ICICI Limited project re-flow funds.
A "Joint Statement on Cooperation in Energy and Related Environmental Aspects" was signed by the U.S. Energy Secretary, Bill Richardson, and the Indian External Affairs Minister, Jaswant Singh, on October 26, 1999. USAID led the design and implementation of an inter-agency Climate Change Strategy, with strong support from the Ambassador. The strategy supported Indian industry, academic, and non-governmental organization (NGO) partnerships to identify opportunities for investments in India through climate change mitigation partnership projects. As a result, there has been a significant shift in the GOI's willingness to participate in global climate change action. This shift has resulted in broad-based Indian understanding and acceptance of the benefits from a market-based approach to GHG reduction; 15 climate change mitigation projects are under development with private sector partners. USAID supported the establishment of two "Global Climate Change Information and Facilitation Centers" which are now providing information resources and technical assistance to NGO's, government agencies, and the private sector.
USAID assistance also strengthens incentives for: adoption of energy efficient technologies; certified environment management systems; and the enhancement of capacity of Indian industry to incorporate such technologies and practices into their operations. This assistance strengthens GHG reduction efforts. Energy intensive sectors, with high GHG emitting potential such as textiles, paper, automobiles and steel were targeted for assistance in the first project phase. Three firms have received ISO 14001 certification to date, three more will receive certification in December 1999, and nine more are on track for certification by March 2000.
USAID's technical assistance to the Pune Municipal Corporation in the preparation of an Environmental Status Report has led 11 other cities in Maharashtra to replicate the application of this innovative "tool kit". USAID provided a small grant to the Gujarat Mahila Housing SEWA Trust, a renowned women's self help organization, to facilitate small loans to low income families for accessing basic services. The Housing and Urban Development Corporation (HUDCO) completed the borrowing of $10 million from the U.S. capital markets under USAID's Urban and Environmental Credit Program to help finance water supply, sewerage and solid waste-to-energy projects in the cities of Nagpur and Surat. On their completion, these projects will provide access to water supply and sanitation services to approximately one million urban poor.
Possible Adjustments to Plans: The urban environmental program will seek to design financing for new municipal projects using the Development Credit Program to integrate energy, urban, and natural resource aspects of climate change mitigation.
Other Donor Programs: USAID works closely with the World Bank, the British Department for International Development, and the Asian Development Bank on power sector reform and restructuring and on urban environmental infrastructure development.
Principal Contractors, Grantees or Agencies: Principle grantees and contractors include: International Resources Group; Tetra Tech; U.S. Department of Energy; Winrock International; Institute of International Education; United States Energy Association; Hagler Bailly Services Corporation; and The Communities Group Inc. Indian partners include: Ministry of Power; central and state electricity regulatory commissions; state and private sector power utilities; ICICI Limited; Industrial Development Bank of India; National Thermal Power Corporation Limited; Confederation of Indian Industry; Society for Development Alternatives; National Institute of Urban Affairs; Housing and Urban Development Corporation; and Infrastructure Leasing and Financial Services Limited.
Selected Performance Measures: Baseline
(1995)Target
(1999)Target
(2000)Target
(2001)Emissions of carbon dioxide equivalents avoided (in million tons) 0 1.93 5.29 8.52 Increased number of firms that meet international environmental quality standards in selected industrial sectors (number of firms) 0 10 15 20 Increased number of local governments/authorities that have one or more of the urban environmental management tools (cumulative) 1 8 10 12 U.S. Finance Table (Microsoft Excel)
ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Reduced Transmission and Mitigated Impact of Infectious Diseases, especially STD/HIV/AIDS in India, 386-007
STATUS: Continuing
PLANNED FY 2000 OBLIGATION AND FUNDING SOURCE: $15,000,000 CSD
PROPOSED FY 2001 OBLIGATION AND FUNDING SOURCE: $17,000,000 CSD
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2006Summary: This strategic objective (SO) responds to the global issue of improving health under the Mission Performance Plan. India has the largest number of HIV infected persons worldwide. In FY 1992, USAID responded to early evidence of a growing problem of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in India by developing the AIDS Prevention and Control (APAC) activity in the south Indian state of Tamil Nadu-one of India's three recognized HIV epicenters. The ten- year APAC activity was developed to prevent and control sexual transmission of HIV among groups engaging in high-risk behavior by using proven strategies for behavior change, such as, increasing access to, and utilization of, high quality condoms, and expanding access to, and utilization of, quality treatment for sexually transmitted diseases (STD).
In FY 1999, USAID expanded its program to include the state of Maharashtra, which accounts for over 50% of reported AIDS cases in India. AVERT, a seven year, $41.5 million program will fund comprehensive prevention and care programs in the cities of Mumbai, Pune, Thane and Sangli, where more than 80% of Maharashtra's sex workers live and work. The activity helps strengthen the capacity of the state government and non-governmental organizations to respond to the epidemic and particularly addresses issues of women and children.
Additional support for the above activities includes the Program for Advancement of Commercial Technology/Child and Reproductive Health (PACT/CRH) which is strengthening the private sector to improve access to and use of quality health products and services, especially condoms. Two other priorities under this strategic objective are reducing the impact of other infectious diseases (such as polio and tuberculosis) and strengthening key aspects of India's surveillance system.
FY 2000 and FY 2001 funds will continue ongoing activities with APAC, AVERT, and PACT/CRH, polio, and other infectious diseases.
Key Results: The SO seeks to achieve reduced transmission of HIV/AIDS and related infectious diseases in Tamil Nadu. The results are: (1) increased number of individuals belonging to specified high-risk groups who report increased condom use in most recent sexual encounters with a non-regular partner; (2) increased number of individuals with STD seeking care from qualified medical practitioners in Tamil Nadu; and (3) increased number of APAC grants for AIDS prevention in Tamil Nadu.
Performance and Prospects: In the last four years, 82 non-governmental organizations (NGOs) in Tamil Nadu have been funded to carry out over 100 prevention programs for high risk groups such as truck drivers and their helpers and sex workers and their clients. In 1998, 75% of truck drivers and their helpers reported condom use during their last sexual encounter with a sex worker-up from 55% in 1996. Also in 1998, 80% of truck drivers and their helpers who had STD symptoms, reported that they sought care from qualified medical practitioners - a 16% increase in care-seeking behavior up from 64% in 1996. To improve the quality of care for STDs, more than 1,000 physicians and over 2,100 auxiliary health care providers have been trained by APAC funded NGOs. Through a collaborative effort between a commercial manufacturer and the APAC program, the number of condom retail outlets has increased from 25,000 to 42,500. In addition, over 1,300 retailers have been trained to more actively promote condoms at the point of purchase.
The Maharashtra program (AVERT) was signed into effect on September 15, 1999. Four preparatory research studies have been commissioned and negotiations for selecting the implementing partner are currently underway. USAID is also currently funding two activities that provide support to street children, children of sex workers and children of parents with AIDS for periods of critical episodes of the disease. Three more activities are being developed for funding starting in January 2000.
Under the polio eradication activity, support from USAID, the GOI and other donors resulted in a large-scale campaign, which inoculated approximately 136 million children under five years of age on a single day in both 1998 and 1999. Due to a strengthened polio surveillance system, new cases are being rapidly detected and investigated. Additional rounds of polio immunization are underway to eliminate the virus from hard-to-reach populations. USAID is supporting expanded delivery and improved surveillance for polio and other infectious diseases
A model directly observed therapy short-course (DOTS) program, initiated in March 1999, has trained over 500 individuals to carry out tuberculosis diagnosis and treatment activities in Tamil Nadu. Operational research activities have been initiated to facilitate replication nation-wide. Multi-site research studies on anti-microbial resistance and childhood respiratory infections have been initiated.
Under the PACT/CRH activity loans have been provided to private-sector manufacturers to expand the marketing and distribution of condoms and to promote rapid diagnosis of infectious diseases. PACT/CRH has assisted both condom manufacturers and the Government to improve their internal quality control capacity and procedures. PACT/CRH has also provided a grant to the Confederation of Indian Industry to develop and market packages for prevention of HIV/AIDS in industrial workplaces. Assistance also has been provided to three commercial manufacturers to develop and market low-cost rapid diagnostics for HIV, hepatitis B, chlamydia, syphilis and malaria.
Possible Adjustments to Plans: USAID plans to broaden its Infectious Disease strategy in FY 2000 beyond the state of Tamil Nadu and activities aimed at HIV/AIDS, to include other infectious diseases. For the revised strategy, a new set of indicators will be developed. USAID will explore options to expanding the HIV/AIDS activities to Pondicherry and Goa (two states that border the current HIV/AIDS programs in Tamil Nadu and Maharashtra) and program resources, as appropriate, in urban infectious diseases.
Other Donor Programs: The World Bank-funded $191 million, five-year National AIDS Control Program (NACP II) was launched in August 1999. UNAIDS coordinates the response of the UN agencies to HIV/AIDS in India. The British Department for International Development recently initiated a $36 million HIV intervention with truck drivers to promote behavior modification and STD treatment, and also to promote behavior change programs in the Indian states of Andhra Pradesh, West Bengal, Kerala, Gujarat, and Orissa. Australia AID (AUSAID) will support HIV prevention programs in the states of Manipur, Meghalaya, Mizoram and Delhi beginning in January 2000 while the Canadian International Development Agency (CIDA) will begin its HIV activities in the states of Rajasthan and Karnataka in the summer of 2000. All donor programs are carefully coordinated under the leadership of the National AIDS Control Organization (NACO). Memorandum of Understanding have also been signed between National Institute of Health (NIH) and for HIV/AIDS- infectious disease and maternal and child health.
Principal Contractors, Grantees or Agencies: USAID provides $4 million annually to help implement the Government of India's polio eradication program (through WHO, UNICEF and Rotary). Also, $2 million has been provided to the WHO over the last two FYs for the development of a model DOTS program at the GOI's tuberculosis research center in Chennai. Since FY 1998, additional assistance ($1.8 million) was provided to WHO to strengthen the national disease surveillance program, and $2.95 million was provided to the International Clinical Epidemiology Network (INCLEN) for research on infectious diseases in India. Voluntary Health Services is the primary implementing organization for APAC in Tamil Nadu while the ICICI Limited is the central organization for PACT/CRH activities. Family Health International, a U.S. based agency provides technical assistance to both the Tamil Nadu and Maharashtra activities; Program for Appropriate Technology in Health (PATH) collaborates under the PACT/CRH activities; and INCLEN is the implementing agency for the infectious disease research activities. WHO, with technical assistance from the Centers for Disease Control (CDC) in Atlanta, Georgia, implements the tuberculosis, polio and disease surveillance activities. Finally, USAID also supports CDC in its provision of technical assistance to the Mission and GOI on HIV and infectious disease.
Selected Performance Measures: Baseline
(1996)Target
(1999)Target
(2000)Target
(2001)Percentage of individuals belonging to specified high-risk groups who report condom use in most recent sexual encounter with a non-regular partner (Tamil Nadu) 37 52 57 62
(2002)Percentage of population with symptomatic sexually transmitted disease (STD) seeking care from qualified medical practitioners in Tamil Nadu 52 67 72 75 Cumulative number of APAC grants for AIDS prevention in Tamil Nadu. 18 60 75 100
(2002)U.S. Finance Table (Microsoft Excel)
ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Expanded Advocacy and Service Delivery Networks for Women, 386-009
STATUS: Continuing
PLANNED FY 2000 OBLIGATION AND FUNDING SOURCE: $1,800,000 DA; $1,250,000 CSD
PROPOSED FY 2001 OBLIGATION AND FUNDING SOURCE: $2,300,000 DA; $676,000 CSD
INITIAL OBLIGATION: FY 1996 ESTIMATED COMPLETION DATE: FY 2005Summary: This special objective (SpO) responds to the U.S. national interests of strengthening democracy and fostering respect for human rights under the Mission Performance Plan. Gender equality is now universally accepted as being a prerequisite for sustainable human development. In India, although some progress in women's development has been made, women continue to lag behind men. The adverse sex ratio, poor educational and nutritional status, inequality in wages and prevalence of violence against women, including coerced trafficking, point up the glaring inequalities in key areas of social, political and economic decision-making by women in India. According to the United Nations Development Program (UNDP) Human Development Report (1999), literacy rates for female were 39.4% as opposed to 66.7% for males. Perhaps the most telling is the figure for "missing women" as reflected in excess female mortality and the declining gender ratio. For example, according to the 1996 Sample Registration System Projection of the Government of India (GOI), there were only 926 females for every 1,000 males. Finally, trafficking of women and children has emerged as another major social concern.
This special objective on gender seeks to expand women's role and participation in decision-making by supporting activities in the areas of microfinance for women, girls' education, and combating violence against women. In the area of microfinance, USAID has initiated a new activity that creatively adds information technology as a tool for promoting livelihoods of low-income craftswomen. The education activity is now focussed on strengthening the capacity of education providers including government institutions and civil society organizations to boost enrollment and retention of girls in primary schools in Uttar Pradesh (UP). Research on domestic violence financed under this objective is being widely disseminated. The challenge today is to develop a strong advocacy platform and strategy in this area.
In FY 2000 and FY 2001, ongoing activities in micro-finance for women, girls' education and violence against women will be continued. In addition, USAID will fund a new bilateral micro-finance activity to link poor women with the formal commercial banking system as well as initiate new activities in the areas of education to eradicate child labor and anti-trafficking of women.
Key Results: The special objective has three results related to the ongoing activities: (1) increased number of women clients receiving financial services from participating institutions; (2) increased number of local institutions collecting data or assisting in informed advocacy on violence against women; and (3) increased enrollment and retention of girls in primary schools in one district in Uttar Pradesh (UP).
Performance and Prospects: Through USAID assistance, Friends of Women's World Banking (FWWB) trained non-governmental organizations (NGOs) in strategic business planning which exceeded the planned target. As a result of the training, outreach of financial services to low-income women is expected to increase by almost 60%. FWWB also developed a comprehensive training module in strategic business planning, which has been field-tested and is being translated into two regional languages. FWWB also developed and is distributing an affordable financial software package to meet the demand of women's microfinance institutions, which want to better manage their loan portfolios. A major achievement of this activity is that FWWB built an excellent pool of experts drawn from trained NGOs and is using them as a resource to reach out to more organizations. The impacts of this activity have exceeded expectations. Today, these same NGOs are conducting regional training programs bringing small grassroots organizations into their fold.
Primarily research-based, the USAID violence against women (VAW) activity fills a critical information gap by establishing a national database on patterns and trends of domestic violence that can serve as an advocacy tool for effective judicial and medical responses to VAW. The research is being conducted by Indian centers on women's studies, some of whom are recognized as the best in their field. In 1999, the draft reports on best practices in the states of Maharashtra, Madhya Pradesh, Gujarat and Karnataka were completed. A summary report of the key findings was prepared and widely disseminated by the USAID grantee, the International Center for Research on Women (ICRW). ICRW researchers completed the analysis of records of police cells and hospitals on domestic violence. The studies on court records and NGO records are in their final stages of completion. The multi-site population-based survey carried out by the International Clinical Epidemiologists Network in seven different geographical sites of India was completed in October 1999. The focus throughout 1999 has been on dissemination of the research findings, refining the advocacy strategy with the aim of generating awareness around the issue of domestic violence, sensitizing stakeholders, and advocating for programs and policies to address the problem. As a result, many partner organizations are organizing advocacy campaigns, and advocating new legislation. The Indian Social Institute, a reputed local NGO, will publish an article on the research findings in their development journal, "Women's Link." The Center for Women's Development Studies, in New Delhi, has expressed an interest in placing the reports on their website. The "Beijing+5" draft report cites USAID-funded research on the subject. Considerable interest has been expressed by various women's groups to disseminate the findings and recommendations among their respective constituencies.
In FY 2000 and FY 2001, USAID will continue to address the issue of violence against women through ground breaking research on male responses to domestic violence, and documenting and evaluating community-level responses to domestic violence.
In September 1999, with USAID support, the Academy for Educational Development (AED), assumed the mandate of strengthening the organizational capacity of state education institutions like the District Institutes of Education and Training (DIETs) in UP to improve girls' education. Also, AED will work closely with the operating partners of Catholic Relief Services (CRS) and equip them with tools and knowledge to enable them to achieve the objective of increased enrollment, retention and completion of girls in schools. AED is currently in the process of setting up a girls' education coordination center, Bringing Education through Innovation (BETI), a term of endearment for daughters. It is envisaged that the BETI center, among other things, will serve as a clearinghouse for information on program interventions for encouraging girls' education; will become a repository of training materials developed by other programs; would ensure dissemination and discussion of policy, research, and evaluation studies; and build networks and coalitions for advocacy.
Possible Adjustments to Plans: USAID plans to initiate new activities in the area of microfinance for poor women and education to eradicate child labor. With Asia and Near East Bureau regional resources, new initiatives in the areas of anti-trafficking of women and children, and child labor are also planned. We plan to work with federations of poor women's self help groups to help strengthen their capacity in accessing and managing loans; link them with commercial banking systems; and to help make these federations financially viable. USAID will review and revise this special objective's results framework to incorporate results for the new activities.
Other Donor Programs: The UN agencies, World Bank, British Department for International Development (DFID), Swiss, Dutch and Canadian Governments support credit and enterprise programs for women. Most of these programs focus on women's self-help group formation and development of home-based enterprises. USAID focuses on upgrading the technical and managerial capabilities of non-traditional financial institutions, which, by operating on a sound, sustainable basis, will increase the quality and quantity of the financial services they provide to women.
Donors such as the World Bank, the DFID and the UN agencies largely dominate the primary education sector in India through their support to the GOI's District Primary Education Program to improve coverage and quality of primary education in several Indian states. However, none of these donor programs have a specific gender focus or address specific and sensitive factors affecting girls' participation in school. Similarly little attention has been given to strengthening the capacity of education providers (both public and private) or informal schools for inaccessible communities. USAID activities fill a critical gap by strengthening the capacity of public and private education providers such as CRS in promoting girls' primary schooling in UP. The BETI center will help carry this agenda further through its advocacy and alliance building role.
In the violence against women area, other donors have assisted support services or legal awareness programs.
Principal Contractors, Grantees or Agencies: Academy for Educational Development (AED), International Center for Research on Women (ICRW) and sub-grantees, Friends of Women's World Banking (FWWB), PeopLink, and other local institutions.
Selected Performance Measures: Baseline
(1996)Target
(1999)Target
(2000)Target
(2001)Increased number of participating institutions trained in strategic business planning 0 50 N/A N/A Increased number of local institutions collecting data or assisting in informed advocacy on violence against women 0 30 N/A N/A Training module being used in 'X' new blocks in Uttar Pradesh 0 12 6 N/A U.S. Finance Table (Microsoft Excel)
ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Increased Capacity of Financial Markets and Government to Transparently and Efficiently Mobilize Resources, 386-011
STATUS: New
PLANNED FY 2000 OBLIGATION AND FUNDING SOURCE: -0-
PROPOSED FY 2001 OBLIGATION AND FUNDING SOURCE: $9,000,000 DA; $5,000,000 ESF
INITIAL OBLIGATION: FY 2000 ESTIMATED COMPLETION DATE: FY 2006Summary: This strategic objective (SO) will respond to the U.S. national interest of economic prosperity including broad-based growth under the Mission Performance Plan. The launch of this SO is contingent upon the lifting of sanctions on non-humanitarian assistance. The purpose will be to increase the capacity of financial markets and government to transparently and efficiently mobilize resources for development. The SO will build on past successes in financial markets development and will initiate activities in areas which have been identified as high priority to achieving economic growth.
Today, India is a large ($400 billion) economy. However, with 35% of its one billion population living below the poverty line, it has more poor people than Africa and Latin America combined. In 1997, per capita Gross National Product (GNP) was $390, placing India in the bottom quartile of a ranking of 157 countries. Absolute poverty remains large because the post-independence Indian economy has substantially under-performed relative to its potential. Accelerated growth is essential for significant reduction of poverty in India. The drop in the percentage of people living below the poverty line from about 55% to 35% since 1973-74 is mostly attributable to economic growth (World Bank Report, 1997). There is a widespread consensus that India can achieve a trend rate of growth of at least seven percent, provided it launches a second generation of economic reforms. A two percentage point increase in annual economic growth from the current five percent to seven percent, sustained over the next fifteen to twenty years, would make a significant contribution to poverty reduction in India.
Higher economic growth and poverty reduction require major reforms. Financial markets must do a much better job of mobilizing and allocating domestic and international financial resources than at present. While significant improvements have been made in financial markets efficiency and transparency in the past five years, the job is only half done. In the areas of monitoring and surveillance, secondary debt market development, and self regulations the markets remain below international standards. Securities markets have barely begun to be tapped to raise capital for urgent infrastructure projects, which is conservatively estimated at $350 billion by 2006.
A prudent and fair fiscal policy that is efficiently administered at both the center and in the states is urgently needed. At present, India's performance in fiscal policy and administration is weak. Deficits are much too high by any standard. The tax base, is too narrow. Expenditures on unmerited subsidies are excessive, and administration is uneven. The consolidated fiscal deficit (center, states and public sector undertakings) in 1998-99 stood at over 10% of the gross domestic product (GDP). Much of the problem is at the state level with states contributing nearly 3.9% of GDP to the consolidated fiscal deficit in 1998-99. Increased state governments' borrowing to finance the deficit is pushing up interest rates and crowding out private sector borrowings. Sharp reductions in capital expenditure, in attempts to reduce the fiscal deficit, is also leading to large cutbacks in infrastructure development at the state level.
Adequate physical infrastructure - roads, ports, and a dependable and widespread telecommunications network that supports a speedy and vibrant information highway-are fundamental to faster economic growth. Surveys of multinational and domestic business have cited inadequate infrastructure as one of the main constraint to investing in India.
To deal with the above problems, the Mission plans to initiate and fund in FY 2001, the regulatory component of the FIRE activity and the state fiscal reform and infrastructure development activity.
Key Results: Performance measures will be identified during the design phase of activities.
Performance and Prospects: The Mission already has extensive experience in working in financial markets reform through the Regulatory component of the Financial Institutions Reform and Expansion (FIRE) activity. Some design work has been done earlier on state-level fiscal policy reform and an infrastructure program. Accordingly, the start-up of this SO is expected to be within the anticipated timeframe.
Possible Adjustments to Plans: Strategic Objective 11 will commence with resumption of the Regulatory component of the FIRE activity. The activity will initially focus on raising India's securities markets to international standards of transparency and efficiency. Components will be added, as needed, to assist private participation in insurance and pension fund management, in order to expand availability of long-term capital for infrastructure development.
Further, activities will be launched at the state level in fiscal policy reform and infrastructure development. During the decade of the 1990s, devolution of authority and power to the states was a major political and economic change in India.
In the area of fiscal policy, USAID will explore, in consultation with state governments, possible areas of intervention on the revenue and expenditure sides. These might include assistance to introduce the Value Added Tax (VAT), the strengthening of tax enforcement, training in better expenditure management and controls, and/or improved debt management, and budgeting and analytical capability to develop and assess impact of changes in fiscal policy.
USAID will work with state governments to identify infrastructure policy, regulatory and institutional issues that need to be addressed to attract and mobilize increased public and private sector resources for infrastructure development.
Also, at the national level, USAID will explore the role of assistance in improving telecommunications and information technology infrastructure with specific focus on the spread of the Internet as a tool of development and commerce. Wider and deeper access to information technology/Internet, especially by people located in distant rural areas will benefit them in agriculture product marketing, education, in the promotion of responsive governance, development administration, etc.
U.S. assistance, among others, will be based upon criteria such as states' commitment and readiness to reform, absorptive capacity, concentration of complementary USAID interventions, and relative need.
Other Donor Programs: The World Bank (WB) and the Asian Development Bank (ADB) have state- level program adjustment loans including fiscal reform; they also have programs at the center and state levels for infrastructure regulatory reform and development. The British Department for International Development (DFID) has activities to assist fiscal policy reform and infrastructure regulatory reform and development at the state level. The World Bank is active in financial markets development.
Principal Contractors, Grantees or Agencies: Principal contractors, grantees, or agencies will be identified when implementation of activities commences.
Selected Performance Measures: Performance measures are yet to be identified.
U.S. Finance Table (Microsoft Excel)
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Last Updated on: November 17, 2000 |
