#DEVELOPMENT CLINIC #SPECIAL SCHOOL #RESOURCE CENTRE #PARENT TRAINING
Our team of developmental specialists are engaged in community services as well as field-based research activities on child development. We have worked in collaboration with UNICEF as well as with well-known non-profit organizations like Amar Seva Sangam (Tamil Nadu) and Ummeed (Mumbai) in various projects. We are also a partner member of the global network for Early Childhood Development, ECDAN.
CURRENT ACTIVITY
1. We are running a multi-disciplinary child development clinic in Kolkata in the name of Unmesh Clinic, 6 days a week. This clinic provides state-of-the-art specialized services for assessment and management of all neuro-developmental disorders.
2. We are running a school for special children in Kolkata as Unmesh Special School, 5 days a week, 10AM-2PM.
3. We are setting up a Resource Hub named ‘Smarajit Memorial Resource and Activity Centre’ to generate awareness on Early Childhood Development among urban parents from all socio-economic strata.
4. Starting an interactive program for mother child groups through group meetings, activity programs for children, ‘Mama and Me’ programs, childrens’ book library, toy library and free play area for children of all socio-economic strata, thereby providing children with a rich stimulating environment with ample early learning opportunity.
HISTORY
We have been working to promote child development and early intervention for over a decade as “Udbhaas”. Recent organizational changes were made for better coordination of our services, and we rebranded ourselves as UNMESH. The people at the administrative level and those responsible for administering care and education remain the same. As the services provided are continuing as Unmesh, any references to “Udbhaas” in these pages relates to work done prior to the name change (May 2022) as well as some shared responsibilities.
Our achievements so far reflect our existence under Nanritam, a pre-eminent NGO operating in the state of West Bengal. We started out as Udbhaas, a unit focused on developmentally challenged children 11 years ago. We have been running a clinic and a school to nurture our target population and their primary caregivers. While the clinic helps in identifying children with developmental challenges, the school provides a platform where these challenges are met head-on and resolved with the participation of personnel with the necessary skill set. Obviously, these would not be possible without the help and participation of parents and caregivers. Our transition from Udbhaas to Unmesh reflects the next phase of our journey where we are trying to morph into an independent organization focused on developmental challenges in both rural and urban settings. Our achievements reflect the shared root of Unmesh and Udbhaas and, therefore, reflect our shared achievement.
Our impact over the last decade [2011-2021]
1. RURAL CLINICS
We have been working on child development and Early Intervention in the remote, rural district of Purulia (spanning across 6259 km2, with a population of 2,930,115 of which 87.26% live in villages) since 2011. Our focus has been on neuro-developmental follow-up of high-risk newborns, early detection of developmental delays and Early Intervention. We run a multi-disciplinary developmental clinic in the village area (on weekends), catering free services to more than 1500 enrolled children with developmental challenges. As a team of specialists, we are also continually involved in capacity building and awareness generation among doctors, nurses, teachers, field workers and parents. Since 2011, we have been working in collaboration with UNICEF.
Children with developmental delays are referred to us from across the district by field level health workers like ASHA, ANM and AWWs, by the mobile health team as well as by the District Early Intervention Centre at the District Hospital. Our centre has been functioning as a referral unit for the district, as well as the adjoining state of Jharkhand. We are proud to serve the children referred to us by the Govt Health machinery.
Until 2020 (prior to the COVID pandemic) we had screened 8111 children and had identified 928 children with developmental delays/ challenges from across the district. (Table 1)
Table 1: Patients screened and treated annually
Year | Screened | Identified | |
2012-13 | 638 | 168 | |
2014 | 640 | 111 | |
2015 | 733 | 169 | |
2016 | 1600 | 134 | |
2017* | 1500 | 142 | |
2018* | 1200 | 110 | |
2019* | 1800 | 148 | |
Total | 8111 | 982 | |
Chart 1: Distribution according to referring agent in 2018-2019 is as follows
Chart 2: Diagnosis wise distribution
In 2020 we adopted a novel project in Purulia for home-based Early Intervention services to children detected with developmental challenges through the agency of field level workers (FLWs), whom we had trained up. We have now 81 such children in remote villages who are receiving regular weekly therapy sessions at home from our FLWs, whose service delivery is being closely monitored by our specialist team from the backend utilizing a mobile application. Thus, we are enabled to reach out to the ‘unreachable’, that too, in a cost-effective manner.
2. URBAN CLINIC
We run a multi-disciplinary child development clinic fully equipped to diagnose and treat various neuro-developmental disorders. All patients are primarily examined and assessed by a senior Developmental Paediatrician, following which a therapy program is assigned and therapies provided by the specialist team. Here we have facilities for developmental assessment of children from 0-6 years, intelligence testing for 6-12 yrs. and screening and assessment for autism, behavioural abnormalities and learning disabilities. Tools used include DDST II, DASII, Stanford Binet test, ISAA, CARS, ESDM etc. We also run a neuro-developmental follow-up clinic for high-risk newborns to pick up developmental problems as early as possible. This clinic has been functioning from 2008 and till date we have 969 children enrolled with us. Patients are coming not only from the city and its suburbs, but also different districts of West Bengal and Bangladesh too.
Chart 3: Geographical distribution of patients
3. SPECIAL SCHOOL
This unit provides regular, structured, play based educational support programs and group activity to children with mental challenges and learning & behavior problems, which include mental retardation, Autism Spectrum Disorder, ADHD & learning disabilities. Here we stimulate all-round life-skill development & ADL and help prepare them for main-streaming to regular schools eventually. Our major focus is on improving communication skills, socialization, attention and concentration. We provide 1:1 as well as classroom sessions, which include play, music, sensory integration and simple Yoga in addition to basic education. Presently we have 55 students enrolled with us, ages ranging from 3-18 years. Of them 65% are in the autism spectrum. Many are still wait-listed.
4. COUNSELLING & ADVOCACY
Our team constantly works with the parents, to sensitize them to their child’s problem. Parents are groomed and actively involved in the regular therapy procedures. We also actively take up issues on advocacy for the child with special needs at schools and other social settings. Regular parent training and awareness programs, webinars and classes are being organized.
5. DETECTION AND EARLY INTERVENTION PROGRAMS AT COMMUNITY LEVEL
We have been conducting developmental delay detection and early intervention programs in Purulia since 2012 and have screened more than 4400 children from the rural areas of Purulia and have detected more than 800 children with various delays/ challenges.
6. TRAININGS & CAPACITY BUILDING
Udbhaas organizes training and awareness programs on Developmental challenges, their identification and management and Early Childhood Development (ECD) for various groups of professionals and care givers, which include Pediatricians, primary physicians, nurses, schoolteachers, ICDS workers, supervisors and project officers, community-based caregivers and parents.
a) Trainings at various levels have been provided, both in the city as well as in rural settings to more than 3000 trainees so far.
b) In a project on Early Childhood Development, we have provided a 3-day training on ECD to 550 field level workers (ASHA, ANM and AWWs) from 2 blocks in rural Purulia during 2018-19.
c) 230 FLWs and Supervisors have been trained in the district of 24 Paraganas, West Bengal in 2022 on ECD-Nurturing Care. Many of these trainings are supported by UNICEF.
7. RESEARCH PROJECTS (In Collaboration with UNICEF)
We have been working in collaboration with UNICEF since 2012 till date, on various projects on
- Neurodevelopmental follow-up of high-risk newborn
- Early detection of Developmental Delays,
- Impact on Early Intervention
- Early Childhood Development
Our research work has been published in various international medical journals and has been presented at different international conferences.
| Table 2: Projects with UNICEF | ||||
| YEAR | OBJECTIVES | ACTIVITIES | NUMBER | TOTAL |
2011-13 Neuro-Developmental Screening & Intervention for Neonates Discharged from Sick Newborn Care Unit (SNCU), Deben Mahato Sadar Hospital, Purulia Budget INR 1011120 (USD 18192) | Developmental screening of SNCU graduate Capacity building | Tracking of babies Screening Detected with dev delay EI started Started Dev clinic at Para | 634 434 135 135 | Screened 1921 Detected 467 Trained 1667 Awareness program for 700+ Families reached for ECD:3000+ Home visits 102 ICDS visits 92 Mothers’ meetings 30 |
| Training of doctors/nurses/PHN/ICDS supervisors (3-day) | 128 | |||
| Awareness program for parents/care givers | 400 | |||
2013-14 Proposal For Detection and Early Intervention Program for High-Risk Babies and Neuro-Developmentally Challenged Children in Purulia Budget: INR 1570800 (USD 28560) | Screening of all high-risk babies Provide Early Intervention Popularize home-based EI | Training of FLWs (own team) | 40 | |
| Training on RBSK implementation for mobile health teams (Pan district) | 60 | |||
| Started DEIC at State hospital | ||||
| Field work in 10 blocks | ||||
| Started 2 satellite clinics | ||||
| Home based detection by FLWs | 120 | |||
| SNCU graduates screened | 134 | |||
| Detection from SNCU graduates | 42 | |||
2014-15 Follow-Up Of High-Risk Newborns and Promotion of Early Detection and Early Intervention in Developmental Delay in Purulia, West Bengal. Budget INR 1191980 (USD 19696) | Make early intervention therapy available to all challenged children Increase awareness among all stake holders | Training of ANMs from all blocks | 645 | |
| 4 Satellite ND Clinics (each for 4-5 blocks) | ||||
| Total patients seen | 512 | |||
| New patients | 101 | |||
| SNCU graduates screened/assessed | 152 | |||
| Detection from SNCU graduates | 69 | |||
2016-17 Promotion And Evidence Generation: High-Risk follow-up of SNCU Graduates Budget INR 2414000 (USD 35380) | Systematize & strengthen follow-up of SNCU graduates through capacity building and awareness generation To promote and pilot a comprehensive survival, growth & development package for high-risk babies | Developmental and nutritional screening in one block | 1806 | |
| Screening at ICDS centres | 22 | |||
| At Dev clinic total cases | 1081 | |||
| New cases | 318 | |||
| Training of AWWs on ECD | 194 | |||
| TOT for CDPOs in 2 districts followed by monitoring | 46 | |||
| Awareness programs for AWW and care givers | 300 | |||
| Field visits with interactive sessions with mothers and AWWs | 82 | |||
2018-20 Convergent Project on Early Childhood Development Budget INR 3344000 (USD 47770) | Demonstrate a comprehensive and convergent ECD and EI programme for children 0-3 years, involving frontline workers and parents, utilizing the revised MCPC card A state level workshop on ECD & EI, parenting, early detection of developmental delays and intervention. | 3-day training of FLWs (ASHA, ANM, AWW): 10 such | 554 | |
| Ongoing Monitoring& On-Site Training | ||||
| Home visits by trained FLWs: parental awareness generation | ||||
| Number of families reached: (from 2 blocks) | 3000 | |||
| Mothers’ meetings | 30 | |||
| ICDS centre visits | 92 | |||
| home visits by trainers | 102 | |||
| Advocacy Workshop: Multisectoral Approach in Early Childhood Development: From Policy to Practice’, on 12/12/19 at CII Suresh Neotia Center, Salt Lake. | 220 attendees |
8. PUBLICATIONS
Various publications include:
Training modules for doctors, nurses and ground-level health workers on Early Child Development: Detection & Management of Developmental challenges (approved by UNICEF)
Books on Parenting
Books on developmental problems written by our specialists, for mass awareness
Books on Early Teaching methods for children with special needs
Guidebooks on ECD-Nurturing Care activities
Storybooks for children
- Various scientific publications in medical journals
Chattopadhyay Nandita1, Aneja Satinder2. The Status of Early Childhood Development in India: Will We Reach the Countdown to 2030 Targets? Indian Pediatr. Volume 58, Supplement 1– October 15, 2021
Chatterjee N, Basu S. Comparative Study About Impact of Inadequate Psychomotor Stimulation on Neuro-Development in Pre-School Children in Rural India. J Nepal Paediatr Soc. 2020;40(2):78–86.
Chattopadhyay Nandita. Cross-Sectional Study to Identify Risk Factors for Impaired Early Childhood Development in Rural India. Int J Child Health Hum Dev 2020;13(4)
Chattopadhyay N (2019) Early Childhood Development: The Buzz Word in Child Health Today. J Community Med Public Health Care 6: 061.
De P, Nandita Chattopadhyay N. Effects of Malnutrition on Child Development: Evidence From A Backward District Of India. Clinical Epidemiology and Global Health, https://doi.org/10.1016/j.cegh.2019.01.014
Banerjee A, Nandita Chattopadhyay N. Impact of Malnutrition on Neuro-Development in Children From a Marginalized Rural Community In India, International Journal of Scientific Research: Volume-8 | Issue-2 | February-2019 | ISSN No 2277 - 8179
Chattopadhyay N, Saumitra M. Developmental Outcome in Children with Malnutrition. J Nepal Paediatr Soc 2016;36(2):170-177.
Chattopadhyay N, Mitra K. Neurodevelopmental Outcome of High-Risk Newborns Discharged From Special Care Baby Units In A Rural District In India. Journal of Public Health Research 2015; volume 4: No 1; pp7-12
Our impact over the next decade [2022-2032]
FUTURE PLANS:
1. We propose to extend into the rural community in the 2 districts we have been working with a project on holistic child development for all, which will include promotion of early childhood development in all children (0-5 years), early detection of any developmental delay through screening and streamlined management of these children with special needs through a homebased approach. For this project we will need to adopt an integrated approach and involve local personnel, whom we will have to train. It is estimated that if we serve a cohort of 1000 children, of whom 60-100 may have a developmental delay, the total cost involved will be approximately INR 500/child/month.
2. To reach out to the unreachable, we need to probe deeper into the rural areas, for which we propose to procure a vehicle which will carry an exhibition: ‘ECD on wheels.’ This will incur a onetime expenditure of INR 15,000,000/- and a running expenditure of approximately INR 80,000/- per month.
3. To spread the message of ECD far and wide, many more voluntary organizations and the government machinery need to get involved. With the educational resources we have generated, we are eager to start a training cell for various categories of service providers. Any onsite training for 40-50 persons for 2-3 days incurs a cost approximately INR 2,00,000/-.