| 1. Background Karuna Trust(KT) and Vivekananda Girijana Kalyana Kendra (VGKK) are both voluntary, non-profit orgainzations (see www.vgkk.org and www.karunatrust.org for details). Both organizations are committed to rural and tribal development. Both organizations are built on strong values of personal integrity, volunteerism and service to mankind. Both organizations present several short-term opportunities for visitors/volunteers/researchers. In the past, such opportunities have helped visitors benefit in their career/their understanding of the dynamics in rural and tribal areas. An important learning for us is that there is a need to align the aspirations of the visitors and the needs of the organization to achieve a shared objective for such short-term associations. This helps in mutually sharing the benefits of the work that the visitor undertakes between the community we serve and the external organization/individual. The present document presents a brief outline of opportunities at KT and VGKK and is a pre-requisite for considering short-term associations/voluteership/reasearch at KT and VGKK. 2. Short-term opportunities 1. Voluteership: Volunteers are individuals who would like to 'volunteer' for working at any of the different field sites/offices of KT and VGKK. They can expect to be exposed to working in 'challenging' settings. They shall be assigned to a unit with a supervisor. This will be decided by a designated coordinator in consultation with the Secretary. It is expected that volunteers will self-finance their stay and will bear the expenses for the accommodation and food provided. The working committee may choose to waive this in certain cases. 2. Internships: Internships are ideally for students - graduate/post-graduate in social sciences or public health. Interns are assigned to a supervisor. Programs for interns will be discussed and outputs in terms of reports or activities may be worked out in consultation with the intern. Interns are generally supported by organizations sponsoring them. KT and VGKK will provide basic facilities at a subsidized cost. 3. Rural postings: These include posting of medical or para-medical professionals to the various health centres run by KT or VGKK. The terms are pre-determined by the institution which sends the individuals. This includes posting of students from medical colleges who will report to the medical officer of the centre assigned. An orientation may be given regarding KT and VGKK's approach to primary health care. Attendance and participation in clinical as well as field activities shall be obligatory. 4. Projects: Individuals/institutions may take up projects for activities or operational research. This will be worked out after consultation and mutual agreements with the Secretary and coordinators at the head office. 5. Fellowships: KT and VGKK offer fellowships for a fixed period of time. Fellows may be supported by other organizations for their stay. They generally include professionals who would like to work on a specific project for experience or research. Fellows may design their work in consultation with one of the coordinators.
3. Broad guidelines All visitors/fellows/interns are expected to conform to the following guidelines. Complete agreement to these is essential pre-requisites for the official recognition of the work with KT and VGKK. 1. Mutual benefit: KT and VGKK hope to provide a learning experience for the visitor clearly derived through field experience. KT and VGKK being non-profit service-oriented organizations promote and encourage work that is meaningful to the community directly or through support to our projects. A specific benefit to Karuna trust either in the form of data being documented, interventions that have been beneficial to the community or improvements in current practices/service delivery is encouraged. 2. Approval: All field level activities should be approved directly and beforehand by the Secretary or the Coordinator (Health and Research). Activities taken up without such approval may be considered as a violation of the terms. 3. Full disclosure: Data and information acquired from staff at the health centres or at VGKK involve privileged communication with individuals in the community and cannot be shared especially if their application will be done for any proprietary or commercial reasons. If the work involves any data collection or information gathering, full disclosure of all the instruments, methodology and details of what is going to be done with the information will have to be provided to the head office. (See data policy below) 4. Dissemination & feedback: At the end of the association, a meeting should be held by the Fellow/Intern with key Karuna Trust staff to present findings and copies of the report should be submitted for the posting to be recognized. A meeting with the staff of the head office for feedback on logistics and arrangements is also foreseen. Reports on the field activity by the Fellow/Intern – one for Karuna Trust records, one for the field level service providers, one for any funding agency and one for the fellow/intern may be required. 5. No monetary benefits shall be given to field staff of Karuna Trust directly. Any financial transactions will be undertaken through the Karuna Trust head office in Jayanagar, Bangalore 4. Data policy Research is not an individual experience. It is shared knowledge based on a common understanding of some aspect of the physical or social world. For that reason, the social conventions of research play an important role in establishing the reliability of scientific knowledge. If these conventions are disrupted, the quality of research can suffer. KT and VGKK are action-based organizations which are largely involved with implementation of people-oriented and community-based programs. Pure research has almost no standing in our setting and we encourage applied or operational research. Data shall mean all information including electronic, printed or verbal communication. Fellows or interns shall be sensitive to the privileged nature of information that is gathered especially regarding patients and their communication with doctors. Please note the following points about data collection and any deviation from the following shall be considered as a violation of the terms of association with KT and VGKK. 1. Interference: Data gathering and the procedures should not hamper the functioning of the health centre or program. Audio/video recording or photographs may require permission from the person in-charge of the setting. 2. Exclusion for individuals: KT and VGKK encourage individual learning by participation in the various activities. The following data policy does not apply to people who intend to enrich their individual learning through field-level experience. 3. Sharing of proposal: Interns/Fellows shall follow the policy of 'full disclosure' of all affiliations and projects as may be relevant. The research proposal and methodologies shall be discussed with the Coordinator and the Secretary. 4. Sharing of outputs: All the results and the outputs of the research shall be shared with KT and VGKK. Authorships and acknowledgements as may be ethical and appropriate shall be discussed. 5. Copyrights and dissemination: KT and VGKK are non-profit people-oriented organizations and discourage stringent copyrights and patent practices that may exclude ownership and dissemination of research findings. The fellows/interns shall strive to ensure dissemination of their papers/reports or other outputs with the community that helped them with data gathering and with the relevant staff that facilitated this. In keeping with this, they must apply suitable licenses that encourage sharing (eg. creative commons licensing-share and distribute alike) 5. Suggested topics Operational and action research are encouraged. The following topics are guidelines for potential areas of research. Fellows and interns can identify areas of interest and develop on those. These projects should be time bound and the objective should clearly be the following: | Topic | PHCs | BR Hills Gumballi | Others | Specific inputs | | Demographic data | | Human Development Index Ranking, literacy rates, bed population ratio, | √ | √ | | | | Disparity – Health status, health care utilization, BPL, caste distribution, education, housing, income, utilization of health services | √ | √ | | | | I Maternal morbidity | | Causes, statistics, interventions, service delivery, innovations | √ | | | Comparison between PHCs | | Comparison with State/national level data | √ | | √ | This may require obtaining information from other Government bodies/reports | | Maternal mortality – causes, statistics, service delivery, health education, development of IEC material, advocacy | √ | | | | | II Child Morbidity | | Demographic data, nutrition, child to child programs, health education, breast feeding practices, weaning, food security | √ | √ | | | | Immunisation coverage/vaccine storage/cold chain maintenance | √ | √ | | | | Nutrition | | Anthropometric assessments, Health education, child to child programs, nutritional demonstration, role of infectious disease | √ | √ | | | | Non-communicable diseases | | Documentation/screening/health promotion/follow up/treatment/referral services/health education | √ | √ | √ | Special focus on sickle cell anemia in tribal populations | | Mental health – screening, diagnosis, community care, treatment, referral, follow up. | √ | √ | √ | The Manasa project can be studied separately | | Cancer – Knowledge, attitudes and practice, existing services | √ | √ | | | | Elderly health, services available, screening programs, community based care | √ | √ | | | | Disability – Community based rehabilitation, referral services, medical/surgical management, disability reduction | √ | √ | | | | Management | | Capacity assessment of PHC staff, management skills | √ | √ | | | | Primary care services | | Provision of essential services, quality of care, | | | | | | Staff /Personnel | | Capacity/training needs/Knowledge, Attitudes Practice/ Vacancies | √ | | | | | Referral services | | Structures/innovations/emergency referrals/transport/ambulance service | √ | | | | | Pharmacy/Laboratory | | Stock taking/indenting/supplies/staffing patterns/essential drugs and reagents/ quality of lab testing | √ | | | | | Alternative medicine | | Traditional medicine Herbal gardens, demonstration plots, self help groups, roles | √ | | | | | Water and Waste management | | Waste disposal systems, segregation at source, universal precautions | √ | | | | | Water supply | √ | | | | | Training | | Training gaps/quality of training received/further training/special interests/academic interests/Government training | √ | | | | | School health/Anganwadi checks | | Routine screening services, health education, nutritional supplementation programs, training for teachers, First Aid, dental checks | √ | | | | | Panchayati Raj Institutions | | Structure, function, interaction with health services | √ | | | | | Village health and Sanitation Committees/Arogya Raksha Samhiti function/structure | √ | | | | | Community participation | | Community empowerment, self help groups, PRI involvement, | √ | √ | | | | Tribal health | | Specific health practices documentation, immunization coverage, sickle cell anemia outcomes and management. | | √ | | | | Mobile health units | | Coverage area, disease distribution, follow up, drug supply, immunization, health education, IEC | | √ | | | | Health Management Information Systems | | Role in financial and personnel management, reporting delays, training needs of staff, structure of data management, innovations | √ | | | |
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