The initial journey with strong partnership helped MAMTA to emerge as an organization to institution to contribute its core area of concerns. The progress can be seen in following broad sections: a) thematic movement to reflect target based intervention to formation of thematic domain b) evolution of institutional mechanism and c) technological advancement to meet growing need
MAMTA’s initial work was more focused on health of women and children. While improving women and child health, the institute has adopted a Life Cycle Approach (LCA) based on some of the robust evidence brought forward. Over the years, following three population groups have become main target beneficiaries.
Pregnant and lactating women
Children (0-2 years)
Young people including Adolescents (10-24 years)
However, while working with all these three population groups’ boys and men involvement is central in all groups. Meanwhile addressing the physical
factors of development amongst the target beneficiaries, MAMTA also recognized the need of addressing social factors playing a critical role in maternal and infant morbidity and mortality i.e. early marriages, gender inequality, marginalization etc. MAMTA’s contribution through its publications and papers on life cycle approach to address concerns of three segments of beneficiaries played significant role in filling up literature gap nationally and internationally. Over the years MAMTA’s interventions with adolescents (married and unmarried) started receiving recognition by different donor agencies as well as government at Center and State level.
Thus, sexual and reproductive health and rights of adolescents and young people emerged as one of the important themes of MAMTA’s interventions. It has institutionalized the issues of SRHR as a key strategy through its partnership with RFSU (Swedish based International NGO on reproductive and sexual health) and other international institutes. The International learning helped MAMTA to integrated gender, sexuality and rights with SRHR theme from 2003 onwards. It was this time that MAMTA revisited its core issues to impact adolescents and young people health and development through a participatory approach with network partners. This led to identification of six major areas of concern: Sexuality Education; Youth Friendly Health Services; Early Marriage and Early Pregnancy, Education Retention, Sex Ratio and HIV/AIDS. Gender and Rights remained as cross-cutting issues with the aim to reach poorest of the poor and socio-economically marginalized.
Recognizing the inter-generational impact of age at marriage on health and other areas, MAMTA began working on this social determinant in 1999 with the support of John D. and Catherine T. MacArthur Foundation (MacArthur Foundation) in Rajasthan. With continued support from MacArthur Foundation and Swedish Sida, MAMTA expanded this work to four states in the subsequent years advocating for prioritization of the issue with the government through effective implementation of the social legislations, programmes and schemes. MAMTA is a pioneer institute in the area of child marriage having worked on it as an exclusive area of attention. It scaled up its work on child marriage to Nepal and Bangladesh with the support of European Union and continues its fight to end child marriage in India and the South Asian region at large. Results of advocacy for an issue which had very few takers are now apparent, with the central government moving to drafting the National Strategy on Child Marriage in 2013 with MAMTA as one of the lead contributors in its development.
During the same time along with the strengthening and consolidation of SRHR, MNCHN as a thematic area, the institute also felt the need to respond to the emerging need of HIV & TB across the continuum of care through a development approach. Since 1995 the organization was working very closely with National AIDS Control Organization (NACO) and has contributed in its different programme cycles. MAMTA through its partnership with International HIV/AIDS Alliance took the challenge of establishing community based care and support programme for children in low prevalence state of Delhi (2001- 09) and the evidence emerging out of it helped the Delhi State AIDS control society to incorporate the evidence into its state plans for children infected and affected by HIV and ADIS. While a scaled up intervention in more than 100 districts was being done with RFSU, MAMTA in partnership with AusAid took an intervention to integrate PMTCT into RCH in two states of India (2003-08) resulting in significant contribution to NACP-III on PMTCT within the public health system framework. Besides, through its partnership with RFSU and Sida (Sweden) MAMTA started integrating SRH-HIV into all its efforts such as mainstreaming it into YFHS within public health system; into sexuality education with NACO and establishing positive youth group’s district forum in its intervention district and states. All this resulted into MAMTA partnering with Lund University and National Institute of Health and Family Welfare ( 2008-13) to further mainstream SRH- HIV and issues of sexuality ( MSM, LGBT) into trainings of Public health care providers and managers. These development and intervention helped MAMTA to categorize its effort into three board thematic areas. By the year 2005 following thematic division emerged in the institution. All this helped in emergence of HIV & TB as a specific thematic working area within MAMTA.
Though realization of integration of HIV and TB had started since 2007 when MAMTA wrote an approach paper on HIV & TB integration to work in communities with civil society participation. This was the beginning of its work in the area of Tuberculosis, which the institute felt to be addressed in the context of HIV. In 2006-07, MAMTA entered into a partnership with World Vision for Advocacy, Communication and Social Mobilisation (ACSM) and in 2008, it started a long-term project on TB in partnership with International Union against Tuberculosis and Lung Disease (The Union). In 2010, realizing with changing lifestyle and increase in non-communicable diseases, the institute initiated a new thematic area on Non-Communicable Conditions or Diseases (NCC). This was based on MAMTA’s ongoing work in the core sectors of MNCHN and SRHR and growing epidemiological evidences. We followed an integration approach of NCC/ NCDs i.e. ARHS-NCC and MNCHN-NCD’s
MAMTA received the Global Health Award for male involvement in safe mother hood (2000) and during 2003-05 it became a member of WHO-CAH, Technical and Advisory Committee. Similarly, during 2007-09 the organization was members of STAC-WHO, HIV-Aids department at Geneva.
With the progression of thematic division the organization witnessed noteworthy change in number and nature of human resources. The development of human resources has been organic since inception and staff strength has increased many folds in the past two decades from five staff in 1991-92 to 220 in 2013 with significant diversity in gender, caste and religion. With the emergence of new thematic areas like HIV & TB and NCD in recent years, Human Resource Development has attended specific emphasis within the institute with focus on technical expertise along with leadership and managerial skill. Four Thematic Units (verticals) led by sector specialists has emerged as key departments supported by Finance, Administration & HR, and Research & Documentation (R&D). Technical capacity of unites has been strengthened by supporting staffs to attend international programme/workshops and advance training in the areas of internal interest. This is also directed towards developing the second line of leadership within each vertical to drive thematic and institutional agenda. This was a strategic and purposeful move to have adequate programmatic support in case of any changes in the leadership role. In fact, the middle level managers have been given additional charge to lead the units/verticals independently.
The emerging nature of work and spread of national and international operation made it mandatory for the organization to focus on its technical advancement. Emergence of institute as knowledge based technical agency led to automation of resources with the support of computers and internets. Facilitated by Sida ( Sweden ) MAMTA initiated online resource library to provide technical input to its 140 network partners working on sexual and reproductive health concerns of young people. Besides through a web based system ( www.yrshr.org) MAMTA developed interactive and dynamic mechanism to address the concerns of young people. At that time it was unique and pioneer in its nature when getting scientific information on the issue of sexual and reproductive health was a challenge. Though these information was in English making its accessibility difficult for large section of population. Realizing the importance MAMTA came up with additional website known as www.12teen.org in Hindi for large population of the country.
This web site was mainly for young people hence it was important to develop a comprehensive web portal to address the concerns of different segment of stakeholders who have interest in the area of SRHR. The recent web site www.youthcourisity.org is an answer to desired need that addresses need of parents, young boys/ girls and teaches in three languages, Hindi, English and Kannad. The social factors such as child marriage have direct bearing on poor reproductive and sexual health of young people. Realizing insufficient information base at the district level on the issue of child marriage, the institute started a web portal named as www.khub.org to provide information and data to the concerned stakeholders for effective advocacy and implementation of their programme.
Due to enhanced role of IT, the organization has developed a sound IT policy to meet national and international standard. At this state when organization has diversified its operation managed by automation and online system, the larger management has also become compute based. All projects have robust MIS followed by software based data analysis tools (SPSS/STATA), assisted by MIS operation and data managers. Along with physical field support, mobile, internet, Skype have made inroad into monitoring and mentoring of the projects and over the years its importance has increasing realizing MAMTA increased role at PAN India level and in international arena.