Partnerships, planning and pitching for scale up of Atmiyata project in India
10 minutes: the pitch
After 5 hours of waiting on one of the hottest days (48º Celsius!) ever recorded in Ahmedabad, Gujarat, Mr J P Gupta, Commissioner of Health, Medical Services & Medical Education and Principal Secretary, Health & Family Welfare Department, Government of Gujarat, had finally finished his meeting on the heat emergency to hear about the Atmiyata (shared compassion) innovation.
Dr Soumitra Pathare, on behalf of the Atmiyata team, started his pitch with a clear message:
“Atmiyata will perfectly complement the government’s District Mental Health Programme. We will fill the mental health treatment gap at the community level for common mental disorders and also drive demand for government mental health services through referrals of people with severe mental disorders. We will do this by training volunteer community leaders from existing women’s Self Help Groups (Sakhi Mandals) and Milk Co-operatives (Dudh Mandalis).”
Soumitra’s slick presentation used infographics to explain the pilot study results, a smartphone to demonstrate the project’s awareness raising films, and ended with a clear ask from the Commissioner:
“We would like the government’s cooperation in scaling up Atmiyata in Mehsana District, Gujarat”.
Soumitra’s pitch was swiftly followed with an endorsement from Dr Fahmy Hanna, World Health Organization (WHO): “In supporting Atmiyata, the Gujurat government will follow an evidence-based approach that aligns with WHO guidelines and standards.”
Ten minutes and 2 questions later, the Commissioner was sold on the project, instructing the team to give him the full timetable of activities as soon as possible. A seemingly effortless policy change. But in reality the preparation for this moment took much longer: 5 years and 3 days led up to these crucial 10 minutes.
3 days: Planning stakeholder engagement for scale up
Soumitra’s 10 minute pitch was delivered to perfection. It had a strong message, clear results and a concrete ask – music to any Communication Manager’s ears! Granted Soumitra is a great presenter, but the messaging was not pulled together on a whim. It took strategy and planning.
I was able to take part in the meeting with the Commissioner as MHIN were India for a stakeholder engagement country visit (see previous posts on visits to the Friendship Bench, Zimbabwe and Family Networks for Kids, Pakistan), where we are funded by Grand Challenges Canada to work with mental health innovators to plan for scale up. Over our 3 days in Maharashtra and Gujurat, Dr Fahmy Hanna, WHO, Josephine Tsui, Overseas Development Agency (ODI), and I worked with the Atmiyata team on stakeholder engagement plans for scale up:
- Identifying challenges to scale up and objectives on how to overcome them, e.g. the long-term sustainability of community worker supervisors
- Deciding on strategies to achieve the objectives
- Learning from case studies of scale up in other countries
- Using communications techniques and tools to prepare compelling pitches and infographics
- Monitoring progress on objectives for course-correction
That 10 minute pitch was the result of working with an enthusiastic and knowledgeable team willing to take an afternoon to carefully plan the key messages and create compelling infographics of pilot study results.
5 years: Partnerships and evidence
But a pitch alone won’t change policy. Evidence the innovation works and strong relationships with scale up partners are also needed.
Demonstrating success of the innovation depended on community health workers, or Champions, with enough compassion to volunteer for the Atmiyata pilot project, and a local NGO with good relationships in a rural district. Over 2 years the team worked with NGO BAIF in Nasik district, Maharashtra, a rural area with strong communities of low socioeconomic status. With 7 days training by the project the 60 Champions worked with 2 trained, paid supervisors to provide community care to 14000 people.
“I volunteered for Atmiyata because I believe in working together for a stronger community.”
- Mr Manohar Borse, Champion and Farmer’s Club leader in Jambhulmal, Peth, Maharashtra
Thanks to the willingness of the Champions to volunteer and look after their communities, Atmiyata has been a success. Without evidence to demonstrate Atmiyata works (to be published soon) the Gujarat government would not have supported the scale up of Atmiyata to 1 million people in Mehsana district, Gujarat.
Following the successful results of the pilot phase in Mahrashtra (where a dissemination workshop is planned with state Government on 27 May), the project is now moving into a new phase in Gujarat. Atmiyata can only work at scale if the team partners with policy makers who also want to improve mental healthcare. Thankfully, the team has worked for 5 years through mental healthcare improvement initiatives to build partnerships with policy makers in Gujarat at all levels – state to district to local. It was the support of policy makers - particularly that of Dr Ajay Chauhan, State Nodal Officer for Mental Health, Department of Health and Family Welfare, Government of Gujarat - that made sure the Commissioner not only agreed to come to the meeting but was also briefed before he arrived. In Gujarat, with a supportive government, the Atmiyata team can now deliver in terms of quality service and quantity at scale.
My main takeaway from MHIN’s visit to Atmiyata? Policy change takes time and needs a combination of partnerships, evidence, and planning and compelling communication skills. What seemed like an effortless pitch during the Commissioner’s meeting was actually the hard work of many people over 5 years all striving to improve mental healthcare in India.
Main Photo Caption: MHIN visit Atmiyata volunteer Champions in Aad Budruk village, Peth district, Maharashtra State, India