In Conversation with Gayatri Divecha, Head of Godrej CSR: Saving Lives from Malaria

Godrej Consumer Products Limited is at the forefront in meeting the UN’s Sustainable Development Goals. The company has also aligned with the Centre’s Social Development Programmes. Among other Corporate Social Responsibility programmes, Godrej’s EMBED programme is making a difference to millions of lives in states like Madhya Pradesh.

The consumer goods company has achieved a tremendous success in reducing deaths due to malaria in the state. Mohammed Rayees ur Rahim of Sakshi Post caught up with Gayatri Divecha, Head – Good & Green, Godrej Industries Limited and Associate Companies to know more about its EMBED programme and how it is saving people’s lives from malaria.

1. What are different initiatives being taken up by Godrej as part of their Corporate Social Responsibility contribution?

At Godrej Industries, we recognise CSR not only as compliance but as a way we do our business and connect with our community. We work in areas where we have a presence and can help solve critical social issues by leveraging our expertise and networks. Over the years, we have aligned our sustainability efforts with the UN’s Sustainable Development Goals, national priorities and the needs of our local communities, to deliver high-impact programmes that are easy to scale. Many of our initiatives are in line with the Government's social development programmes and the priority needs of our communities. Here are some of our key CSR programmes – 

Enhancing livelihoods 

We address a critical need of enhancing the livelihoods of low-income group youth. We collaborate with non-profit organisations to design and run a number of employability training programmes in beauty and hair care, and agriculture and allied services for people from low-income communities. We improve the earning potential of our trainees, by building their skills, providing post-training support and empowering them. Since FY 2012 we have trained close to 600,000 people. By 2025, we aim to train another 300,000 people. 

Elimination of Vector Borne Endemic Diseases (EMBED) 

The EMBED project partners with the Government of India’s mission to eliminate malaria by 2030. We collaborate with non-profits and local governments to fight malaria in high Annual Parasitic Index regions through intensive behaviour change programmes, capacity building of healthcare workers, community mobilisation and increased access to testing and treatment services. Since FY 2016 the programme has reached out to 11.5 million people across India. 

Integrated Watershed Management

Climate change is affecting seasonal weather patterns, leading to either intense precipitation or drought-like events. We are working in partnership with NABARD to help restore the ecological balance of the region and mitigate the risk of climate change for the local farmers in drought-prone regions. In FY 2021-22, we have treated over 7,800 hectares of land, and helped capture over 23.5 million kL of water.

Community Waste Management 

Beyond taking measures to reduce, reuse and recycle waste at our manufacturing plants, we have initiated community waste management projects with the aim to divert waste from landfills. We are working in partnership with local municipalities to scientifically process their waste in an environmentally friendly manner which otherwise would end up in landfill. The project also aims to build capacity and ensure the safety of sanitation workers. In FY 2021-22, we diverted over 5,530 tonnes of waste from landfills.

Access to social security and entitlements

Millions of farmers and construction workers have no employment benefits or any safety net of funds. The government provides a number of welfare schemes for farmers and workers and the benefits range from pension, education and maternity assistance, loans for business, and even accident and medical expenses. We run entitlements enablement programme that connects people to avail welfare schemes and unlock government funds. So far, we’ve helped close to 30,000 people avail benefits and aim to support 500,000 by 2025. 

2. Could you walk us through the Godrej initiative Elimination of Mosquito Borne Endemic Disease (EMBED)?

EMBED is Godrej Consumer Products Limited’s flagship CSR programme running since 2016 when it was piloted in Madhya Pradesh (MP). Being an industry leader in household insecticides with a purpose to protect people from mosquito-borne diseases, investing our resources in the EMBED programme was a natural choice for us. From 2016 to 2021, EMBED has become one of our most impactful programmes. It has reached and made a difference to the lives of over 11.5 million people at high-risk for malaria, most of whom reside in media-dark, high-endemic and largely poor communities.

The successful partnership between Godrej and the MP government led to 89% decline in Malaria morbidity in the state. In 2015, Madhya Pradesh was in category-3 (high prevalence) with 25 districts having malaria cases. In 2021, Madhya Pradesh figured in Category-1 (elimination phase) and was among top 10 states having low malaria cases, owing to strong administrative effort, innovative methods of public-private partnership and responsiveness of the public. The current malaria infection has declined to below 1 case per 1,000 population in Madhya Pradesh which is a 96% decline in malaria cases from 2015 to 2021 in the state, one of the most rapid declines in the world in the same time period. 

3. How is Godrej contributing to India’s national goal of malaria elimination by 2030?

We work in collaboration with the state and local administration to aid their projects for Malaria elimination by 2030. The Government of India and the MP state health department have a well-organised system in place to tackle Malaria and other deadly vector borne diseases. Our role and aim through the EMBED programme is to bridge the gap in the existing framework. This was achieved through working collaboration with ASHA workers, ANMs, and health practitioners, utilising the Health department commemoration of Nutrition days as events to spread Malaria prevention information.

EMBED is a 3 year intensive programme aimed at raising awareness and changing behaviour of endemic and vulnerable communities by fostering local health leaders and propagating a package of practices. In addition, the first 2.5 years are focused on capacity building of local health functionaries (ASHA and Anganwadi workers) and community volunteers, raising awareness in communities, and enabling collaboration with private health practitioners and even faith healers for maximum coverage in the community. The last 6 months are focused on a handover to the local government, CBOs and community so that the work can carry on after we exit the district.

Under the programme, our non-profit partners have developed not just IEC (Information, Education & Communication) and BCC  (Behaviour Change Communication) material aimed at community members, but also e-modules for health practitioners and workers. In addition, we have developed an app for Malaria treatment, which has been adopted by the Health Departments of Uttar Pradesh, Madhya Pradesh & Chhattisgarh. It is available in local languages like Gondi and Halbi for both Android and iOS. This app provides details of the types of Malaria, categorises treatment as per the age of the patient to determine the line and strength of the treatment. 

4. Were there any challenges during the implementation of EMBED in Madhya Pradesh, Uttar Pradesh, and Chhattisgarh states? 

Yes. We have adapted EMBED to cater to the local needs and cultural norms. One example is our core strategy of the project for generating awareness on malaria and dengue among the community was by holding small group meetings or gram chaupals with community members. 

The project management information system (MIS) data showed that by the end of FY2016-17, only 44 percent of all registered households were being reached through gram choupals and VHND. Community members were either finding the timing of the choupals inconvenient or adult members of the households were working in agricultural fields or forests during the day, making it difficult for them to participate in project activities. In 2017-18, we adopted a new strategy of making home visits along with continuing with gram chaupals and VHND to maximise coverage. This strategy worked well and within a year, the MIS data showed an enhanced coverage of 92 percent by the end of FY2017-18. Now we continue to have high coverage of the project in our target villages. 

Another example is the distribution of Long Lasting Insecticidal Nets (LLIN). LLINs are an excellent preventive measure that is affordable and easy to use. The health department authorities typically distribute 2-3 nets for an average family of 5. 

However, considering prevalent cultural norms such as in Chattisgarh where the adult male in a household often sleeps alone on the bed (if there’s one), and the adult female often sleeps with the youngest child, while the other children sleep together; the exception being teenage siblings who do not sleep alongside. If you consider these minor yet crucial details, the number of LLINs’ needed in this family of 5 would be 4 to 5 nets, versus the customary 2 or 3 nets distributed. Our team supplemented the efforts of the health department, and distributed LLINs among houses taking note of the cultural norms and encouraged their regular use.

5. How effective the EMBED programme has been in achieving the predefined goals and outcomes in terms of decline in malaria and morbidity reduction?

EMBED aimed to save lives that succumbed to this deadly vector-borne disease and spread information regarding Malaria prevention. The three key objectives of the EMBED programme are:

1. To improve knowledge, health-seeking behaviour, and community action for prevention, treatment, and control of Malaria and Dengue at the household and community level.

2. Support state government/s in prevention and treatment efforts for malaria elimination

3. Improve capacities of government functionaries and project staff on monitoring and evaluation and data use for planning and decision making

We were able to surpass expectations & projections on achieving all the objectives. The successful partnership between Godrej and the MP government led to 89% decline in Malaria morbidity in the state. Currently malaria infection has declined to below 1 case per 1000 population in Madhya Pradesh which is a 96% decline in malaria cases from 2015 to 2021 in the state. The biggest win is in 2015, Madhya Pradesh was in category-3 with 25 districts having malaria cases. In 2021, Madhya Pradesh figured in Category-1 and was among top 10 states having low malaria cases. EMBED’s contribution has been formally acknowledged by the Health Minister of Madhya Pradesh, Dr Prabhuram Choudhary.

6. What kind of collaborative efforts are being made to combat malaria in the Hindi-belt states?

Public health problems are too large to be solved by one entity. And it’s essential to not leave anyone behind. ASHA and anganwadi workers, who are in-charge of tracking Malaria cases, providing the first line of medication and guidance to families, are often poorly trained to deal with recurring fevers and other Malaria symptoms. This is primarily because ASHA and Anganwadi workers are more focused on mother and child health issues such as POSHAN Abhiyan, Mission Indradhanush and a few diseases like TB from time to time. Further, it is no secret that their workload is high and remuneration limited. 

Hence, having a line of public health champions working primarily for Malaria and other vector borne diseases is crucial. Our Behaviour Change Communication Facilitators helped ease the ASHA worker’s burden, supported them with the skills to raise awareness and test for cases, and even pivoted to Covid 19 awareness and vaccination drives when the need arose. 

Under the programme, our non-profit partners have developed not just IEC (Information, Education & Communication) and BCC  (Behaviour Change Communication) material aimed at community members, but also e-modules for health practitioners and workers. In addition,  we also developed an app for Malaria treatment, which is being used by the Health departments of UP, MP & Chhattisgarh. The app is available in local languages for both Android as well as iOS. This app provides details of the types of Malaria namely Plasmodium falciparum, Plasmodium vivax or the hybrid of both and further categorises treatment as per the age of the patient to determine the line and strength of the treatment. 

7. Would you like to explain some of the behavioural change campaigns needed to combat malaria in the rural areas?

Behavioural change campaigns need to be adapted to local languages and cultural norms and need to be delivered with consistency over a period of time to be able to demonstrate any degree of success. The medium and the message needs to be localised. For example, one of the ways we communicated and sparked conversation on malaria was through village nukkad nataks (street plays) and communications vans. This was impactful and the message was well received by the community members. In addition, by ensuring that saturating a community with consistent messages by involving key influencers in the community (Panchayat, ANMs, ASHA, teachers, village volunteers, etc.), ensuring high visibility during local haat days, co-opting faith healer, and by involving the children in the community via school, the programme has been able to gradually but effectively change the mindset and practices of communities across the three intervention states.

8. What has been the impact of Covid-induced lockdown and restrictions in combating malaria?

At the peak of COVID-19 first wave in the first quarter of FY20-21 year, the risk of malaria outbreak was looming large in India as the monsoon season was about to set in. While healthcare systems were grappling with COVID-19 cases, there was a dire need to keep a check on malaria outbreaks and double down on precautions.  

There were approximately 6,600 cases of malaria across Madhya Pradesh in India in 2020. This was a decrease compared to the previous year when the state reported over 14,000 cases of the disease. Our pre-season preparedness and awareness activities started as early as April 2020 during the initial lockdown. At the same time, we also extended our support to local health departments to spread awareness on COVID-19. We provided support to local health workers, relaying information back to primary or community health centres and following up of at-risk, suspected, and quarantined persons. 

9. Would you like to share any success stories of EMBED?

The biggest win for the programme has been moving the needle considerably on the malaria status of the region. In 2015, Madhya Pradesh was in category-3 with 25 districts having malaria cases. In 2021, Madhya Pradesh figured in Category-1 and was among top 10 states having low malaria cases, owing to strong administrative effort, innovative methods of public-private partnership and responsiveness of the public. 

Our findings from a third-party impact study of four high Malaria endemic districts of MP viz. Alirajpur, Jhabua, Sheopur and Shvipuri, 1.5 years post exit from those locations, revealed that 97% of households continued to accurately recollect that malaria spreads due to bite of a mosquito compared to 85% households back in 2016. 98% of them went on to say they know that fever and/or shivering are key symptoms of malaria compared to 42% in 2016. 91% of the respondents stated using preventive measures either throughout the year or only during the peak seasons for mosquitoes (monsoon and summer) compared to 75% in 2016.

This success in healthy personal hygiene habits also reaped multiple benefits for the families in terms of a 17% increase in productivity at work and a 22% decrease in absenteeism at school or work. The Malaria proofing of house spaces resulted in substantial savings in out of pocket expenditure for health, and greater productivity at work and school.  

Our successful partnerships with various government entities at the State Health departments, District Collectors, Chief Medical Officers and the people at the Panchayat were an essential ingredient to our success. 

The successful first stint also drove the state departments from Chhattisgarh and Uttar Pradesh to come on board, to replicate the model in their states in partnership with the Godrej Consumer Products. We have also expanded our horizon to initiate a dedicated programme focussed on dengue in nine cities - Bhopal, Gwalior, Indore, Jabalpur, Lucknow,Kanpur, Agra, Meerut, and Raipur. This is our effort to foster civic leaders who will be trained in technological know-how of vector borne diseases and their treatment. 

Here’s a quote by Dr Prabhuram Choudhary, Health Minister, Madhya Pradesh, on the EMBED partnership, "Family Health India and Godrej CSR, in collaboration with Madhya Pradesh Public Health & Family Welfare, are running project EMBED to eliminate vector-borne disease in 11 Malaria affected districts of the state. This project has participated at the community level in IEC, BCC activities, ASHA, and training of ground-level health workers. The state's health department has received excellent help from project EMBED regarding Malaria elimination as a public awareness programme. Technical assistance has also played a vital role. 

EMBED project has developed a Malaria dose chart application for the right treatment of Malaria positive cases which is used by ASHA and ANM workers and is applicable in all 51 districts of Madhya Pradesh. This application is helping in the correct and complete treatment of Malaria. In collaboration with these institutions, the state government has worked on properly using LLIN (Long-lasting insecticidal nets), fever surveillance, and comprehensive treatment of Malaria patients. It has also helped in the reduction of vector sources. The combined efforts have brought MP from category 3 to category 1 in Malaria elimination in 2021. I hope the EMBED project will be extended in the state to Malaria affected districts so that the State government can continue getting help in eradicating Malaria and Dengue control.”