After completing his MA in History from the University of Oslo, His Excellency Nils Ragnar Kamsvag, Ambassador of Norway to India, joined the MFA in 1981. After being the Secretary of the Royal Norwegian Embassy, Rome, in 1989, he was assigned a number of high-profile assignments including the one as Head of Information Division, MFA in 1993, which were succeeded by various roles including those as Ambassador, Middle East and North African Affairs, MFA from 2001 till 2003, as the Norwegian Representative to the Palestinian Authority, Al Ram till 2005, as Project Manager, Crisis Management, MFA till 2006 and many others. From 2010 – 2015 Ambassador Kamsvag served as Ambassador to Serbia, Macedonia and Montenegro Royal Norwegian Embassy, Belgrade. In this interview to Sarah Berry he talks about the NIPI or Norway-India Partnership Initiative, its essence, challenges, milestones and the future prospects. Excerpts:
1. What were the 3 main factors that lead to the implementation of NIPI?
When we look back a decade, the main reason for the Norway India Partnership Initiative (NIPI) to be launched in 2006 was to support India’s Millennium Development Goals 4&5 of reducing infant and maternal mortality rates. In 2005, the then Prime Ministers, Prime Minister of Norway Jens Stoltenberg and Prime Minister of India Manmohan Singh met in Norway and committed to work together, and help save mothers and infants of rural India from preventable deaths.
As NIPI grew, the various healthcare interventions that developed through techno-managerial support from NIPI, in constant consultation with the Government of India, were found to be simple, low cost and easy to understand. All NIPI supported programs, to date, utilize the exceptionally talented Accredited Social Health Activists (ASHAs), nurses and midwives appointed by the Government of India. Skilling and empowering the women of the village has profound social and economic benefits for rural India. Involving families at counselling sessions and in post-delivery care of new mothers and babies had remarkable social impact, beyond healthcare. Simple concepts like hand washing, exclusive breastfeeding, immunization schedules, checking body weight, nutrition for mother and child were applied through planned home visits and medical checkups. Never heard before concepts like Emergency Triage and Treatment Centres were set up without too much infrastructure changes in paediatric departments in order to treat sick and emergency care infants and children.
In particular, NIPI’s working model has today become a classic example of development work. Our governance structure, involving constant consultations between policy makers and technical experts from both nations, has proven to be a useful learning experience for everyone involved. Norway was willing to partner India for the testing of basic low cost interventions that have eventually been recommended for countrywide scale up in many cases.
As a result, what was meant to run from 2006-2012 with a total budget of NOK 500 million (Approx. 350 Crores Rupees), further progressed from 2013 to 2017, with an additional budget of NOK 250 million (Approx. 200 Crores Rupees) from Norway.
2. The NIPI has seen many milestones being achieved; what was the biggest breakthrough?
Basic low cost interventions and working with all levels of stakeholders in rural India, starting from a family and upwards have been the biggest achievements. While it is a healthcare program, NIPI involved skill development and women upliftment, which were socially relevant. Newborn health is so important now that India has its own Newborn Action Plan to ensure safe births.
3. How are the next 5 years envisaged for the project?
With the view to further strengthen the relationship between our two countries, the Norwegian Ministry of Foreign Affairs and the Ministry of Health and Family Welfare of India (the Parties) recently signed a Letter of Intent on 28th of September, 2017 to extend the cooperation in the field of health, through the Norway India Partnership Initiative (NIPI), for a period of three years, starting from 2018. This cooperation will continue to be aligned with the development goals of the Indian Government as outlined in its National Health Policy 2017, for achievement of Sustainable Development Goals (SDGs). It shall focus on global health issues of common interest. It will include reproductive, maternal, newborn, child and adolescence health, and shall build on experiences from NIPI phases I and II.
4. What were the most notable challenges faced during the implementation phase?
Challenges are part and parcel of development work. Having been in this field for over 30 years now, all I can say is that we embrace challenges as learning experiences for the betterment of our work.
Since NIPI was about testing innovations, we were prepared to celebrate success and accept trials in good faith.
Across various programs, I have been informed by our partners and program implementers that changing the mindset of people to go beyond social barriers and educate them on basic concepts, for instance, hand washing, could actually save lives. More than spending funds on building new structures, NIPI’s mechanisms reworked the existing channels of healthcare delivery and tweaked the outlook of the healthcare system. Since it is about mothers and their newborns, who else would understand better and be involved in the healthcare delivery more actively than the women of the village themselves. This was initially seen as a non profitable and intangible way of working, till the results were there for all to see.
5. How is the common man a part of this project or is it solely a government to government implementation?
Development work is meant for the common man. That goes without saying. We need governments for law and order and making proper policies and ensuring implementation. This is part of any good democracy. As I mentioned earlier, in NIPI, we involved the women of the village to be the enablers, influencers and mobilisers of the different programs that were implemented by the Government of India. Families were counselled and then actually involved to take care of new mothers and newborns, as in the case of Family Participatory Care.
And then we have our unique governance model, where government to government consultations helped formulate implementation plans. So, everybody was a relevant stakeholder in the successful implementation of NIPI.