Promoting People's Participation in Health: Arogya Gram Sabhas Initiative in Maharashtra
The Regional Consultation on Community Action for Health in Maharashtra highlighted the importance of community-based approaches in promoting accountability in the health system. Initiatives like CBMP, VHSNCs, and RKS have been instrumental in engaging communities for monitoring and planning health services since 2007. The conceptual framework includes processes like feedback, action, state planning, monitoring committees, and village health and sanitation committees to ensure effective implementation.
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AROGYA GRAM SABHAS: PROMOTING PEOPLE S PARTICIPATION ON HEALTH AND ITS DETERMINANTS IN MAHARASHTRA 10th February 2016 Regional Consultation on Community Action for Health S T A T E H E A L T H S Y S T E M R E S O U R C E C E N T R E , P U N E N A T I O N A L H E A L T H M I S S I O N , P U B L I C H E A L T H D E P A R T M E N T , M A H A R A S H T R A
BACKGROUND Communitisation and decentralized planning are the important Communitisation and decentralized planning are the important core components of NRHM vision and mandate core components of NRHM vision and mandate These are important elements to ensure accountability in health These are important elements to ensure accountability in health system system Various efforts under NRHM since beginning regarding Various efforts under NRHM since beginning regarding communitisation: CBMP, VHSNCs and RKS communitisation: CBMP, VHSNCs and RKS CBMP initiated in Maharashtra since 2007 in 5 districts on pilot CBMP initiated in Maharashtra since 2007 in 5 districts on pilot basis and now expanded to 13 more districts in phased wise basis and now expanded to 13 more districts in phased wise manner. manner.
COMMUNITY BASED MONITORING AND PLANNING OF HEALTH COMMUNITY BASED MONITORING AND PLANNING OF HEALTH SERVICES PROCESS IN MAHARASHTRA SERVICES PROCESS IN MAHARASHTRA It was launched on a pilot basis in 2007 in 9 states including Maharashtra It was launched on a pilot basis in 2007 in 9 states including Maharashtra under NRHM under NRHM Data gathering and Data gathering and filling report cards filling report cards
CONCEPTUAL FRAMEWORK: CONCEPTUAL FRAMEWORK: PROCESS OF FEEDBACK & ACTION PROCESS OF FEEDBACK & ACTION State Planning & State Planning & Monitoring Monitoring Committee Committee District Planning & Monitoring Committee Feedback Block Planning & Monitoring Committee & Reports PHC Planning & Monitoring Committee Village Health and Sanitation Committee
In 2012 State level Monitoring and Planning committee meeting In 2012 State level Monitoring and Planning committee meeting (Chairperson: Hon. State Health Minister) issues flagged and discussed: (Chairperson: Hon. State Health Minister) issues flagged and discussed: - - Delayed decision making Delayed decision making - - No platform for community to voice their health demands etc. No platform for community to voice their health demands etc. Decision has been taken that at village level separate Gram Sabha can Decision has been taken that at village level separate Gram Sabha can be organized be organized Gramsabhas are looked as the important corner stone of the Gramsabhas are looked as the important corner stone of the democratic decentralization in India democratic decentralization in India
AROGYA GRAM SABHA Issued GR dated 26th June 2014 by Department of Rural Development, Maharashtra Organization of Health Gramsabha : Once a year (during period: 24th April to 1st May ) Arogya Vishayak Janajagruti Gramsabha Main two mandates: Awareness generation to improve the uptake of services as well as improving health seeking behavior VHSNC fund planning for rational utilization
OBJECTIVES OF AROGYA GRAM SABHA 1) To generate awareness regarding various health and nutrition related schemes To promote the community to take benefits of various Government schemes To improve participation and involvement of community in health planning process To inform community regarding health facilities available nearby To provide information related to health programs and facilities available in health facilities To provide information about the health system To plan the VHSNc fund utilization 2) 3) 4) 5) 6) 7)
HEALTH TOPICS TO BE DISCUSSED DURING GRAM SABHA 1) Maternal and Child Health 2) Janani Shishu Suraksha Yojana 3) Routine Immunization 4) Village Child Development Centre (VCDC) 5) Child Treatment Centre (CTC) 6) Nutrition Rehabilitation Centre (NRC) 7) Disease Control Program 8) Rashtriya Bal Swasthya Karyakram (RBSK) 9) Village Health Nutrition Sanitation Committee 10) Mobile Medical Unit 11) Special Schemes for tribal areas 12) Rugna Kalyan Samiti (RKS) 13) National Health Programs 14) Information about Toll free numbers: 102,104,108 etc. 15) ASHA
OBSERVATIONS First step towards making Health as priority at village level Awareness generation: regarding various health programs, facilities, entitlements, concerns of community In more than 40000 revenue villages where Health Gramsabha has been conducted Role of Gramsevak and Sarpanch was important for community mobilization and overall organization of gramsabha Before each Gramsabha VHSNC members, ASHA ,AWW and ANM should prepare a agenda for the gramsabha Role of MO PHC, ANM,ASHA, AWW: part and facilitated the Gramsabha by providing information about various health related topics Role of ASHA and ASHA BF important in mobilizing community to participate in Gramsabha
AROGYA GRAM SABHA RALLY After After Completion Of Completion Of gramsabha: gramsabha: Field Staff Field Staff arranged rally arranged rally to create to create awareness in awareness in the village the village
LEARNING AND CHALLENGES 1) 1) Publicizing the need and objective: Publicizing the need and objective: - - Less clarity among organizers as well as among community about objective (regular gramsabha vs Health Gramsabha) - Capacity building of concerned functionaries to utilize the forum for health demand generation and planning - Need to make constant and focused efforts to strongly establish this new initiative 2) Possibility of becoming Monologue (one way information 2) Possibility of becoming Monologue (one way information providing forum) providing forum) 3) Community mobilization and Participation: Big challenge 3) Community mobilization and Participation: Big challenge - - Involving all sections (minority, women) - Maximum participation - Active participation in the discussion - Role of local CSOs/Youth Groups/SHGs would be crucial - Strengthening VHSNCs
LEARNING AND CHALLENGES (CTND..) 4) Preparation is important 4) Preparation is important - Making a clear agenda of the sabha by VHSNC, ASHA, AWW and ANM - The health issues came across during the year can be listed out by VHSNC and ASHA/AWW/ANM 5) Facilitating the meeting 5) Facilitating the meeting - - Role of local health workers ASHA,ANM and AWW: important as a facilitator and mobilisers - Similarly role and participation of VHSNC members is important but it hardly seen
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