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| Expansion of Community Based Monitoring activities |
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The National Rural Health Mission (NRHM) seeks to provide universal access to equitable and affordable quality health care, responsive to the needs of the people. Community-based monitoring (CBM) of health services is an important strategy for achieving this goal. In Maharashtra, a CBM pilot project was launched in 2007, covering 225 villages.
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| The FRCH, as a partner in the process, covers the Parinche Primary Health Centre and five villages under this PHC. Initially, meetings were held in these villages to discuss the importance of community involvement in health monitoring and planning. A Village Health and Sanitation Committee was formed in each village. A three-day workshop was organised at the Parinche Resource Centre for the members. Themes covered in the training were right to health, NRHM objectives, importance of community participation in health planning and monitoring, responsibilities of the committee, proper use of funds and so on. |
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| Poster display, village notice boards, FRCH newsletter 'Sawali' were used extensively to create awareness in the village. Discussions with community members, especially women and marginal groups, were held to understand their assessment of health services in their village. timepiecebuy
Based on their experience, a health service report card was prepared which covered the services of MPW, ANM and Anganwadi worker; the status of antenatal and postnatal care as well as infant and maternal mortality rate. From August 2008 onwards, similar activity was taken up every 3 months for nutrition, water supply and sanitation issues in the villages. |
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| Public Hearing |
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| The next step was organising Jansunvai (Public Hearing), where the community members could voice their grievances in the presence of government health providers and administrators. These meetings were organised during August-September 2008, followed by representation of the demands to the Primary Health Centre Monitoring and Planning Committee. The PHC Monitoring and Planning Committee was immediately formed and its members were given training at Parinche to enable them to perform their tasks competently. The committee reviewed the PHC work and sent its report to the Block Monitoring and Planning Committee, and to the district-level Jansunvai. |
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| The impact of these activities could be seen in two spheres: first the people are more aware now of their rights and, secondly, government officials are answerable to them. They know their own responsibility. There is also an improvement in terms of behavioral change in health service providers and availability of better antenatal care. Other service providers such as Multipurpose Workers and anganwadi workers have likewise realised that they are accountable to the people. However, there are issues such as shortage of medicines and manpower or lack of proper infrastructure, which need to be addressed at a higher level and would be taken up in district and state-level meetings. |
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| The next stage of CBM is people's participation in health planning. Meetings and discussions are being held to prepare the community for a more active role in defining local needs, planning and use of available resources, with a focus on capacity building of Panchayat Raj institution members. |
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| Partners : |
SAATHI-CEHAT, Pune
MASUM, Pune |
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| Support : |
FRCH, Pune |
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| Contact persons : |
Appasaheb Ghadge, Prabha Dudhal |
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