“Communitization is a positive process which ensures active involvement of community in planning, management, implementation and monitoring of NHM initiatives and their stake in decision making. The main goal of NHM is to reduce Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), promote universal access to public health services, immunization, nutrition, water sanitation, population stabilization, gender and demographic balance, prevention of communicable and non-communicable diseases and promotion of healthy life-style”.
Communitization of National Health Mission (NHM)
Context
Government of Madhya Pradesh had taken initiative during the year 2007 towards constitution of Village Health and Sanitation Committee (VHSC) for each village. VHSCs were expected to monitor implementation of NRHM activities. ASHA’s were selected from the local villages and committees were formed taking representatives from panchayat, health, other line departments and community. The biggest challenge was to train the VHSC members in a very simple and systematic manner so that they can discharge their responsibilities and take democratic decisions based on the local needs.
MPVHA Efforts
MPVHA had taken initiatives in the field of Communitization of NHM, earlier called NRHM with support of UNFPA in Maheshwar block of Khargone district and Nalchha block of Dhar district during 2008 to 2012. And with support of Poorest Area Civil Society (PACS) – A DFID Programme in Jhabua and Harda districts of Madhya Pradesh during 2011 to 2015. All these four districts are predominantly tribal areas of the state.
(A) Initiative with support of UNFPA
Government of Madhya Pradesh had taken initiative during the year 2007 towards constitution of Village Health and Sanitation Committee (VHSC) for each village. VHSCs were expected to monitor implementation of NRHM activities.
MPVHA in collaboration with the state government and with the support of UNFPA implemented pilot project on Communitization of National Rural Health Mission (NRHM) in Maheshwar block of Khargone district and Nalchha block of Dhar district during 2008 to 2012.
The objectives were:
- Improvement in knowledge and understanding on Reproductive Health issues impacting RH outcomes of members of VHSC.
- Capacity building of VHSC on development of Village Health Plan.
- Monitoring of RCH services during village health and nutrition days.
The major focus was to strengthen VHSC, bring transparency, use untied fund, team building for democratic decisions and do monitoring of the health facilities. This pilot project was successful in many aspects as many components are being in practice till date.
(B) Initiative with support of PACS
The main objective of the project was to improve maternal and child health among socially excluded population, mainly scheduled caste and scheduled tribe, by making basic health services and schemes non-discriminatory, friendly, more responsive, accountable and accessible to socially excluded communities in Harda and Jhabua districts.
Project strategy aligned with the outputs was:
- Strengthen and empower CBOs/Civil Society Organizations to raise issues, demand and access the basic health services and schemes for socially excluded population.
- Women and socially excluded are better represented and have more voice in health decision making committees formed by the government at district, block and village level.
- Health service providers made more accountable and responsive for providing friendly, non-discriminative and quality basic health services to the socially excluded population, particularly women.
- Civil society ensures learning and wide dissemination of project lessons
MPVHA implemented this project directly as well as involving four member organizations.
Major Outcomes
- Village Health and Sanitation Committees reorganized and strengthened.
- Proper utilization of untied funds done with active involvement of VHSC.
- Service seekers and providers both came close and accessibility of services increased.
Recognition
Government through its District Collector, Khargone appreciated and issued a certificate of appreciation to MPVHA for its work.