Community Action for Health (CAH) in NE States

Initiation…….. Assam was one of the 9 states selected for implementation of the pilot phase of community based monitoring (CBM) of NRHM during in 3 districts. In it started in Arunachal Pradesh as a pilot basis in two districts (Lower Subansiri & Tawang) which could not be implemented. In , CAH was implemented in East Siang district. In Meghalaya, it was implemented in In , it was implemented in Manipur. By , all the states had received approval for CAH in RoPs, except for Nagaland.

Implementation Model Kebang system (village headman) in Arunachal Zonal NGO covering 4-5 districts in Assam District Nodal NGO in Meghalaya and Tripura State Nodal NGO

CAH in districts Arunachal Pradesh Planned to expand the program to 2 more districts (West Kameng and Changlang) during in addition to East Siang district. AssamIn , scaled up the program to 5 more districts. In , it covered all districts. Meghalaya3 districts by (East Khasi Hills, Jaintia Hills and West Garo Hills) Manipur,In , implemented in one block (Khumbong) of Imphal West district. MizoramSerchhip district is identified. TripuraGomati district will be implementing.

Status till date………. Community Enquiry was started by VHSNCs in 2 districts of Meghalaya. All States have State Advisory Group for Community Action (SAGCA) / State Mentoring Group (SMG) at state level. State Nodal NGOs were identified and MoU signed in Assam. 4 zonal NGOs for 4 zones out of 6 zones were identified in Assam. Budget to be released. MoU signed with NGO in Mizoram and budget released. Nagaland is having the system of communitisation. In Manipur, State Nodal NGO was discontinued after 1 year of signing the MoU in and the activities were done by the State Community Process section along with DPMU and BPMU.

State ArunachalRs L Approval pended, not shared the physical and financial progress.Rs L Re-vaildated Rs L. AssamRs L Approval pended as state has not given any details. Re-vaildated reflected under committed expenditure of Rs L Approved amount of was reapproved. ManipurRs. 10 L 0 MeghalayaRs LRs LRs LRs L Mizoram No proposalRs L Rs LRs L Nagaland Approval pended. rework and submit the proposal Approval pended as the proposal was not as per GoI guideline. Approval pended as details not provided. Approval pended. State has to rework and resubmit the proposal. Sikkim Rs based on utilization.Rs LNot approved Rs L for Jan Sambad. Tripura No proposal Rs. 7.6 L approved for 2 blocks in Dhalai district. Not approved as activities approved in were not implemented. Rs. 4.4 L for Gomati district.

Overall Issues in CAH Lack of orientation of state / district officials including finance division. Delay in release of fund. Readiness / Inadequate planning of activities under CAH. Limited availability of NGOs. Separate program officers for CAH and ASHA Program. Lack of monitoring indicators to measure CAH progress. Low monitoring and supervision. Lack of proper documentation. Frequent turn over of trained staffs in NGO. Timely submission of SoE and U/C.

Recommendations Orientation of state / district officials so that the proposal of Community Monitoring is developed as per GoI guideline. Activity details against which budget is released needs to be specified in RoPs. Orientation of all divisional heads including finance on CAH prior to rolling out of the program. Break up the activities of CAH into sub-activities and planning the sub-activities which could be accomplished in a year. Implementation of CAH in a phased manner in the states through designing workable plans taking into consideration strength of implementing agencies. Involvement of RRC-NE for planning and monitoring of CAH activities in NE.

Recommendations Nodal Officer for Community Process to look after all the CP activities including CAH. Develop monitoring indicators and improve monitoring by SAGCA / SMG members. Improved co-ordination of Community Process personnel at district and block level is required for monitoring and providing support. CAH needs to focus towards strengthening VHSNC members or to PRI members which will help to own the program and to increase the accountability, convergence and will strengthen decentralized planning. Regular supportive supervision. Involvement of IEC division in documentation of CAH activities and to disseminate the good practices.

Role of RRC-NE in implementing CAH Supporting state in designing CAH for SPIP; Training state to block level officials on CAH; Helping state in report card generation and analysis of report cards; Supporting state in holding public hearing; Regular supportive supervision;

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