Prosperous Village Programme Jathika Saviya & Gama Neguma Programme

Government of the people by the people for the people - Abraham Lincoln

Thailand Experience 1960s - Initiation of community participation in health development programme through village volunteers 1975 - Creation of a nation-wide village volunteers system to form the backbone of the National Primary Health Care Programme 1982 - village self managed Primary Health Care Programme 1983 “Basic Minimum Needs” programme to improve the quality of life of people

“Basic Minimum Needs” Programme Slogan “ Health is a part of socio-economic development” Village is the key development unit Eight basic minimum needs with 32 indicators Management of micro development projects by the people Inter-sectoral action Health Agriculture Education Interior

Pillars of Self-Reliance in BMN

Experiences of Other Countries China Community led management India Kerala Tamilnadu Indonesia Women’s organisation

Sri Lanka Change agent programmes Participatory rural development programmes Family health action programme - HEB Mahaweli volunteer programme Model health village programme - Anuradhapura Mother’s society programme – Hambantota Sabaragamuwa Suwasetha – Ratnapura ECCD community action plans Etc.

Delivery of Health Services Equity Right based approach Responsiveness Community mobilisation & empowerment

What is new Political leadership Holistic approach Spiritual development Infra structure development Social and economic development Participation of the community Janasaba concept Cost reduction by using local manpower, other resources and technology

“GAMA NEGUMA” Development Programme A project of paramount importance as envisioned in Mahinda Chinthana. Ministry of Rural Livelihood Development co-ordinates with line Ministries, state institutions, provincial councils, local government bodies and community based organizations with the active participation of the rural community Planning and implementation commenced on 24th March 2006

Vision To develop the village as the centre of national development

Mission To create comprehensive development in the villages through a network of community based organizations formed in the rural community with active participation of its members and to implement them with proper coordination and transparently

Objectives To ensure community participation by motivation, organization, and community empowerment for total development of the rural community based on self reliance To introduce a formal mechanism for participatory decision making and project planning at village level To obtain optimum benefits from the development programme by implementing integrated village development plans to avoid duplication

Objectives Co-ordination of human resources which is crucial for rural development, other rural, and external resources, through an efficient mechanism of resource allocation To introduce a results based participatory progress review and evaluation mechanism at village level To ensure improvement of living standards of the village communities through development of the physical, economic, social and cultural environment To create total development of the village under a community based, planned development programme

Development Strategy To prepare integrated village development plans with community participation targeting all development efforts to achieve a common objective To make opportunities for the rural community to participate actively in their economic, social, cultural and spiritual development efforts To organize and empower rural community to ensure their total commitment and contribution in the development process To pool all resources utilized in village development, and implement productive transparent integrated village development plans for proper co-ordination at village and divisional level

Development Strategy (contd.) To transform the rural community to a group of activists with ideological and comparative thinking abilities and enhance self determination by developing their abilities and skills demand for sustainable development dependant on self help, while changing the subsistent mentality with an orientation towards achieving targets. Simultaneous rural livelihood development, with infrastructure development for economic resurgence and social development

GAMA NEGUMA Community Activities To educate all state officers at village level and the rural community on GAMA NEGUMA Development strategy To identify village level problems, disparities, local resources, livelihood development, opportunities using surveys of resources and information, the methodology of participatory rural appraisal To establish a data base of Rural needs Rural resources / scarcities Identification of required external assistance Preparation of rural development plans

GAMA NEGUMA Community Activities (contd.) Preparation / updating of profiles of families and village resources Co-ordination of financial allocations for project proposals Establishment of suitable mechanisms for implementation, evaluation and review of development projects Co-ordination of institutions involved in project implementation with Divisional and District Secretariats. 9. Establishment of ‘JANA SABHA’

JANA SABHA The principal organization responsible for implementation of ‘GAMA NEGUMA’ A JANA SABHA will be established in every village with the participation of - religious leadership - community based organizations - political leadership - state officials - rural community Drafting of statutory laws for establishment of JANA SABHA is in progress

Community Action Planning Model ‘Janasaba’ Training of Community Health workers (Praja Saukkya Sevika) Assessment of the needs Decide on the objectives Assessment of the available resources Identify the activities & responsibilities Identification of resources & time-frame Develop an action plan for holistic development Implementation & coordination Directing & logistics Monitoring and evaluation

Five Precepts of Sanitation Ensure access to supply of safe water and the use of boiled cooled water to drink for all Ensure home gardening of the households Ensure sanitary disposal and recycling of waste Ensure the use of sanitary toilets by all including children Ensure a clean, smoke free house with adequate light & ventilation

Maternal and Child Health Ensure adequate care is received by mothers and children Ensure proper nutrition including breast feeding and complementary feeding of children Assist in conducting Growth Promotion centres and MCH clinics Follow-up of advice given by health workers to ensure health of mothers and children Assist the health education programmes conducted in the community

Maternal and Child Health Ensure adequate post-partum care is received by the post partum mothers Ensure all the children are receiving adequate early Childhood Care for their optimal growth and development Assist in providing / strengthening of infrastructure, equipment and consumables Promote child friendly environment within the family and the community Prevent child abuse Ensure adequate participation of male in MCH care

Environmental health Assist health workers in educating the community Monitor the adequacy of the measures taken by the community to prevent communicable diseases in the community Assist prevention of communicable diseases including diarrhoeal diseases and dengue Inform health workers on the spread of communicable diseases promptly Develop the occupational settings in the community to be health promotive Create an animal friendly environment by motivating people to care responsibly for the animals such as dogs and cats by facilitating immunisation of the dogs, family planning & encouraging caring practices etc.

Food Hygiene Assist health workers to educate workers working in food processing establishments and people about proper food hygiene Monitor food hygiene of the food processing establishments Promote locally available home based food

Prevention of Non-Communicable Diseases Assist health workers in educating public on non- communicable diseases Ensure prevention of abusive substances such as alcohol and tobacco in the community Ensure reduction of home and other accidents Promote mental health and prevent suicides in the community Assist health workers in screening the community for non-communicable diseases and referral of the patients Follow-up of patients with non communicable diseases to prevent complications

Promoting Health of the Youth Promote health of youth by forming youth clubs and sport clubs Facilitate empowerment of youth to improve their own health Create supportive environment for development of youth in the community

Care of the Elderly Promote health of the elders by facilitating day care centres Facilitate empowerment of the elders to improve their own health Create supportive environment for the care of elders in the family and the community

Rehabilitation of the Differently Abled Persons Assist health workers in rehabilitation of the differently abled persons Facilitate services provided by the Department of Social Services, other sectors and NGOs to improve the health of differently abled persons Facilitate income generating activities by differently abled persons to improve their status of living

Other Social Development Facilitate other social and economic development of the community to improve their health Liaise with other sectors and NGOs to improve social and economic development

Improve Access to Health Services Filling of the vacancies of the public health personnel in selected villages Ensure easy access to MCH clinics Ensure basic facilities in PHC hospitals and easy access to high quality curative care Filling of the vacancies of PHC hospitals Screen people for chronic diseases Follow-up of people with chronic diseases to ensure regular treatment

Improve Access to Health Services Ensure access to health information through planned regular health talks, night film shows etc. Ensure access to screening of school children and proper follow-up to ensure proper care Promote the school as a health promotive school and empowerment of school children through school health societies

Next step Educate all MOOH and district level staff - Feb.2007 Survey of physical infrastructure/ equipment needs of the selected villages – Feb. 2007 Develop an action plan to improve physical infrastructure with a budget – Feb. 2007 Communicate infrastructure development plan with the Janasaba, local political leadership and Divisional Secretary – March. 2007 Training of Community health workers Family survey – Feb-March. 2007 Formation of a Janasaba sub committee on health Develop an action plan for the holistic development of the village – March 2007 Implementation of the action plan – March – Dec 2007 Monitoring and review Monthly review of the programme at the Janasaba sub committee on health Monthly conference Monthly review at the Janasaba meeting Monthly Divisional level meeting Monthly District level reviews of the health sector Monthly District level meeting with the District coordinating committee Bi-monthly Provincial level reviews

Ministry of Healthcare & Nutrition Coordination of Jathica Saviya and Gama Neguma at national level Issuing of policy direction Conduct quarterly review at National level Participate in Provincial level review programme

We have done it ourselves ! Go to the people Live among them Learn from them Love them Start with what they have Build on what they have But of the best leaders When their task is accomplished Their work is done The people all remark We have done it ourselves ! - Ancient proverb