Community Action for Health in Bihar Population Foundation of India National Consultation on Community Action for Health October 28, 2014

Presentation outline Overview Implementation structure and processes Key outcomes Scaling up plan Challenges

Overview Since 2011, Population Foundation of India (PFI) is the State Nodal Agency for implementing Community Action for Health Supported by the State Health Society Bihar (SHSB) Process implemented in 5 districts I 10 blocks I 300 villages, in partnership with local organizations Scale up planned in 10 districts I covering 750 Gram Panchayats)

Implementation structure

The steps 1.Education and awareness promotion : Community awareness on health entitlements Training of Village Health Sanitation and Nutrition Committees (VHSNC) and Rogi Kalyan Samities (RKS) members Display of Citizen’s charter and service guarantees 2. Monitoring and information sharing Collection of information and sharing of report cards, community experiences of health services Multi stakeholder Monitoring and Planning Committees at PHC, Block and District levels 3. Public dialogue Periodic public dialogue (Jan Samvad) - Engagement with providers based on community evidence

Key outcomes Community Based Planning and Monitoring (CBPM) programme in BiharOutcome clip.wmvOutcome clip.wmv

Outcomes- Utilization of untied funds PoorAverageGood

Outcomes- ASHA functioning PoorAverageGood

Notable changes Village level Increased utilization of untied funds Improved service delivery- especially during Village Health Sanitation and Nutrition Day (VHSND) Facility level Functioning of Sub Health Centers Reduced demands for informal payments Grievance Redressal- complaint boxes, citizens charters duty roster, display of stock availability, purchase of medicines etc

Scaling up plan Formation and orientation of Planning and Monitoring Committees- at the district and block level Orientation of District and Block Community Mobilizers (DCM and BCM) Creating a pool of master trainers for capacity building of VHSNCs Mapping of NGO,CBOs - and identifying organizations to lead implementation at divisional level

Challenges Mechanisms for effective grievance redressal to address systemic issues- human resource, infrastructure Delays in programme funding Presence and capacity of NGOs to scale up processes across the state. Coordination with Department of Social Welfare (Women and Child Development)

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