Seminar on Village Health and Sanitation Committee A Vision under NRHM Shib Sekhar Datta

Presentation Design Renewed thrust on PRI under NRHM Constitution of VHSC – a targeted intervention Capacity building Roles an responsibilities Maintenance of bank account Future vision References

Renewed Thrust on PRIs under NRHM NRHM framework revolves around activation of PRIs in the rural India Determinants of health take front seat Water, environmental sanitation and nutrition identified as vital components for better health Convergence starts from the village level and flows up. First step being merger of Panchayat Raj Village health committees and water and sanitation committees.

Constitution of VHSC – a targeted intervention Increased no. of members: increased scope of work ASHA – an institution in itself, most ambitious intervention under NRHM Sarpanch, Secretary, AWW, ANM, ASHA, teachers, village members, CBOs, SHGs are members, with due representation from each hamlet, community and weaker sections 50% female members (SC/ST/OBC group) 30% from NGO sector

Capacity building The states have a huge task of building capacity of these Committee members. Have to empower them to adapt to their new role: monitoring of activities, evaluate planning process and maintenance of accounts. Initial hand holding is important ? NGOs to come into picture Village health planning process to emerge through community development process

Roles and responsibilities House hold survey: maintain records Present annual health report of the village in the Gram Sabha Identify all members of health support team and work as a team Develop a village health plan with detailed activities Participatory Rapid Assessment Support ASHAs and AWWs to collect information Support and supervise ASHAs and AWWs to carry out all RCH activities Organize village health nutrition days (VHND) Ensure death*, birth and marriage registration

Roles and responsibilities.. Ensure clean water Plan for environmental sanitation – organize public health activities like cleanliness drives, sanitation drives, school health activities, health and nutrition days Managing Village Health Fund Maintain accounts – of untied funds under NRHM Leverage funds from other sources Many more……….

Powers of the Committee The convener will sign the attendance registers of the AWWs, Mid-Day meal Sanchalak, MPWs, and ANMs. MPWs and ANMs to submit a bi-monthly village report to the committee along with the plan for next two months. Village Health Committee would decide format and contents of the bi-monthly reports. The committee will receive funds of Rs 10,000 per year. This fund may be used as per the discretion of the VHC.

Some yardsticks for monitoring at the village level Village Health Plan NRHM indicators translated into Village health indicators Tools for monitoring at the village level Village health Register Records of the ANM Village Health Calendar Infant and Maternal death audit Public dialogue (Jan Sambad)

Maintenance of bank accounts Untied revolving fund – granted in installments Decide on the joint account holders – states to decide Options may be – Sarpanch/President of VHSC with ASHA/ANM/AWW Activity details and account register maintenance by – states to decide (ASHA/VHSC) Options may be - ASHA/ANM/AWW Supervision and monitoring of the expenditure and records by – ANM/MPW/Gram Panchayat

Accountability To maintain updated Household Survey data to enable need based interventions. Register of details of activities undertaken, expenditure incurred etc. will be maintained for public scrutiny. Periodically reviewed by the ANM/Sarpanch. Block level Panchayat Samiti will review functioning and progress of activities of VHSC. The District Mission through members/block facilitators elicit information on the functioning of VHSC. A data base may be maintained on VHSCs.

Critical Role of PRI in the success of the NRHM PRIs are seen as critical to the Planning, Implementation, and Monitoring of the NRHM. Key to NRHM success are: Inter-sectoral convergence Community ownership steered through village level health committees at the level of the Gram Panchayat, and Well functioning public sector health system with support from the private sector.

Future vision Complete decentralization Empowerment Convergence Health infrastructure maintenance Need based programming Effective use of resources Sustainability

References 1.Government of India. National Rural Health Mission ( ), Mission Document. 2.Government of India. National Rural Health Mission, Monthly village health nutrition day, MOHFW, GOI Special Thanks to: 1.District Health Office, Wardha 2.Dr. Arun Amle District Tuberculosis Officer and DHO In-charge, Wardha 3.Dr. Dhakte District Training Officer, Wardha