1. 1Karnataka Health Promotion Trust; 2 University of Manitoba, Canada
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Promoting Dialogue, Collective Decision-making and Collaborative Action Among Frontline Health Workers (FLW) And Community Representatives Through Sub-center Forums (SCF) For Improving MNCH Service Delivery
Suresh S1, Mallika Tharakan1, Prathibha Rai1, Rajaram S1, Krishnamurthy J1, 2, Mohan H L1, 2
1Karnataka Health Promotion Trust; 2 University of Manitoba, Canada
BACKGROUND: FLWs play a critical role in ensuring that all women enter and continue in the MNCH care continuum. Field discussions with 2000 FLWs carried out as part of BMGF funded Project Sukshema revealed that poor teamwork and community support; lack of vision and motivation; absence of opportunities for growth and spaces for discussion affected their morale and ability to effectively track women for outreach and respond to community demands.
METHODOLOGY: We formed Sub-centre forums to promote collaborative action among FLWs and community representatives. They are informal spaces where both groups jointly shape the agenda, identify priorities, deliberate on field level challenges, address conflicts and act on common concerns around MNCH service delivery. In these forums FLWs review the progress of the MNCH community interventions, identify the critical gaps and understand the areas of support needed for their enhancing outreach services.
RESULTS: We formed 1959 SCFs covering 5100 villages, FLWs and 5100 Community representatives. SCFs meet once a month at the sub-centre level covering 5-6 villages. Apart from this, SCFs across 6 priority districts organized a campaign reaching 4,900 villages promoting community accountability and joint ownership of MNCH service delivery by health workers and communities. SCFs have fostered positive work environment, stronger team relationships and increased MNCH service uptake. The project’s recent progress report showed Bagalkot district with maximum number of active SCFs with 81% conducting regular meetings. .
The data used in the graphs is from the project’s Community Behaviour Tracking Survey. It is a simple and rapid sample survey of target populations to measure intended project outcomes. The survey is conducted once every 4 months in a representative sample of women who have a delivered in the past 2 months.
CONCLUSION: Increasing coordination and synergy building among the health workforce and community representatives results in improved outreach of MNCH services
Acknowledgements:
We would like to thank Bill & Melinda Gates Foundation (BMGF) for its funding support to implement Project Sukshema and we thank all field investigators who conducted and the respondents in the community who participated in the survey.