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Current Projects

Community based monitoring and planning of health services

Project : Community Based Monitoring and Planning of Health Services under National Rural Health Mission (NRHM)
Duration : Pilot Phase- June 2007 to November 2008
Continuation Phase- December 2008 to March 2012, April 2011 to March 2012 and April 2012 to March 2013, April 2013 to March 2014, April 2014 to March 2015, April 2015 to March 2016


Current phase – November, 2016 to March 2017

Funded by – NHM

Background :
The National Rural Health Mission (NRHM) was launched for the period 2005 to 2012 with the goal of improving the availability of and access to quality health care for people, especially for those residing in rural areas, the poor, women, and children. Community Based Monitoring and Planning was introduced as important component in order to ensure that the services reach those for whom they are meant. It was an outcome of consistent effort taken by Jan Swasthya Abhiyan. Community Based Monitoring is also seen as an important aspect of promoting accountability & community led action in the field of health. The monitoring process also includes outreach services, public health facilities and the referral system. It is assumed that, the most important input on what, where and how health services are needed and should be provided or improved, can be given most efficiently by the users/ beneficiaries of the services themselves. Community based monitoring places people at the centre of the process. Community Based organizations (CBOs), people's movements, non government organizations and Panchayat representatives monitor demand/need, coverage, access, quality, effectiveness, behavior and presence of health care personnel at service points, possible denial of care and negligence as well as directly give feedback about the functioning of public health services, including giving inputs for improvement. This has enabled people’s participation in monitoring health resources and direct dialogue with health officials. The platform ensures accountable as well as transparent practices.

Objectives of Community Based Monitoring

  1. To provide regular and systematic information about community needs, which will be used to guide the planning process appropriately
  2.  To provide feedback according to the locally developed yardsticks, as well as on some key indicators.
  3. To provide feedback on the status of fulfillment of entitlements, functioning of various levels of Public health system and service providers, identifying gaps, deficiencies in services and levels of community satisfaction, which can facilitate corrective action in a framework of accountability.
  4.  To enable the community and community-based organizations to become equal partners in the health planning process. It would increase the community's sense of involvement and participation to improve responsive functioning of the public health system.


Scope and structure of Community Based Monitoring
Community Based Monitoring process has been implemented as a pilot in selected nine states of India of which Maharashtra is one state. Thirteen districts are selected from Maharashtra - first phase districts namely Amaravati, Nandurbar, Osmanabad, Pune and Thane. In the second phase of CBMP, this activity has been expanded to Aurangabad, Beed, Chandrapur, Gadchiroli, Nashik, Kolhapur, Raigad and Solapur districts. The representatives of Health Officials, Panchayat Raj, Community Based Organizations/ NGOs/ Peoples Movements and villagers are part of Monitoring and Planning Committees at Village, PHC, Block, District, and State levels.

Key Activities

  1. Publications- Preparation of monitoring tools, training, orientation and awareness materials like brochure, guidebook and documentation format.
  2. Formation of State Mentoring Committee that played important role of finalization of state appropriate frameworks.
  3.  State level workshop and training of trainers (ToT)- Training of Community based monitoring team at different levels.
  4. District level workshop and training of trainers (ToT)- Formation of District mentoring team and training of block facilitators for implementation of community based monitoring activities.
  5. Formation of monitoring and planning Committees at village, PHC, block and district level.
  6. Orientation and training of CBM committee members at all levels.
  7. Data collection and preparation of report card- Data collected regarding status of health services at all levels by monitoring and planning committee members with the help of tools.
  8. District Media workshop for improving media coverage of activities and findings of the pilot phase of CBM.
  9. Jun sunwai- Block and district level community monitoring exercises include a Public Dialogue (Jan Samvad) or Public Hearing (Jan Sunwai) process once or twice in the year in each PHC, district and state.
  10. State review workshop, evaluation and process documentation.


SATHI as State Nodal NGO
SATHI-CEHAT has taken the responsibility to work as a state nodal NGO for this project, providing training material like guidebook, posters, Aarogya Hakka Calendar, tools for data collection and state level coordination with Government of Maharashtra as well as 13 districts and 29 Block nodal NGOs for implementation of Community based monitoring and planning activities.

District Nodal NGOs
In selected districts, selected NGOs have taken the responsibility for the activities in that district. The following organizations have been working as District nodal NGOs in the selected thirteen districts
First Phase districts

  1. Amravati – Khoj
  2. Nandurbar - Janarth
  3. Osmanabad - Halo Medical Foundation and Lokpratishthan
  4. Pune- Mahila Sarvangin Uthkarsh Mandal (MASUM)
  5. Thane - Van Niketan

 

Second Phase districts
> Aurangabad - Marathwada Gramin Vikas Sanstha (MGVS)
> Beed - Manavlok (Marathwada Navnirman Lokayat)
> Chandrapur- Youth Awareness and Rural Development(YARD)
> Gadchiroli - Aamhi Amchi Arogyasathi
> Kolhapur - Sampada Gramin Mahila Sanstha [SANGRAM]
> Nashik- Voluntary Association for Community Health and Nature (VACHAN)
> Raigad- Disha Kendra
> Solapur - Halo Medical Foundation
To know more about Community based Monitoring process under NRHM at national level click here.    http://www.cbmpmaharashtra.org

Promoting participatory action on local Health budgets and medicine distribution in Maharashtra

Project Duration - upto 31st March, 2017


Funded by - International Budget Partnership
Goal - Responsive district health planning and effective medicine distribution in Maharashtra to ensure significantly improved primary health care service delivery with a broader framework of community accountability.

Objective

  1. Central role played by RKS members and CBMP committees in local need based health planning and budgeting, leading to more effective and appropriate functioning of health services. Strengthened spaces for participatory planning and accountability related to health services.
  2. Active involvement of CBMP committees in monitoring expenditures of Program Implementation Plan (PIP) budgets, ensuring effective utilization of these funds and improved service delivery.
  3. Demand driven and adequate medicine distribution in rural public health facilities based on key changes in medicine distribution system.
  4. Effective state level collaboration and advocacy with the help of the CBMP network for ensuring greater responsiveness of district health planning and medicine distribution processes.

 

To achieve these objectives, SATHI would collaborate with five partner organisations to conduct project activities in an intensive manner. Further, capacity building related to various activities would be carried out with 24 CBMP implementing organizations in 13 districts. The project would consist of a three pronged strategy to achieve these objectives – action oriented research and evidence building, capacity building of key stakeholders, and advocacy at various levels. To move towards attaining the stated objectives, we propose to carry out the following activities in this project:

  1. Activity 1 -Study of pattern of utilization of RKS (Patient welfare committee) funds in 6 selected PHCs and 3 Rural Hospitals from 3 districts of Maharashtra, linked with participatory interventions in planning of RKS funds by CBMP and RKS committee members, leading to more appropriate use of flexible funds.
  2. Activity 2 Capacity building of  24 civil society organisations from 13 districts on PIP related issues, for ensuring budget accountability and monitoring of district and block health plans.
  3. Activity 3 -Tracking implementation of community oriented and innovative components of PIPs as well as local level advocacy for its effective implementation in 2 Districts.
  4. Activity 4 - Action oriented analysis of medicine distribution system linked with advocacy for more responsive supply system in 3 selected districts of Maharashtra.
  5. Activity 5  -State level networking and advocacy to influence the public health system, towards more participatory local health planning and effective medicine distribution systems.

 

Anusandhan Trust

Anusandhan Trust, a public trust registered under the Bombay Public Trust Act, 1950, (Registration No: E-13480), runs two centres namely: CEHAT based in Mumbai and SATHI in Pune.
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