The COVID pandemic underlined the importance of well-functioning public health services. Although public health services are chronically underfunded and understaffed, poor and marginalised people depend critically on them. In the post-pandemic recovery period, nationally and globally, there is a renewed call with urgency to invest and improve public services without further delay. On this background, SATHI’s perspective to improve public health services by enabling local communities, particularly marginalised sections, to create inclusive mechanisms for dialogue between communities and public health functionaries while deepening the accountability culture is valuable. So, SATHI is activating institutionally mandated participatory forums to enable communities to access improved health services.
Objectives
Establish and activate participatory forums in rural/ tribal blocks of Maharashtra, as mandated by the government. These forums enhance communities’ access to primary healthcare services and schemes.
To establish, activate, and strengthen participatory forums in urban areas in specific urban wards of Pune City, to increase access of communities in healthcare services.
SATHI focuses on specific rural and urban health institutions and processes to enhance access to health services. The organization has initiated community-level dialogues between health functionaries and the public, with the goal of highlighting community perceptions of health services in meetings with health officials.
Objectives
This grant is to amplify accountability issues in the private and corporate health sectors, and specific to SRHR, at the national and the South Asia regional levels.
Objectives
Strengthening access to maternal and child health nutrition services in the tribal area of four districts of Maharashtra by empowering local community, thereby improving ANC, PNC care and reducing malnutrition.
Objectives
This project empowers pregnant and lactating women by improving awareness about public health and nutrition services, and increasing access to these services through local interventions.
To enable this, a project orientation workshop was conducted for officers and other community level stakeholders to enlist their involvement in the project including frontline service providers ANM, Anaganwadi , and ASHA workers, in the selected slum areas.
Beneficiary groups include pregnant and lactating women, and their relatives or family members. Beneficiaries receive awareness and training about available health and nutrition services, role of different stakeholders who can assist with access to healthcare services, and relevant forms for applying to entitled scheme benefits. Training and awareness raising also include visits by beneficiary groups to nearest PMC health centre and local Anganwadi centre, to understand the actual services and schemes. Other community awareness campaigns include enhanced awareness of health and nutrition services, available schemes, vaccination and anaemia campaign, ANC/PNC services, breast feeding practices, best food and recipe practices, and food demonstrations.
Monthly meetings with beneficiary groups help to track health and nutrition services they are availing, and contribute to improving regular ANC and PNC services.
Expected Outcomes
Though SATHI has been providing technical and knowledge inputs to various organisations, this is an opportune time to fully evolve into a resource organisation working in the health sector at state and national levels. Given the pandemic experience, healthcare has re-emerged as a global and national priority; this project support will critically help distil organisational and programmatic learnings during the pandemic, revisit program assumptions, and develop effective strategies to shape future work.
For SATHI, a successful strategy is not just a premeditated plan or rigid set of instructions, but a program design that evolves in the context of changing conditions.
The National Rural Health Mission (NRHM) was launched in 2005 with the goal of improving the availability of, and access to quality health care for people, especially for residents in rural areas, the poor, women, and children. Community Based Monitoring and Planning (CBMP) was introduced as an important component, to ensure that 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 as an essential aspect of promoting accountability & community led action in the field of health. The process includes outreach services, public health facilities and the referral system. It is assumed that, the most relevant 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, and give direct feedback about the functioning of public health services, including inputs for improvement. This has enabled people’s participation in monitoring health resources and direct dialogue with health officials. The platform ensures accountable and transparent practices.
Objectives of CAH
Scope and structure of CAH
Maharashtra is one of nine selected Indian states for implementation of CBMP. Five districts in Maharashtra were included in the first phase, which was expanded to cover eight districts in the second phase of CBMP. Currently CAH is successfully implemented in 17 districts by SATHI and STAPI as an SNGO.
Involved stakeholders include representatives of Health Officials, Panchayat Raj, Community Based Organizations/ NGOs/ Peoples Movements and VHSNC members, PHC & Block federations, District level committee members as DMRG, also SMC as State level committee.
Key Activities
SATHI as State Nodal NGO
SATHI- Action Center ofANUSANDHAN TRUST has responsibility to work as a state nodal NGO for this project, providing training material like guidebook, posters, tools for data collection and state level coordination with Government of Maharashtra, as well as intervention with districts nodal NGOs for implementation of Community action for health activities.
District Nodal NGOs
Selected NGOs have taken responsibility for activities in the target districts. The following organizations have worked as district nodal NGOs in selected communities
Current Phase
While pandemic-related academic and epidemiological research is abundant, there is undoubtedly a dearth of narrative analysis that captures people’s stories. Almost every house in India has a Covid – 19 story to tell. These stories are predominantly about who died, who was exploited in the hospital, who took a bribe, and who can help get a vaccine; amindbogglingvariety of distress experiences.
Predictably, the massive state machinery is out to control the narrative, and hide its abject failure in protecting citizens. Thecontestationis to fix the meaning of the pandemic experience. We at SATHI, believe this is an opportune time to work on health narratives, to enhance the effectiveness of our work on transparency, accountability and governance. We endeavour to combine extended individual monologues related to experiences of seeking health care during the pandemic, and create a collage of voices to puncture the dominant narrative thatabdicates thegovernment of gross neglect.
We seek to work on equitable health systems for the post-Covid world, using narrative strategies to change discourse on universal health care, for strengthening public healthcare, and regulating the private health sector.
Three broad objectives