Current Projects under Public Health Programme
Project Title: Improving maternal health and nutrition services for urban poor in Pune City.
Project Period: 5th July 2022 to 4th October 2024
Donor Agency: Bajaj Finserv Limited
Background:
Improving access to maternal health and nutrition services in the urban slums in Pune city where pregnant and lactating women will be empowered to improve awareness about public health and nutrition services and increase access of these services through local interventions. Project orientation workshop for officers and other community level stakeholders to get their involvement in the project.
Orientation workshop for frontline service providers- ANM, Anaganwadi workers and ASHA in the selected slum areas.
Formation of beneficiary groups (Beneficiary groups includes pregnant, lactating women and their relatives or family members) in the community Training of the beneficiary groups about available health and nutrition services, role of different stakeholders who can assist with access to healthcare services, and form applying for entitled scheme benefits. Visits by beneficiary groups to nearest PMC health centre and local Anganwadis’ centre, to know about the actual services and schemes. Community level awareness campaigns for beneficiary groups for 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 to ascertain which health and nutrition services they are availing. This will contribute to improving regular ANC and PNC services
Expected Outcomes:
- Improvement in access of health services for 600 ANC & PNC mothers and 600 infants as direct beneficiaries.
- 2.30% increase in number of ANC check ups.
- Improved coordination between Pune municipal health officials, frontline workers, and beneficiaries regarding access to maternal health services and scheme.
Project Title: To Build organisational sustainability and future Readiness..
Project Period: April 2022 to March 2024
Donor Agency: GROW FUNDS- EdelGive Foundation
Background:
Over the years, SATHI has evolved into a high impact organisation working in the health sector, with unique ability to develop transformative community health programs focussing on entitlements and improving access to health care, liasoning and working at various levels of the public system- starting from PHC to state-level policy-making, and playing a lead role in shaping national level processes like community-based monitoring of health services and decentralised health planning. SATHI’s legitimacy and credibility among diverse stakeholders in the health sector, like academic institutions, other NGOs, the NHRC, state and national level health decision-making spaces, and international networks is now firmly established. In addition to working with the public health sector, SATHI took the lead in developing a discourse on the complex agenda of reforming private healthcare, developing a framework for patient’s rights in the private sector, and outlining steps to improve patient-doctor relationships. Although implicitly, 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 the state and the national level. Given a pandemic experience, and as health has remerged 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 will not be just a premeditated plan or rigid set of instructions but a program design that will evolve in the context of changing conditions
The support from GROW funds will be crucial for reinventing the modes of organisational sustenance and functioning in view of pandemic experience, while equipping organisation to deal with post-pandemic scenario. In this regard, following activities have been planned in this project.
- Strengthening SATHI communication strategy by hiring communication officer and upgrading staff skills on using multimedia and story-based techniques.
- Organising expert consultations and engaging domain expert on domestic fundraising.
- Developing SATHI program strategy by foregrounding pandemic experience and insights from community interventions.
- Upgrading technological and communication infrastructure and access to knowledge management tools.
- Strengthening SATHI action research by identifying data needs accessing specialised data sources and international knowledge resources.
- Review of upgraded programmatic and fundraising strategies.
Project Title: Equitable Health Systems for the Post Covid World: Using Narrative Strategies to Develop Popular Discourse on Universal Health Care, Strengthening Public Healthcare, and Regulation of the Private Health Sector.
Project Period: January 2022 to December 2023
Donor Agency: WEMOS
Background:
While pandemic-related academic and epidemiological research is abundant, there is undoubtedly a dearth of narrative analysis that captures the stories of people. Almost every house in India has a story to tell. These stories are predominantly about who died and who was exploited in the hospital, who took a bribe, and who can help get a vaccine; there are mindboggling varieties of distress experiences. Predictably, the massive state machinery is out to control the narrative and hide its abject failure in protecting citizens. The contestation is to fix the meaning of the pandemic experience. Hence, we believe that 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 the experience of seeking health care during pandemic and create a collage of voices to puncture the dominant narrative that abdicates government from gross neglect.
This seeks to work on equitable health systems for the post covid world- using narrative strategies to change discourse on universal health care, strengthening public healthcare, and regulation of the private health sector.
Three broad objectives:
- To develop a grounded, people-centred counter-narrative on healthcare that questions the existing state of healthcare and health policymaking.
- To generate community-level evidence for promoting the development of UHC system in India
- To contribute to developing a regional and global south counter-narrative on privatisation and commercialisation of healthcare.
Project Title: Community Action for Health (CAH), funded by National Health Mission (NHM), Maharashtra. (Based on CBMP)
Project period : April 2022 to July 2023
Donor Agency : National Health Mission (NHM), Maharashtra
Background
The National Rural Health Mission (NRHM) was launched from 2005 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 (CBMP) 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 essential 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, behaviour 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 Action for Health
- To provide regular and systematic information about community needs, which will be used to guide the planning process appropriately.
- To provide feedback according to the locally developed yardsticks, as well as on some key indicators.
- To provide feedback on the status of fulfilment 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.
- 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 Action for Health
selected nine states of India of which Maharashtra is one state. Five districts are selected from Maharashtra in first phase. In the second phase of CBMP, this activity has been expanded to Eight districts. Now, it has successfully implemented in Seventeen districts by SATHI and STAPI as an SNGO. Involved stakeholders – The 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
- Publications- Preparation of tools, data collection formats, training, orientation and awareness materials like brochure, guidebook and documentation format.
- Formation of District Monitoring and planning committee (DM&PC) that played important role for district level intervention.
- State level workshop and training of trainers (ToT)- Training of CAH field team and different levels.
- District level workshop and trainings for Formation of District mentoring team and training of block coordinators for implementation of community-based activities.
- Jan Arogy Samitee’s (JAS) members federations formation at HWC and block level.
- Orientation and training of all JAS members at both levels.
- Jansanvad- HWC, Block and district level Community actions exercises include a Public Dialogue (Jan Sanvad) or Public Hearing (Jan Sunwai) process once or twice in the year in each Block.
SATHI as State Nodal NGO
SATHI- Action Center of ANUSANDHAN TRUST has taken the 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 Districts nodal NGOs for implementation of Community action for health activities.
District Nodal NGOs
In selected districts, selected NGOs have taken responsibility for the activities in that district. The following organizations have worked as District nodal NGOs in the selected communities.
Current Phase
- Aurangabad – Marathwada Gramin Vikas Sanstha (MGVS)
- Beed – Manavlok (Marathwada Navnirman Lokayat)
- Kolhapur – Samvad
- Osmanabad – Halo Medical Foundation
- Pune- SATHI Sanstha
- Solapur – Astitva Samaj Vikas & Sanshodhan Sanstha
- Sangali – Sampada Gramin Mahila Sanstha [SANGRAM]
- Yawatmal- Rasikashray sanstha
- Amaravati – Apeksha Homiyo Society
Project Title: Mobilising communities, supporting COVID patient families, revitalising health systems during COVID Improving delivery of Maternal health services for tribal communities in Maharashtra, in the COVID recovery phase.
Project Period: January 2022 to December 2022; extended upto March 2023
Donor Agency: Association for India’s Development (AID)
Background:
COVID-19’s impact on the urban poor has been multidimensional- besides job losses, lockdown effect on informal sector, healthcare is also an area where people witnessed significant financial and mental distress. Two trends seen in urban areas during the COVID epidemic have been –
- Government’s orders on rate capping for COVID care (due to many reported instances of overcharging) lacked effective implementation. Although it was a necessary step and fully supported by CSOs, nonetheless, private hospitals, particularly corporate and larger hospitals, continued to extract profits from numerous vulnerable patients and families.
- Key health schemes like, MPJAY (Mahatma Phule Jan Arogya Yojana), Pune Municipal Corporation’s scheme for urban poor etc. did not function optimally because of unavailability of easily discernible information about these schemes in public domain, and the general reluctance of public and private hospitals to inform patients about these schemes.
In view of the above situation, the project aims to rejuvenate the public healthcare system in selected districts in order to streamline and restore the provision of essential health services in the post-pandemic period, mainly through capacity building of local committee members and a cadre of health communicators. The project intervention has been focused on three tribal/rural areas (Pune and Nandurbar) and one urban area (Pune city). This project will be inclusive of all socially excluded, marginalised and underserved communities from the intervention areas
Project outputs-
Related to rural health intervention (component A)
- Cadre of health communicator (total around 45 from all three blocks) will be developed who bring awareness amongst the community which will carry out the local health interventions (Social audit process in each HWC area).
- Active community leaders (VHSNC and JAS members) will be developed who will have special skills of conduction of Social Audit process and will be available as resource teams for the improved health services in the block.
- Jan Arogya Samitis will be formed and activated in around 45 HWCs.
- Developed training material for capacity-building workshop for JAS and PRI members will be developed.
- Trained JAS and PRI members will participate in the local intervention to bring change in the local health system.
- Compiling and analysing stories of change of the patients/community.
Related to urban health intervention (component B)
- Grassroots activists belonging to 3-4 organisations working with patients will be made aware about health rights, patient rights and schemes through information dissemination program
- Patients in the community will be guided to avail the benefits of insurance schemes and state orders related to healthcare services.
- Patient rights charter will be displayed in large number of government and private hospitals in Pune
Related to providing technical support to victims of COVID related overcharging (component C)
- Complaints received through CEMPS and JAA networks will be scrutinised, numbered, compiled with tabulation of key information for each complaint, and appropriately forwarded to relevant health officials for audit process.
- Based on rapid analysis of key features of complaints, relevant patterns and features would be identified and made available to support the audit process.
- Grassroots activists and individual complainants will be provided online technical guidance and support as per requirement.
