• मोफत/सवलतीच्या दरात उपचाराबाबत माहिती व मार्गदर्शनासाठी.. साथी हेल्पलाईन 94 22 32 85 78

Previous Projects

Public Health System Strengthening – Previous Projects

Project Title
To Build organisational sustainability and future Readiness..

Project Period

April 2022 to March 2024

Donor Agency

GROW FUNDS- EdelGive Foundation

SATHI is a high impact organisation working in the health sector, capable of developing transformative community health programs focusing on entitlements, and improving access to health care, liasoning and working at various levels of the public system- 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 uses the support from GROW funds for crucial reinventing of modes of organisational sustenance and functioning in view of the pandemic experience, while equipping the organisation to deal with the post-pandemic scenario. Some project activities supported by this fund are

  • Strengthening SATHI communication strategy by hiring communication officer and upgrading staff skills on using multimedia and story-based techniques. (348 words)
  • Organising expert consultations, and engaging domain expert for 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.
  • Reviewing and upgrading programmatic and fundraising strategies.

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.

Project Title
Community Action for Health (CAH)

Project period

April 2022 to March 2024

Donor Agency

National Health Mission (NHM), Maharashtra

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

  • To provide regular and systematic information about community needs, that guide the planning process appropriately.
  • To provide feedback according to 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, to facilitate corrective action in a framework of accountability.
  • To enable 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 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

  • 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), which plays an important role for district level intervention.
  • State level workshop and training of trainers (ToT)- Training of CAH field team at different levels.
  • District level workshop and trainings for Formation of District Mentoring Team, and training of block coordinators for implementation of community-based activities.
  • Formation of Jan Arogy Samitee’s (JAS) members federations 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 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

  • 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.

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)

COVID-19 had multi-dimensional impacts on the urban poor. Beside job losses and the lockdown effect on the informal sector, people experienced significant financial and mental distress while dealing with the healthcare sector. Two trends seen in urban areas during the COVID epidemic were-

  • Government’s orders on rate capping for COVID care (due to multiple reports of overcharging) were ineffectively implemented. It was a necessary step, fully supported by CSOs, but private hospitals, particularly corporate and larger hospitals, continued to extract profits from vulnerable patients and families.
  • Key health schemes like, MPJAY (Mahatma Phule Jan Arogya Yojana), Pune Municipal Corporation’s scheme for urban poor etc. were under-used due to unavailability of easy-to-understand information about these schemes in the public domain, and general reluctance of public and private hospitals to inform patients about these schemes.

The project aims to rejuvenate the public healthcare system in selected districts, and streamline and restore provision of essential health services in the post-pandemic period, through capacity building of local committee members and a cadre of health communicators. The intervention focuses on three tribal/rural areas (Pune and Nandurbar) and one urban area (Pune city), and covers socially excluded, marginalised and underserved communities in the intervention areas.

Project outputs-

Rural health intervention (component A)

  • Capacity building of 45 health communicators from all three blocks, to enable improved awareness raising in the community, and enhanced ability to carry out the local health interventions (Social audit process in each HWC area).
  • Development of active community leaders (VHSNC and JAS members) able to conduct Social Audit processes, and available as resource teams for improved health services in their block.
  • Formation and activation of Jan Arogya Samitis in around 45 HWCs.
  • Development of training material for capacity-building of JAS and PRI members.
  • Participation of trained JAS and PRI members, in local interventions to improve the local health system.
  • Compiling and analysing stories of change of the patients/community.

Urban health intervention (component B)

  • Information dissemination program for awareness raising of grassroots activists from 3-4 organisations, working with patients about health rights, patient rights and government schemes.
  • Guidance for patients from the community, to benefit from insurance schemes and state orders related to healthcare services.
  • Displaying of patient rights charter in several government and private hospitals in Pune.

Technical support to victims of COVID related overcharging (component C)

  • Scrutiny, compilation, and counting of complaints received through CEMPS and JAA networks with tabulation of key information for each complaint, and forwarding to relevant health officials for audit process.
  • Analysis of key features of complaints to identify patterns useful to support the audit process.
  • Online technical guidance and support for grassroots activists and individual complainants, as per requirement.

Project Title
Improving delivery of Maternal health services for tribal communities in Maharashtra, in the COVID recovery phase.

Project Period

1st June 2021 to 30th May 2022, extended upto 30th September 2022 and further extension upto 31st December 2022

Donor Agency

International Budget Partnership (IBP)

Background
This project aims to Strengthen agency group’s understanding on delivery of RCH services aimed at increased access to maternal health services and schemes. Strengthen key maternal and child health entitlements and services and track post-COVID shifts in public health services to support community-based action. The grassroots level intervention will lead to mobilised communities and beneficiary women for maternal and child health services and related schemes. Grassroots experiences and findings regarding RCH services will be shared with frontline workers and local elected representatives, to strengthen maternal health services. Further, mobilised communities successfully relay ground level feedback regarding health and nutrition services to enable a system level dialogue with decision makers regarding monitory schemes. This set of interventions will constitute a vertical integration approach to health system reform, focused on maternal and child health services amongst tribal community in Maharashtra.

Project area-Amravati, Nandurbar, Thane, Yawatmal

Key activities-

  • Strengthening the capacities of tribal communities and agency group in the project area to engage on RCH delivery of services.
  • Evidence generated by the communities from project area on the gaps in the delivery of RCH services, as well as the related challenges in terms of the allocation and use of the health budgets.
  • Strengthened tribal communities and agency group monitor and engage with health authorities and spaces (local to state and national) on improving the delivery of RCH services and schemes.

Project Title
Reconstructing Health Systems beyond COVID Critically analysing official transnational investments, shaping policy discourse to promote Right to Healthcare (RTH) in Maharashtra.

Project Period

January 2022 to December 2022

Donor Agency

Rosa-Luxemburg-Stiftung

Background
The COVID-19 pandemic has acted as a powerful ‘MRI scanner’ helping us to scrutinise India’s health system, starkly revealing the architectural weaknesses of the under-resourced, atrophied public health system, along with exposing the predatory nature of unregulated, commercialised, hypertrophied private health care. During this period poorly staffed public hospitals proved insufficient compared to the population’s health requirements resulting in inadequate facilities for COVID-19 patients, while many corporate and large private hospitals engaged in massive overcharging and profiteering.

Within India, Maharashtra state has suffered from not only the largest number of COVID cases and deaths compared to any other state, but strikingly also had one of the highest case fatality rates (among COVID cases, the proportion who died) compared to major states in the country.

The cross-state differences in COVID outcomes among major Indian states seem to be primarily related to differences in effectiveness of public health systems; Maharashtra with one of the highest COVID case fatality rates among Indian states has a highly privatised health system, with inadequate public health services. Compared to this, Kerala has much lower COVID case fatality rate, associated with a robust public primary healthcare system.

With such catastrophic impact of the pandemic, the stage has been set for healthcare and health systems to emerge as an agenda for urgent policy attention. In this setting, on one hand regressive solutions are being promoted by the establishment focussing on further privatisation, corporatisation, private sector oriented transnational investments, and securitisation of healthcare. On the other hand, there is high degree of social receptivity for progressive proposals centred on major strengthening of public health services, regulation of private healthcare providers, and fulfilment of health rights through a democratised healthcare system, based on public-centred universal health care. There is no doubt that the COVID-19 pandemic can become a critical turning point for the health system in India, and especially in states like Maharashtra. This is an opportune time to reimagine health systems and powerfully build socio-political will from below for comprehensive, people centred, rights-based health system change.

Given this context, SATHI proposes to conduct activities on two complementary fronts during the COVID recovery situation, which can help shape the policy discourse in the health sector in a pro-people direction. The first component would focus on studying and deconstructing official transnational development investments in the health sector, with focus on German development agencies, to understand the impacts which these influential investments have on health systems and access to healthcare for deprived and marginalised populations in India. The second component would be focussed on the state of Maharashtra (the second largest state in India, which has suffered the worst during the COVID pandemic), towards shaping policy discourse to promote major strengthening of public health systems and operationalisation of Right to Healthcare.

Key Inputs

  • People-centred Maharashtra Right to Health Care bill, and legal brief outlining steps for operationalisation of such bill is available in the public domain, publicised widely in media, and discussed with policymakers.
  • Series of broad-based consultations on UHC in Maharashtra culminated in set of Policy briefs on critical health system themes which can be used for policy-level advocacy.
  • A policy brief on innovative health system financing for Maharashtra aligned with the UHC objectives, with clear articulation on sources of additional resources for public health systems, is published and widely circulated among diverse stakeholders.
  • Concrete evidence on patterns of inadequate remuneration and various key concerns related to ASHAs is placed in the public domain, gaining media attention and further opening space for policy-level dialogue and improvement in status and role of ASHAs.
  • Contemporary status update and analysis of ESI health services in Maharashtra is shared with trade unions, employee associations, and activists working with the informal sector workers

Expected outcomes

  • Discourse on equity-oriented, tax-based, public health system centred Universal Health Care is amplified and provides a necessary counter-narrative to privatisation oriented, commercial insurance-based ‘Universal Health Coverage’ models.
  • Draft people-centric right to healthcare bill and concrete proposals for raising additional resources for the UHC influences processes of enactment of state-level right to healthcare act.
  • Trade Unions and other stakeholders use ESI-health services related updated information to strengthen demand for improved ESI health services. Similarly, ASHA associations use study findings to demand improved working and employment conditions for ASHAs, with positive implications for all frontline health workers.

Project Title
Promoting people’s health rights in Maharashtra, during and beyond the COVID-19 epidemic

Project Period

1st July 2020 to 31st October 2022

Donor Agency

The Fund for Global Human Rights (FGHR)

Background
People in India experience a fragmented and commercialised health care system which is dominated by for-profit private healthcare, responsible for around 70% of healthcare utilisation. With a mere 1.15 % of the GDP being invested in health, India has among the world’s highest levels of out of pocket expenditure on healthcare, leading to around 5.5 million people falling into poverty annually due to catastrophic healthcare expenses. A weak public health system, coupled with lack of accountability and regulation of private healthcare, results in frequent unethical, medically inappropriate practices, substandard and unaffordable healthcare, and exploitation of vulnerable people seeking treatment.

Maharashtra has been one of the worst affected states in the COVID-19 epidemic, with people experiencing major hardship in seeking healthcare from overwhelmed public hospitals and exploitation and overcharging in private hospitals despite the governments efforts to provide free and affordable healthcare to its citizens through extending coverage of central and state public insurance schemes to all citizens, capping of costs of treatment in private hospitals. However, reports of denial of treatment to vulnerable communities, discrimination, inflated billing, abuse of patient’s rights continue to be highlighted in media reports and documented by civic society.

The COVID 19 epidemic has underscored the urgent need for a strong and well-equipped public health system along with expansion and strengthening of urban health services, especially primary healthcare. Given the high degree of dependence on private healthcare, there is a need to ensure patients’ rights and regulation of the huge, unregulated private healthcare sector. This includes the need for social accountability of publicly funded health insurance schemes like PMJAY / MPJAY which are supposed to provide hospitalisation coverage to the entire population of Maharashtra by involving private hospitals.

Objectives

  • Rights based actions to improve access to rural health services in Maharashtra, especially linked with COVID-19 situation Promoting people’s mobilisation to ensure access to urban health services during COVID-19 epidemic
  • Alliance building with healthcare workers on joint issues highlighted during COVID-19 epidemic
  • Highlighting demands for regulation and entitlements related to Private health sector in context of COVID-19, campaign for Patients’ rights
  • Conducting action-oriented research in COVID-19 situation, for supporting social action towards people-centered health systems
  • Workshops to promote health sector reform as highlighted during the COVID-19 epidemic, taking forward the discourse on Universal Health Care (UHC) in Maharashtra.

Project Title
Activities for improving coverage of COVID 19 vaccination in selected rural and tribal PHCs in the state of Maharashtra.

Project Period

January to June 2022

Donor Agency

Azim Premji Philanthropic initiative (APPI)

Background
Two unmissable trends in the Maharashtra vaccination coverage are- vaccination coverage is unequal and highly skewed towards urban areas; secondly, vaccination in less developed rural and tribal areas is particularly lagging. Among a range of issues causing poor coverage, one that needs to be addressed with urgency is the overall coordination of the vaccination initiative at the PHC level.

Objective-100% coverage of vaccination in selected PHC’s population.

Project Title
Community Action for Health (National Health Mission, Maharashtra)

Project period

April 2021 to March 2022

Donor Agency

National Health Mission (NHM), Maharashtra

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 organisations (CBOs), people’s movements, non-government organisations 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 organisations 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
Community Based Monitoring and Planning process has been implemented as a pilot in 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 Thirteen districts namely Aurangabad, Beed, Nandurbar, Osmanabad, Pune, Palghar, Gadchiroli, Nashik, Kolhapur, Solapur, Sangli, Thane & Yawatmal. The representatives of Health Officials, Panchayat Raj, Community Based Organisations/ NGOs/ Peoples Movements and villagers are part of Monitoring and Planning Committees at Village, PHC, Block, District, and State levels.

Key Activities

  • Publications- Preparation of monitoring tools, data collection formats, training, orientation and awareness materials like brochure, guidebook and documentation format.
  • Formation of State Mentoring Committee that played important role of finalisation of state appropriate frameworks.
  • State level workshop and training of trainers (ToT)- Training of Community based monitoring team at different levels.
  • 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.
  • Formation of monitoring and planning Committees at village, PHC, block and district level.
  • Orientation and training of CBM committee members at all levels.
  • 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.
  • Data collection, follow up and analysis of Indicators data i.e. Pregnant women and High-risk pregnant women, VHNSC data etc.
  • District Media workshop for improving media coverage of activities and findings of the pilot phase of CBM.
  • Jansanvad- PHC, Block and district level community monitoring exercises include a Public Dialogue (Jan Sanvad) or Public Hearing (Jan Sunwai) process once or twice in the year in each PHC, Block, District and state.
  • State review workshop, evaluation and process documentation.

SATHI as State Nodal NGO
SATHI- ​Action Center ofANUSANDHAN 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 13 districts and 28 Blocks nodal NGOs for implementation of Community based monitoring and planning activities.

Project Title
Ensuring integrated access to Health Care for vulnerable urban and rural populations, in context of Covid 19 epidemic in Maharashtra; Extended work of Rural help desks and patient advocate in the urban slum area of Pune

Project period

1st May 2021 to 31st August 2021

Donor Agency

Association for India’s Development (AID)
Background
The second wave of COVID has its onslaught with very virulent spread. For example, In Pune the daily count of the cases coming COVID positive were around 2200 in the first wave. In the second wave as on 3rd April 21 the daily count of COVID positive patients was 5720. The count is rising. THE SITUATION is not as encouraging as in Mumbai, but continuous decline in active cases for the last one week has raised hopes that the worst in the second wave might be over in Pune as well. Unlike Mumbai, Pune is still reporting more than 10,000 cases a daily, this number dropped below 6,200, the lowest this month. But during the past one-week, active cases in Pune have come down by more than 25,000. It peaked on April 19 when the city reported 1.25 lakh Covid-positive people. On Monday, this figure was just about one lakh, though still the second highest in the country after Bengaluru.
At the same time, rural areas in Maharashtra facing unique challenges as they are particularly vulnerable, with poor access to healthcare facilities. With all state efforts focused on epidemic containment, disruptions are being reported in provision of essential non-COVID related health services in rural areas, along with difficulties in accessing relief measures. The vulnerable rural population needs support to access even basic healthcare. The COVID and non-COVID patients in these areas would need support and facilitation to access healthcare facilities.
In urban India, in Big cities like Pune the public healthcare system is virtually at the same scale as was thirty years back. And at primary healthcare level there is big gap and neglect. Not surprising that in this situation, the poor and working class living in slums and low-cost housing, that comprises nearly 50% of the urban population is suffering to get access to quality healthcare that is affordable or free
COVID has exposed this harsh skeleton of nearly non-existent public healthcare in cities like Pune. COVID also has compelled the government to push its many schemes for poor and vulnerable and also out of compulsion the Maharashtra State Government has made the scheme like Mahatma Phule Jan Arogya Yojana – a scheme for nearly 900 secondary and tertiary procedures available to whoever asks for it, expanding the scheme to cover the entire population, beyond the normal eligibility criteria for poor people with Keshari Ration Cards only (BPL and above BPL).
Objective
  • To help patients to get assistance in accessing COVID and Non-COVID entitlements in public healthcare institutions as well as in private sector hospitals which have been taken by the government to admit the COVID patients
  • Project Title
    Ensuring integrated access to Health Care for vulnerable urban and rural populations, in context of Covid 19 epidemic in Maharashtra

    Project period

    1 August 2020 to 31 July 2021 extended upto 31st August 2021

    Donor Agency

    Association for India’s Development (AID)

    Background
    Pune city has already emerged as the second largest hotspot in Maharashtra, and fifth largest focus of COVID-19 in the country (as on 22nd June 2020, total cases 13,267 and deaths 517). In Pune slums, low income settlements and crowded inner city areas are particularly affected,since measuresfor containing COVID 19 such as social distancing, home isolation are difficult to implement. With lowering the lockdown and given limited implementation of intensive outreach based control measures, Pune is expected to experience even larger number of cases in next two to three months.

    At the same time, rural areas in Maharashtra facing unique challenges as they are particularly vulnerable, with poor access to healthcare facilities. With all state efforts focused on epidemic containment, disruptions are being reported in provision of essential non-COVID related health services in rural areas, along with difficulties in accessing relief measures. The vulnerable rural population needs support to access even basic healthcare. The COVID and non-COVID patients in these areas would need support and facilitation to access healthcare facilities.

    In urban India, in Big cities like Pune the public healthcare system is virtually at the same scale as was thirty years back. And at primary healthcare level there is big gap and neglect. Not surprising that in this situation, the poor and working class living in slums and low-cost housing, that comprises nearly 50% of the urban population is suffering to get access to quality healthcare that is affordable or free COVID has exposed this harsh skeleton of nearly non-existent public healthcare in cities like Pune. COVID also has compelled the government to push its many schemes for poor and vulnerable and also out of compulsion the Maharashtra State Government has made the scheme like Mahatma Phule Jan Arogya Yojana – a scheme for nearly 900 secondary and tertiary procedures available to whoever asks for it, expanding the scheme to cover the entire population, beyond the normal eligibility criteria for poor people with Keshari Ration Cards only (BPL and above BPL).

    Objectives
    • To develop cadre of health activists in one urban and 2-3 rural areas to work on Help desks, MPJAY, COVID related health entitlements and provisions
    • To train health activists will assist around a thousand patients monthly in each of 2-3 rural blocks and one slum cluster in Pune city, for obtaining adequate health care from respective public hospitals and MPJAY and other health schemes.
    • To create awareness amongst people about MPJAY and COVID related provisions and schemes, in total 60 villages in three rural blocks and 10 urban settlements in Pune city
    • To regularly analyse information emanating from the help desks and field experiences, and will produce a document with analysed data and stories of patients who faced barriers in accessing healthcare from the rural blocks and urban areas covered.

     

    Project Title
    Building evidence, strengthening action for a sustainable and generalisable model of Community accountability of Health systems in Maharashtra, India (ARC)

    Project Period

    December 2017 to June 2020

    Donor Agency

    Accountability Research Center (ARC)

    BackgroundAccountability Research Centre and Anusandhan Trust- SATHI (Support for Advocacy and Training to Health Initiatives) are collaborating on a project with research and action components, for developing an advanced model of community accountability of health and health related services and programs in Maharashtra, India.
    This project builds upon both the foundation of Community Based Monitoring and Planning (CBMP) in Maharashtra, facilitated by SATHI with support from the National Health Mission over the last decade, and ARC’s substantial research and training expertise in the sphere of social accountability and participatory governance.

    Objectives

    • Strengthening social accountability of public health and social services through promotion of multisectoral community based processes
    • Promoting accountability of Private medical sector through national documentation of patients’ rights violations
    • Building robust evidence base regarding the impacts of community-based monitoring and planning (CBMP) efforts in Maharashtra’s public health system, through action linked research including both quantitative and qualitative components

    Project Title
    Improving the Delivery of Nutrition Services for Scheduled Tribes in Maharashtra (IBP)

    Project Period

    November 2019 to April 2020

    Donor Agency

    International Budget Partnership (IBP)

    Background-
    SATHI proposes to address the challenge of pervasive malnutrition in Maharashtra, specifically targeting the tribal communities. While the preceding sections have clearly established that fully addressing malnutrition requires a comprehensive multi-sectoral approach, SATHI is proposing to contribute to reducing malnutrition among pregnant and lactating women and children up to six years of age in tribal communities by focusing on the core interventions of direct nutrition services and immediately related health care services.

    SATHI will focus its efforts on two components of AAY, namely the nutritional services and the public health care services necessary to complement towards improving the nutritional status of women and children. To work on both aspects simultaneously will be too much for the short period for which initial funding support is being requested. So, SATHI is finally proposing that the full project concept is implemented in two distinct yet related phases.

    The Objectives of this project will be in two phases-
    Phase 1 Improving the delivery of direct nutrition services
    Phase 2 Ensuring Core Public Health Services needed to Complement Nutrition Services

    Project Title
    Capacity building initiatives for Community based OrganiSations towards building and strengthening Health Rights action in Maharashtra and Bihar

    Project Period

    1stOctober 2018 to 31stMarch, 2020

    Donor Agency

    Association for India’s Development (AID)

    Background-
    In the last phase of project intervention an attempt was made to build capacities of activists from around 10 Civil Society Organisations (CSOs) towards ensuring community action for Health in Maharashtra. All these were involved in generalised Community Based Monitoring and Planning (CBMP) process on voluntary basis since last 3-4 years. Based on technical inputs from SATHI, various community processes were implemented in totally new selected districts and blocks of Maharashtra. In each block, these organisations have facilitated generalised CBMP process such as health rights awareness activities, community-based data collection, documentation of cases of denial of health care and preparation for Jan samwads (Public dialogue programs). All these processes have contributed to initial improvements in health services.

    The objectives of this programme will be as follows –

    • Providing technical and strategic inputs to mass organisations working in Maharashtra, focusing on continuation of ongoing health rights activities with exploring advance strategies and mechanisms towards deepening and expanding community accountability processes in Maharashtra
    • Enhancing capacities of activists of MBSNS from Bihar in addressing more complex health system issues which require multi-level advocacy skills, including engaging exiting democratic bodies and institutions.

    Project Title
    Strengthening capacities of WaterAid India network partners for improving Water and sanitation facilities in health institutions through participatory planning

    Project Period

    October 2017 to March 2018

    Donor Agency

    WaterAid India

    In the last phase of collaboration during the period October 2017 to March 2018, SATHI has significantly contributed for strengthening the ‘Healthy Start’ campaign in the form of building the capacities through national level convention and visiting the field of WaterAid network partners from Odisha, Telangana, Madhya Pradesh and Uttar Pradesh; provided ongoing technical and strategic inputs to WaterAid partners; contributed in developing various documents such as concept note and operational framework of intervention, awareness material etc. It is clearly evolved that there is need for continuation of this collaboration in order to consolidate the efforts are being taken for capacity building of WaterAid network partners; deepening and expanding interventions with regards to improve WASH facilities in Health institutions.

    Expected outputs-

    • Concept note including plan of activities for the entire intervention would be finalised and agreed upon.
    • The key functional documents such as simple tool, IEC material, poster, community report card (as mentioned above) etc. would be developed with the inputs from WaterAid partners organisations.
    • Technical support would be provided to partner organisations during the intervention phase, enabling them to overcome bottlenecks of a technical nature.
    • Field visits in all intervention states for capacity building of WaterAid partner organisations.
    • Exposure visit of team of representatives from WaterAid regional office and field partners to Maharashtra would be organised.
    • One national level convention on RKS and WASH would be organised.
    • A detailed report of activities would be drafted, focused on key lessons.

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

    Project extension Period

    August to 31stMarch, 2017

    Donor Agency

    International Budget Partnership (IBP)

    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

    • 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.
    • Active involvement of CBMP committees in monitoring expenditures of Program Implementation Plan (PIP) budgets, ensuring effective utilisation of these funds and improved service delivery.
    • Demand driven and adequate medicine distribution in rural public health facilities based on key changes in medicine distribution system.
    • 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.

    Project Title
    Community Based Monitoring and Planning of Health Services

    Project Period

    November, 2016 to March 2017, extended upto 30thOctober, 2017

    Donor Agency

    National Rural Health Mission (NRHM), Govt. of Maharashtra

    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 Organisations/ NGOs/ Peoples Movements and villagers are part of Monitoring and Planning Committees at Village, PHC, Block, District, and State levels.

    SATHI continues to work as State Nodal NGO
    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.

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

    Project Period

    1stJune 2014- 31stJuly 2016

    Donor Agency

    The International Budget Partnership (IBP)

    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.

    Objectives-

    • 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.
    • Active involvement of CBMP committees in monitoring expenditures of Program Implementation Plan (PIP) budgets, ensuring effective utilisation of these funds and improved service delivery.
    • Demand driven and adequate medicine distribution in rural public health facilities based on key changes in medicine distribution system.
    • 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.

    Project Title
    Community Based Monitoring and Planning of Health Services

    Project Period

    April 2014 to March 2015

    Donor Agency

    National Rural Health Mission (NRHM), Govt. of Maharashtra

    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.

    Objectives of Community Based Monitoring

    • 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 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.
    • To enable the community and community-based organisations 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 Organisations/ NGOs/ Peoples Movements and villagers are part of Monitoring and Planning Committees at Village, PHC, Block, District, and State levels.

    SATHI continues to work as State Nodal NGO
    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.