13 May 2010
The data was collected from 220 villages and 40 primary health centres across fifteen blocks in five districts of the state including Pune. Sathi–Cehat, a state nodal NGO, collected the information under Community Based Monitoring (CBM) of the National Rural Health Mission (NRHM).
“Nine key health services were rated by Village Health Committee members as either ‘good’, ‘partly satisfactory’ or ‘bad’. Eight per cent of the services were given good ratings in phase 1, which increased to 61 per cent in phase 2 and further to 66 per cent in phase 3. Thus there has been a consistent overall improvement in village health services in the CBM covered villages in last three years,” said Abhay Shukla, co–ordinator Sathi, an NGO working in health sector in Maharashtra.
Elaborating it further, Shukla said, “Under CBM, people collectively monitor activities of auxiliary nurse Midwifery and multi–purpose workers, periodically visit the PHCs and audit the availability of medicines and services, document the regularity of services and behaviour of providers, point out irregular practices, and repeatedly raise these issues with officials at various levels. All this has resulted in real improvements at the ground level.”
The other four districts covered are Amravati, Nandurbar, Osmanabad and Thane.
When the community monitoring process started (phase 1: July – August 2008) it was found that there were significant gaps in services provided at the PHC and village levels across all districts.
“Based on this observation, further activities such as the preparation and display of report cards, dialoguing with health service providers and officials in various committees, presentation of problems regarding public health services through public hearing and publicising some of the observations through media was done,” said Shukla.
‘Widen scope of CBM to water, food security’
To widen the ambit of community based monitoring (CBM), Sathi–Cehat has given a proposal to the Planning Commission to bring CBM in other core issues like water and food security. “Considering the progress made by CBM in areas of health in rural parts of the state, integrating water and food security along with health under CBM will definitely go a long way in providing holistic care. We have already submitted the plan to this effect to the Planning Commission,” said Shukla.