Background

Since 2015, a community-based monitoring and planning project for health services has been implemented in 30 villages of Ghatanji taluka. Further, since 2021, a Community Action for Health program has been implemented across 253 villages under the jurisdiction of 9 Primary Health Centres (PHCs) in Ghatanji and Yavatmal talukas.

The National Rural Health Mission (NRHM) was launched for the period 2005 to 2012 with the objective of improving access to quality healthcare services for people, especially those in rural areas, the poor, women, and children. To ensure that services reach the intended beneficiaries, Community-Based Monitoring and Planning (CBMP) was introduced as a key component. This initiative was the result of sustained efforts by the Jan Swasthya Abhiyan.

Community-based monitoring is considered a critical approach to promoting accountability and community-led action in the health sector. The monitoring process includes outreach services, public health facilities, and referral systems. It is widely recognized that the most valuable insights about healthcare needs—what services are required, where they are needed, and how they should be delivered or improved—come directly from the service users themselves.

This approach places communities at the center of the process. Community-Based Organizations (CBOs), people's movements, NGOs, and Panchayat representatives monitor aspects such as service demand, availability, accessibility, quality, effectiveness, behavior and attendance of healthcare providers, and instances of denial of care or negligence. They also provide direct feedback on the functioning of public health systems, including suggestions for improvement. This enables communities to actively participate in monitoring health resources and engage directly with health authorities, ensuring transparency and accountability.

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Objectives of Community Action for Health

• To provide regular and systematic information on community needs to guide effective planning processes.

• To provide feedback based on locally developed criteria and key indicators.

• To assess the status of rights fulfillment, performance of service providers at various levels of the public health system, gaps and deficiencies in services, and levels of community satisfaction—thereby facilitating corrective actions within an accountability framework.

• To empower communities and community-based institutions to become equal partners in the health planning process, fostering participation and responsiveness in the public health system.

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Key Activities

• Strengthening Village Health, Nutrition and Sanitation Committees (VHNSCs) and making them action-oriented.

• Selection and training of Health Volunteers at the village level to improve awareness and access to health rights, services, and entitlements.

• Formation and capacity building of federations at the taluka and PHC levels to enhance community participation in health services and planning.

• Establishment and strengthening of Jan Arogya Samitis at sub-centre levels to increase community participation in health initiatives.

• Facilitating discussions among Rogi Kalyan Samiti (RKS) members at PHC level regarding challenges and improving availability of services, encouraging decision-making and implementation.

• Formation of a District Steering Committee comprising officials, representatives, and monitoring stakeholders to raise issues from village to taluka levels and ensure policy-level decisions for strengthening health systems.

• Coordination with the Health Department to ensure that quality health schemes and services reach the target beneficiaries.

• Establishment of monitoring and planning committees at village, PHC, taluka, and district levels.

• Capacity building and training of Community Action for Health (CAH) committee members at all levels.

• Data collection and reporting through structured tools by monitoring committees to assess the status of health services.

• Collection, follow-up, and analysis of key indicators such as pregnant women, high-risk pregnancies, VHNSC performance, etc.

• Organization of Jan Samvad (Public Hearings) at PHC, taluka, and district levels once or twice a year to facilitate community feedback and dialogue.

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Rasikashraya as District-Level Nodal NGO

Rasikashraya is serving as the District-Level Nodal NGO for this project. It is working across 9 Primary Health Centres in Ghatanji and Yavatmal talukas, covering Rogi Kalyan Samitis at PHC level, Jan Arogya Samitis at 70 sub-centres, and VHNSCs in 253 villages.

The organization is also responsible for coordinating with district and state-level stakeholders for effective implementation of the Community-Based Monitoring initiative.