Convergence at the village level appears integral to the functions of
both programmes but also to all the related departments.. Such
convergence is critical to the success of the National Rural Health
mission. The National Rural Health Mission (NRHM) is seen as a vehicle
to ensure that preventive and promotive interventions reach the
vulnerable and marginalized through expanding outreach and linking
with local governance institutions. The key to the success is
through inter-sectoral convergence, community ownership through
Village Health Committees at the level of the village.
An
Accredited Social Health Activist (ASHA) is expected to work with
communities for social mobilization and improve access to services.
ASHA’s role will be to facilitate care seeking and serve as a depot
holder for a package of basic medicines. The AWW, schoolteacher,
members of local community based organizations and the Village Health
Committee are expected to support the ASHA in her work.
The
location of the AWC and AWW (mostly local women) and the functions of
nutrition and health make them a natural ally for the health sector.
Key participants in the ICDS scheme are children below six years,
pregnant and lactating women, specifically marginalized women. Thus
the programme design of ICDS is such that it can make significant
contributions to malnutrition and mortality- the success in ensuring
healthy childhoods and outcomes for pregnant mothers.
The child
health strategy concentrates on the: essential newborn care,
breastfeeding, immunization, and care of the sick newborn and child
through outpatient/home based care and inpatient care. This approach
is called the Integrated Management of the Neonatal and Child hood
Illness (IMNCI).
ASHA,
(Accredited Social Health Activist), the mechanism to strengthen
village level service delivery, will be a local resident and selected
by the Gram Panchayat or the Village Health Committee. She will be
supported in her work by the AWW, school teacher, community based
organizations, such as SHGs, and the VHC. Her role would be to
facilitate care seeking and serve as a depot holder for a package of
basic medicines. She will be reimbursed by the panchayat on a
performance based remuneration plan. The Village Health Committee (VHC)
will form the link between the Gram Panchayat and the community, and
will ensure that the health plan is in harmony with the overall local
plan.
Capacity
building of PRI is required in thematic areas and leadership skills,
negotiating, monitoring, ability to withstand patronage and political
interference. Capacity building processes need to be tailored to
literacy levels, sex and circumstances of PRI members. Joint
orientation and sensitization meetings between PRI and health and
medical professionals could help to bridge the gap in education and
social strata. Developing Citizen Charter of Rights and Codes of
conduct also lay down guidelines for boundaries of operation and
accountability which is already addressed under RKS. NGOs could be
involved in PRI strengthening in a variety of ways, including:
consciousness raising, provision of technical advice, support in
participatory planning, capacity building and facilitating monitoring
processes, such as community and social audits to improve
accountability. The sensitization / training is covered under RCH II
and also in NRHM Additionalities. There is no separate budget
proposed.
School
authorities and the students will be involved in health activities.
This includes using of students in health programs, school health
programs in the schools in sensitizing the students etc to health
needs. Teachers may also be utilized for propagation of health
information to the students in turn who will disseminate the messages
to the parents and community.
The
facility survey also indicates that majority of the households are not
provided with potable and safe drinking water. Similarly, sanitation
facilities are also very scarce. Under the convergent efforts of the
line departments, it is hoped that these issues also would be
addressed during the program period.
VH&ND is another area where
convergence has started. The committee will oversee under the aegis of
SHM & DHM. This committee will not only address the health need but
also covering all the aspects of sanitation. For all these activities,
it is proposed that convergent activities will require resources and
time. Therefore, the proposal is as below:
Convergence meetings: At state level 2 times per year with all the
departments. And at the district level, 2 such meetings will be
organized per district.
Workshop on innovations: One workshop per district and 2 workshops
at state level will be organized.
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