Project : Community Based Monitoring of Health Services under National Rural Health Mission (NRHM) Duration :
Pilot Phase- June 2007 to November 2008
Continuation Phase- December 2008 to March 2009
Second Phase of Community Based Monitoring- April 2009 to March 2010

Project Facilitator : Nitin Jadhav

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 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 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 as well as directly give feedback about the functioning of public health services, including giving inputs for improvement. This has enabled peoples participation in monitoring health resources and direct dialogue with health officials. The platform ensures accountable as well as transparent practices.

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 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 Based Monitoring

Community Based Monitoring 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 namely Amaravati, Nandurbar, Osmanabad, Pune and Thane.

The representatives of Health Officials, Panchayat Raj, Community Based Organizations/ NGOs/ Peoples Movements and villagers are part of Monitoring and Planning Committees at Village, PHC, Block, District, and State levels.

Key Activities

1. Publications- Preparation of monitoring tools, training, orientation and awareness materials like brochure, guidebook and documentation format. To view or download the publications, click on http://www.sathicehat.org/Publications/CommunityBasedMonitoringMaterial

2. Formation of State Mentoring Committee that played important role of finalization of state appropriate frameworks.

3. State level workshop and training of trainers (ToT)- Training of Community based monitoring team at different levels.

4. 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.

5. Formation of monitoring and planning Committees at village, PHC, block and district level.

6. Orientation and training of CBM committee members at all levels.

7. 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.

8. District Media workshop for improving media coverage of activities and findings of the pilot phase of CBM.

Press cuttings of State Media WorkshopClick here to see some of the media coverages

9. Jun sunwai- Block and district level community monitoring exercises include a Public Dialogue (Jan Samvad) or Public Hearing (Jan Sunwai) process once or twice in the year in each PHC, district and state.

10. State review workshop, evaluation and process documentation.

SATHI as State Nodal NGO

SATHI-CEHAT has taken the responsibility to work as a state nodal NGO for this project, providing training material like guidebook, posters, Aarogya Hakka Calendar, tools for data collection and state level coordination with Government of Maharashtra as well as 5 districts and 15 Block nodal NGOs for implementation of Community based monitoring activities.

District Nodal NGOs

In selected districts, selected NGOs have taken the responsibility for the activities in that district. The following organizations have been working as District nodal NGOs in the selected five districts

1. Amravati - Khoj

2. Nandurbar - Janarth

3. Osmanabad - Tata Institute of Social Services (TISS)

4. Pune- Mahila Sarvangin Uthkarsh Mandal (MASUM)

5. Thane - Van Niketan

To know more about Community based Monitoring process under NRHM at national level click on http://www.nrhmcommunityaction.org.

* Community Based Monitoring of Health Services Under NRHM in Maharashtra - Circular / GR

CBM Report

Compiled Report of Community Based Monitoring of Health Services Under NRHM in Maharashtra (2007-2010) Download full document