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CAH Briefer 4 Community Action for Health_English |
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COMMUNITY ACTION
FOR HEALTH
under the National Health Mission
Secretariat
Advisory Group on Community Action
Bringing public into public health
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COMMUNITY
ACTION FOR
HEALTH
Community Action for Health (CAH),
a key strategy of the National Health
Mission (NHM), places people at the
centre of the health system to ensure
that the health needs and rights of the
community are being fulfilled. It
provides a mandate to empower
community members, community-
based organisations and elected
representatives to participate and
monitor the progress of NHM schemes
in their areas, thereby contributing
towards equitable, accessible and
quality health services.
PROCESSES
WHY
COMMUNITY
ACTION
• Builds community awareness • Identifies gaps and promotes
on health entitlements
corrective actions to improve
• Fosters community ownership
and active participation of
the delivery of health care
services
marginalised groups
• Enables appropriate utilisation
• Involves Panchayati Raj
Institutions (PRIs) in
monitoring, planning and
allocating budgets to improve
health services and facilities
of untied funds for local
priorities through Village
Health, Sanitation and
Nutrition Committees
(VHSNCs), Mahila Arogya
Samitis (MASs) and Rogi
• Provides a platform for
Kalyan Samitis (RKSs)
community feedback and
dialogue with service
providers and elected
representatives
VHSNCs
MASs
RKSs
Creating
awareness
on health
entitlements
Monitoring
of health
services
Generation
of health
report cards
Jan
Samvads
Local
corrective
actions
Follow-up,
planning and
allocation of
resources in
the PIP
ADVISORY GROUP ON
COMMUNITY ACTION
The Advisory Group on Community
Action (AGCA) was constituted by
the Ministry of Health and Family
Welfare (MoHFW) in 2005 with a
mandate to provide guidance to
community monitoring processes,
especially as related to the
accountability initiative under the
National Rural Health Mission
(NRHM). The AGCA, which comprises
public health experts from across the
country, provides guidance and
inputs for policy and programme
formulation based on ground
realities. Population Foundation of
India hosts the secretariat for AGCA,
with a core team that provides
technical support to state
governments.
AGCA provides technical support to
state governments in:
• Facilitating state-level visioning
and planning exercises to develop
implementation plans
• Undertaking innovative
approaches on community action
with state governments
• Capacity building of state nodal
officers and implementing
organisations
• Adaptation of manuals, tools and
resource materials
• Undertaking periodic programme
implementation reviews
AGCA MEMBERS
• Mr A.R. Nanda
• Dr Abhay Shukla
• Dr Abhijit Das
• Mr Alok Mukhopadhyay
• Mr Gopi Gopalakrishnan
• Dr H. Sudarshan
• Ms Indu Capoor
• Ms Mirai Chatterjee
• Dr Narendra Gupta
• Dr M. Prakasamma
• Ms Poonam Muttreja
• Dr Sharad Iyengar
• Dr Thelma Narayan
• Dr Vijay Aruldas
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COVERAGE
(FY 2019–20)
Funded by the MoHFW, CAH is being implemented
in 24 states and union territories of India,
making it perhaps the world’s largest community-
led accountability initiative.
2,24,186 villages
372 districts, including 51 aspirational districts
72 cities
1,260 master trainers developed
22,229 VHSNC, MAS and RKS members trained
2,442 Jan Samvads held in 9 states
4 states visited as part of the 13th Common Review Mission
INNOVATIONS
Rogi Kalyan Samiti
(Patient Welfare
Committee) strengthening
in Uttar Pradesh, Goa,
Jharkhand, Sikkim and
Odisha
To improve the functioning of RKSs,
thereby ensuring better quality of
health care for patients
Key outcomes:
• Blood storage units
operationalized to address
high-risk cases
• Improved service delivery
practices, including privacy
arrangements in labour rooms
Social audit of health
services in Jharkhand,
Meghalaya and
Uttarakhand
To mobilise the local community in
auditing health services and seeking
redressal on identified gaps
Key outcomes:
• Disbursement of pending
incentives to beneficiaries
and ASHAs
• Resources allocated for
construction and repair of Sub
Health Centres (SHCs) and
Primary Health Centres (PHCs)
Community monitoring of
Health and Wellness
Centres (HWCs) in Assam
To promote community mobilisation
and monitoring for improved health
care services through HWCs
Key outcomes:
• Resources contributed by local
self-governments (LSGs) to
improve amenities, including
seating arrangements and
water supply
• Streamlined supply of
medicines and consumables
based on community feedback
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INNOVATIONS
(Cont’d.)
RESOURCE
MATERIALS
Youth engagement in CAH
in Bihar
To develop youth leaders to
undertake monitoring of Adolescent
Reproductive and Sexual Health
(ARSH) services in two pilot districts:
Darbhanga and Nawada
Key outcomes:
• Four AFHCs/Yuva clinics
established at PHCs/sub-
divisional hospitals
• Commitment from District
Magistrate (Nawada) to establish
12 AFHCs/Yuva clinics from
aspirational district funds
Urban CAH in Odisha,
Gujarat and Kerala
To engage MAS members in
monitoring health services provided
on Urban Health Nutrition Days
(UHNDs) and in Urban Primary
Health Centres (UPHCs)
Key outcomes:
• Evening OPD regularized in
UPHCs
• Privacy arrangements made at
UHND sites for antenatal care
(ANC) check-ups
“ When community-based
monitoring was initiated in
our area, I became a member
of the Planning and
Monitoring Committee (PMC)
at PHC Chandanapuri. Then I
realized that the PHC had all
the health services for which I
was spending money at
private hospitals. Now I only
come to this PHC and have
also mobilised others. People
are coming in high numbers…
the daily OPD is now 150! We,
the PMC members, and PHC
staff worked together for this
change.”
Arogya Gram Sabhas in
Maharashtra
To address local health issues
through Arogya Gram Sabhas
Key outcomes:
• Piped water brought to the
village through voluntary
contribution by local people
• SHC infrastructure and facilities
improved by Panchayats using
14th Finance Commission funds
Gyandev Bhimaji Rahane,
Police Patil and PHC - PMC
member
Chandanapuri PHC, Khambe village,
Sangamner block, Ahmednagar
district, Maharashtra
Secretariat
Advisory Group on Community Action
B-28, Qutab Institutional Area, New Delhi – 110016
T: +91 11 43894 100
Email: agca@populationfoundation.in
www.nrhmcommunityaction.org | www.populationfoundation.in