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CAH Community Action for Health User Manual CAH %28English%29 |
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Cover
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Community Action for Health -
User Manual
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ii | Community Action for Health - User Manual
Acknowledgements
The User Manual is based on the tool used in over 1,600 villages and 300 facilities in the first phase
of community monitoring from 2007 to 2009. The manual and tool were reviewed by a sub-group
comprising representatives of civil society organisations, the Advisory Group on Community Action
(AGCA) and the National Health Systems Resource Centre.
We are grateful to Mr Manoj Jhalani, Joint Secretary (Policy); Ms Limatula Yaden, Director, National
Health Mission in the Ministry of Health and Family Welfare; and AGCA members for their guidance.
Purpose of the Manual
This manual has been designed for the members of the Village Health Sanitation and Nutrition
Committee, the Primary Health Centre Planning & Monitoring Committee, the Block Planning &
Monitoring Committee and the District Planning Monitoring Committee.
It will guide them to conduct community-level enquiry using a set of formats, and in compiling Village
Level Report Cards and Facility Report Cards. This will help in capturing key gaps in public services, and
sharing of the findings with senior authorities.
The manual has six parts – Part A includes an introduction to Community Action for Health and the
understanding and assessing of health systems; Part B details the composition and role of Village
Health, Sanitation and Nutrition Committees and the tool for community enquiry; Part C details the
role and processes of the PHC Planning and Monitoring Committee; Part D includes Block Planning
& Monitoring Committee (BPMC), while Part E has the details of the District Planning & Monitoring
Committee; Part F covers the sharing of results, and processes for conducting a Jan Samwad.
The document also includes two annexes. Annexure I has the tool with formats to be used for
community enquiry and facility survey, and Annexure II includes an overview of the implementation and
capacity building strategy.
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Acronyms
AGCA
AF
ANM
ANC
ASHA
AWW
AWC
BCM
CBMP
CBO
CMO
CMHO
CHC
ICDS
IUCD
JSY
NGO
MoHFW
MTA
MO
Advisory Group on Community Action
ASHA facilitator
Auxiliary Nurse Midwife
Antenatal Care
Accredited Social Health Activist
Anganwadi Worker
Anganwadi Centre
Block Community Mobiliser
Community Based Monitoring and Planning
Community Based Organisation
Chief Medical Officer
Chief Medical Health Officer
Community Health Centre
Integrated Child Development Services
Intrautrine Contraceptive Device
Janani Suraksha Yojana
Non Government Organisation
Ministry of Health and Family Welfare
Mother Teacher Association
Medical Officer
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NHM
ORS
PFI
PMC
PTA
PHC
RKS
SC
VHND
VHSNC
National Health Mission
Oral Rehydration Salts
Population Foundation of India
Planning and Monitoring Committees
Parent Teacher Association
Primary Health Centre
Rogi Kalyan Samiti
Sub Centre
Village Health Nutrition Day
Village Health, Sanitation and Nutrition Committees
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Contents
Acknowledgements
ii
Purpose of the Manual
ii
Acronyms
iii
PART A:
Introduction
1
PART B:
Village Health Sanitation and Nutrition Committee (VHSNC) 3
PART C:
PHC Planning and Monitoring Committee (PHC PMC)
12
PART D:
Block Planning and Monitoring Committee (BPMC)
16
PART E:
District Planning and Monitoring Committee (DPMC)
19
PART F :
Sharing of the results and conducting a Jan Samwad
20
Annexure –I
22
Annexure –II
46
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Part a
Introduction
The Government of India launched the National Rural Health Mission (NRHM)
in 2005.The mission aims to undertake architectural correction of the public
health system and to improve access for rural people, especially poor women and
children to equitable, affordable, accountable and effective primary health care.
While the mission covers the entire country, there is special focus on 18 states, which
have weak public health indicators or infrastructure.With the launch of the sub-mission
on urban health in 2013, it is now called the National Health Mission (NHM).
Community Action for Health
Community Action for Health, earlier known as Community Based Monitoring and Planning (CBMP)
of health services, is a key strategy under the National Health Mission (NHM). It is envisaged as an
important pillar of NHM’s Accountability Framework in order to ensure that the services reach those for
whom they are meant. The accountability framework proposed in the NRHM is a three-pronged process
that includes internal monitoring, periodic surveys and studies, and community based monitoring.
Community monitoring is also seen as an important aspect of promoting community led action in the
field of health. The provision for Planning and Monitoring Committees has been made at PHC, Block,
District and State levels. The adoption of a comprehensive framework for community-based monitoring
and planning at various levels places people at the centre of the process of regularly assessing whether
the health needs and rights of the community are being fulfilled.
In 2005, the Ministry of Health and Family Welfare (MoHFW) constituted an Advisory Group on
Community Action (AGCA) under the NRHM. This group was mandated to advise NRHM on community
action including community monitoring initiatives. It comprises eminent public health professionals and
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civil society representatives. The Population Foundation of India (PFI) hosts the Secretariat of the AGCA.
Understanding and assessing health systems
A health system refers to people, institutions and resources, arranged together to improve the health
of the population they serve, while responding to people’s legitimate expectations and protecting
them against the cost of ill health. Service guarantees under the National Health Mission as well as
additional guarantees provided by the states are updated periodically and vary from one state to the
other. It is critical to identify and list all guarantees within the state and use the information to mobilise
communities and adapt the tool for community and facility enquiry.
We can assess the performance of a health system by its–
• Responsiveness: availability, access, acceptability and quality
• Efficiency: value for money
• Equity: investing on increasing access to health services by vulnerable groups; narrowing the health
gaps between the top and bottom deciles of population
Advantages of monitoring and planning by the community
Advantages for the public health system
Advantages for the people
People’s view point /feedback about services provided can
be taken into account.
People get the opportunity and space to put forth their
complaints regarding health services, and to give their
opinion about the services they need.
It helps in providing health services to more beneficiaries. Unnecessary expenses on private healthcare is avoided as
improved public services are utilised.
A relationship of mutual understanding and co-operation is People learn in detail about the government’s health
built between people and the public health employees. services and schemes.
A review can be done about the extent to which the
objectives of the health services have been achieved.
People do not remain mere beneficiaries of health services,
rather they participate actively in the implementation of
these services.
Obstacles in achieving the objectives of health services can Some health problems at the village level can be solved
be identified well in time.
through co-operation.
Transparency in the provision and functioning of health
services becomes possible. Employees and officers at all
levels become proactive.
The health system becomes accountable to the people.
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Part B
Village Health Sanitation and
Nutrition Committee (VHSNC)
Role of VHSNCs in Community Action for Health
The Village Health, Sanitation and Nutrition Committee (VHSNC) formed at the level of each revenue
village has the following objectives:
1. To provide an institutional mechanism for the community to be informed of health programmes and
government initiatives, and to participate in the planning and implementation of these programmes,
leading to better outcomes.
2. To provide a platform for convergent action on social determinants and all public services directly or
indirectly related to health.
3. To provide an institutional mechanism for the community to voice its needs, share experiences and
issues regarding access to health services, so that the institutions of local government and public
health service providers can respond appropriately.
4. To empower panchayats with the understanding and mechanisms required for them to play a role
in governance of health and other public services, and to enable them to lead their communities for
collective action for the attainment of better health.
5. To provide support and facilitation to community health workers – ASHA and other frontline health
care providers who interface with the community and provide services.
Key functions
• Monitoring and facilitating access to public services and correlating with health outcomes
• Organizing collective action at the local level for health promotion
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• Facilitating service delivery at the village level
• Village health planning
• Community monitoring of health facilities
• Monthly meetings
• Management and accounting of untied village health fund
• Maintaining records
The composition of a VHSNC
Composition
• Gram Panchayat members from the village
• ASHA, Anganwadi Worker, ANM
• SHG leader, Secretary of the Parent Teacher Association (PTA)/Mother Teacher Association (MTA), village representative of
any community based organisation working in the village, user group representative
Chairperson: Panchayat member (preferably a woman or SC/ST member)
Convenor: ASHA; where ASHA is not in position, then the Anganwadi Worker of the village
The Tool
The tool, given in Annexure I, has two sets of formats:
1. Formats for outreach services- This set of formats covers entitlements under maternal and child
health, family planning, adolescent health, and general health services at the village, and services
provided for children under six years of age through the Integrated Child Development Scheme
(ICDS). The data collected from these formats is compiled in the form of a Village Health Report
Card. The formats under this set are listed in Table 1.
2. Format for the Sub Health Centre- The format covers infrastructure, availability and quality of
services and manpower at the Sub Health Centre. Data collected from this format is compiled as the
Sub Health Centre Report Card.
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Table 1– List of Formats and Methodology for Data Collection at the Community and Facility
S. No. Tool
Methodology
1
Maternal
Individual
Health Services Interview
2
ASHA Support Individual
Services
Interview
3
Adolescent Focus Group
Health Services Discussion
4
Village Health Focus Group
Services
Discussion
5
Child Health
Services
Individual
interview
6
ICDS Services
Focus Group
Discussion
7
Anganwadi
Centre (AWC)
Mid day Meal
8 & School
Health
Facility-level tool
9 Sub Centre
Individual
Interview/
Observation
Focus Group
Discussion
Individual
Interview/
Observation
Community-level tools
Respondents
Number
Mothers who have
5 per village (3 from
delivered in the last six marginalised and 2 from general
months
population)
ASHA
all ASHAs
Format
Number
Format No-1
Format No-2
In-school and Out- of-
school children of 11-19
age group (8 per group).
1 per village
Mixed group
A mixed group of 10-12
men & women
2 per village (one from
marginalised and one from
general population)
Mothers of children 5 per village (3 from
aged 0-2 years (8-10 in marginalised and 2 from general
a group)
population)
Mothers of children in
the age group 0-6 years
1 per village (one more group
discussion to be conducted if
there are marginalised group)
Aanganwadi worker 1 per Anganwadi centre
Format No-3
Format No-4
Format No-5
Format No-6
Format No-7
5-10 students
1 per school
Format No-8
ANM
1 per sub centre
Format No-9*
The Process
There are three steps to the Community Action for Health process:
Step 1: Preparatory Activities
• The VHSNC will fix a suitable day for the activities related to the preparation of the Village Health
Report Card.
• The VHSNC will undertake awareness creation activities in the community through nukkad nataks,
kala jathas, wall writings etc. This is to make the communities aware of their health related
entitlements. After awareness generation, hand holding support should be provided to the VHSNC
members for conducting meetings for at least six months before the monitoring activities are
initiated.
* As per the Guidelines for Community Processes, Ministry of Health and Family Welfare, Government of India, 2013
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• The VHSNC will decide and
nominate representatives for
undertaking the activities
related to monitoring, using
the tool, and preparing the
village health report card and
facility score card.
• The VHSNC members,
including the ASHA, will ensure
inclusion of the voice of the
marginalized sections during
the process of monitoring and
in preparation of the reports
cards.
• Make one or two members
of the VHSNC responsible for speaking about the availability of services at the village level and
required improvements during the village meeting.
During the inital stages, VHSNC members will be supported by the ASHA facilitator/NGO/
CBO who would demonstrate each monitoring activity at least for the first two rounds.
The support is crucial for equipping community members to participate in the development
of the Village Health Report Card, and VHSNC members to independently conduct village
level meetings and beneficiary interviews.
The Village Health Report Card is to be prepared biannually and submitted to the PHC
Planning & Monitoring Committee. The tool is administered through focus group discussions
(FGD) and individual interviews.
Step 2: Monitoring outreach services in the village: The
process includes a set of focus group discussions and
individual interviews
Activity 1: Focus Group Discussions
The formats to use for different audiences or groups are mentioned in Table 1.
The process is given below–
• Different groups should be constituted for different formats. For example, a group consisting of
women with children (0-6 years) will be asked to fill the format for ICDS services (Format No-6),
whereas a mixed group will be asked for their perspectives on general health services (Format No-4,
quality of care, water & sanitation, disease surveillance, curative services etc.)
• VHSNC members should inform the groups in advance for ensuring participation in FGDs.
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• Women representatives, including the ASHA, should facilitate the group consisting of mothers with
children of 0-6. However, for the other groups, both male and female representatives of VHSNC should
facilitate the meeting. Participation of panchayat members should be sought as facilitators.
• After an initial round of introductions, the
facilitator explains to the participants the
objective of the FGD and about the various
services and entitlements under NHM.
• The participants should be informed that
this meeting is part of a chain of interactions
that the VHSNC would have with the local
community under the Community Action for
Health programme.
• The facilitator should then use the formats
to fill in the information. The facilitator
should engage the group by asking them to
think about the issue, encourage different
perspectives and then come to a consensus on
what the colour code should be.
• The group discussion should be conducted around the issues mentioned in the specified formats and
responses noted down.
• Conclude the meeting by mentioning that the results will be shared in a village meeting through a
village report card.
Activity 2: Individual Interview
The formats to use for different audiences or groups are mentioned in Table 1.
• During group discussions, VHSNC members can identify respondents for the interview—mothers who
delivered in the last six months (whether in an institution or at home).
• The respondents should be told about the various entitlements under NHM.
• After describing the objective of the interview, explain the process of community action. Explain that
the interview is first in the chain of interactions that the VHSNC will have with the local community in
the process of community based monitoring. Assure the beneficiaries about maintaining confidentiality.
• Conduct the interview with different
respondents as per issues mentioned in the
specified formats.
• The responses should be recorded in the
format by the colours Green, Yellow or Red
depending upon the response.
• Count the number of Green, Yellow, Red
marks for each service and fix the final
colour code as per the collation criteria.
• Conclude the interview by mentioning
that the results will be shared in a village
meeting.
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Conducting Facility Survey in
the Sub Health Centre
The information about the infrastructure and services
in the Sub Centre will be collected through Format
No. 9. The format will be filled by direct observation.
Compilation of Village and
Facility Level Report Cards
The data collected through the formats will be collated
into two types of report cards – the Village Health
Report Card and the Sub Health Centre Report Card.
Each format has themes and sub themes under which
questions are designed. The report cards list the
themes and sub themes. The colour of each sub theme
depends upon the collation of responses for each
question under that particular sub theme. Similarly, the colour of each theme depends upon the collation
of the colour of subthemes under it or the collation of the response of each question if the theme doesn’t
have any sub theme. The criterion for collation is given in the Table 2.
Table 2– Collation Criteria
Criterion
If the number of GREEN tick marks are more than 75%
Between 50 to 74% GREEN
Or
If the number of GREEN tick marks are less than 50% but total number of GREEN and YELLOW are more
than RED
The total number of GREEN and YELLOW are less than the number of RED
Final color
GREEN
YELLOW
RED
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The themes and sub themes of the report cards are as follows:
Table 3–Village Health Report
Village:
Block:
District:
Year:
Period:
S.No Themes
1 Maternal health
Antenatal care
Delivery
Post natal care
Family planning
Janani Suraksha Yojna (JSY) entitlement
Janani Shishu Suraksha Karyakram (JSSK)
2 Adolescent health services
3 ASHA support services
4 General health services
Quality of care
Disease surveillance
Curative services
Untied fund
5 Child health services
Immunisation
Childhood illness
6 ICDS services
Nutritional guarantees
Growth monitoring
Referral services
Other services
Participation by community
Discrimination
7 Mid-day meal & school health
Mid-day meal services
School health
8 Perception of ASHA functioning1
Good
Average
Poor
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Table 4– Facility Report Card (for Sub Centre)
Village:
Block:
District:
Name of subcentre:
Total Population covered by subcentre:
Distance from PHC:
Tool/issue
Availability of staff
Availability of Infrastructure
Availability of services
Good
Average
Poor
Sharing of Report Cards and the Follow up Process
Sharing of findings: After the preparation of community and facility report cards, a meeting is to be
organized by the VHSNC with
village residents, members of
community based organisation
(CBO), Self Help Groups, the
ASHA and the ANM. The
VHSNC Chairperson will
share the findings of the
report cards, discuss gaps and
identify the steps for corrective
action. This is then formulated
as a Plan. The details about
preparing the Village Health
Plan are given in Guidelines
for Community Processes. One
can use the planning sheet
(Table-5) for preparing the
plan.
Table 5– Planning Sheet
Gaps (marked as Red & Yellow in
Report card)
a.
b.
c.
Reasons for gaps Possible
Solution
Responsibility
Timeline
Support
Required
1 It may be noted here that perception of ASHA functioning will be captured from Maternal health, Adolescent Health,
General Health and Child Health services tools.
2 National Rural Health Mission (2013). Guidelines for Community Processes, Ministry of Health & Family Welfare, New
Delhi.
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Plan for follow up:
• The locally developed action plan needs to be followed up at the village level. This can be done
during the monthly meeting of the VHSNC.
• The issues not resolved at the village level would be taken up at the PHC level for resolution and
included in the block level plans.
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Part C
PHC Planning and Monitoring
Committee (PHC PMC)
The Primary Health Centre (PHC) Planning and Monitoring Committee would
monitor the services at the PHC level and help find solutions to issues raised by
VHSNCs and sub centres in its coverage area. It is recommended that the PHC
Committee has representation from the Panchayats, health care service providers
and the civil society.
The Composition of PHC Planning & Monitoring Committee
Composition
30% members should be representatives of Panchayat Institutions (Panchayat Samiti members from the PHC coverage
area).
20% members should be non-official representatives from the village health committees.
20% members should be representatives from NGOs/CBOs and people’s organizations working on community health and
health rights in the area covered by the PHC.
20% members should be health and nutrition care providers, including the Medical Officer – Primary Health Centre and
at least one ANM working in the PHC area.
10% members should be from the PHC-level Rogi Kalyan Samiti.
Chairperson: Panchayat representative, preferably a Panchayat Samiti member belonging to the PHC coverage area
Executive chairperson: Medical Officer of the PHC
Secretary: One of the NGO/CBO representatives
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The committee will administer formats prepared for assessment of services at the PHC level. There are
two types of formats as given in Table 6 and placed at Annexure I:
Table 6– Facility-level formats for PHC
Facility-level formats
Primary Health
Centre (PHC)
Observation
Exit Interview at
facility
Individual interview
Medical Officer 1 per PHC
Patient/
attendant
5 per facility - include at
least three women
These formats will be administered through two types of activities – Individual interviews and direct
observations.
Format No-10*
Format No-12
Activity 1: Individual Interview
Format No 12 will be filled through individual interviews. The process of the individual exit interview is
given below:
• At least five patients leaving the facility after availing the services will be interviewed.
• Be considerate about the patient’s health condition while conducting the individual interview.
• Informed consent for interviews should be taken from the patient and attendant before the
interview is done.
• Explain the purpose of the interview, and assure the patient that confidentiality will be maintained.
• The responses should be recorded in the format and each response is to be marked as Green, Yellow
or Red.
Activity 2: Direct Observation
Format No 10 will be filled through direct
observation by members of the PHC Planning and
Monitoring Committees.
Compilation of PHC Report
Card
The PHC Report Card will be compiled in a
similar way as described in the Village and Sub
Health Centre Report Card in Part A. The collation
criterion is given in Table 2. The PHC Report Card
is given in Table 7.
* As per the Guidelines for Community Processes, Ministry of Health and Family Welfare, Government of India, 2013
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Table 7– Facility Report Card at PHC level
Block:
District:
Year:
Period:
Name of PHC:
Format/issue
Availability of Infrastructure
Availability of staff
General Services
Availability of medicines
Availability of curative services
Availability of reproductive & maternal health services
Child care and immunization services
Laboratory and epidemic management services
Good
Average
Poor
Cumulative Report Card at the PHC level:
In addition to the PHC report card, the PHC Planning and Monitoring Committee will collate the report cards prepared by
VHSNCs for Village Health and Sub Health Centres. The cumulative report cards of Village Health and Sub Health Centres are
given below in Tables 8 and 9.
Table 8– Cumulative Village Report Card at PHC/Block level
S. No. Issue
1 Maternal health services
1.1 Family Planning services
2 Adolescent health services
3 ASHA support services
4 General health services
5 Child health services
6 ICDS services
7 Mid-day meal scheme
8 Perception of ASHA functions
Number of villages
Good
Average
Poor
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Table 9– Cumulative Sub Health Centres Report card at PHC/Block level
S. No. Issue
1 Availability of staff
2 Availability of infrastructure
3 Availability of services
Number of Sub Centres
Good
Average
Poor
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Part D
Block Planning and
Monitoring Committee (BPMC)
The main role of the committee constituted at the block level would be to monitor
the services at the Community Health Centre and find solutions to the issues
identified by the PHC Planning and Monitoring Committees.The committee will
also work for the consolidation of PHC-level health plans. This committee would
have members drawn from service providers, representatives of VHSNCs, PHC Planning
and Monitoring Committees and panchayats.
The composition of Block Planning and Monitoring Committee:
Composition
30% members should be representatives of the Block Panchayat Samiti (Adhyaksha/Adhyakshika of the Block Panchayat
Samiti, or its members, with at least one woman).
20% members should be non-official representatives from the PHC health committees in the block, with annual rotation to
enable representation from all PHCs over time.
20% members should be representatives from NGOs/CBOs and people’s organisations working on community health and
health rights in the block, and involved in facilitating monitoring of health services.
20% members should be officials such as the Block Medical Officer, the Block Development Officer, selected Medical Officers
from PHCs of the block.
10% members should be representatives of the CHC level Rogi Kalyan Samiti
Chairperson: Block Panchayat Samiti representative
Executive chairperson: Block Medical Officer
Secretary: One of the NGO/CBO representatives
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The BPMC will meet every quarter.
The committee will administer formats prepared for assessment of services at the CHC level. There are
two types of formats as given in the Table 10 and placed at Annexure I.
Table 10– Facility-level formats at CHC
Facility-level formats
Community Health Centre Individual interview/
(CHC)
Observation
Senior Medical Officer
Exit Interview at facility Individual interview
Patient/ attendant
1 per CHC
5 per facility- include at
least three women
These formats will be administered by members of the BPMC through individual interviews and direct
observation.
Format No-
11
Format No-
12
Compilation of Block/CHC Report Card
The block/CHC report card will be compiled in a manner similar to the Village and Sub Health Centre
Report Card. The collation criterion is given in Table 2. The Block/CHC Report Card is given in Table 11.
Table 11– Facility Report Card at Block/CHC level
Format/issue
Maternal health services
Family planning services
Curative services
Outreach services
Infrastructure
Availability of drugs, contraceptives, and non-medical supplies
Human resources
Accountability
Maternal and infant death review
Good
Average
Poor
Cumulative Facility Report Card: All the facility report cards under the catchment area of the CHC
will be consolidated to form the Cumulative Facility Report card as given in Table 12.
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Table 12– Cumulative PHC card at Block/district level
S. No. Issue
1
Availability of infrastructure
2
Availability of staff
3
General services
3.1 Availability of medicines
3.2 Availability of curative services
3.3 Availability reproductive and maternal health services
3.4 Child care & immunization services
3.5 Laboratory & epidemic management services
Table 13– Cumulative CHC card at Block/district level
S. No. Issue
1
Maternal health services
2
Family planning services
3
Curative services
4
Outreach services
5
Infrastructure
6
Availability of drugs and non-medical supplies
7
Human resources
8
Commoditization
9
Maternal and Infant Death Review
Number of PHCs
Good
Average
Poor
Number of CHCs
Good
Average
Poor
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Part E
District Planning and
Monitoring Committee (DPMC)
The DPMC constituted at the district level would contribute to the development of
the District Health Plan.This committee would have members drawn from service
providers, representatives of VHSNCs, PHC PMCs, BPMCs and panchayats.
The composition of the DPMC:
Composition
30% members should be representatives of the Zila Parishad
25% members should be district health officials, including the District Health Officer /Chief Medical Officer and Civil Surgeon
or officials of parallel designation
15% members should be non-official representatives of block committees
20% members should be representatives from NGOs/CBOs and people’s organizations working on health rights and regularly
involved in facilitating community-based monitoring at other levels (PHC/block) in the district
10% members should be representatives of Hospital Management Committees in the district
Chairperson: Zilla Parishad representative.
Executive chairperson: Chief Medical Officer (CMO) or officer of equivalent designation
Secretary: One of the NGO/CBO representatives
One of the major roles of the DPMC will be to review the issues emerging from the reports of the BPMC
and plan for corrective action. Members of the DPMC would also be expected to actively participate in
the block level Jan Samwad.
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20 | Community Action for Health - User Manual
Part F
Sharing of the Results and
Conducting a Jan Samwad
The report cards will be shared at the meetings of VHSNCs, Planning and
Monitoring Committees at PHC, block and district levels.These platforms will be
used to jointly review the issues and arrive at solutions to address the problems
identified. At each meeting, an action taken report will be presented. Another
platform to share the report card is the Jan Samwad (Public dialogue).The Jan Samvad
presents an opportunity for dialogue between the community and service providers
where-in cases of denial of services are shared along with the limitations from the
providers’ perspective.The community and service providers can then jointly resolve the
issues.The Jan Samwad will be conducted at block and district levels.
A detailed process of the Jan Samwad is given below:
Preparatory process
• Completion of the village and facility level score cards
• Completion of village level report sharing meetings of the area
• Screening of cases of denial of care for presentation
• Organisation of meeting of various representatives of NGOs/local health committees for planning of
the Jan Samwad
• Mobilisation of people with the help of local organisations and active local groups. The
representation of marginalised section should be ensured.
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 21
• Formation of panel
comprising experts
like teachers, lawyers,
journalists. The panel
should be chaired by
a non government
representative.
• Seek media attention
for the event. The
media can play a vital
role in disseminating
the findings so it is
important to contact
the media and
sensitise them to the
whole process.
• Invite Government health officials for the public hearing. The presence of government health
officials is essential for the public dialogue. The officials to be invited are Medical Officers of
different PHCs in the region, the Civil Surgeon, the District Health Officer, Additional Director of
Health Services and others.
Organiser- Members of Planning and Monitoring Committee at PHC, block and district level
Participants at the Jan Samwad
• Representatives of the Health department- Chief Medical Officer, Block Medical Officer
• Members of the Planning and Monitoring and Committee at PHC, block and district levels
• PRI members
• Members of VHSNCs
• Member of CBOs
• General public
Steps for conducting Jan Samwad
• Introduction of the Jan Samwad by the Chairperson
• Presentation of the Cumulative Village Report Card and discussion on the implementation of the
outreach services under NRHM
• Presentation of the Facility Report Card and discussion on improving the facility-level service
utilisation
• Presentation of denial of care/adverse outcomes cases
• Discussion on improving the quality of care and support to cases
• Preparation of the list of recommendations for providers, facilities and the community.
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22 | Community Action for Health - User Manual
Annexure –I
The Tool
FORMAT 1– Maternal Health Services
(Individual Interview)
Instructions: Information to be collected from a woman who has delivered in the last six months. You need to do at least five
interviews. Three of these must cover poorer and marginalized communities, while the remaining two can be done from the
main village / dominant community.
Name of District:
Village Name:
Name of Block:
S.No Question
Maternal Health Services
1 Antenatal Care
1.1
Did the ANM register you in first three months of your
pregnancy?
1.2
Did the ANM give you a registration card / Maternal Health
card?
1.3
Did you undergo at least 4 ante natal check ups in your last
pregnancy?
1.4
Were the following services provided by the ANM during last
pregnancy?
Good
Yes
Yes
Yes
Response
Average
Level
Poor
I
No
I
No
I
No
I
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 23
S.No Question
Good
Response
Average
Blood Pressure (BP) taken in all ANC visits
Yes
Two TT injections
Yes
Weight checked in all ANC visits
Yes
Blood test for Hb in all ANC visits
Yes
Abdomen examination in all ANC visits
Yes
Iron and Folic Acid tablets (IFA) (90 tablets or 3 strips)
Yes
Urine test (at least once)
Yes
Counselling for appropriate diet and rest
Yes
Counselling for institutional delivery
Yes
Enquiry about any danger signs like - swelling, blurring of
vision and severe headache or fever with chills
Yes
1.5
Did you receive Take Home Ration (THR) from the AWC
during your last delivery?
Yes
1.6
Did the ANM confirm with you the expected date of
delivery?
Yes
Did the ANM tell you about the various changes that occur
1.7 during pregnancy and what precautions you should take
Yes
etc.?
1.8 Did the ASHA support participation in every ANC visit?
Yes
1.9
Did the ANM perform breast examination for you during
ANC period?
Yes
2 Delivery
2.1
Where did you deliver? (If delivery took place in a
Government facility, please ask Question No-2.2)
2.2 Was your delivery attended to by a doctor or nurse ?
2.3
Were you advised to stay for at least two days after delivery
in the institution?
Government
hospital, PHC,
Subcentre
Yes
Yes
2.4 Was breast feeding initiated within half an hour of delivery?
Yes
2.5 Was an attendant allowed with you during the delivery?
Yes
3 Postnatal Care
3.1
Did the ANM examine you and the child physically during the
post-natal period?
Yes
Did the ANM explain to you the danger signs for both
3.2 yourself and the child during the post natal period and first
Yes
year of life?
4 Family Planning
4.1 Did the ANM give you advice regarding contraception?
Yes
4.2
Were you counselled about various forms of contraception
and given a choice on what method to choose?
Yes
Level
Poor
No
I
No
I
No
I
No
I
No
I
No
I
No
II
No
I
No
I
No
I
No
I
No
II
No
III
No
I
No
III
Home
I
No
I
No
II
No
I
No
III
No
II
No
II
No
I
No
III
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24 | Community Action for Health - User Manual
S.No Question
5 Janani Suraksha Yojana (JSY) entitlement
5.1
Did you receive JSY payment (Rs 1400 for Institutional
delivery and Rs 500 for Home delivery)?
5.2
Did you have to pay any amount to PHC/CHC staff to get
JSY benefits?
5.3
Did you face problem in opening bank account for JSY
incentives?
5.4 Was the cheque/cash given to you at the time of discharge?
5.5 Did you face any harassment in getting the money?
6 JSSK entitlements
6.1 Did you receive free drug and consumables?
6.2
Did you receive essential diagnostic (Blood test, Urine test,
Ultra sonography etc.) free of cost?
6.3
Did you get free food for three days (in case of normal
delivery) and 7 days in case of C-section?
6.4
Did you get free transport between facilities in case of
referral?
6.5
Did you receive free drop back and pickup services from the
institution to home after 48 hours stay?
6.6 Did the hospital charge you any kind of user fee?
6.7
In case your new born required any treatment in the first 30
days was if fully free?
7 Perception on ASHA Functioning
7.1
Did ASHA confirm the pregnancy with the pregnancy
diagnosis kit in her drug box?
7.2
Did the ASHA help you register with the ANM after you got
pregnant?
7.3 Did the ASHA counsel you regarding birth preparedness?
7.4 Did the ASHA counsel you for institutional delivery?
7.5
Did the ASHA inform you about the JSY and JSSK schemes
and explain to you all the benefits?
7.6 Did ASHA counsel on family planning ?
7.7
Did ASHA accompany you? ( For those whose delivery took
place in Government facility)
7.8
Did the ASHA give you advice regarding breast feeding and
weaning and care ?
Good
Response
Average
Yes
No
No
Yes
No
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Level
Poor
No
I
Yes
I
Yes
I
No
I
Yes
I
No
I
No
I
No
I
No
I
No
I
Yes
No
I
No
II
No
I
No
I
No
I
No
I
No
I
No
I
No
II
* Count the number of Green, Yellow and Red responses. If
1. Number of Greens is more than 75 percent then final colour is 'GREEN',
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final colour is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final colour is RED.
** State may adapt this format as per state context
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FORMAT 2– ASHA Support Services
(Individual Interview)
Instructions: Information to be collected from the ASHA of the area.
Name of District:
Village Name:
Name of Block:
S.No Question
1 Have you received training in Modules 6 and 7 in the
following rounds?
1.1 Round 1
1.2 Round 2
1.3 Round 3
1.4 Round 4
2 Have people you have referred been treated adequately /
satisfactorily in the health facility?
3 Have you received financial incentives as per the norms?
Good
Yes
Yes
Yes
Yes
Yes
Yes
4 Have you had problems in getting your activities attested by
your supervisor in order to get your incentives?
5 Has the disbursement of your incentive money ever been
delayed beyond two months?
6 Do you receive support from AWW in your area to carry out
your various activities?
7 Do you receive support from ANM in your area to carry out
your various activities?
8 Do you receive support from your VHSNC to carry out your
various activities?
9 Have you received the equipment kit?
10 Have you received the drug kit?
11 Do you receive regular supply of contraceptives-Oral pills,
condoms?
12 Do you receive ORS regularly?
13 Is the drug kit being replenished by SC/PHC on regular basis?
14 Do you receive Contrimoxazol for anti-respiratory infection?
15 Are you aware of a grievance redressal mechanism put in
place by the department for ASHAs?
16 Are you satisfied by the behaviour of health facility staff?
17 Do you have a special waiting room in the PHC for use when
you accompany a patient for delivery?
Overall Status of ASHA Functioning*
Yes
No
Yes
Yes
Yes
Yes
Yes
Always
Always
Always
Always
Yes
Yes
Yes
Response
Average
Sometimes /
irregularly
Sometimes /
irregularly
Sometimes
Sometimes /
irregularly
Sometimes /
irregularly
Sometimes /
irregularly
Sometimes /
irregularly
Sometimes
Sometimes
sometimes
sometimes
sometimes
sometimes
Sometimes /
irregularly
Somewhat
Poor
No
No
No
No
No
No
No
Yes
No
No
No
No
No
Never
Never
Never
Never
No
No
No
Level
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
II
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final colour is 'GREEN',
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final colour is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final colour is RED.
** State may adapt this format as per state context
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26 | Community Action for Health - User Manual
FORMAT 3– Adolescent Health Services
(Group Discussion with Adolescent Girls)
Instructions: Information to be collected from a group of high school going adolescent girls and those who are out of school.
You need to have at least 8 to 10 in a group.
Introduction: Namaste everyone! I would like to start by welcoming you to this group meeting. I thank you for taking the
time to participate in our discussion. Today we will be talking about how you as a group perceive the services provided for
adolescents in the school/village. Your feedback will help us improve access to the health care services. Before we continue,
let me introduce myself. My name is __________ and I am a member of your VHSNC. I am sure you all know what a VHSNC
is. Your participation and opinions are important! Let’s start by introducing ourselves…). We will now discuss each of the
questions on this sheet. If you feel the services are good we will put a tick in the green box, if the services are average (not
good, but not poor either), then we will put a tick in the yellow box, and if the services are poor, then we will tick the red box.
After that we will add all the boxes ticked green, yellow and red separately. The result will be shared with health officials and
we will ask them to improve the poor services. The process will be repeated after six months and we will do a review to see if
services have improved.
Name of District:
Name of Block:
Village Name:
Name of the School:
S.No Questions
1 Do you get bi-annual deworming tablets?
2 Do you get IFA (blue) tablets?
3 Does the doctor check for ENT and Skin related
problems?
4 Perception about ASHA's functioning
4.1 Does ASHA organise monthly meeting with adolescent
girls?
4.2 Does ASHA distribute sanitary napkins to adolescent
girls?
Response
Level
Good
Average
Poor
Yes
Occasionally /
No
I
not regularly
Yes
Occasionally /
No
I
not regularly
Yes
Not sure
No
II
Yes
Occasionally /
No
I.
not regularly
Yes
Occasionally /
No
II
not regularly
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final colour is 'GREEN',
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final colour is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final colour is RED.
** State may adapt this format as per state context
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FORMAT 4– General Health Services in the Village
(Group Discussion)
Instructions: Information to be collected from two groups of individuals at the community level. Each group should consist of
10 to12 members (both males and females). One group discussion is held in the main village and the other group discussion is
with members of Dalit / religious minorities groups based on village composition.
Name of District:
Village Name:
Name of Block:
Introduction: Namaste everyone! I would like to start by welcoming you to this group meeting. I thank you for taking the
time to participate in our discussion. Today we will be talking about how you as a group perceive the services provided in the
village. Your feedback will help us improve your access to the health care services. Before we continue, let me introduce myself.
My name is __________ and I am a member of your VHSNC. I am sure you all know what a VHSNC is. Your participation and
opinions are important! Let’s start by introducing ourselves…). We will now discuss each of the questions on this sheet. If
you feel the services are good we will put a tick in the green box, if the services are average (not good, but not poor either),
then we will put a tick in the yellow box, and if the services are poor, then we will tick the red box. After that we will add
all the boxes ticked green, yellow and red separately. The result will be shared with health officials and we will ask them to
improve the services marked poor. The process will be repeated after six months and we will do a review to see if services
have improved.
S.N. Questions
1 Quality of Care in Health Facility
1.1 Is the ANM always available in the Sub Centre?
1.2 Is the regular daily schedule of the ANM displayed in SC?
Good
Yes/always
Yes
1.3 Does the OPD in PHC opens at scheduled time every day? Yes/always
1.4 Is the OPD being conducted by PHC Medical Officer on a Yes/always
daily basis?
1.5 Have you been asked to purchase drugs in any facility
Yes
from outside?
1.6 Are you satisfied with services available at the health
Yes
facility?
1.7 Are you satisfied with generally behaviour of health staff
Yes
in health facility?
1.8 Have you been asked to conduct blood and urine test
No
from outside?
Response
Average
Sometimes
Not updated
regularly
Irregular
Sometimes
Sometimes
Sometimes
Somewhat
Sometimes
Poor
Never
No
Level
I
I
I
No
I
Never
I
No
I
No
II
No
II
Yes
I
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28 | Community Action for Health - User Manual
S.N. Questions
Good
Response
Average
1.9 Have you ever been asked to consult a private doctor by
No
Sometimes
the staff of any health facility?
1.10 Have you ever been asked to pay for the service by the
staff of any facility?
No
Sometimes
2 Water and Sanitation
2.1 Does every household in your village have access to safe All households
drinking water? (hand pump, piped water, covered well)
Not all
2.2 Is any source of drinking water in your village polluted
Yes
with arsenic, fluoride, iron etc.?
2.3 Is water quality tested and results shared publicly by
Health or other government departments?
Yes
Not sure
2.4 Do BPL families receive subsidy for constructing
Individual Household Latrines?
Yes/all
some
2.5 Does every household have a functional toilet?
Yes /all
some
3 Disease Surveillance
3.1 Are blood samples taken by ANM/ASHA from individual
patients suffering from fever?
Yes/all
Not always
3.2 Do health staff visit to collect information about
occurrence of water borne diseases (Gastroenteritis,
jaundice, diarrhoea)?
Yes
sometimes
3.3 Are regular preventive activities for vector borne diseases
(Malaria, Filaria, Kala Azar, Japanese Encephalitis) done
in the village?
Yes/always
Sometimes
4 Curative Services
4.1 Is treatment for dog bite available in the PHC/CHC?
Yes/always Sometimes
4.2 Is treatment of snake bite available at PHC/CHC?
Yes/always Sometimes
4.3 Does the PHC/CHC provide facility for diagnosis of TB
patients (DOTS)?
Yes/always Sometimes
4.4 Do malaria patients regularly get anti malarial tablets
from the health staff?
Yes/always Sometimes
Level
Poor
Yes
II
Yes
I
I
None
I
No
II
No
III
None
I
none
III
No
II
Never
II
No
I
Never
I
Never
I
Never
I
Never
I
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S.N. Questions
5 Untied Fund
5.1 Do you know that the VHSNC receives untied fund of Rs
10,000/- every year for community action and planning
activities?
5.2 Do you think this fund is being utilized appropriately on
locally identified problems and priorities?
6 Community Perception of ASHA Functioning
6.1 Does the ASHA help in registering births and deaths in
the village?
6.2 Does the ASHA Identify leprosy signs in the community?
(in endemic areas only)
6.3 Does the ASHA inform people about the VHND and its
date and time?
6.4 Does the ASHA convene the VHsNC meeting on a
monthly basis?
Good
Response
Average
Level
Poor
Yes
Not sure
No
II
Yes
Not sure
No
II
Yes
Not sure
No
I
Yes
Not sure
No
III
Yes
Sometimes
No
I
Yes
Not regularly /
No
I
sometimes
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final colour is 'GREEN',
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final colour is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final colour is RED.
** State may adapt this format as per state context
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FORMAT 5– Child Health Services
(Individual Interview)
Instructions: Information to be collected from mothers of children aged 0-2 years. You need to do at least five interviews.
Three of these must be from poorer and marginalised communities, while the remaining two can be from the main village /
dominant community.
Name of District:
Village Name:
Name of Block:
S.N. Questions
Good
Response
Average
1 Immunization
1.1 Are immunisation services being organised in your village
every month?
1.2 Have you received the Mother and Child (MCH) card?
1.3 If the age of your child is less than**
Yes/regularly Not regularly
Yes
Yes but with
the ANM
2 months answer Question number a
less than 3 months answer Question b
less than 4 months answer Question c
less than 9 months answer Question d
less than 12 months answer Question e
a Has your child received BCG and OPV (Polio drop) on birth if it is Received all
institutional delivery
b Has your child received BCG, DPT-1 and OPV-1?
Received all
c Has your child received BCG, DPT-1, DPT-2, OPV-1 and OPV-2? Received all
d Has your child received BCG, DPT-1, DPT-2, DPT-3, OPV-1, OPV-2 Received all
and OPV-3?
e Has your child received BCG, DPT-1, DPT-2, DPT-3, OPV-1, OPV- Received all
2, OPV-3, measles and Vitamin-A?
2 Childhood Illness
Received
some
Received
some
Received
some
Received
some
Received
some
2.1 If a child has diarrhoea or Acute Respiratory Infection (ARI) who ASHA/ANM/ PHC
is your first point of contact?
AWW
2.2 Do you know the first aid for a child with diarrhoea? (ORS)
2.3 Do you know how to identify the danger signs of diarrhoea?
2.4 Do you know how to identify the danger signs of respiratory
illness?
Yes (can
describe)
Yes all
Yes all
Yes (Not
clear)
At least One
At least One
Poor
No
No
received
none
received
none
received
none
received
none
received
none
private
providers
(quacks)
No
No
No
Level
I
I
I
I
I
I
I
I
I
II
III
III
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S.N. Questions
Response
Level
Good
Average
Poor
3 Perception about ASHA's Functioning
3.1 Does the ASHA inform parents about the next date of
Yes regularly Irregular /
No
II
immunization?
sometimes
3.2 Does the ASHA counsel you for exclusive breast feeding for first
Yes
Sometimes
No
I
6 months?
3.3 Does the ASHA counsel you for management of Acute
Yes
Not sure
No
I
Respiratory Infection (ARI)?
3.4 Has the ASHA made 6 visits for home based new born care?
Yes
Not sure
No
I
3.5 Does the ASHA give ORS to children suffering from diarrhoea?
Yes
Irregular /
No
I
sometimes
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final color is 'GREEN',
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final color is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final color is RED.
** Cross check with the Immunization card.
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32 | Community Action for Health - User Manual
FORMAT 6– ICDS Services
(Group Discussion)
Instructions: Information to be collected from a group of mothers whose children are currently attending the Anganwadi
Centre. The group should have at least 6 to 8 mothers, Preferably from the same caste group. If there are any marginalized
groups like Dalits / religious minorities then have a separate interview with mothers from that group.
Name of District:
Village Name:
Name of Block:
Introduction: Namaste everyone! I would like to start by welcoming you to this group meeting. I thank you for taking the
time to participate in our discussion. Today we will be talking about how you as a group perceive the services provided in
the Anganwadi centre. Your feedback will help us improve your access to the healthcare services. Before we continue, let me
introduce myself. My name is __________ and I am a member of your VHSNC. I am sure you all know what a VHSNC is. Your
participation and opinions are important! Let’s start by introducing ourselves…). We will now discuss each of the questions
on this sheet. If you feel the services are good we will put a tick in the green box, if the services are average (not good, but
not poor either), then we will put a tick in the yellow box, and if the services are poor, then we will tick the red box. After that
we will add all the boxes ticked green, yellow and red separately. The result will be shared with the health officials and we will
ask them to improve the poor services. The process will be repeated after six months and we will do a review to see if services
have improved.
S.N. Questions
1 Nutritional Guarantees under ICDS
1.1 Does your child get hot cooked meal every day? (for 3-6 years
old) ( 6 times a week)
1.2 Do all children under 3 years get take home ration on a
regular basis?
1.3 Do all pregnant and lactating mothers in your hamlet get take
home rations on a regular basis?
1.4 Does the Anganwadi worker visit houses of malnourished
children for follow up?
1.5 Are you satisfied with the quality of food served at the AWC?
2 Growth Monitoring
2.1 Does the Anganwadi Worker weigh all children on a monthly
basis?
2.2 Did the AWW discuss the weight of your child and provide
advice?
2.3 Does every child in AWC have a growth chart?
2.4 Does the AWW provide advice on feeding of the child?
3 Referral Services
Good
Response
Average
Level
Poor
Yes
Irregular
No
I
Yes
Sometimes
No
I
Yes
Irregular /
No
I
Not Aware
Yes
Irregular /
No
I
Not Aware
Yes
Somewhat
No
I
Yes
Irregular
No
I
Yes
Sometimes /
No
III
irregularly
Yes
Sometimes /
No
III
irregularly
Yes
Sometimes
No
III
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 33
S.N. Questions
Good
Response
Average
Level
Poor
3.1 Are severely malnourished children referred to the Nutritional
Yes
Sometimes /
No
I
Rehabilitation Centre (NRC) or the PHC for treatment?
irregularly
4 Other Core ICDS Services
4.1 Is non formal education provided to your child in the AWC? (for
Yes
Irregular /
No
I
children of 3-6 age group)
Not Aware
4.2 Did the Anganwadi worker advice you on exclusive breast
Yes
Not Aware
No
I
feeding?
5 Participation of Community
5.1 Is there a mother's committee constituted under the AWC and Yes/regular Yes/irregular
No
III
does the committee meet regularly?
meeting meeting
5.2 Have these meetings led to any change in your nutrition, health
Yes
Sometimes
No
III
or hygiene practices?
5.3 Does the Parents committee / management committee of the
Yes
Sometimes
No
III
ICDS center meet regularly?
6 Discrimination
6.1 Have you ever come across instances of denial/ discrimination
Yes
Sometimes
No
I
in the provision of services at AWC?
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final colour is 'GREEN',
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final colour is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final colour is RED.
** State may adapt this format as per state context
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34 | Community Action for Health - User Manual
FORMAT 7– Facility Assessment for Anganwadi Centre (AWC)
(Individual Interview)
Name of District:
Name of Block:
Village Name:
Instructions: Information to be collected from AWW by direct observation and interview
S.N.
Questions
Response
Good
Average
Poor
PART A: OBSERVATION
1 Infrastructure
1.1 Does the Anganwadi Centre (AWC) have the following?
Own building
Yes/In good Yes/poor
condition condition
No
Electricity connection
Yes
No
Safe drinking water
Yes
Stored water
No
Child friendly toilet
Yes/being Yes/Not
used
being used
No
Boundary wall
Yes
Yes/poor
condition
No
2 Manpower
2.2 Does the AWC have a full time Anganwadi helper?
Yes/always Yes/available
available sometimes
No
3 Basic Equipment, Aids and Other Supplies
3.1 Does the AWC have the following equipment and supplies?
Weighing Machine (infant )
Yes/being Yes/not
used
being used
No
Weighing Machine (adult )
Yes/being Yes/not
used
being used
No
Adequate cooking vessels and serving utensils
Yes/being Yes/not
used
being used
No
Smokeless Chullah
Yes/being Yes/not
used
being used
No
Mother and Child cards and counterfoils
Yes/being Yes/not
used
being used
No
Posters and other IEC material
Yes/being Yes/not
used
being used
No
Pre-school learning material and teaching aid
Yes/being Yes/not
used
being used
No
Toys
Yes/being Yes/not
used
being used
No
Basic medicines like IFA tablets, deworming tablets and ORS
packets
Yes/being Yes/not
used
being used
No
Level
I
I
I
I
II
I
I
I
I
I
I
I
I
II
I
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 35
S.N.
Questions
Good
Response
Average
4 Services
4.1
Have all the eligible children (0-6 age group) enrolled in the
AWC?
Yes/all
covered
Partially
covered
4.2
Have all the eligible children, pregnant women and lactating
mothers enrolled in the AWC?
Yes/all
covered
Partially
covered
4.3
Does the AWC have a menu for supplementary food for
children and is it being regularly followed?
Yes/followed
Yes/Not
followed
4.5 Are double rations given for malnourished children?
Yes
Sometimes /
irregular
PART B: INDIVIDUAL INTERVIEW
5 Support System
5.1
Do you think you get adequate support from your supervisor to
do your work effectively?
Yes
Sometimes
5.2
Are budget for condiments, supplies and individual expense
reimbursed on a monthly basis?
Yes
Sometimes
5.3
Do you think you get adequate support from the community
(VHNSC) to do your work effectively?
Always Sometimes
5.4
Do you think you get adequate support from the ASHA to do
your work effectively?
Always Sometimes
Poor
poorly
covered
poorly
covered
No
No
No
No
Never
Never
Level
I
I
I
I
I
II
II
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final colour is ‘GREEN’,
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final colour is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final colour is RED.
** State may adapt this format as per state context
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36 | Community Action for Health - User Manual
FORMAT 8– Mid Day Meal (MDM) & School Health Programme
(Group Discussion)
Name of District:
Name of Block:
Village Name:
Name of the School:
Instructions: Information to be collected from a group of primary school children on the school
premises. You need to have at least 5-10 students in a group.
S.N.
Questions
Response
Level
Good
Average
Poor
1 Mid-day Meal
1.1
Is a hot cooked meal provided to all children on a regular
basis? (For primary students only)
Yes/always Sometimes
No
I
1.2 Are the meals prepared as per the menu chart displayed?
Yes/followed
Yes/Not
followed
No
I
1.2 Does the school have potable water facility on the premises?
Yes
Yes/poorly
maintained
No
I
1.3 Does the school have a separate shed for cooking?
Yes/being Yes/not
used
being used
No
I
1.4
Is there a designated cook and helper appointed under the mid
day meal scheme?
Yes/always
available
Yes/irregular
availability
No
I
1.6 Is the quality of the food good?
Always
Sometimes
not good
Not good
II
2 School Health Programme
2.1 Are all children examined by doctor once a year?
Yes/always Sometimes Never
I
2.2 Are the height and weight of all children taken (each time)? Yes/always Sometimes Never
I
2.3 Do all children receive deworming tablets?
Yes/always Sometimes Never
I
*Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final color is ‘GREEN’,
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final color is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final color is RED.
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 37
FORMAT 9– Observation Checklist for Health Sub-Centre
(As per The Guidelines for Community Processes, Ministry of Health and Family
Welfare, Government of India, 2013)
Name of District:
Village Name:
Name of Block:
Name of the Sub Centre:
Instructions: Information to be collected from ANM
S.No.
Questions
Response
Level
Good
Average
Poor
PART A: OBSERVATION ( Validate with records
available)
1 Availability of staff at the sub-centre
1.1 Is there an ANM available/appointed at the centre?
Yes
No
I
1.2 Is there health worker-male (MPW) available/appointed?
Yes
No
I
1.3 Is there a part-time attendant (female) available?
Yes
No
I
2 Availability of Infrastructure at the sub-centre
2.1
Is there a designated government building available for the
sub-centre?
Yes
No
I
2.2 Is the building in working condition?
Yes
No
I
2.3 Is there a regular water supply at this sub-centre?
Yes
No
I
2.4 Is there regular electricity supply at this sub-centre?
Yes
No
I
2.5
Is the blood pressure apparatus in working condition in this
sub-centre?
Yes
No
I
2.6
Is the examination table in working condition in this sub-
centre?
Yes
No
I
2.7
Is the steriliser instrument in working condition in this sub-
centre?
Yes
No
I
2.8
Is the weighing machine in working condition in this sub-
centre?
Yes
No
I
2.9 Are there disposable delivery kits available in this sub-centre?
Yes
No
I
3 Availability of Services at the sub-centre
3.1 Does the doctor visit the sub-centre at least once a month?
Yes
No
I
3.2 Is the day and time of this visit fixed?
Yes
No
I
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38 | Community Action for Health - User Manual
S.No.
Questions
Response
Level
Good
Average
Poor
3.3
Is facility for delivery available in this sub-centre during a full
24-hour period?
Yes
No
I
3.4
Is treatment of diarrhoea and dehydration offered by the sub-
centre?
Yes
No
I
3.5
Is treatment for minor illness like fever, cough, cold, etc.
available in this sub- centre?
Yes
No
I
3.6
Is facility for taking a blood slide in the case of fever for
detection of malaria available in this sub-centre?
Yes
No
I
3.7 Are contraceptive services available at this sub-centre?
Yes
No
I
3.8
Are oral contraceptive pills distributed through this sub-
centre?
Yes
No
I
3.9 Are condoms distributed through the sub-centre?
Yes
No
I
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 39
FORMAT 10– Observation Checklist for Primary Health Centre
(As per The Guidelines for Community Processes, Ministry of Health and Family
Welfare, Government of India, 2013)
Name of District:
Name of the PHC:
Name of Block:
Instructions: Information to be collected from Medical Officer
S.No.
Questions
PART A: Observation Checklist for PHC Centre
1 Availability of Infrastructure
1.1
Is there a designated government building available for the
PHC?
1.2 Is the building in working condition?
1.3 Is water supply readily available in this PHC?
1.4 Is electricity supply readily available in this PHC?
1.5 Is there a telephone line available and in working condition?
2 Availability of Staff in the PHC
2.1 Is a Medical Offi cer available/appointed at the centre?
2.2 Is a Staff Nurse available at the PHC?
2.3 Is a health educator available at the PHC?
2.4 Is a health worker-male(MPW) available/appointed?
2.5 Is a part time attendant (female) available?
3 General Services
Availability of Medicines in the PHC
3.1 Is the anti-snake venom readily available in the PHC?
3.2 Is the anti-rabies vaccine readily available in the PHC?
3.3 Are drugs for malaria readily available in the PHC?
3.4 Are drugs for tuberculosis readily available in the PHC?
4 Availability of Curative Services
4.1 Is cataract surgery done in this PHC?
4.2
Is primary management of wounds done at this PHC?
(stitches, dressing etc.)
4.3 Is primary management of fracture done at this PHC?
4.4 Are minor surgeries done at this PHC?
4.5
Is primary management of cases of poisoning done at the
PHC?
4.6 Is primary management of burns done at the PHC?
Good
Response
Average
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Level
Poor
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
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5.8 Page 48 |
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40 | Community Action for Health - User Manual
S.No.
Questions
5
Availability of Reproductive and Maternal Health
Services
5.1 Are ante-natal clinics regularly organised by this PHC?
5.2
Is facility for normal delivery available in the PHC 24 hours a
day?
5.3
Are facilities for tubectomy and vasectomy available at the
PHC?
Are internal examination and treatment for gynaecological
5.4 conditions and disorders like leucorrhoea and menstrual
disturbance available at the PHC?
5.5
Is facility for abortion- Medical Termination of Pregnancy
(MTP) available at this PHC?
5.6
Is treatment for anaemia given to both pregnant as well as
non- pregnant women?
5.7
How many deliveries have been conducted in the last quarter
(three months)?
6 Child Care and Immunisation Services
6.1 Are low birth-weight babies treated at this PHC?
6.2 Are there fixed immunisation days?
6.3 Are BCG and measles vaccine given at this PHC?
6.4
Is treatment for children with pneumonia available at this
PHC?
6.5
Is treatment of children suffering from diarrhoea with severe
dehydration done at this PHC?
7 Laboratory and Epidemic Management Services
7.1
Is laboratory service available at the PHC? Is blood
examination for anaemia done at this PHC?
7.2
Is detection of malaria parasite by blood smear examination
done at this PHC?
7.3
Is sputum examination to diagnose tuberculosis conducted at
this PHC?
7.4 Is urine examination of pregnant women done at this PHC?
Good
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Response
Average
Poor
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Level
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 41
FORMAT 11– Facility Assessment Tool for Community Health Centre (CHC)
(Observation/Individual Interview)
Name of District:
Name of Block:
Name of the CHC:
Instructions: Information to be collected from Medical Superintendent/Senior Medical Staff
S.N.
Questions
Good
Response
Average
Level
Poor
PART A: OBSERVATION (validate with records)
1 Infrastructure
1.1 Does the CHC have its own building?
Yes/good
condition
Yes/poor
condition
No
I
1.3 Does the CHC have a functional operation theatre?
Yes/
Yes/not
functional functional
No
I
1.4 Does the CHC have a functional laboratory?
Yes/
Yes/not
functional functional
No
I
1.5 Does the CHC have labour room with labour table?
Yes/
Yes/not
functional functional
No
I
1.6 Does the facility have a total 30 beds in the wards?
Yes/In good
condition
Yes/Not
in good
condition
No
I
1.7 Does the facility have separate toilets for men and women?
Yes/well Yes/poorly
maintained maintained
No
I
1.8 Is there adequate provision of drinking water?
Yes and
being used
Yes/not
in usable
condition
No
I
1.9 Is there a functional blood bank?
Yes available Yes but
regular
irregular
No
I
1.10 Does the CHC have a referral transport facility – ambulance?
Yes/being Yes/not
used
being used
No
I
1.11
Does the CHC have appropriate process disposal of medical
waste, including waste disposable pit?
Yes and Yes but not
being used usable
No
I
2 Status of availability of drugs and non medical supplies
2.1
Does the CHC have regular and adequate supply of the
following drugs? ( as per IPHS standards)
2.2 All emergency drugs
Yes
Yes but
irregular
No
I
2.3 Drugs for treating severely ill children
Yes
Yes but
irregular
No
I
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42 | Community Action for Health - User Manual
S.N.
Questions
2.4 Antibiotics
2.5 Drugs for Blood Pressure (BP)
2.6 Drugs for Diabetes
2.7 DOTS
2.8 IV fluids
2.9 Anti-Snake Venom (ASV)
2.10 Anti Rabies vaccine (ARV)
2.11 All kinds of contraceptives (Condoms, pills, IUCDs etc.)
3 Status of availability of equipment
3.1 Does the CHC have the following equipment available?
3.2 Boyles' apparatus
3.3 Oxygen cylinder
3.4 Emergency Obstetric Care (EmOC) drug kit
3.5 Standard surgical kit
3.6 New born kit
3.7 Labour room kit
3.8 RTI/STI lab kit/ HIV testing kit
3.9 Tubal rings
3.10 Equipment for a blood storage / banking facility
4 Availability of Human Resources
4.1 What is the status of availability of the following manpower?
4.2 Obs & Gyn specialist (Obstetric & Gynaecologist)--( No)
Good
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes/being
used
Yes/being
used
Yes/being
used
Yes/being
used
Yes/being
used
Yes/being
used
Yes/being
used
Yes/being
used
Yes/being
used
Posted/
available
Response
Average
Yes but
irregular
Yes but
irregular
Yes but
irregular
Yes but
irregular
Yes but
irregular
Yes but
irregular
Yes but
irregular
Yes but
irregular
Level
Poor
No
I
No
I
No
I
No
I
No
I
No
I
No
I
No
I
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
Yes/not
being used
No
I
posted/not
available
Not posted
I
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S.N.
Questions
Good
Response
Average
Level
Poor
4.3 Paediatrician
Posted/
available
posted/not
available
Not posted
I
4.4 Surgeon
Posted/
available
posted/not
available
Not posted
I
4.5 MD medicine
Posted/
available
posted/not
available
Not posted
I
4.6 Anaesthetist
Posted/
available
posted/not
available
Not posted
I
4.7 Dentist
Posted/
available
posted/not
available
Not posted
I
4.8 General duty Medical Officers - (Number)
Posted/
available
posted/not
available
Not posted
I
4.9 Staff Nurses- (Number)
All posts
filled
posts
partially Not posted I
filled
4.10 Pharmacists
All posts
filled
posts
partially Not posted I
filled
4.11 Lab Technicians
All posts
filled
posts
partially Not posted I
filled
4.12 Ward Boys-( Number)
All posts
filled
posts
partially Not posted I
filled
5 Accountability
5.1
Does the CHC have a citizen charter? If Yes, is it prominently
displayed in the local language?
Yes and Yes but not
displayed displayed
No
I
5.2
Does the CHC have a functional RKS with representation from
PRI,CBO & NGOs?
Yes
Yes /No
comm repr.
No
I
5.3 Are the meetings of RKS organised on regular basis?
Yes, regular
meeting
Yes, irregular
meeting
No meeting
I
5.4
Are RKS funds used to improve the delivery of services at the
facility?
Yes
Yes but
usage
limited
No
II
5.5
Does the CHC have a mechanism to record client feedback &
complaints?
Yes
yes but not
working well
No
II
5.6
Does the CHC display availability of basic drugs and staff duty
roster?
Yes
Yes but
no regular
updation
No
III
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44 | Community Action for Health - User Manual
S.N.
Questions
Good
Response
Average
Level
Poor
PART B INDIVIDUAL INTERVIEW
6 Provision of Maternal and Child Health Services
6.1
Does the CHC provide 24 hour service for normal delivery and
emergency obstetric care?
Yes/regular
Yes/irregular
No
I
6.2 Does the CHC have facility for Cesarean Section?
Yes/regular Yes/irregular
No
I
6.3
Does the CHC provide services for Reproductive Tract
Infections (RTI/STI)
Yes/regular Yes/irregular
No
I
6.4
Does CHC provide service to infants needing critical care for
ARI and diarrhoea?
Yes/regular Yes/irregular
No
I
6.5 Does CHC provide service to severely malnourished children? Yes/regular Yes/irregular
No
I
7 Provision of Family Planning Services
7.1 Is the facility for tubectomy and vasectomy available at CHC?
Yes
No
I
7.2
Is couselling for Family Planning given during Maternal &
Child Health (MCH) Services?
Yes/regular Yes/irregular
No
I
7.3 Does the CHC provide PPIUCD services?
Yes/regular Yes/irregular
No
I
7.4 Is there a counsellor in CHC?
Yes but
Yes
comes
No
irregular
7.5
Does the CHC provide Medical Termination of Services (MTP )
services?
Yes/regular Yes/irregular
No
I
7.6
Is the facility of testing and counselling for HIV/AIDS
available?
Yes/regular Yes/irregular
No
I
8 Provision of Curative Services
8.1 Does the OPD function daily at the designated time?
Yes/regular Yes/irregular
No
I
8.2
Does the CHC provide service for simple surgeries like hernia,
hydrocele, Heamorrhoids etc?
Yes/regular Yes/irregular
No
I
8.3
Does the CHC have facility for emergency surgeries like
appendicitis etc?
Yes/regular Yes/irregular
No
I
8.4 Is X-Ray service available in the CHC?
Yes/regular Yes/irregular
No
I
8.5
Does the CHC provide dental services or Ear, Nose & Throat
(ENT) services?
Yes/regular Yes/irregular
No
I
9 Maternal & Infant Death Review
9.1
Does the CHC conduct maternal death review (MDR)
regularly?
Yes
Irregular
No
II
9.2 Does the CHC conduct infant death review (IDR) regularly?
Yes
Irregular
No
II
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final color is ‘GREEN’,
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final color is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final color is RED.
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 45
FORMAT 12– Tool for Exit Interview at Facility
(Individual Interview)
Name of District:
Name of Block:
Name of the Facility (PHC/CHC):
Instructions: Exit interviews with five patients/attendants to be conducted at each facility level (PHC/CHC).
S.N.
Questions
1
Are you satisfied with behaviour of ANM/nurse / doctor of
PHC/CHC?
Response
Good
Average
Poor
Yes
somewhat
No
2 Have you been provided free medicine as per the prescription?
Yes
Sometimes
No
3
Have you been asked to conduct blood and urine test from
outside?
No
Sometimes
Yes
4 Have you ever been asked to consult a private doctor?
No
Sometimes
Yes
5
Have you ever been asked to pay for the services like
laboratory test, X-Ray etc.?
No
Sometimes
Yes
6
Are you satisfied with the overall services provided at the
facility ?
Yes
Not always
No
Level
I
I
I
I
I
I
* Count the number of Green, Yellow and Red responses. If
1. Number of greens is more than 75 percent then final color is ‘GREEN’,
2. Number of GREENS is between 50 to 75 percent OR if GREENs are less than 50 percent but total of GREENS and YELLOWS are more than REDS
then final color is YELLOW
3. Total number of GREENS and YELLOWS are less than number of REDS then the final color is RED.
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46 | Community Action for Health - User Manual
Annexure –II
Overview of Implementation and Capacity Building
Strategy
As a first step to implementing Community Action for Health at the state level, a State Advisory Group
on Community Action (State AGCA)/ State Mentoring Group is to be constituted with the mandate
to guide the implementation process in the state. The group will have representation from various
departments including Women and Child Development, Rural Development and Panchayati Raj, Public
Health Engineering, Education, State Health Department and civil society organizations.
The State AGCA will identify state level structures to implement the Community Action for Health
process. Processes at the state level could be led by a State Nodal NGO, State ASHA Resource Centre/
Community Process Resource Centre, State Institute of Rural Development (SIRD), or the State Health
Systems Resource Centre (SHSRC). These state level structures will work under the guidance of the State
AGCA with technical support from the national AGCA Secretariat.
The State AGCA in coordination with the state level structures will identify district and block structures
to facilitate the roll out of Community Action for Health. The district level structure could include
District NGO, District Community Mobiliser, District Programme Manager. The block level structure for
implementing the programme could include Block NGO, Block Programme Manager, Block Community
Mobilizer. At village level, the process will be implemented by the Village Health, Sanitation, Nutrition
Committee (VHSNC).
Once the structures are identified, the next step would entail the formation of planning and monitoring
committees at different levels.
Formation of Committees
Planning and monitoring committees will be formed at PHC, block and district levels. These committees
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 47
will function with the mandate of reviewing the current status of health care service delivery and
facilitating corrective action to improve the system at different levels. It is important to constitute the
committees from village level upwards in an inclusive manner – a few members from VHSNCs will be
included in the PHC committee; similarly a few PHC committee members will be included in the block
committee and so on. Adequate representation from the marginalized sections should be ensured in the
various committees.
Details about the composition of these committees are provided in the accompanying Guidelines and
this User Manual.
Capacity Building
The process of capacity building to roll out implementation will include: a) Orientation workshops for
different levels of planning and monitoring committees and other stake holders b) Training of VHSNCs
using the cascade approach with training of trainers at the state and district levels, followed by the
training of VHSNC members.
Orientation workshops– A series of one-day orientation workshop will be organized as detailed
in the table below. The participants will be oriented on topics such as introduction to NHM, service
guarantees and health rights, the process and implementation structures of Community Action for
Health, and roles and responsibilities of different stakeholders.
Training– A cadre of master trainers will be trained at the state level by the national AGCA Secretariat.
The training will be for a duration of five days. The state level master trainers will provide training to
district/block level trainers. This training will be for a duration of three days. The district/block trainers
will undertake training of the VHSNCs. The duration and mechanism for training the VHSNCs will be
decided by the state based on the existing plan for training of VHSNCs as per the National Guidelines
for Community Processes.
Level, Structure, Training Days, Participants and Content
Level
Structure Training days Participants
Content
Orientation Workshop
State
State Planning 1 day
& Monitoring
Committee/
State AGCA
SAGCA Members, State Nodal •
Officers, State trainers from
•
SIRD, SIHFW, ASHA Trainers, Civil •
Society Organizations (CSOs)
working in the area of health and
rights.
•
Introduction to NHM
Service guarantees and health rights
Process of Community Action for
Health (including screening of a
documentary film)
Roles and responsibilities of
committees
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48 | Community Action for Health - User Manual
Level
District
Block
PHC
Structure Training days Participants
Content
District level
Planning &
Monitoring
Committee
1 day
Block
Planning
Monitoring
Committee
1 day
District Nodal Officers from
•
the departments of Women
•
and Child Development, Rural •
Development and Panchayati Raj,
Public Health Engineering and
Education, CSOs, District ASHA •
Trainers, District Programme
Manager, District Community
Mobilizer, along with members
of the District Planning and
Monitoring Committees
Block Panchyat Officer, Doctor •
representing CHC, Block
•
ASHA Coordinator, Block Data •
Assistant, Block NGO, Block
Pramukh, Members of the
Block Planning and Monitoring •
Committees
Introduction to NHM
Service guarantees and health rights
Process of Community Action for
Health (including screening of the
documentary film)
Roles and responsibilities of
committees
Introduction to NHM
Service guarantees and health rights
Process of Community Action for
Health (including screening of a
documentary film)
Roles and responsibilities of
committees
PHC Planning 1 day
Monitoring
Committees
• Community level enquiry and facility
surveys
• Organising Jan Samwad and
ensuring corrective action
Members of the PHC Planning • Introduction to NHM
and Monitoring Committee, PHC • Service guarantees and health rights
Doctor, Lady Health Supervisor, • Process of Community Action for
CSO representatives
Health (including screening of the
documentary film)
• Roles and responsibilities of
committees
• Community level enquiry and facility
surveys
• Organising Jan Samwad and
ensuring corrective action
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Guidelines For ProgrammeCMoamnmaguenristyOAnctCionmfmorunHietyalAthct-ioUnsFeor rMHaenaultahl | 49
Level
Structure Training days Participants
Content
Training of Trainers
State
State Trainers 5 days
District
Block
District
Trainers
3 days
3 days
State Nodal Officers (NHM), State •
trainers from SIRD, SIHFW, ASHA
Trainers, State Nodal NGO
•
District Nodal Officers , Officers, •
District NGOs, PHNs, District
ASHA Trainers, Selected Doctors •
5 members from each VHSNC
with a cluster of 6 VHSNCs at •
Block level.
•
Overview on health rights and
accountability
Participatory training methodologies
Introduction to NHM and
communitization
Rights based approach & Community
monitoring in NHM
Service Guarantees, IPHS standards
Process of Community Action for
Health (including screening of
documentary film)
• Roles of different stake holders
• Introduction to community enquiry
and facility survey tools
• Field practice on tools and sharing of
experiences
• Organizing Jan Samwad
• Documentation and reporting
Village
VHSNC
members
To be rolled
out in phases as
decided at the
state level
All members of each VHSNC
• Introduction to health rights
• Introduction to NHM and
communitization
• Service Guarantees, IPHS standards
• Process of Community Action for
Health
• Roles and responsibilities of VHSNC
members
• Introduction to community enquiry
and facility survey tools
• Documentation and reporting
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Back
Cover
Advisory Group on Community Action (AGCA)
Secretariat
Population Foundation of India
B-28 Qutab Institutional Area,
New Delhi- 110 016, India
Telephone: + 91-11-43894100; Fax: +91-11-43894199
E-mail: info@populationfoundation.in
www.nrhmcommunityaction.org
National Health Mission
Ministry of Health and Family Welfare
Government of India
New Delhi