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Kutch Mahila Vikas Sangathan (KMVS)
Proposal for Pachchham Women's Clinic
Background• Pachcham is located in a region called Kutch situated in the northwest state of
Gujarat, India. The population is predominantly Muslim followed by Harijan,
Kolis, etc.
• Pachchham is one of the most remote areas of Kutch, where there is only one
severely understaffed government healthcare facility for a population of more
than 40,000 people.
• The patriarchal mindset prevalent in the community generally restricts women's
mobility and freedom to access healthcare. Multiple children and malnutrition
also take a toll on women’s bodies.
• As a result women often silently suffer from various forms of health problems
particularly gynecological and reproductive health issues.
• However, over the past 10 years, the status has improved due to the sustained
efforts and training by a team of urban and rural health workers with the local
organization Kutch Mahila Vikas Sangathan. The community has now started
demanding services that are accessible and high quality.
KMVS: Brief History
• 1989: Sushma bahen began organizing Mahila Mandals in villages across
Kutch.
– Small projects began in all areas depending on the need and interest
expressed by women in the mandals
• 1990-2000:
– Dais were trained in hygiene and risk assessment.
– The Sangathans collaborated with Bhojay Sarvodaya Trust in setting up
gynecological camps in Khavda.
• 1996: Pachcham Sangathan came together to build an office in Khavda, and
elected a committee of women to lead major projects
• 2001: Massive Earthquake
• 2003: KMVS begins to revive health activities
Health Insurance Project
• Problem:
– Because of working and living conditions, women tend to have
extremely poor health.
– While families spend an enormous amount of money on health
problems (about ¼ of their monthly income), women are rarely
prioritized
– There are few services available locally in Pachcham. Women would
have to travel far (at high costs) in order to access any reliable or
appropriate service.
– Private insurance in such an area is practically impossible
Health Insurance Project
• KMVS Solution:
Cooperative health insurance program among KMVS women
– Women would be guaranteed high-quality services when they
are in need, regardless of the expense for a particular problem
– The services would focus on gynecological and reproductive
health, those services most needed for women
– The program would emphasize preventative and prenatal care
ServicesThrough the insurance scheme, a woman will receive services at 3 different locations.
• Services provided at Sangathan Khavda Clinic:– Deliveries (normal and complicated, not requiring an operation)– Antenatal and Postnatal Care– Gynaecological diagnosis and treatment– Paediatric diagnosis and treatment for children 0-3– Blood testing – Provision of Dai Kits– Provision of Contraceptives
• Services provided in Bhuj (through collaboration with a private hospital and linkage with
the government hospital)– Operations required for delivery (caesarean, etc.)– Sonography– Blood Bank– Family Planning operations
• Services provided by Bhojay Sarvodaya Trust Hospital– Operations for serious gynaecological issues– Operations for serious paediatric issues
Transportation from Khavda will be provided when patients are referred.
Winning Combination
• Health Insurance Memberships
• Monetary help from the local citizens and other institutions
• Partnership with the government
• The doctors will provide scientific diagnosis and allopathic treatment
• The staff nurse will provide vaccinations and conduct antenatal and postnatal checkups
• The dais (local midwives) will provide traditional knowledge and counselling.
Membership and Payment Scheme
• Self-sufficiency at the end of a five-year period.
• 5000 women members, paying a Rs.375 yearly premium.
• This will cover the running costs for services at all 3 locations of
Rs.18,72,000.
• For the first year the target is 500 women, which would result in the
collection of Rs.1,87,200.
Running Costs (In Indian Rupees)
Monthly Salary
Yearly Salary
MBBS Doctor 20,000 2,40,000
Visiting Gynec 6,000 72,000
Visiting Paediatrician 6,000 72,000
3 Dais 6,000 72,000
Nurse 8,000 96,000
Compounder/Doctor’s Assistant /Administration
3,000 36,000
Pune/Clerk 1,000 12,000
Total 50,000 6,00,000
Service Anticipated Incidence
Service Cost
Total Cost
Deliveries (normal and forceps)
300 150 45,000
Antenatal and Postnatal Checkups
600 50 30,000
Gynecological Treatment
300 100 30,000
Pediatric Treatment 540 200 1,08,000
Blood and Urine Tests
600 100 15,000
Sonography 300 200 60,000
Delivery Operations (Caesarean)
20 6,000 1,20,000
Blood Transfusion 60 300 36,000
Bhojay Operations (Gynec and Peds)
48 6,000 2,88,000
Total 7,32,000
Salaries Services
Monthly Yearly
Electricity, Telephone, and other costs
15,000 1,80,000
Vehicle (Driver, Diesel, Maintenance)
30,000 3,60,000
Total 5,40,000
Administrative
Total Running CostsRupees USD
Salaries Rs.6,00,000 $13,950
Services Rs.7,32,000 $17,000
Administration Rs.5,40,000 $12,550
Total Rs.18,72,000 $43,500
Year Number of women enrolled
Premium collected (at rate of Rs. 375)
% of Remaining costs to be covered during that year from outside fund
Remaining costs to be covered during that year from outside fund
1 500 1,87,500 90% Rs.16,87,500 ($39,200)
2 1250 4,68,750 75% Rs.14,06,250 ($32,700)
3 2250 8,43,750 55% Rs.10,31,250 ($24,000)
4 3500 13,12,500 30% Rs.5,62,500 ($13,100)
5 5000 18,75,000 0% 0
Road to Self-Sufficiency
Government Partnerships
Local Awareness
Local Awareness
Recent Progress
• A referral clinic was inaugurated on February 11, 2005
• Clinic building was donated by the government
• Tripartite partnership between the Government, community and the Non-Government Organization (NGO) KMVS
• The clinic will serve primarily women and their young children.
• The women's care will focus on gynecological and reproductive health issues and child care will cover basic ailments and vaccinations.
• The clinic has a check-up room, labour room, one ward (5 beds), a waiting room with reception and medicine counter, a counselling and patient-education room, living quarters for staff, and a training hall.
• 9 successful deliveries so far…
• Positive response from the community
Recent Progress
• Members from other blocks realize the need for such a clinic at accessible distances
• Several training programs are scheduled over the next few months (practical hands on training, class room trainings, awareness camps and meetings at the village level)
• PMVS have organized 6 trainings during the last quarter.
• These trainings have focused on the importance of safe and hygienic delivery, clean and healthy habits and other related issues.
• Other blocks (SJS, Nakhatrana) have also organized orientation and trainings during the last quarter.
Training Camps
# List of activities / services Number of
Participants Visiting doctor
13th March camp
1. Training and orientation on reproductive and gynaec health
135 women
2. Gynaec check up 65 women
3. Blood grouping and Hb check up etc 94 women
4. Blood donation 30 women
Dr Bhadarka (Gynaec) and a lab tech from G K General hospital. District IPD was represented by Ms Shailendra Zala
20th March camp
5. Gynaec check up
6. BP and other check up 41 women Dr Mittalben Pitthal
The Future: KMVS Women’s Health Clinic• Run by the women of KMVS
• Services provided by both local Dais and an in-resident doctor
• Specialized women’s services: reproductive and gynecological healthcare
– not overlapping with services that the government can be held
accountable for
• Partnership with government
• Partnership with the whole community: funded by the community health
insurance program
– sustainable
• Not just to provide health services but also to impart health knowledge
• Train village health workers
• Engage citizens in activism about the health of their communities
Contact Information
• ASHA Cleveland Chapter
– Email: [email protected]
• Vishal Haria (ASHA Volunteer)
– Phone: (440) 212-0044
– Email: [email protected]
• Sheela Maru (KMVS Volunteer)
– Phone: (410) 627-3143
– Email: [email protected]
