National Consultation on Community Action for Health, Gulmohar Hall, India Habitat Centre, New Delhi...
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National Consultation on Community Action for Health, Gulmohar Hall, India Habitat Centre, New Delhi I October 28, 2014 OUR EXPERIENCES, LESSONS AND WAYFORWARD
National Consultation on Community Action for Health, Gulmohar
Hall, India Habitat Centre, New Delhi I October 28, 2014 OUR
EXPERIENCES, LESSONS AND WAYFORWARD PERSPECTIVES OF DEVELOPMENT
PARTNERS ON COMMUNITY ACTION FOR HEATH Usha Kiran Tarigopula,
Deputy Director
Slide 2
OUR APPROACH FOR SCALED COMMUNITY MOBILIZATION IN HEALTH 1
Create/leverage existing self-help groups to integrate Health Focus
on most marginalized women and RMNCHN and WSH Facilitate
participatory learning and action to improve health Facilitate
access and linkages to frontline workers and VHSCs Promote
collective action Work with members of groups to mobilize
non-members Support states to strengthen accountability through
local self-governance structures Generate evidence and share our
learnings with government and partners to inform scale-up
Slide 3
COMMUNITY ENGAGEMENT FOR NHM/RMNCH+A: UP AND BIHAR EXAMPLE 2
Uttar Pradesh Focus on the most marginalized groups from BPL
Promoted 70,000 groups in 160 blocks in 41 districts Trained ~
100,000 women leaders as health volunteers Established a proof of
concept to strengthen VHSNCs for MNCH Demonstrated potential of
leveraging self- help groups (SHGs) to increase uptake of health
interventions Demonstrated potential of leveraging self- help
groups (SHGs) to increase uptake of health interventions Bihar
Focus on SCs/STs and Pusmanda Muslims in 60 blocks in 8 districts;
36,000 groups Trained and capacitated ~2,600 as health volunteers
and promoted participatory learning and action Encouraging health
outcomes data from external midline Work to strengthen VHSNCs
underway in 100 Panchayats Plans are being developed together with
other partners for scale up through NRLM Focus in promoting
individual and collective action for shifting norms, uptake of key
interventions, linkages with health workers/facilities and links
with VHSNCs
Slide 4
Source: Parivartan Midline; Notes: */**/***=adjusted difference
significant at the 10/5/1 percent level. ns not significant Chi-sq
test for association between outcome indicators and time.
*/**/***=significant at the 10/5/1 percent level *** * Most
marginalized women in SHGs with Health layering showed better
increase in selected critical outcomes BIHAR: EARLY FINDINGS FROM
MIDLINE EVALUATION ARE ENCOURAGING (1/2)
Slide 5
BIHAR: EARLY FINDINGS FROM MIDLINE EVALUATION ARE ENCOURAGING
(2/2) Maternal Health New Born and Child careFamily Planning
Source: Parivartan Midline; Notes: */**/***=significant at the
10/5/1 percent level. Chi-sq. test (unadjusted associations) Strong
Correlations between health volunteer advice and selected outcomes
for most Marginalized women in SHGs
Slide 6
COMMUNITY ENGAGEMENT IN HEALTH: SUPPORT TO STRENGTHEN VHSNCS IN
KARNATAKA 5 Strengthen capacities of 1150 VHSNCs in two districts
in Karnataka with GOK and foundations support through training and
handholding: Understand roles and responsibilities Plan and monitor
village-level health activities Help community prepare a practical
and actionable health plan Take ownership of health services and
facilities within the community Work together with different
departments to achieve common health goals Help the community raise
voice for provision of services & identify local problems and
generate solutions
Slide 7
EVALUATION FINDINGS: INCREASED PROPORTION OF HEALTH TOPICS
DISCUSSED IN THE LAST VHSC MEETING IN KARNATAKA
Slide 8
KARNATAKA: EVALUATION FINDINGS SHOW INCREASED PROPORTION OF
VILLAGE ANNUAL HEALTH PLANS
Slide 9
Our experiences and evidence to date excites us about the
potential to leverage community structures to complement the supply
side interventions in health The biggest challenge in front of us
is reaching scale with quality to support the aspirational goals of
NHM Apart from working with VHSNCs and PRIs to strengthen
monitoring and accountability for health, we see the GOIs NRLM
offers an incredible platform of womens groups and their
federations at scale to leverage for health Womens groups offer
incredible opportunity to shift social norms, increase of uptake of
life saving interventions through household and community action
for health The synergistic actions between FLWs, womens groups,
panchayats and other local structures critical to achieve community
action for health In addition to supporting NHM and ICDS, we plan
to provide national and state level TA to NRLM to develop and
institutionalize capacity to integrate health 2014 Bill &
Melinda Gates Foundation | 8 IN SUMMARY.
Slide 10
THANK YOU
Slide 11
COMMUNITY ENGAGEMENT IN HIV PREVENTION: AVAHAN EXAMPLE 10
Focused in 5 southern Indian states over the last decade in 83
districts with most at risk Reaches 300,000 FSWs, MSMs and TGs
10,000 groups and over 100 registered CBOs Strong focus on risk
reduction by addressing key issues like violence Strong evidence on
how community mobilization can help reduce riskl Focused in 5
southern Indian states over the last decade in 83 districts with
most at risk Reaches 300,000 FSWs, MSMs and TGs 10,000 groups and
over 100 registered CBOs Strong focus on risk reduction by
addressing key issues like violence Strong evidence on how
community mobilization can help reduce riskl
Slide 12
2014 Bill & Melinda Gates Foundation | 11 Increased
Collective and Individual PowerIncreased Knowledge and Uptake of
Services Increased CCU Reduced Gonorrhea and Chlamydia Prevalence
Low Medium High ** * * * * * * * *AOR p