Jatan believes that preventive health care (avoiding or slowing the course of an illness) is an important determinant of health. Investment in human capital leads to a healthy and educated populace, which contributes to the growth of an economy through its employability, creativity and productivity.
Community Monitoring is a form of public oversight, ideally driven by local information needs and community values, to increase the accountability and quality of social services. Within the CM framework, members of a community affected by a social programme generate demands, suggestions, critiques and data, which they feed back to the organization implementing the programme. CM aims not only to generate the appropriate information for high quality service delivery but also seeks to strengthen local decision-making, public education, community capacity and effective public participation in local government.
Jatan was selected as a nodal agency for the community monitoring programme of the National Rural Health Mission (NRHM) in the Udaipur district. This effort was initiated in 3 blocks of Udaipur district wherein 45 new Village Health and Sanitation Committee’s (VHSC) were formed and 45 existing VHSCs were reformed or strengthened. Besides being a nodal agency Jatan actively implemented the activities in 3 Public Health Center’s (PHC) of Gogunda block of Udaipur district.
Under this programme, members of 90 VHSC's were informed about the public health system. Emphasis was placed on the entitlements in the NRHM, preparing village health plans, and using tools for monitoring and completing a village health report card. They were oriented about use of untied funds as well as prepared for organizing public dialogue as a tool for securing health rights of the people.
Each PHC held an orientation meeting in respective PHC/blocks, and the updated activity MIS (monthly information system) was shared with the members. A major achievement was the preparation each PHC and village’s report card in every three months. Information was collected from the village level report cards on disease surveillance services, maternal and child health services, curative services at village level, Angan Wadi (preschool education centres) services, availability of services and quality of care available at PHC and utilization of village untied funds.
Information was collected from the PHC level report cards on infrastructure, services, availability of human resources, availability of essential drugs and exit interview of patients (quality of service, behaviour of providers, corruption etc.).
- Citizens are informed about the health services provided by the government and they are coming forward to claim those benefits
- Community ownership is being realized through village level health committees
- Health service providers are being bound to provide health services regularly at their centres
- Registration of pregnant women and immunization of children has become regular activity
- A number of documented instances by implementing organizations point towards the definite change in the attitude of health functionaries and increases in use of the services.
Quality Assurance in Health Services
Recently, the focus of health services, especially RCH (reproductive and child health) services, is shifting towards better quality of service delivery. The concept of quality health services is gaining wider acceptance among the health professionals. Major efforts are under way to improve the quality of services. For instance, the Government of India has published a set of guidelines to improve the quality of reproductive and child health services delivered from Community Health Centre’s (CHC), PHCs, and SCs and in RCH camps. Government of Rajasthan with the support of UNFPA has initiated the task of quality assurance in RCH services in four districts- Ajmer, Nagaur, Sikar and Udaipur.
Jatan initiated an effort to ensure quality health care services in Mavli block of Udaipur district. Five VHSC training programmes were organized. Under these programmes, 113 Accredited Social Health Assistant’s (ASHA) and 68 Panchayati Raj Institution’s (PRI) were provided training on Quality Assurance Programme. Through these trainings capacity building of ASHA’s and PRI members was undertaken. At the same time, the trainings of PRI members were used as platforms to share the concerns related to access to maternal health care services and motivating the village level stakeholders to ensure access. In this way, Jatan was able to contribute to defining, designing, assessing, monitoring, and improving the quality of health care.
The delivery of quality of health services is not only central to improving the health status of the population, but it also results in decreased fatality and complication rates.