Community Processes under National Health Mission (NHM)
From the time of the launch of the National Health Mission (NHM), the Mission was committed to a vision of universal access to health, with a strong focus on community engagement to ensure people’s participation in health and to enable action on the social determinants of health. Community participation is defined as “a process by which people are enabled to become actively and genuinely involved in the defining the issues of concern to them, in making decisions about factors that affect their lives, in formulating and implementing policies, in planning, developing and delivering services and in taking action to achieve change’ (WHO, 2002, p.10). The focus continues with community processes being at the heart of the outcome of the Mission.
The ASHA Programme as it stands today is a powerful reflection of a strong community process at the ground level. More than 45000 ASHAs in the State of Odisha are the most visible faces at the community level along with other interventions under National Health Mission. The ASHA is a woman selected by the community, resident in the community, who is trained and supported to function in her own village to improve the health status of the community through securing people’s access to health care services, enabling improved health care practices and behaviours and health care provisions as is essential and feasible at community level.
ASHAs have been established themselves as the first port of call for all health related and allied activities at the community level. It is their facilitation support, commitment and dedication which have helped the health system to achieve the desired results. Further they have been playing the pivotal role in mobilising the community to promote appropriate health seeking behaviour and adopt right health practices. Sincere and dedicated efforts have been made to provide them the required support provisions, need based capacity development, timely incentive payment on order to sustain their continued efforts at the community level for better health outcomes.
Gaon Kalyan Samiti
The Village Health Sanitation and Nutrition Committee which is known as Gaon Kalyan Samiti (GKS) in Odisha has demonstrated unique ability to drive the local health agenda. Functioning as a community level platform, GKS take collective action on issues related to health and its social determinants at village level. They are central to local level community action under NHM which is gradually develop to support the process of decentralized health planning.
There are around 45000 Gaon Kalyan Samiti in the State of Odisha functioning at the Revenus Village level. Ward Member acts as the President, AWW acts as the Convener and ASHA acts as the facilitator for the functioning of GKS. It provides an institutional mechanism for the community to be informed of health programmes and government initiatives. Further they also provide a platform for convergent action on social determinants and all public services directly or indirectly related to health. Annual untied fund of Rs.10000/- provided to GKS to take up local level action to address health related issues.
Community Process Resource Centre (CPRC), Mission Directorate, NHM provides required support for the effective implementation of Community Process activities in the State.