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Chhattisgarh Swasth Panchayat Yojana: Convergent Community Action for Health and Its Determinants in Rural India

  • Samir GargEmail author
Chapter

Abstract

This chapter provides the implementer’s perspective on the Chhattisgarh Swasth Panchayat Yojana as an example of convergence on a single, decentralized action platform for health and its determinants. The rationale for this initiative was the wide-ranging participation of community institutions like the Panchayat (an elected Village Council) in coordination with the Village Health, Sanitation, and Nutrition Committees (VHSNC), and Mitanins (Community Health Workers or CHW), stewarded by the State Health Resource Centre of Chhattisgarh in collaboration with the state Government. From 2006 onwards, there has been active community engagement in the collection of data on indicators of health status, access to health services, and determinants of health (nutrition, water, gender, employment). Indicators have been designed so that the community can record, understand and make use of the data to advocate for and monitor improvements in public service delivery. The challenges and lessons are many, including the fact that poor progress on indicators can sometimes reflect the severity of social determinants and not merely the lack of progress or success of any action. The process has seen several iterations and revisions, and the addition of new components to compile and use the data at levels beyond the village. This chapter attempts to describe how multiple interventions were brought in at various stages. The impact is a result of the mutually-reinforcing, interlinked and therefore integrated set of interventions, with some interventions being seen as more successful than others. The community platform was strengthened at each stage, where further components were added based on a periodic analysis of what worked and what did not. The process of analysis and the adding of components was also guided by a vision of community empowerment and a holistic definition of health that specifically included SDH. The complex and interlinked nature of interventions were crucial to achieving convergent action on health and Social Determinant of Health (SDH) and its scaling-up. Chhattisgarh has scaled-up the Swasth Panchayat program across the state and has institutionalized its implementation and facilitation arrangements. The National Health Mission has included the essential components in its guidelines. The adequacy of arrangements for the facilitation of community-level structures and the autonomy of key actors will be crucial to the success of its replication.

Keywords

Rural health Village health Sanitation and nutrition committees Healthy panchayat Chhattisgarh 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  1. 1.State Health Resource CentreRaipurIndia

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