1. Community Action for Health Maharashtra
Regional Workshop on Community action for health Mumbai, 31st Jan. and 1st Feb. 2017
Presentation by
Dr. Sunil Patil
Joint Director (Tech.), National Health Mission, Maharashtra 1 1

2. Community Action for Health in Maharashtra
Community Based Monitoring and Planning
Village health Nutrition and Sanitation committee
Community Action for Health in Maharashtra
Decentralized Health Planning
Rugna Kalyan Samiti (RKS)
Grievance Redressal Mechanism
MAS in Urban areas

3. Community Based Monitoring and Planning process of Health Services

4. Scale of CBMP process (CBMP) in Maharashtra
Under regular project mode covers 14 districts with formation, orientation and activity of multi-stakeholder committees in
Over 815 villages
120 PHC areas
35 Blocks
Currently the CBMP process with lower intensity generalizable mode is being implemented in 1490 villages and 65 blocks of 23 districts of Maharashtra.

5. Institutional mechanism for implementation of CBMP Levels of committees for Feedback & Action
State Planning & Monitoring Committee
District Monitoring & Planning Committee
Action
Feedback
Block Monitoring & Planning Committee
PHC Monitoring & Planning Committee
Village Health, Water supply, Nutrition and Sanitation Committee

6. Composition of CBMP committees
Public
Health
officials
Elected
representatives –
Panchayat
members
Representatives
from lower
committees and
community members
CBO /
NGO
representatives 6

7. Key processes in Community monitoring - Maharashtra
Data gathering and
filling report cards
Community awareness
programmes
Meetings of community based
monitoring committees
Visits by committee members
To health facilities

8. Public hearings (Jan sunwais/Sanvad): a forum for people’s voice and accountability
Report cards and cases of denial presented
Health officials respond to issues raised by people
Actions ordered regarding services at village, PHC and Rural hospital levels
Over 550 Public hearings organised so far at PHC, block and district levels

9. Progress under CBMP FY 2016-17
Sr. No.
Name of activities
Activities completed 1.
State level meetings, workshop 02 2.
District level meetings, workshops 16 3.
Block level meetings, workshops 20 4.
Monbitoring and Planning committee meetings at PHC, CHC 82 5.
VHNSC meetings
600 6.
Awareness programs at village level 52 7.
Data collection at village level 90
DECENTRALIZED HEALTH PLANNING PROCESS 8.
Collection of People’s Demands at village level
160 9.
District and block level workshops, meetings 46

10. Resource material produced under CBMP
Since last 9 years,
Under CBMP process
total 116 different
Kinds of CBMP
publications
(brochures, booklets,
tools, posters, report
cards, policy briefs
etc.) which have been
disseminated across
Maharashtra.

11. Significant improvements in health services in CBM areas
Practice of PHCs prescribing medicine from private shops has largely stopped
Illegal charging by certain medical officers has now been checked; challenging corruption
Frequency of visits of ANM and MPWs in villages has improved
Rude and abusive behaviour stopped
Definite improvement in immunisation coverage
Non-functional sub-centres, mobile units, lab facilities now started functioning
Significant rise in outpatient, inpatient utilisation in CBM areas

12. Community helps to solve problems of health care providers
In Bhongowali PHC in Bhor block of Pune district, the doctor was not staying at the PHC. Raised during Jan Sunwai, he complained that he did not have quarters. A CBM committee member offered to arrange a house for him in the village on the spot.
Today doctors are regularly staying at the PHC even at night.

13. State level recognition by CBMP process to well performing health care providers

14. Community Based Monitoring and Action of ICDS
Expansion CBM concept in other social sector such as Nutrition.
SATHI is the state nodal organization for CBMA ICDS in Maharashtra since 2013 with the support of Women and Child Development (WCD) department of Maharashtra.
Leading implementation of Community based Monitoring and Action of ICDS in 189 Anganwadis of 9 districts of Maharashtra from 2013.

15. Strengthening VHNSCs and RKS

16. RKS and VHSNC
Maharashtra developed various strategies to strengthen the functioning of these two important community level committees
Formed State level Support group for strengthening RKS and VHSNC comprising of NHM PO, SHSRC consultants, SATHI representatives and State RKS and VHSNC trainers
The group will primarily involved in developing and executing strategies for strengthening these committees (Eg: RKS coordinators capacity building workshop, Filed mentoring visits, Small studies to understand the gaps etc.)

17. GramSabha

18. Grievance Redressal Mechanism in Maharashtra

19. State level Grievance Redressal Cell
State Grievance Redressal Cell was established in September 2009 at State Level under National Health Mission, Mumbai.
The Hon. Commissioner (FW) & Director, NHM is the aultimate authority of the Statel level Grievance Redressal Cell.
At State level there is a separate Telephone number ( ) to registered grievances.

20. Circle level Grievance Redressal Cell
At each Circle Level, total 8 Grievance Redressal Cells have been established in the year of under Dy. Director, Health Services, Maharashtra.
Each circle level there is a separate Telephone number to registered a grievances.
Circle level Grievance Redressal Cell Committee 1)
Dy. Director, Health Services, Circle Offices
Chairman 2)
One Retired Judge or Sr. Press Reporter of the City
Member 3)
One Representative of NGO 4)
Circle Programme Manager
Member Secretary

21. District level Grievance Redressal Cell
The State Health Society established Grievance Redressal Committee/ Cell under 35 Districts in the year of
The District Programme Manager (DPM) is looking after the all grievances.
District level Grievance Redressal Cell Committee 1)
Chief Executive Officer, Zilla Parishad
Chairman 2)
District Health Officer, Zilla Parishad
Member 3)
Civil Surgeon, Civil Hospital 4)
District Programme Manager, Zilla Parishad
Member Secretary 5)
Administrative Officer, District Health Department, Zilla Parishad
Based on recommendation from CBMP, the State Health Society will be established at Block level Grievance Redressal Cell /Committee in

22. Various sources for collection of grievances at different levels
Written applications from complainant
Via telephone call (HACC – 104, registered GRC telephone number)
Via

23. Details of number of complaints under Grievance Redressal Cell at various levels
Year
No. of Complaints Received
No. of Complaints Resolved
No. of Complaints in process
State
300
298 2
(till Dec. 16) 44 33 11
Circle
1830
1797
1160
893
267
District
2117
1951
166
1444
1143
301

24. Plans for scaling up in FY 2017-18
Planning to cover all tribal districts (16 districts) of Maharashtra under CBMP process
Generalising community monitoring in voluntary mode in various new districts and regions
Strengthening Community Based Planning process under Decentralized Health Planning by using existing spaces/structures such as RKS committee, VHNSC, Gram Sabha
Block level federations, grievance redressal facilitation cells, resource units working with youth
Decision to organise ‘Arogya Gram Sabhas’ in all villages where services can be reviewed, planning decisions can be taken

25. Thank you!!!!!!!!!