1. Regional Consultation, New Delhi February 10, 2016
Update on implementation of Community Action for Health under the National Health Mission
Regional Consultation, New Delhi
February 10, 2016

2. Accountability Framework National Health Mission (NHM)
Three pronged approach
External surveys
Routine program monitoring
Community based monitoring

3. Advisory Group on Community Action (AGCA)
Group of civil society experts constituted by the MoHFW in 2005, with Population Foundation of India (PFI) as the Secretariat
Mandate :
Advise on developing community partnership and ownership for the Mission
Provide feedback based on ground realities to inform policy decisions – community monitoring , Common Review Mission, fact finding missions
Develop models on community action

4. Process Monitoring and information sharing of data on health services
Education and awareness generation
Community awareness on health entitlements
Display of citizen’s charter and service guarantees in health facilities
Training of VHSNC, RKS and Planning & Monitoring Committees
Monitoring and information sharing of data on health services
Collection of information on community experiences of health services
Compilation and sharing village and facility report cards
Regular meetings of Planning and Monitoring Committees at block, district and state levels to take decisions on issues and gaps
Public dialogue
Periodic public dialogue (Jan Samwaad) - Engagement with providers based on community evidence
Follow up action to resolve issues and gaps
Including incorporation into the District and State Programme Implementation Plans (PIPs)
A systematic approach was adopted in the implementation of community action. This involved :
Structured trainings for VHSC members and block and district planning and monitoring committees
Use of folk media and communication materials for dissemination of information on NRHM and its health entitlements
Display of citizens charters and minimum service guarantees (including roles and responsibilities of service providers, timings of services) at the village and in health facilities
Community enquiries were done through community meetings and information was collected for health facilities through direct observation and exit interviews. This was done at an interval of six months.
Multi-stakeholder committees were formed and trained to feed inputs emerging from the community enquiry and facility surveys for planning and corrective actions.
Block, District and State Level Jan Samwads (Social audits) were organized to share instances of denial of services and outcomes of the community monitoring process.

5. AGCAs support
Facilitate state level visioning and planning exercises, including development of State PIPs
Develop/adapt guidelines, manuals, communication materials documentary films, TV and radio spots, IEC materials on health entitlements, newsletter
Develop capacities of state nodal officers and implementation organizations
Regular mentoring and guidance to states on programme implementation
Undertake programme implementation reviews
Documentation and dissemination of best practices community action models, grievance redressal, decentralized health planning

6. 2015-16 – Proposed in 26 States’ & UTs PIP
Scaling up
– Proposed in 26 States’ & UTs PIP
– Approved in 19 states
Rajasthan
Gujarat
Maharashtra
Karnatakac
Madhya
Pradesh
Uttar
Uttarakhand
Orissa
Chhattisgarh
Bihar
Jharkhand
Assam
Nagaland
Manipur
Arunachal Pradesh
Mizoram
Meghalaya
Tripura
Sikkim
Kerala
Punjab
Delhi
Daman & Diu
Himachal Pradesh
West Bengal
Goa
Rajasthan
Gujarat
Maharashtra
Karnataka
Madhya
Pradesh
Uttar
Uttaranchal
Orissa
Chhattisgarh
Bihar
Jharkhand
Assam
Nagaland
Manipur
Kerala
Arunachal Pradesh
Himachal Pradesh
Delhi
Goa
Meghalaya
Mizoram
Sikkim
Tripura
Punjab
West Bengal
The AGCA guided the implementation of a pilot, which was implemented in 9 states, 36 districts and 1600 villages.
26 States and UTs- include 19 approved states, 4 non approved, 2 pending states and one UT (Daman and Diu) not approved.
19 approved states- Arunachal Pradesh, Assam, Chhattisgarh, Gujarat, Himachal Pradesh, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Meghalaya, Mizoram, Odisha, Punjab, Sikkim, Tripura, Uttar Pradesh, Uttaranchal, West Bengal, .
Approved
Approval pended
Not approved

7. Implementation in the States
Component included by 25 states
News states: Tripura, Himachal Pradesh and West Bengal
Approvals as per Record of Proceedings (ROP) – 19 states (Arunachal Pradesh, Assam, Chhattisgarh, Gujarat, Himachal Pradesh, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Meghalaya, Mizoram, Odisha, Punjab, Sikkim, Tripura, Uttar Pradesh, Uttaranchal, West Bengal)
Budget
Proposed: Rupees - 49,84,56,000
Approval: Rupees- 27,70,22,000 (23 % increase*)
Approval (FY ): Rupees - 22,49,11,000
Pending approval states: Rajasthan, Uttar Pradesh, Nagaland and Manipur
Rajasthan : Budget Rs.2.17 crore No detailed plan submitted.
Nagaland : budget of Rs lakh (covering 2 districts)
Manipur: Budget Rs lakh No detailed plan submitted.

8. Priority areas- going forward
Support states in mentoring of VHSNCs to enable community level planning and monitoring
Strengthening of RKS as per the MoHFW guidelines in selected states
Support states in operationalizing grievance redressal mechanisms
Coordinate with the Ministry of Panchayati Raj to build capacities of PRI members on health and its determinants
Guide states in contextualizing the implementation mechanisms and scaling up implementation
Pending approval states: Rajasthan, Uttar Pradesh, Nagaland and Manipur
Rajasthan : Budget Rs.2.17 crore No detailed plan submitted.
Nagaland : budget of Rs lakh (covering 2 districts)
Manipur: Budget Rs lakh No detailed plan submitted.

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Thank You For more information please visit our website