Parivartan: Strengthening Village Health Sanitation and Nutrition Committees;

Duration: 2014–2016

Location: Khagaria and Saharsa districts

The project goal is to revitalize and strengthen Village Health Sanitation and Nutrition Committees (VHSNCs) in Bihar through training and technical assistance. When the project was launched in Khagaria and Saharsa in April 2014, an assessment of VHSNCs was done through in-depth interviews with Mukhiyas ward members, auxiliary-nurse-midwives (ANMs) and their lady supervisors. The findings were that most VHSNCs existed only on paper, as their members had either retired or been transferred.

Agragami helped re-form the 102 VHSNCs of the intervention area and also formed 220 Nigrani Samities through a participatory process that made each member understand that she/he was a unique and important contributor to improving the status of health, nutrition and sanitation of the community. Agragami's master trainers bridged the gap between the members of the committees, and generated faith in them about Government's intentions and systems. A 100 VHSNC bank accounts were made operational by liaising with bank managers and medical officers-in-charge to update the lists of authorized signatories and utilization of untied funds.

Members of the VHSNCs and Nigrani Samitis, were trained to take collective decisions during monthly meeting; 581 monthly meeting were held and 145 Village Health Action Plans (VHAPs) developed. Areas of under-utilization of untied funds were identified, untied funds spent, utilization properly documented and utilization certificates and statements of expenditure submitted.

In Amba Icharua panchyat, Manoj Kumar, the master trainer from the project, met the Mukhiya, Mr Naveen Kumar and the ANM Kumari Urmila, to discuss the formation of the VHSNC and the Nigrani Samiti. At first they ignored him, but Manoj made them understand the importance of the VHSNC and its functions. After a while, the Mukhiya and the ANM agreed to re-form the VHSNC and Nigrani Samiti. The five VHSNC members were elected/finalized and regular monthly meetings began to be held.

The VHSNC's bank account was made operational by updating the list of signatories of the account. All members were very excited about preparing a health action for the village and implementing it. They decided that the two Mushahar tolas of Prash Mushari and Amba needed platforms for their hand pumps on a priority basis. They also decided to organize an awareness rally on sanitation, an antenatal camp, and a wall-painting exercise to build awareness on antenatal issues.

Approximately Rs 20,000 was spent on these planned activities, which were supervised by the VHSNC-Nigram Samiti. Utilization certificates and statements of expenditure have been submitted to the primary health centre (PHC).