Introduction: Decentralization through introduction of Village Health Sanitation and Nutrition Committees (VHSNCs) was a key initiative introduced in 2007 under the National Health Mission (NHM), India to address local health and sanitation issues. This study was done to assess the functioning of the VHSNCs. Aims and Objectives: 1. To assess the level of awareness among the VHSNC members about their roles and responsibilities 2. To assess the level of awareness among the community members about the committee and its functions. 3. To assess the pattern of disbursement and utilization of untied funds under VHSNCs. Methodology: A cross-sectional study of 30 VHSNCs conducted in district Kangra of state Himachal Pradesh. Information was collected through a review of records and in-depth interviews with community and VHSNC members. Results: All committee members knew about VHSNCs but the level of awareness among community members was comparatively less (67%). Some members were confused about their roles and responsibilities. Most active members were the FHWs, AWWs, ASHAs, Mahila mandal representatives, and the female ward panch. A major chunk (65%) of the funds is utilized on the cleanliness activities. For the nutritional part, the majority of the work is already being undertaken by the AWCs so there is no clarity regarding the functioning of the committee on this aspect.

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In the study medical schools, we observed providers using several harmful or unnecessary practices on pregnant women in labor, including routine pubic shaving, enema on admission, routine episiotomy, application of fundal pressure, delivery in the lithotomy position, and unindicated augmentation. n Barriers to adherence to the recommended evidencebased intrapartum practices included fear of perineal tear/injury to the baby in different birthing positions; lack of physical space, resources, and time; and outdated knowledge and beliefs of faculty and labor room staff.