An assessment of the functioning of the Village Health Sanitation and Nutrition Committee in the rural areas of Kamrup district, Assam

Abstract

Background: The Village Health Sanitation and Nutrition Committee (VHSNC) is a first step toward decentralized planning and community empowerment approach Objective: To assess the constitution of the VHSNCs, to assess the activities undertaken by them, and to assess the funding and utilization status of the VHSNCs. Materials and Methods: Study design-Community-based cross-sectional study. Study place-Three blocks of Kamrup district viz, Boko-Bongaon, Hajo, and Sualkuchi. Study period-July 1 to October 31, 2015. Study population-The functionaries of VHSNCs present during visit and the records maintained. Sample size-Total 78 VHSNCs were assessed in this study. Sample collection technique-Out of the total 12 blocks, 3 blocks were selected. Sub-centers (50%) under these three blocks selected and two villages from each SC selected. All the 78 VHSNCs operating in these villages were included in this study. Data collection tool-Predesigned and pretested schedule containing both open-and closed-ended questions. Primary data were collected by interview method and secondary data obtained from various records. Results: 55.12% VHSNCs had 11 or more members. Panchayati Raj Institution (PRI) member, Auxiliary Nurse Midwife (ANM), Accredited Social Health Activist (ASHA), Anganwadi Worker (AWW), and Medical officer were members in all of the committees. Only 16.67% of the VHSNCs conducted 10-12 meetings in 1 year. 16.67% VHSNCs had maintained and updated the untied fund register. Formation of new committee and new members (96.15%), ASHA's incentive (94.87%), and Anganwadi Center (AWC) repairing (88.76%) were commonly discussed topics in monthly meetings. A majority of 67.93% VHSNCs utilized more than 90% of the funds allotted to them. Conclusion: It was observed that although VHSNCs have been constituted in all of the revenue villages in the study area, there are several lacunae in their organization.

Are village health, sanitation, and nutrition committees functional? Evidence from Chhattisgarh and Madhya Pradesh

“…[ 14 ] Similarly, another study from Assam also showed that around only 17% of the VHSNCs had conducted regular monthly meetings in the assessed year. [ 15 ] The present study evidence that the meetings of VHSNCs were not done in a serious mode.…”

Assessing engagement of scheduled tribe communities in the functioning of Village Health Sanitation & Nutrition Committees in India

“…It was identified that the understanding about the role of VHSNC was highest among ANMs, AWWs and ASHA workers. Das et al 13 also reported that there was a lack of clarity about the roles and responsibilities among VHSNC members. Srivastava et al 10 noted that a detailed training was imparted to ASHAs and AWWs, while others received only a brief orientation, which many, did not consider as ‘training’.…”

“…Regularity in meetings : As per NHM, each VHSNC should organize monthly meetings, as it is during the meetings that the problems are identified, discussed and plans charted out for their mitigation 7 . However, irregularities in the monthly meetings of VHSNCs were observed, where the committees struggled to organize regular meetings and with full attendance 9 - 11 , 13 . Semwal et al 16 mentioned that among all 18 VHSNCs, meetings were not organized regularly.…”

“…Even after 15 years of the conception of VHSNCs, we found a dearth of studies from the tribal dominated blocks of India, where tribals are more than 50-90 per cent of the population and are generally poorer than the rest of the social groups. Despite substantial inequalities in health, nutrition and other aspects between ST and non-ST populations, only a handful of articles have assessed the functioning of the VHSNCs and that too from the villages with mixed populations of caste-peasantry and tribal people 8 - 11 , 13 - 21 . In such mixed villages, the committees were dominated by the non-tribal members, in matters of attendance, record keeping and usage of schemes and funds.…”