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

Abstract

Background: The Village Health, Sanitation, and Nutrition Committee (VHSNC) is a participatory effort aimed to strengthen the village-level agencies and to provide better health and sanitation services. However, there is a lack of evidence on the functionality of VHSNCs. Objectives: The present study aimed to explore the functionality of VHSNCs in the selected localities. Materials and Methods: The study was conducted in five districts of Chhattisgarh and Madhya Pradesh states. Using a multistage sampling method, a total of 508 VHSNCs were studied. The VHSNCs were considered as the unit of study. From each VHSNC, some key functionaries and its members were interviewed using a semi-structured interview schedule to understand the nature and effectiveness of its functioning. The researchers closely observed the meetings of VHSNCs and their records. Data were analyzed using descriptive statistical methods along with the impressions from the field notes. Results: The result of the study indicates that the functionality of the majority of the VHSNCs is not promising. Inadequate participation and improper implementation of key tasks are evident. Conclusion: The functionality of the VHSNC can be improved through the active involvement of Panchayati Raj Institutions and local communities.

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

“…However, several studies have reported that VHSNCs do not have the required number of members among them for proper functioning. Azeez et al 9 noted that <10 members were present in ~17 per cent of the committees. Srivastava et al 10 reported that VHSNCs were formed according to the State-level guidelines in both Jharkhand and Odisha.…”

“…and service users like pregnant women constitute the VHSNCs 8 . The VHSNC is aimed to plan and implement health, nutrition and sanitation targets for the marginalized and poor sections at the village level 9 . Although VHSNCs are envisioned to ensure community participation, their performances are also influenced by the factors such as accessibility of funds and preparedness of their members to perform.…”

“…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.…”

“…However, the studies reported improper maintenance of the records. Azeez et al 9 reported that 37 per cent VHSNCs did not maintain proper records, while 35 per cent VHSNCs did not keep a register. Sah et al 11 reported that majority of the VHSNC members revealed that neither minutes were recorded nor any village health, birth or death registers were maintaining.…”

Current Status of Malnutrition in India and Government Initiatives to Improve Nutrition and Health

“…It oversees the operation of the village's Anganwadi Center (AWC) and supports its efforts to raise the nutritional status of mothers and children. 21…”