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Empowering Communities: Lessons in Health System Strengthening

Community Action for Health (CAH) functions as a key component under the National Health Mission (NHM), placing people at the center of the process of ensuring that the health needs and rights of the community are being fulfilled.The right to health serves as a cornerstone of social justice, encapsulating the right of people everywhere to have access to quality health services, good nutrition, education and freedom from discrimination. This yearu2019s World Health Day also emphasized the importance of the right to health, with the theme u2018My Health, My Rightu2019.

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Empowering Communities: Lessons in Health System Strengthening

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  1. Empowering Communities: Lessons in Health System Strengthening Community Action for Health (CAH) functions as a key component under the National Health Mission (NHM), placing people at the center of the process of ensuring that the health needs and rights of the community are being fulfilled.The right to health serves as a cornerstone of social justice, encapsulating the right of people everywhere to have access to quality health services, good nutrition, education and freedom from discrimination. This year’s World Health Day also emphasized the importance of the right to health, with the theme ‘My Health, My Right’. A key method to strengthen not just the right to health but also the systems supporting health services is to ensure strong community engagement in the implementation of health-related services and policies. Engaging communities is widely believed to have a positive impact on the effectiveness of health programmes, enhancing social capital, community empowerment and an improved health status with reduced inequalities. Community Action for Health is viewed as the first systematic and health sector-wide institutional mechanism for civil society engagement in health services. The process of communitization involves, among other things, creation of a cadre of female community health workers or accredited social health activists (ASHA) as well as creation of ‘Rogi Kalyan Samitis’. CAH has developed and evolved as a means to improve health outcomes by strengthening community participation and ensuring empowerment by making communities more accountable for their health needs.

  2. The CAH processes involve strengthening the Village Health, Sanitation and Nutrition Committees (VHSNCs), Rogi Kalyan Samitis (RKSs) and Planning and Monitoring Committees (PMCs) at the primary block, district and state levels, creating community awareness on NHM entitlements, roles and responsibilities of service providers as well as training of VHSNC, RKS and PMC members. Undertaking community level enquiry to assess the availability, range and quality of health services, developing village and facility level reports to reflect the status of health services and organizing Jan Samwad or public dialogue for advocacy with health providers and managers are also included within CAH processes. Another key task for CAH includes corrective action and planning to address emerging issues and gaps.

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