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VimoSEWA Arogya Sanshodan

This presentation provides an overview of the Swasthya Sanshodan project, summarizing the baseline findings and analysis plan. It explores the effectiveness of health education in reducing unnecessary hospitalization for diarrhea, fever, and hysterectomy. Research questions focus on the drivers of hysterectomy, the impact of education on knowledge and response to gynecological care, and the differences in healthcare seeking behavior between insured and uninsured members. The intervention design includes implementing health education through selected sevikas, with regular surveys conducted over a two-year period.

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VimoSEWA Arogya Sanshodan

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  1. VimoSEWAArogya Sanshodan Baseline Findings Jan 2011

  2. Today’s Presentation • Overview of Swasthya Sanshodan project • Summary of baseline findings • Analysis plan • Your feedback on data, analysis and use

  3. Action Research – Why? • VimoSEWA claims 2007-9 • Primary illness 40% of claims • Hysterectomy top claim for rural women, avg age 37 • Effectiveness of health education • Longstanding SEWA activity, in different forms • Recent studies show impact on neonatal mortality • Can it work for primary care and hysterectomy?

  4. Research Questions • Can health education reduce unnecessary hospitalisation for diarrhea and fever? • Incidence • Expenditure • Health seeking behaviour • What are the drivers of hysterectomy? • How does education impact on knowledge and response to hysterectomy and gynecological care? • Do insured members seek health care differently? • Does an education program work differently for the uninsured?

  5. Intervention Design • Selected 28 sevikas who work where VimoSEWA/LSM active • Randomly selected 14 sevikas to implement health education • Focus on diarrhea, malaria/fever and hysterectomy • Film, games and demonstrations • Capacity building and regular feedback • Over 2 years, 5 survey rounds amongst insured and uninsured to capture health seeking behavior

  6. Study Coverage • 70 HH sampled in each cluster • 35 uninsured – from area listing • 35 insured – from Vimo MIS

  7. HH Profile

  8. Education: % ever studied

  9. Respondent Profile

  10. Women’s Work

  11. Housing : % HH by Type

  12. Household Toilets

  13. Drinking Water

  14. Mosquito precautions

  15. Ration Cards/BPL

  16. SEWA Health Services

  17. VimoSEWA Services

  18. VimoSEWA Coverage

  19. HH with anyone ill – last month

  20. Illness Rates – last month

  21. Leading Illnesses - Women

  22. Place of OPD Treatment Avg private exp: Rs. 380 Avg private exp: Rs. 501 Primarily private care, but less so in city Note slight differences within HH

  23. % HH reported hospitalisation in last 6 months

  24. Hospitalisation per 100; last 6 mos.Rural and Urban

  25. Hospitalisation amongst women Rural Urban

  26. Rates: Rural Vimo/Non-insured

  27. Rates: Urban Vimo/Non-insured

  28. Where Hospitalised - All Rural Urban

  29. Place of Hospitalisation

  30. Expenditure – Vimo and NV

  31. Are VimoSEWA members different? DIFFERENCES • SES – only urban • More salaried • Higher exp • More pucca houses • Demographic • More widows • Less educated (urban) • Much more likely to have a ration card SIMILARITIES • SES • Income • Toilets • Housing (rural) • Demographic • HH size • Family structure

  32. Reproductive Health Rural Urban

  33. Hysterectomy

  34. Age at hysterectomy

  35. Hysterectomy Reasons

  36. Place of Hysterectomy

  37. Analysis Plan Baseline • Women’s illnesses and health seeking behaviour • Insured and Uninsured • Social Determinants of Health Overall • Impact of health education – with qualitative • Hysterectomy – with qualitative • Community health workers – performance and roles

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