Cargando…
Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India
India’s National Health Mission constituted Village Health Sanitation and Nutrition Committees (VHSNCs) as a key mechanism for community health governance. Health committees provide citizens with the opportunity to shape health systems and policies. Yet much remains to be learnt on how best to susta...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195149/ https://www.ncbi.nlm.nih.gov/pubmed/30364368 http://dx.doi.org/10.1136/bmjgh-2017-000681 |
_version_ | 1783364347746058240 |
---|---|
author | Ved, Rajani Sheikh, Kabir George, Asha S VR, Raman |
author_facet | Ved, Rajani Sheikh, Kabir George, Asha S VR, Raman |
author_sort | Ved, Rajani |
collection | PubMed |
description | India’s National Health Mission constituted Village Health Sanitation and Nutrition Committees (VHSNCs) as a key mechanism for community health governance. Health committees provide citizens with the opportunity to shape health systems and policies. Yet much remains to be learnt on how best to sustain health committees as vehicles for community health governance at scale. This paper reflects on the authors’ experiences of introducing revised guidelines and an institutional support package for VHSNCs in two pilot settings in India and outlines lessons we learnt for sustaining community health governance at geographic scale. We describe the importance of ensuring norms for equitable participation, aligning committee rules with existing forms of decentralised government and providing key supports in terms of engaging NGOs as key implementation facilitators. Integration with rigid and unresponsive government administrative structures however remains a persistent challenge for scaling up health committees. With sustained financial support and strategic deployment of key personnel, VHSNCs could pave the way for more equitable and effective community participation in health governance at scale. |
format | Online Article Text |
id | pubmed-6195149 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-61951492018-10-24 Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India Ved, Rajani Sheikh, Kabir George, Asha S VR, Raman BMJ Glob Health Practice India’s National Health Mission constituted Village Health Sanitation and Nutrition Committees (VHSNCs) as a key mechanism for community health governance. Health committees provide citizens with the opportunity to shape health systems and policies. Yet much remains to be learnt on how best to sustain health committees as vehicles for community health governance at scale. This paper reflects on the authors’ experiences of introducing revised guidelines and an institutional support package for VHSNCs in two pilot settings in India and outlines lessons we learnt for sustaining community health governance at geographic scale. We describe the importance of ensuring norms for equitable participation, aligning committee rules with existing forms of decentralised government and providing key supports in terms of engaging NGOs as key implementation facilitators. Integration with rigid and unresponsive government administrative structures however remains a persistent challenge for scaling up health committees. With sustained financial support and strategic deployment of key personnel, VHSNCs could pave the way for more equitable and effective community participation in health governance at scale. BMJ Publishing Group 2018-10-03 /pmc/articles/PMC6195149/ /pubmed/30364368 http://dx.doi.org/10.1136/bmjgh-2017-000681 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Practice Ved, Rajani Sheikh, Kabir George, Asha S VR, Raman Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India |
title | Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India |
title_full | Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India |
title_fullStr | Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India |
title_full_unstemmed | Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India |
title_short | Village Health Sanitation and Nutrition Committees: reflections on strengthening community health governance at scale in India |
title_sort | village health sanitation and nutrition committees: reflections on strengthening community health governance at scale in india |
topic | Practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195149/ https://www.ncbi.nlm.nih.gov/pubmed/30364368 http://dx.doi.org/10.1136/bmjgh-2017-000681 |
work_keys_str_mv | AT vedrajani villagehealthsanitationandnutritioncommitteesreflectionsonstrengtheningcommunityhealthgovernanceatscaleinindia AT sheikhkabir villagehealthsanitationandnutritioncommitteesreflectionsonstrengtheningcommunityhealthgovernanceatscaleinindia AT georgeashas villagehealthsanitationandnutritioncommitteesreflectionsonstrengtheningcommunityhealthgovernanceatscaleinindia AT vrraman villagehealthsanitationandnutritioncommitteesreflectionsonstrengtheningcommunityhealthgovernanceatscaleinindia |