Student Dissertation

Agency : Strengthening, Village Health, Nutrition Day, NRHM, Quality of Health Services

Objective : To find the effectiveness of following factors 1) Supportive Supervision 2) Capacity building 3) Facility trainings 4) Interdepartmental Convergence 5) Technical Support

Background : Village Health and Nutrition Days (VHNDs) are a major initiative under the National Rural Health Mission (NRHM) to improve access to maternal, newborn, child health and nutrition (MNCHN) services at the village level. Across the country, VHNDs are intended to occur in every village once a month usually at the Anganwadi Centre (AWC) or other suitable location. AWCs are a central feature of the Ministry of Women and Child Development’s flagship Integrated Child Development Services (ICDS) programme. VHNDs provide a basket of health and nutrition services and counseling to the community on a pre-designated day, time and place. VHNDs require convergent actions from the Department of Health and Family Welfare (DHFW) and the Department of Women and Child Development (DWCD) at state, district and block levels to plan, implement and monitor the programme. Accredited Social Health Activists (ASHAs) along with Anganwadi Workers (AWWs) are responsible for mobilizing the community for VHNDs, with support from Panchayat Raj Institutions (PRIs), and holding health education sessions. Auxiliary Nurse Midwives (ANMs) provides maternal, newborn and child health services such as antenatal care (ANC) and routine immunizations. AWWs provide growth monitoring services and referral of children with severe acute malnutrition in addition to distributing supplementary nutrition. The presence of all three frontline workers (i.e. AWW, ASHA and ANM) is critical for the provision of the intended package of services at VHNDs.

Methodology : Experimental, interventional study design with 24 Villages, AWC/SHC at Raipur block, District Rewa, Madhya Pradesh. The duration of study was for 3 months (February 2014 to April 2014). The respondents for the following study included the frontline workers (ANM, ASHA and AWW) at the VHND session site. Purposive sampling has been taken in the study. Sample is selected form 24 VHND sites form 24 Villages as Baseline Data by simple random technique and to full fill the purpose of study same sample were selected which have been selected for baseline and compared with end line. A sample size of 24 was taken. VHND held on Tuesdays and Fridays of every week. Thus, in a time period of 3 month, 24 VHND sites have been visited.

Findings : The study revealed that the factors had contributed to increase 50 the access, use and quality of health and nutrition services at strengthening of VHND’s. The technical assistance and collaboration with district officials has demonstrated the importance and building on existing platforms and systems in order to achieve better results.

Recommendations : The joint efforts of District and block level officials, the factors such as Supportive supervision, Technical support, Capacity building, Facility training had contributed to increase the access, use and quality of health and nutrition services at strengthening of VHND’s. The study’s technical assistance and collaboration with district officials has demonstrated the importance and building on existing platforms and systems in order to achieve results. End line survey clearly describes that the factors have shown the effectiveness in strengthening of VHND at 24 sites but haven’t achieved to maximum level and program need to concentrate on beneficiaries side rather than only from service provider, and socio demographic factors like population and education shows some effectiveness for strengthening of program


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