Isabella Carter
The Village Health and Sanitation Committee (VHSC) is a standing committee on health constituted in each village to develop the village health plan. The committee consists of 6-8 members from different backgrounds, such as the panchayat representative, ICDS worker (Anganwadi Worker), school teacher, respected village elders, and the ASHA, a representative of non-government or community-based organizations, or self-help groups. The VHSC collects data on population status, available health resources, and disease burden, and uses this information to develop health interventions and meet the health needs of the village population. The National Rural Health Mission (NRHM) was launched in 2005 to provide accessible, affordable, and quality healthcare to rural populations, focusing on determinants of good health, such as nutrition, sanitation, hygiene, and safe drinking water.
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What You'll Learn
Village Health, Sanitation and Nutrition Committees (VHSNC)
The Village Health, Sanitation and Nutrition Committees (VHSNC) are an integral part of India's healthcare system, particularly in rural areas. VHSNCs were instituted by the National Health Mission as part of its synergistic approach to healthcare, recognising the link between health, sanitation, hygiene, and nutrition.
VHSNCs play a crucial role in promoting health and wellness in villages. They are involved in health promotional activities such as formulating and implementing village health plans, including efforts to improve drinking water safety and facilitate the construction of toilets. VHSNCs also organise monthly Health Days (or Village Health and Nutrition Days) at the anganwadi level, where services like immunisation, ante/post-natal check-ups, and mother and child healthcare are provided.
The composition of VHSNCs varies, but they generally consist of elected members from the village community. In some states, like Punjab, the VHSNC is appointed by the Panchayat Samiti, a local self-government body that acts as the link between the village council (Gram Panchayat) and the district council (Zila Parishad). The Panchayat Samiti oversees the funding and implementation of village plans, evaluating them based on financial constraints, social welfare, and area development.
The success of VHSNCs has been mixed, with some challenges noted in a review of their functioning. These challenges include a lack of clear-cut roles and responsibilities, irregular meetings, workforce shortages, a lack of inclusivity, and delays in fund processing. Despite these issues, VHSNCs have made significant contributions to improving health, sanitation, and nutrition in villages, particularly in reducing childhood diseases and maternal complications.
Overall, VHSNCs are a vital component of India's rural healthcare infrastructure, empowering communities to take charge of their health and well-being and bridging the gap between policy and local implementation.
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Gram Pradhan
The Gram Pradhan, along with selected members of the Village Health Sanitation and Nutrition Committee (VHSNC), constitutes the planning committee responsible for integrating various village plans. The VHSNC is also known as the Village Health, Sanitation, and Nutrition Committee, and it plays a crucial role in formulating and implementing village health plans, promoting health, sanitation, and nutrition within the community.
The VHSNC's activities include making drinking water safe, facilitating the building of toilets, and organising monthly Health Days or Village Health and Nutrition Days (VHNDs). During VHNDs, services such as immunisation, ante/post-natal check-ups, and mother and child healthcare, including nutrition, are provided. The VHSNC also aims to establish a village-level health institution co-located with the Anganwadi centre (AWC) of the Integrated Child Development Services (ICDS).
In addition to their role in health and sanitation, Gram Panchayats, led by the Gram Pradhan, are responsible for providing various other services to their villages, such as education and infrastructure. They also collect and process village plans for funding and implementation, evaluating them from financial, social welfare, and area development perspectives. Gram Panchayats are the intermediary level of local self-government bodies in India, linking the village council (Gram Panchayat) with the district council (Zila Parishad).
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Accredited Social Health Activists (ASHAs)
In 2005, India's National Rural Health Mission (NRHM) was launched with the goal of providing accessible, affordable, and quality healthcare to rural populations. The NRHM targets health determinants such as nutrition, sanitation, hygiene, and safe drinking water.
One of the key components of the NRHM is the Accredited Social Health Activist (ASHA) program. The program was launched in 2006 with the goal of connecting marginalized communities to the public healthcare system. ASHAs are community health workers employed by the Ministry of Health and Family Welfare (MoHFW). They are trained to act as health educators and promoters within their communities.
ASHA workers are female residents of the villages they serve, preferably between the ages of 25 and 45. They are selected by and accountable to the gram panchayat (local government) or village council. While considered volunteers, they receive outcome-based remuneration and financial compensation for training days.
ASHA workers facilitate access to health services, such as immunizations, ante and post-natal check-ups, supplementary nutrition, and sanitation services. They also act as depot holders for essential provisions, including oral rehydration therapy (ORS), iron folic acid tablets, disposable delivery kits, oral pills, and condoms. Additionally, they promote good health practices and provide information on health determinants, such as nutrition, basic sanitation, and hygienic practices. They also counsel women on birth preparedness, the importance of safe delivery, breastfeeding, complementary feeding, immunization, contraception, and the prevention of common infections.
ASHA workers receive incentives for facilitating institutional deliveries, completing child immunizations, and facilitating family planning. For example, if an ASHA facilitates an institutional delivery, she receives ₹600 (US$7.10), and the mother receives ₹1,400 (US$17). ASHAs also receive ₹150 (US$1.80) for each child completing an immunization session and ₹150 (US$1.80) for each individual who undergoes family planning. The average monthly salary for an ASHA worker is around ₹10,000 (US$133).
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Mahila Arogya Samitis (MAS)
In 2016, the National Health Mission, Maharashtra (NHMM) collaborated with SNEHA to form Mahila Arogya Samitis (MAS) in urban vulnerable settlements. The initiative aimed to create 9393 women's groups, each consisting of 8-12 locally resident women for every 100 households. These groups would be responsible for neighbourhood health planning, addressing social determinants of health, and monitoring local services.
The MAS programme trained 1600 state, ULB, and NGO trainers, as well as 3600 ASHAs and NGO field staff. By the end of the programme in October 2018, 8075 MAS groups were formed, with bank accounts opened for 5733 of them.
A study in Indore city, Madhya Pradesh, assessed the functioning of MAS groups, including the number of households covered, the reasons behind joining, and the awareness of roles and responsibilities among members. The study found that a majority of ASHA and Anganwadi workers (AWW) believed that each MAS covered more than 200 households.
MAS groups are an important intervention under the National Urban Health Mission, aimed at improving the reach and utilisation of health services among vulnerable and marginalised populations in urban areas. They play a crucial role in addressing health issues and promoting wellness among women in their communities.
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Panchayat Samiti
In India, a Panchayat Samiti is a rural local government body at the intermediate tehsil or block level. It is also referred to as the "panchayat of panchayats" and acts as a link between the gram panchayat (village council) and the zila parishad (district council). The name Panchayat Samiti is used in some states, while in others, it is known by different names such as "block panchayat," "mandal parishad," "taluka panchayat," "janpad panchayat," "panchayat union," or "anchalik panchayat."
The Panchayat Samiti is responsible for providing various services to the people in its area, including sanitation, healthcare, education, and infrastructure. It collects plans prepared at the gram panchayat level and processes them for funding and implementation by evaluating financial constraints, social welfare, and area development. The main sources of income for a Panchayat Samiti are state aid and traditional taxing functions, with tax revenues often shared between the gram panchayats and the Panchayat Samiti.
The composition of a Panchayat Samiti varies, but it typically includes elected members from the area, such as the block development officer, members of the state's legislative assembly, and members of parliament belonging to that area. It also includes representatives from otherwise unrepresented groups, such as Scheduled Castes, Scheduled Tribes, and women. Associate members, such as farmers or representatives from the agricultural sector, may also be included. The samiti is elected for a term of five years and is headed by a chairman or president and a deputy, elected by the members of the Panchayat Samiti.
The most common departments found in a Panchayat Samiti include the health department, the education department, the public works department, the agriculture department, and the social welfare department. Each department has its own officer, often a state government employee acting as an extension officer, but occasionally a local employee in more revenue-rich Panchayat Samitis. A government-appointed Block Development Officer (BDO) supervises the extension officers and serves as the executive officer and administrative chief of the Panchayat Samiti.
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Frequently asked questions
The VHSNC is a committee that promotes health, sanitation, and nutrition in villages. They facilitate the building of toilets and work to make drinking water safe.
The VHSNC is constituted by the Gram Pradhan and selected members of the VHSC.
The Gram Pradhan is the chief of the Gram Panchayat, a cluster of villages and hamlets under local governance. They are responsible for integrating various village plans.
The VHSNC is involved in health promotional activities such as the formulation and implementation of village health plans. They also organise monthly Health Days or Village Health and Nutrition Days (VHNDs) to provide immunisation, ante/post-natal check-ups, and services related to mother and child healthcare.
A review of studies on VHSNCs in India found that they often function without a clear definition of roles and responsibilities, irregular meetings, and workforce shortages. There was also a lack of inclusivity and accountability, and delays in processing funds.
