Hand Book for Gaon Burahs and Panchayati Raj Leader

25and monitoring programmes to improve their health status. Villagehealth planning is a complex process. The process of participatoryplanning raises several expectations and the state must be serious in itscommitment to meet such expectations and fulfill people’s demands.Nevertheless it is perhaps the only effective way of catalyzingimprovements in primary health care and enabling the goals of theNRHM and ensuring sustained gains. The NRHM proposes thefollowing facilitating features to enable local action.• Decentralization of the NRHM to the Gram Panchayat• Activation of the Village Health Committee and involvement of agreater number of stakeholders particularly women and those frommarginalized communities.• Appointing and training a woman from the community –ASHA, toplay a key role in mobilizing people and supporting village healthplanning and action.• Enabling support to ASHA from the ANM, AWW, and village basedfunctionaries of other departments.• Involvement of the ANM in village planning process made possibleby provision of an additional worker at the sub center (depending onthe states’ need)• Ensuring inter sectoral convergence, particularly with programmesfor women’s empowerment, nutrition, water, household andenvironmental sanitation.• Establishment of an untied fund at the sub center level to meetunmet health related needs of the sub center facility and thepopulation in its area of coverage. (Guidelines on how these are toused have been developed).• Monthly camp at the Anganwadi Center where a Medical Officerand ANM will visit the village to provide services.2. Community Needs Assessment Approach (CNAA) is a village basedplanning tool currently being used by the ANM to assess keyreproductive and child health (RCH) needs in her sub center area.CNAA is a combination of a household survey and qualitativemethodologies, primarily interviews with the AWW, TBA, representativesof the Panchayati Raj Institutions, and members of the women’s groups.CNAA serves as basis to estimate service requirements of a sub center.Thus the information collected is collated into a sub center action plan toassist the ANM to ensure that all women and children in her area arecovered by the service delivery package of RCH.3. Village Health planning in the NRHM will use similar participatoryprocesses, but the scope of the CNAA will expand cover a wider rangeof public health needs, such as: Communicable diseases, nutritionalissues, water and sanitation, RCH, other medial and health issues, andlife style related conditions.