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CAHR 2010-2011

CHSJ has been involved in pioneering the approach of community monitoring of NRHM in the last few years with the aim to support decentralized governance in healthcare by empowering citizens/ citizens groups and building effective community leadership. Citizens’ groups are strengthened for evidence based advocacy through capacity building, networking, action research, documentation and information sharing in order to increase state and social accountability and influence effective policy implementation. This work included the following: 

Health Expenditure Monitoring under NRHM

CHSJ is working on this project with its partners The Ant and The Humanity in the districts of Chirang in Assam and Bolangir in Orissa respectively The objective is tracking out- of- pocket spending on healthcare and increase communities’ involvement and interest in budget and expenditure tracking and to build their capacity to do monitoring of health expenditure at the village level. Through this process we also intend to increase transparency and accountability among health providers and government health departments regarding health expenditure. Activities during the year included:

  • Mobilisation: Meetings were conducted with Gaon Kalyan Samiti (GKS) and Rogi Kalyan Samiti (RKS), on NRHM related financial entitlements and secondary data was gathered from frontline workers and PRI members. Wall writing, translating posters into local languages were other activities to increase awareness related to health expenditure and entitlements.
  • Community Enquiry: A community enquiry was conducted that included community mobilization meeting, village health mapping and free listing exercises, group discussions with women and capturing case studies on history of illnesses. Health facilities like Sub Centres, Primary Health Centres and Sub Divisional Hospital were also observed under this activity.

The process revealed people’s low awareness about health and financial entitlements and referral transport support. Women are not aware about the transportation cost provided under JSY. People had little knowledge about expenditure of the flexi funds like Untied Funds or the Annual Maintenance Grants.

Supporting Community Monitoring processes within NRHM


  • National Dissemination Meeting of Community Monitoring under National Rural Health Mission (NRHM) -CHSJ organized a dissemination meeting in June in collaboration with Population Foundation of India (PFI) to share the results and process of the first phase of community monitoring among all stakeholders, especially in those states where this process has not been implemented yet and who are responsible for the expanded roll-out and implementation. The final report on Community monitoring Reviving Hopes, Realizing Rights was disseminated along with a short film depicting the outcome of the process.
  • Leadership Development ProgrammeCHSJ conducted a Leadership Development Programme (LDP) for all District Programme Managers under NRHM in Assam during August 2010. The objective of the training was threefold- Creating awareness around social determinants of health and how they impact poor people’s health. Strengthen leadership capacity and lastly to help participants develop effective plans for the communitisation components of NRHM, through application of their leadership skills. As an outcome of the training the trained DPMs and staff of Regional Resource Centre developed personal plans of action and also set up an e-group “Yes We Can” to share their work and challenges from different districts.
  • Training of Trainers, Resource Group Training -  The State of Punjab is in process of launching the Community Monitoring project. In this relation CHSJ provided technical support to them. A three day training for the State resource group members was conducted in January 2011 in Chandigarh, Punjab. The objective of this training was to build capacity of the state resource group in all aspects of Community Monitoring and to help them draw the road map to carry out the community monitoring exercise in their respective state. The outcome of this training was that a resource group has been set up in the state which will oversee and handhold the entire community monitoring process. 

Technical Support to Open Society Institute (OSI)

CHSJ has been requested by Public Health Program of Open Society Institute (OSI), New York, USA, to build capacity among their grantees in using Community Monitoring approaches.