Members Present:

Representatives of Mission Director, NRHM, Ministry of Health ad Family Welfare: 

Others in Attendance (invited):

Members who could not attend the meeting:

The fourth meeting of the Advisory Committee on Community Action was organized with the main agenda of deliberating on strategic frameworks for facilitating community monitoring in NRHM Mr A R Nanda welcomed the participants and requested Prof. Ranjit Roy Choudhary to Chair the meeting.

Agenda No 1: Confirmation of minutes of the Third Meeting of the Advisory Group on Community Action – NRHM

The member suggested that the following section ‘Under Janani Suraksha Yojana the members suggested that all deliveries should be the responsibility of the public health system’ mentioned in Page 3, para 4 first line of the minutes of the third meeting of the Advisory Group on Community Action, NRHM be deleted and ‘all poor women should be covered under the Janani Suraksha Yojana irrespective of age, parity and proof of BPL status’ be added. The members then approved the minutes of the third meeting subject to this correction.

Agenda No 2: Presentation of the report of the Sub Committee on Community Monitoring

Dr Abhay Shukla, Dr Abhijit Das and Dr Narendra Gupta presented the highlights of the report of the sub committee on community monitoring. The report suggested an outline for facilitation of community monitoring under NRHM. It provided a broad framework on the strategies towards facilitating a community action process.

Dr Shukla in his presentation suggested an overall role of the advisory group on community action to actively facilitate the process. The suggested framework includes a national preparatory phase, state preparatory phase, initiating a pilot project in selected blocks, state level workshops involving all stakeholders such as government, NGO networks, CBOs, PRIs. He emphasised that building community action will not be a routine exercise but a process that will be facilitated throughout. There was need for special facilitation in the form of small groups comprising 2-3 members of the advisory group. These groups would work out the details and operational modalities.

Members suggested that the framework should include community based planning which is key towards community action. This planning to be undertaken at the village level should reflect the assessed community needs in a participatory manner. The process should be undertaken by community based organisation preferably those who are not implementers. The outcome of community based planning should be towards effective monitoring of NRHM.

The second presentation by Dr Abhijit Das mentioned steps towards increasing transparency in order to facilitate community monitoring. The framework mentions the three levels at which community monitoring should be undertaken – village level, facility level and district level. Members suggested that such a process of monitoring should not introduce parallel structures within the system, but build capacities of the existing structures and forums such as the Gram Sabha, the Rogi Kalyan Samities etc. However, it should include diverse group of grassroot organisations, institutions, people’s networks and alliances. The process should be institutionalised within the system.

Dr Narendra Gupta presented the detailed indicators and outcome of community based monitoring. He emphasised the need for steering the process of capacity building.

Recommendations

Members appreciated the report of the sub committee on community monitoring. They suggested that the framework required further modification and detailing including provisions for human and financial resources for the process to be effectively implemented. The timeline for community monitoring should also be extended. The sub group members should present the revised report by the end of August. In the meanwhile, members may send their suggestions/comments within next 2 weeks.  The revised report will be sent by P.F.I. to Govt of India by early September, 2006.