Community Action for Health

The Community Action for Health (CAH), earlier known as Community Based Monitoring and Planning (CBMP), is a key strategy of the National Health Mission (NHM), which places people at the centre of the process of ensuring that the health needs and rights of the community are being fulfilled. It allows them to actively and regularly monitor the progress of the NHM interventions in their areas resulting in the community’s participation and contribution towards strengthening the health services. Thereby, Bringing Public into Public Health.

The process involves the following steps: (a) strengthening of Village Health, Sanitation and Nutrition Committees (VHSNCs), Rogi Kalyan Samities (RKSs), and Planning and Monitoring Committees (PMCs) at the PHC, block, district and state levels; (b) creating community awareness on NHM entitlements, roles and responsibilities of service providers; (c) training of VHSNC, RKS and PMC members; (d) undertaking community level enquiry to assess the availability, range and quality of health services; (e) developing village and facility level reports to reflect the status of health services; (f) organising Jan Samwad (public dialogue) for advocacy with health providers and managers to highlight gaps and find solutions; and  (g) corrective action and planning to address the emerging issues and gaps.

The Ministry of Health and Family Welfare (MoHFW) constituted the Advisory Group on Community Action (AGCA) in 2005 to provide guidance on community action initiatives under the National Rural Health Mission (NRHM) at the national level.  The AGCA comprises eminent public health professionals associated with major NGOs. The Population Foundation of India hosted the Secretariat for the AGCA from 2005 to 2023.

The AGCA with support from the Ministry of Health and Family Welfare (MoHFW) guided the implementation of a pilot on Community Action for Health in 1,620 villages across 36 districts in nine states (Assam, Chhattisgarh, Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Odisha, Rajasthan and Tamil Nadu) between 2007 and 2009.

Subsequently, the AGCA continued to provide technical support to the MoHFW and state governments to initiate/strengthen and scale-up the process. A team based at the AGCA Secretariat now provides the following technical support to the states:

  • Develop capacities of state level institutions: State Health Societies (SHS), State Institute of Health and Family Welfare (SIHFW), State Health Systems Resource Centre (SHSRC), ASHA Resource Centre (ARC), Regional Resource Centre (RRC), State Institute of Rural Development (SIRD) and implementation organisations to initiate and scale up implementation of processes.
  • Facilitate state level visioning and planning exercises, including the development of State NHM Programme Implementation Plans (PIPs).
  • Develop/adapt guidelines, manuals and communication materials.
  • Strengthen accountability mechanisms such as grievance redressal, social audit, public display of health service guarantees and citizen’s health rights charters at the district and sub district levels.
  • Undertake programme implementation reviews, including participation in the Common Review Mission (CRM) and undertaking fact-finding missions on important issues.
  • Regular mentoring and guidance to states’ programme implementation.

In the Financial Year 2018-19, the AGCA provided technical support to 24 states[1] to strengthen and scale up implementation of the CAH component. The processes are currently being implemented in approximately 2,24,186 villages across 352 districts, including 49 aspirational districts of the country.

[1] Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Delhi, Goa, Gujarat, Himachal Pradesh, Jammu & Kashmir, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Manipur, Meghalaya, Nagaland, Odisha,  Rajasthan, Sikkim, Tamil Nadu, Telangana, Uttar Pradesh, Uttarakhand.