Bridging the Digital Divide –
Connecting Communities with Health Systems through virtual Jan Samwad

The platform of Jan Samwads (Public Dialogues) is an important mechanism to seek community feedback on health services and redress grievances under the National Health Mission (NHM). These events are usually organised bi-annually at the Primary Health Center (PHC), block and districts levels. The community feedback on health services is collected through a set of tools and presented at the event before a panel comprising District Civil Surgeon, Block Medical Officer, Nodal NGO, and retired Judges. The participants include: Panchayat, Village Health Sanitation and Nutrition Committee (VHSNC) members, Mahila Arogya Samiti (MAS) in urban areas, ASHAs, ANMs, local NGOs, and community members. The panel listens to the community feedback and provides directions to health officials for improvement and corrective actions.

The COVID-19 lockdowns and isolation that were caused by the pandemic led to a disruption in the provision of health services and contacts with the community. The Advisory Group on Community Action (AGCA) Secretariat realised that it is most important to listen people in such moments of crises – their voices, concerns, and ideas. We did precisely this by organising virtual Jan Samwads that provided a platform for a diverse group of community representatives to share their feedback on health services with the district and block health officials.

In December 2020, the first Jan Samwad was organised at Pakaribarawan block of Nawada district in Bihar. We ensured that only those who could travel safely, visited the gram panchayat offices, and a stable internet connectivity was made available. During the three-hour Jan Samwad, participants directly shared their experiences and grievances about the delivery of public health services with the Civil Surgeon. Key issues raised by the participants were related to restoring out-patient services at hospitals, provision of ante natal care (ANC) services, distribution of iron folic tablets, postings of doctors at Additional PHC, and a female doctor at the Community Health Center (CHC).

The event was extremely constructive and ended with the Civil Surgeon promising to take actions to address the issues highlighted. The minutes of the meeting and the action taken report were finalised within a week. A government notification was issued for posting of doctors at the Additional-PHCs in Budhauli and Dumrawan. All ANMs were instructed to provide complete range of ANC services at VHSND sites as well as at the health sub-centres. The Civil Surgeon sent a request to the Principal Secretary- Health, Government of Bihar to depute a gynaecologist at the CHC.

The state nodal officers from six states joined at the event and showed interest in replicating this initiative in their respective states.

The replacement of routine in-person meetings with the virtual Jan Samwad may be a small step but, what we did is replicable and scalable. It brings together the community and key decision makers at the state, district and block levels, which would otherwise, not be feasible. The key pre-conditions for a successful virtual event include: a fair degree of community mobilisation, presence of a facilitating organisation/ an active NHM community processes team, and a stable internet connectivity.

Since December 2020, seven events have been organised in Bihar and Rajasthan. We are working with a couple of states to organise virtual Jan Samwads in the coming months.