Including the excluded in Gaya district,  Bihar

The Community Based Planning and Monitoring (CBPM) programme in Bihar has made specific efforts to include marginalized communities in the process.

Each Village Planning and Monitoring Committee (VPMC) has a rule representative from the Scheduled Caste (SC)/Scheduled Tribe (ST) community or from a religious minority. These members raise issues specific to the marginalized communities and also engage with them to raise their awareness regarding health and health care entitlements. These efforts have seen an improvement in the health-care seeking behaviour of the marginalized communities.

Manju Devi is a ward member from the Musahar and Muslim tola of Roopin village in Morhe Panchayat, Fatehpur block, Gaya district. Manju also represents her community in the VPMC. According to her, while the ANM used to visit the tola even earlier for immunization, women would not take their babies to her for immunization as they feared it would make their babies get fever. However, after the implementation of CBPM programme, awareness has increased in the community as a result of the VPMC meetings and the staging of nukkad natak (street plays). Now, the number of babies getting immunization has increased. Similarly, more women now seek antenatal care services unlike a few years earlier. She also feels the quality of care they receive in the Primary Health Centre has improved. However, Manju feels many of their needs are still not being met. Several women have white discharge per vaginum and menstrual problems. There are no services for this at the PHC though some medicines are given for white discharge, and neither is there a woman doctor. Women have to travel up to the district headquarters to access any services for these complaints. She feels these services need to be introduced at the PHC itself.

The CBPM programme also ensures that the needs of the marginalized communities are represented in the village enquiry process. Special meetings are ensured in the hamlets in which these communities live to capture specific issues related to them in the enquiry process. Similarly, the sharing of the report card is also done specially in these hamlets.