Paxman John M, Sayeed Abu, Buxbaum Ann, Huber Sallie Craig, Stover Charles
Management Sciences for Health, Cambridge, MA 02139-4613 USA.
Stud Fam Plann. 2005 Sep;36(3):203-20. doi: 10.1111/j.1728-4465.2005.00062.x.
The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government's reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. The program established health committees in 620 villages, recruited and trained 1,850 community health volunteers, and added 232 sites to extend government services. Using three strategies--demand creation, increased access to services, and local capacity building--the NGOs increased contraceptive-use rates by 78 percent, on average; child immunizations by 67 percent; and antenatal care by 78 percent among the populations served. Community resources--such as local health personnel, community-supplied clinic sites, and community drug funds--added 40 cents to every dollar provided by donors. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services.
印度地方倡议项目采用了印度尼西亚和孟加拉国使用的一种模式来实施政府的生殖和儿童健康战略。1999年至2003年期间，三个印度非政府组织在印度北部四个邦为78.4万人提供了服务。该项目在620个村庄设立了健康委员会，招募并培训了1850名社区健康志愿者，还增设了232个服务点以扩大政府服务范围。通过采用三种策略——创造需求、增加服务可及性和加强地方能力建设，这些非政府组织使所服务人群的避孕药具使用率平均提高了78%；儿童免疫接种率提高了67%；产前护理率提高了78%。社区资源，如当地卫生人员、社区提供的诊所场地和社区药品基金，为捐赠者提供的每一美元额外增加了40美分。事实证明，这种模式是建立医疗服务提供体系和促成行为改变的合适平台，这些非政府组织很快就找到了维持和扩大服务的方法。
