Kamble Raviraj Uttamrao, Garg Bishan S, Raut Abhishek V, Bharambe Madhukar S
Department of Community Medicine, MGIMS, Wardha, Maharashtra, India.
Indian J Community Med. 2018 Jul-Sep;43(3):148-152. doi: 10.4103/ijcm.IJCM_171_17.
Community participation is one of the core principles of primary healthcare. The village health nutrition and sanitation committee (VHNSC), one of the elements in implementation of the National Health Mission (NHM), is an example of community participation. There are not many studies conducted to assess the actual participation of VHNSC in health-care delivery at the village level.
The objective of the study is to develop a VHNSC Maturity Index (VMI) and pilot it to assess the institutional maturity of VHNSC.
This community-based, cross-sectional study was conducted in 83 villages under four Primary Health Centres (PHCs) of the Wardha Community Development block. VMI was developed, Through several discussion sessions with VHNSC members and staff of the DCM; observations of VHND; attending VHNSC monthly meetings; the VMI was finalized after piloting it in all the four PHC areas.
All the 83 VHNSCs were constituted as per norms led down under NHM. Forty-eight (57.8%) VHNSCs had developed an annual Village Health Action Plan, 72 (86.7%) VHNSCs had ≥4 meetings held in the past 6 months, and ≥70% attendance in the past 6 months was observed in 40 (48.2%) VHNSCs. A majority of 82 (98.8%) VHNSCs helped in organizing the village health and nutrition day, 59 (71.1%) VHNSCs monitored the implementation of national health programs. The entire untied fund received in the previous year was utilized by 68 (81.9%) VHNSCs.
The study shows that VMI can be used for continuous monitoring and assessment tool for VHNSC to evaluate and plan different health activities.
社区参与是初级卫生保健的核心原则之一。村庄健康营养与环境卫生委员会（VHNSC）是国家卫生使命（NHM）实施要素之一，是社区参与的一个范例。目前评估VHNSC在村级卫生保健服务中实际参与情况的研究并不多。
本研究旨在制定VHNSC成熟度指数（VMI）并进行试点，以评估VHNSC的机构成熟度。
本基于社区的横断面研究在瓦尔达社区发展区四个初级卫生保健中心（PHC）下辖的83个村庄开展。通过与VHNSC成员和地区首席医疗官（DCM）工作人员进行多次讨论会议、观察VHNSC活动、参加VHNSC月度会议来制定VMI；在所有四个PHC地区进行试点后最终确定VMI。
所有83个VHNSC均按照NHM规定的规范组建。48个（57.8%）VHNSC制定了年度村庄健康行动计划，72个（86.7%）VHNSC在过去6个月内召开了≥4次会议，4个（48.2%）VHNSC在过去6个月内的参会率≥70%。82个（98.8%）VHNSC中的大多数协助组织了村庄健康与营养日活动，59个（71.1%）VHNSC监测了国家卫生项目的实施情况。68个（81.9%）VHNSC使用了上一年收到的全部非捆绑资金。
该研究表明，VMI可作为VHNSC的持续监测和评估工具，用于评估和规划不同的健康活动。
