Kakoti Misimi, Srivastava Siddharth, Chatterjee Prabir, Mishra Shraddha, Nambiar Devaki
The George Institute for Global Health, New Delhi, India.
State Health Resource Centre, Kolkata, India.
Glob Public Health. 2024 Jan;19(1):2306466. doi: 10.1080/17441692.2024.2306466. Epub 2024 Feb 7.
India's experience with the National Rural Health Mission (NRHM) is notable on account of nationally formalising - at scale - community action in service delivery, monitoring, and planning of health services. A study was undertaken to document and create a historical record of NRHM's 'communitization' processes. The oral history method of the Witness Seminar was adopted and two virtual seminars with five and nine participants, respectively, were conducted, and supplemented with 4 in depth interviews. Analysis of transcripts was done using ATLAS.ti 22 with the broad themes of emergence, evolution, and evaluation and impact of 'communitization' under NRHM. This paper engages with the theme of 'emergence' and adopts the Multiple Streams Framework (MSF) conceptualised by John Kingdon for analysis. Key findings include the pioneering role of boundary spanning decision makers and the in advocacy and design of 'communitization' structures, and the legacy of rights based social mobilizations and state-civil society partnerships in health during the 1990s influencing the ethos underlying 'communitization'. Democracy, leadership from the civil society in policy design and implementation, and state-civil society partnerships are linked to the positive results witnessed as part of 'communitization' in NRHM.
印度的国家农村卫生使命（NRHM）项目经验值得关注，因为它在全国范围内大规模地将社区行动正式纳入卫生服务的提供、监测和规划之中。为此开展了一项研究，以记录并创建NRHM“社区化”进程的历史记录。研究采用了见证研讨会的口述历史方法，分别举办了两场虚拟研讨会，参与者分别为5人和9人，并辅以4次深度访谈。使用ATLAS.ti 22软件对访谈记录进行分析，围绕NRHM下“社区化”的出现、演变、评估及影响等宽泛主题展开。本文围绕“出现”这一主题，采用约翰·金登提出的多源流框架（MSF）进行分析。主要研究结果包括跨界决策者在倡导和设计“社区化”结构方面的先锋作用，以及20世纪90年代基于权利的社会动员和卫生领域的国家-民间社会伙伴关系遗产对“社区化”潜在理念的影响。民主、民间社会在政策设计和实施中的领导力以及国家-民间社会伙伴关系，都与NRHM“社区化”所见证的积极成果相关联。
