Limitations in the functioning of Village Health and Sanitation Committees in a North Western State in India

Constitution of Village Health and Sanitation Committees (VHSC) is one of the special initiatives under the National Rural Health Mission (NRHM) to improve the availability and access to quality health care for people residing in rural areas through increased ownership and power to local people. Such committees are functional throughout the country. The main objective of the study was to assess whether VHSCs in the study area have been formed and function according to given NRHM guidelines and if the committee members were aware of various aspects under VHSC.

This was a cross sectional study done with 17 VHSCs from one block of a district in a North Western state in India. The study district and block were purposively selected while 25% VHSCs (17 out of 66 VHSC in the block) were randomly selected from the block. The respondents of the study included all the members of the VHSCs. In total, 94 members from the selected VHSCs participated in the study. Primary data was collected with the help of an instrument while the secondary data was collected by observation records of ANMs; documents from district and block level NRHM branches; maintenance registers and other records maintained at the VHSC.

The study found that composition of all the 17 VHSCs did not meet the NRHM guidelines and lacked participation from school teachers and ASHA workers. There was very low awareness among the members about functions of the committee. The study found low knowledge level related to activities and processes carried out by the VHSCs; areas where Village Health Fund (VHF) could be utilized. None of the VHSCs selected under study conducted any awareness campaign; did not prepare any Village Health Plan and did not do any budgeting for the future year. The monitoring, inspection and evaluation part of the VHSCs was also very weak.

The study indicates many problems and gaps in composition, formation and functioning of VHSC when compared with the actual guidelines laid down under NRHM. The problems relating to selection of members, their training, supportive supervision, proper reporting and responsive feedback mechanism can only be improved with a strong will and action of Panchayat Raj Institution (PRI) along with the health department and other stakeholders.