Towards a Healthy Village

Introduction

Ill health not only prevents individuals from working but also drains resources due to medical expenses, hospital expenses, bystander’s time and loss of employment. Maintaining and ensuring health of our citizens will ensure the success of all the programmes of the Gram Panchayat and will yield long term dividends.

What is health?

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This is the definition provided by the World Health Organization (WHO).

To achieve this state, there are many factors to be taken into account.

• A conducive social, economic and physical environment and
• An individual’s characteristics and behaviour.

Specifically, the following factors play a critical role:

Household habits and their contribution to health

A house with appropriate sanitation, water and power has to be accompanied by healthy and clean household habits. A basic requirement is a cooking option where smoke is kept out of the house, as are measures for disposing of soiled water, separation of waste into appropriate categories and disposal, avoiding stagnation of water, preventing the access of mosquitoes to stagnant/stored water. In addition, habits like routine hand washing using soap, sterilization of utensils used to feed babies, drinking boiled water, washing of food before cooking, preventing access of vectors to the food, ensuring personal hygiene-periodic cutting of nails and hair, regular bathing, wearing clean clothes, proper use and disposal of sanitary napkins etc. are very much required for a healthy life.

Health of mothers and children in a village

An enabling environment is required to be created for ensuring the health of women and children. Each expectant mother must be able to avail the facilities of immunization, better nutrition and regular health checkups as early as possible. Apart from expectant mothers, absolute and uncompromising individual attention is required for ensuring complete immunization and breast feeding for each new born and child. Marriage at an early age and early pregnancies may lead to multiple issues related to health of mother and child. Consecutive pregnancies are another cause leading to poor health of mother and child. Counseling service to couples along with affordable family planning measures can be achieved by leveraging the existing schemes.

Disease control

Most communicable diseases are preventable. Life style diseases (diabetes, hypertension, high cholesterol, stroke) are also on the rise even in rural areas.These diseases, collectively known as non communicable diseases, are important causes of premature death in the young and middle aged. The problem of substance abuse is also increasing, along with alcohol intake and tobacco abuse. Most often accidents and diseases can change the status of a family from a prosperous one to a destitute one. Disease control requires concerted effort and education.

Why Panchayats?

The activities mentioned above conform to the subjects of the Panchayats as per the 11th Schedule of the 73rd amendment of the Constitution of India - Family welfare, Health and sanitation, including hospitals, primary health centers and dispensaries.

Gram Panchayat can work to

How do we begin to plan for ensuring Health in the Gram Panchayat?

What can our Gram Panchayat focus on while planning for a Healthy Village?

How do we set targets to achieve the goals?

If these are our goals, what are the specific things we should plan to achieve and by when? Can our Gram Panchayat plan for some of the following?

What can a Gram Panchayat Do?

• Take steps to empower communities and community based organizations to participate in health programmes.
• Map vulnerable population based on age, reproduction, occupation, area and assess health needs for each category.
• Map schemes, resources and human resource available for health services in the Gram Panchayat.
• Set the local health goals and targets for the Gram Panchayat in collaboration with the health department
• Based on goals and targets, develop specific plans for each category. Apart from general plan ensure customized care for each individual.
• Leverage resources available under various government schemes and programmes of national and international agencies
• Monitor quality of services of various health facilities and extension services and ensure coordination and convergence.
• Integrate the IEC programmes with Panchayat led social campaigns for health.
• Supervise care providers – ASHA, ANM & AWW.
• Ensure effective functioning of the Village Health Sanitation and Nutrition Committee (VHSNC) and Rogi Kalyan Samiti (RKS).
• Review every maternal death/neonatal death/child death in the Gram Panchayat and identify actions for future.
• Ensure participation of the Gram Sabha and community in planning and monitoring the Village Health Plan.
• Converge various nutrition/ food security schemes and programmes and make a comprehensive plan which will ensure the specific nutritional needs of infants, children, adolescent girls, women in reproductive age group, pregnant and lactating women and elderly.
• Organise social awareness campaigns on tobacco control/alcohol/illicit drugs and take control measures – ban and restrictions on sale of tobacco/illicit drugs.
• Map at village level of people with mental health problems, substance, drug and alcohol abuse and provide treatment, counseling and rehabilitation for these people and their families.
• Form emergency help centers and train and equip them to provide support and care services to victims of road traffic accidents. Strengthen emergency transport systems.
• Strengthen the emergency care systems in the health institutions in the Panchayat and ensure timely emergency care accessible to all.

Resources to look for

People to support us

Auxiliary Nurse Midwives (ANMs), doctors, ASHAs, Anganwadi workers.

Here is an example

Possible steps to be followed if the Gram Panchayat decides to go for immunization coverage to all children and expectant mothers in the Panchayat.

• A situational analysis of immunization status as part of the Gram Panchayat Development Plan (GPDP).
• Initiate a campaign on immunization. Include this in GPDP .
• Prepare a registry of all pregnant mothers and children in the Gram Panchayat and update their immunization records.
• Update the list of children in the Gram Panchayat and collect the details about their immunization status.
• List out those not immunized and categorize them according to the reasons– for example not immunized due to lack of awareness, due to taboos regarding immunization, due to lack of access to immunization facilities, non-availability of decision makers etc.
• Develop strategies to address these concerns.
• Identify and train volunteers who can tackle these issues.
• Make household visits to each of these families and address the concerns.
• Create a system to update the register periodically including the status of migrant children.
• Create facilities for Aadhar and mobile number linking to the target population.

How is this exercise linked to Sustainable Development Goals?

Sustainable Development Goal 3 - Ensure healthy lives and promote well-being for all at all ages.

The Universal Targets

• By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
• By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to less than 10 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.
• By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
• By 2030, reduce by one third premature mortality from non- communicable diseases through prevention and treatment and promote mental health and well-being.
• Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
• By 2020, halve the number of global deaths and injuries from road traffic accidents.
• Universal access to sexual and reproductive health-care services - family planning, IEC, and the integration of reproductive health into national strategies and programmes.
• Achieve universal health coverage, including financial risk protection,access to quality essential health-care services and access to safe,effective, quality and affordable essential medicines and vaccines for all.
• Substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.
• Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate .

Now look at the goals and targets set by your Gram Panchayat – you are contributing to the Global goal and targets to ensure healthy lives and promote well-being for all at all ages!

Source : Handbook on Sustainable Development Goals and Gram Panchayats