Sector Wide Approach to Strengthening Health ( SWASTH )

Bihar Technical Assistance Support Team (BTAST)
Government of Bihar initiative supported by Department for International Development, UK


BTAST workshop rejuvenates key stakeholders in Bihar

The workshop was conducted with the underlined idea that promoting community participation could enhance the efficacy of VHSNDs.

Banka: With the aim of improving quality and coverage of Village Health Sanitation and Nutrition Day (VHSND), a workshop was organised for the key stakeholders last month in Banka, Bihar.
The VHSND District Training-of Trainers (TOT) was organised with the support of Bihar Technical Assistance and Support Team (BTAST) at the local hospital in Banka.
The objective of this workshop was to build the capacity of district level officers who in turn could transfer the same at grassroots level by providing training at the block level to the frontline health workers (FLWs) and Panchayati Raj Institutions (PRIs).
Inaugurating the workshop, Dr Sudhir Kumar Mahto, Civil Surgeon, Banka, shared the value and vitality of VHSND in improving Maternal and Child Health. Mahto highlighted the importance of quality Antenatal care (ANC), monitoring of sessions, and follow up of progress in the meetings at different levels for the successful conduct of VHSND.
Ashok Kumar Singh, Director, Programme Implementation, BTAST, shared the roles and responsibility as well as SWASTH mandates towards VHSND strengthening. He also discussed the role of VHSND monitoring.
Sharing the overview of the Current Health Nutrition scenario of Banka, Dr Ashok Kumar Singh, Monitoring and Evaluation (M&E) expert, BTAST, said that VHSND plays an important role in improving health indicators.
Dr Singh through his presentation highlighted the key indicators for the success of VHSND. Some of the key indicators include the Maternal Mortality Ratio (MMR), Under 5 Mortality (U5MR), Contraceptive Prevalence Rate (CPR), under-weight children (0-5 years) and percentage of pregnant women age 15-49 with anaemia.
Citing figures to support his view, Dr Singh said that the institutional deliveries have increased from 12.1 % (1992-93) to 22 % (2005-06) to 27.7 % (2007-08) 65.3% (2014-15).
Similarly, the antenatal care has increased from 15.9 % (1998-99) to 26.4 % (2007-08) to 32.8 % (2014-15). Full Immunization coverage has also increased from 10.7 % (1992-93) to 53.8 % (ISB, 2009) to 60.4 % (2014-15).
Even the use of contraceptives has increased from 23.1 percent (1992-93) to 28.4 percent (2007-08) to 41.2% (2014-15).
Waquar Anjum, Regional Manager, BTAST, shared the issues and experiences that have surfaced at different forums. He also discussed the advocacy made by BTAST team regarding strengthening of VHSND services regarding their quality and approach.
Anjum stressed that VHSND is the only platform where all stakeholders come together on a common platform. He further added that VHSND can be strengthened by advocacy at different levels, inter-sectoral convergence and by promoting community participation at different levels.
Manoj Kumar Choudhry, Executive Engineer, PHED, discussed about the role and responsibility of PHED. He reiterated his commitment to monitoring support by BC-SBM and provision of water test kits for all Uddeepan centres and IEC related to sanitation and hygiene.
The workshop dwelled on various issues including lack of involvement of Panchayati Raj Institutions (PRIs), Public Health and Engineering Department (PHED), Vikas Mitra at VHSND. It also discussed challenges related to the shortcoming of monitoring matrix and feedback sharing mechanism and availability of water testing kits.
The other issues discussed include lack of utilization of VHSNC fund for IEC, shortage of VHSND Tally sheet, growth monitoring of child and lack of availability of ANC Table and proper space for ANC.
Some of the major recommendations that emerged during the workshop include conducting convergence meeting with line department at district level on quarterly basis and as well as block level on monthly basis.
The other recommendations include orientation of various stakeholders on VHSND, quality and timely meeting of VHSNC, adequate supply of logistics, vaccine & medicine, availability of equipments for quality ANC care and monthly review by AYUSH Doctors at APHC level.
Village Health Sanitation and Nutrition Days (VHSNDs) are one of the flagship initiatives of the National Rural Health Mission and have been implemented in Bihar since 2011. Support to VHSNDs in each district has been multifaceted and non-uniform and is visible as a combination of various government and development partner initiatives.