Sector Wide Approach to Strengthening Health ( SWASTH )

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


JEEViKA aims at holistic progress of rural Bihar: State Mission Director

The Bihar Rural Livelihoods Project, also locally known as JEEViKA, aims for social and economic empowerment of rural poor in the state. Aided by the World Bank, JEEViKA is managed by the Bihar Rural Livelihoods Promotion Society (BRLPS), an autonomous body under the Department of Rural Development of the Government of Bihar (GoB). Excerpts from an interview with Shri Arvind Kumar Chaudhary (IAS), CEO-cum-State Mission Director:

OneWorld: The Bihar Technical Support Team works closely with JEEViKA on the Gram Varta programme? How has this partnership strengthened the WASH interventions through SHGs in the state?

Arvind Kumar Chaudhary: When we started the work of JEEViKA, we saw that a major component of the household income is spent on treating illnesses. We realised that it’s important to work on health and nutrition simultaneously. If we want to address the impact of poverty, I think that’s where the Gram Varta approach of the Sector Wide Approach to Strengthening Health (SWASTH) programme is useful. The experience has been that one should focus on health, nutrition and sanitation. If better behaviour gets ingrained in the fabric of the SHG movement, it would have a long lasting and sustainable impact. The results can be remarkable. So, with the support of BTAST and through the Gram Varta intervention, we are giving health messages in meetings of SHGs. Since this is happening in a very systematic manner, I think it will help in a big way.

OneWorld: What has been the feedback?

Chaudhary: Some evaluations were also done through trials in different settings. In the first block we had SHG and good health messaging. In the second block, we had no SHG and no health messages. In the third block, we had both SHG and health messaging. The outcome was the best in the block where we had both SHGs and health messaging. In the second place, we expected to see the block or village with health messaging but no community platform, but it did not happen. So, it was realised that a community platform is needed for spreading messages on health, nutrition and sanitation. We focussed on using the 

Gram Varta strategy, weaving it into the basic fabric of JEEViKA. So, creating awareness on Health, Nutrition and WASH through the SHG platform within JEEViKA is the way forward for Bihar. That is how we are going to scale up the open defecation free (ODF) initiative and expand it across the state. The aim is to make the state ODF in the next five years. I know it’s a Herculean job, but I am sure it will happen.

OneWorld: How is JEEViKA’s work on cross-cutting theme like gender playing out?

Chaudhary: Women’s empowerment is now looked at as something being core to the development of the state. If you just look at how the state has done in the last 10 years, you will find that there is a consistent focus on the empowerment of women.

The establishment of JEEViKA itself is highly focussed on women and its aim is to form 10 lakh SHGs by 2017, up from the existing 4.5 lakh SHGs. Then, look at the reservation provided to women in Panchayats and local bodies. With cycles offered to girl children, there are significant changes in the education scenario. While all this was being done, but there was no formal state policy on women’s empowerment.

The Women Empowerment Policy of the Department of Social Welfare (DoSW) has been developed by BTAST with the support of DFID. Last year we worked hard on it and for more than two months we took inputs from all the stakeholders who are working in this sector. Our honourable Chief Minister held a special cabinet meeting to pass the Women Empowerment Policy. The policy was launched on 22nd March, 2015 on Bihar Diwas and that I think is very significant as it shows the commitment of the State Government towards this policy. A policy can be converted into reality only with execution. Since this is multi- dimensional and multi-departmental matter, a high level committee at the level of the Chief Secretary has been formed to look at the progress of the Women Empowerment Policy and actions to be taken in that direction.

Also, I would also like to talk about the Gender Resource Centre. There was a discussion about shifting the Centre somewhere else. Since WDC is the nodal agency for  women related activities in Bihar, it was agreed that the Centre should be housed in it. We have also had preliminary discussions with international institutions like  IDS, Sussex, which are working on the issue, and educational institutions like Patna University, which have a gender resource cell. 

OneWorld: You have highlighted the importance of an integrated approach wherein you have to care about nutrition and health before you think about providing livelihoods. How challenging has it been for you to get all departments together and work in the same direction?

Chaudhary: It might appear that various departments ­­­­are working in different directions, but who are our targets? For each department, the target is the same community members and their betterment. So, the best platform for convergence is actually the community. If we converge at that level, we actually converge. If our programmes don’t converge at the community level, then we are not converging in the true sense.

JEEViKA has already created the infrastructure. The aim is to reach 50 million households. There are already approximately 5 million households in JEEViKA’s fold. So, this platform can be used by all the departments for furthering their own objectives. And if all the departments achieve their own objectives at the community level, we will have the best convergence. I think that is how it’s happening. The good part is that now the departments are looking at JEEViKA as their partner. JEEViKA is trying to achieve their objectives for them with their support and JEEViKA is not competing with them.

At the same time, one important factor is also that getting the credit should never be the motto. If who gets the credit is not the motto, you will find that convergence is easy. The moment you start getting into the business of getting credit, it becomes difficult. The focus should be on getting the desired results. Let credit lie wherever it has to. So, we at JEEViKA work in such a way that the departments get the credit. For example, in the case of credit mobilisation, banks are taking the credit that they are doing so well. Many of the banks have won awards. So, that is how we work.

OneWorld: How have JEEViKA’s SHGs benefited from BTAST’s Gram Varta initiative? What are the key learnings from these community engagement programmes, which have been followed in other similar initiatives in Bihar?


Chaudhary: One of the important learnings is that expansion of this kind of a programme can be possible only through a community approach and for that we have developed very good community resource persons. For example, when we talk about health and nutrition aspects, the community resource are the ones who are taking it forward in other areas of the state. Reaching out to so many households is not possible for any department or any government programme without the support of the community. So, that has been a very important learning. The second learning is that whatever you do, it is to make it a part of the journey of SHGs, which will make it sustainable and happen on its own. For example, bank account opening and credit linkage used to be a very difficult process in the beginning. Now we find that there is not much issue there as it has been ingrained in the fabric of SHGs. The same thing is being done with Gram Varta on Health, Sanitation & Nutrition, etc. Some other initiatives are also being undertaken, like the Community-based Management of Acute Malnutrition (CMAM). So, I find that the community’s involvement is important because nutrition outcomes are poor in Bihar. Whatever we do, if the work does not improve the status of the newborns, we might have missed out on something. So, the aim is to ensure that the future generation is healthy and they have the best possible opportunity to grow and develop as good human beings and good citizens of the country.

OneWorld: What are the learnings of the SWASTH programme for other states?

Chaudhary: One important learning from the SWASTH programme is that if the partner agencies work with the department, the results are much more impressive and sustainable. If they just do a pilot somewhere and expect the department to adopt it, it may not happen. So, one of the strengths of the SWASTH programme has been that it has been part of the department. Competent personnel working with the department, tweaking the intervention wherever needed, and giving impetus to improve the mainstream programme of the department are the strengths of SWASTH programme.