NGO Partner: SAMWAD
Location :  Ratnagiri, Maharashtra
Chapters :   Duke/RTP, NC
Budget:   $8752 (1 Year)

Geographic and climatic factors hamper access to medical facilities in several villages of the Chiplun taluk (Ratnagiri district, Maharshtra). To address this problem, the project aims to select a total of 20 women from 10 of these villages to serve as arogyasakhis (health workers) in their own villages. The primary function of arogyasakhis is to provide basic medical assistance for common ailments like cold, fever, diarrhea and RTA. They also provide referral services, spread awareness of preventive and promotive health, and address key issues like the right to health.

• Primary health care training to 35 women selected in12 villages in hilly areas of Maharashtra that lack ready access to medical facilities
• Selected Arogyasakhis are trained to offer basic medical assistance to fellow villagers and spread awareness of healthy living and the right to health

The project is monitored by NAVAM and run by a Chiplun-based organization called Sanwad which has been working in this region since 1995. SAATHI-CEHAT, an organisation engaged in training and advocacy initiatives in the health sector, trains the selected health workers.  

1. Two phases

•  Initial outreach meetings with villagers and the selection of Arogyasakhis (Oct 06-Jan 07)
• Training of Arogyasakhis, pre-assessment health survey, treatment and referral services (Feb 07-ongoing)

  2.   Outline of activities

• Meetings with villagers and Sarpanch for selecting probable participants
• Selection of 35 members of local self help groups (SHG) for the primary selection process
• Primary level training and assessment (6 total days, 3 sessions of 2 days each)
• Finalisation of 20 SHG members as Arogyasakhis by CEHAT
• Distribution of health kits to Arogyasakhis
• Advanced training of 30 days spread throughout the year
• Certification from the Shreemati Nathibai Damodar Thackersey Women's University
• Functions of the arogyasakhi
• Conducting baseline survey
• Treatment of diseases like fever, diarrhoea, anaemia, common cold and RTA
• Referral services
• Spreading awareness of preventive and promotive health.
• Making the villagers aware of their right to health and the responsibilities of the government health services.
• Addressing misconceptions and malpractices of health related behaviour

• Three workshops were conducted as a part of phase I for selection of arogyasakhis. Several core health issues were taught in these workshops including:
  
• Concept of Arogyasakhi project
• Introduction to the concept of Health
• Ill effects of addiction
• Introduction to the concept of right to health
• Gender equality
• Concept of “ Arogya Samvad” (Health Communication)
• Problem tree of disease
• Information on Anaemia, pregnancy and kitchen garden

• Selected women were given further specialized training from Feb-July 07

(Phase II)                

• Some of the important topics covered in these advanced workshops include human anatomy, information on injections and tablets, methods of applying bandage to wounds, malnutrition, women's health, use of thermometer, and data documentation
•  CEHAT conducted 5 tests for the Arogyasakhis and they performed commendably achieving an average score of 83%
• The Arogyasakhis started treatment and referral services from July 2007 and the following treatment profile was recorded for the same month.
  
  

• They also conducted a pre-assessment survey from 420 families in the 10 villages, the results of which are currently being analyzed.
  

 4.  Highlights:

• Active participation of Grampanchayat and villagers in the project. The villagers have provided the initial seed money for Arogyasakhi medicine kit. (Villagers contributed Rs. 4000/- for initial medicine kit for their village)
  
• The outreach activities during the first and the second phase helped in spreading awareness of good health practices, significance of kitchen garden, anaemia, myths about use of intravenous saline and injections etc.