Assessing community health governance for evidence-informed decision-making: a cross-sectional study across nine districts of India

Abstract

PurposeThe authors intend to assess the village health sanitation and nutrition committees (VHSNC) on six parameters, including their formation, composition, meeting frequencies, activities, supervisory mechanisms and funds receipt and expenditures across nine districts of the three states of India.Design/methodology/approachThe cross-sectional study, conducted in the states of Uttar Pradesh (five districts), Odisha (two districts) and Rajasthan (two districts), used a quantitative research design. The community health workers of 140 VHSNCs were interviewed using a semi-structured questionnaire. The details about the funds' receipt and expenditures were verified from the VHSNC records (cashbook). Additionally, the authors asked about the role of health workers in the VHSNC meetings, and the issues and challenges faced.FindingsThe average number of members in VHSNCs varied from 10 in Odisha to 15 in Rajasthan. Activities were regularly organized in Rajasthan and Odisha (one per month) compared to Uttar Pradesh (one every alternate month). Most commonly, health promotion activities, cleanliness drives, community monitoring and facilitation of service providers were done by VHSNCs. Funds were received regularly in Odisha compared to Rajasthan and Uttar Pradesh. Funds were received late and less compared to the demands or needs of VHSNCs.Research limitations/implications This comprehensive analysis of VHSNCs' functioning in the selected study areas sheds light on the gaps in many components, including the untimely and inadequate receipt of funds, poor documentation of expenditures and involvement of VHSNC heads and inadequate supportive supervision.Originality/value VHSNCs assessment has been done for improving community health governance.

Activities used by evidence networks to promote evidence-informed decision-making in the health sector– a rapid evidence review

“…The 35 included articles were mainly in the United States ( n = 14) [ 16 – 29 ], Canada ( n = 5) [ 30 – 34 ], Sweden ( n = 2) [ 35 , 36 ], and in other single locations such as Australia, Brazil, Burundi, India, Kenya, and Nigeria, among others ( n = 14) [ 37 – 50 ]. Of those included, 16 articles were qualitative studies [ 18 , 20 , 25 , 28 , 31 – 36 , 44 , 45 , 47 – 50 ], nine were non-empirical papers [ 19 , 22 , 23 , 37 – 39 , 41 – 43 ], four were quantitative studies [ 26 , 27 , 29 , 40 ], and six were mixed methods [ 16 , 17 , 21 , 24 , 30 , 46 ]. Eleven studies reported a population of interest, which were mainly Indigenous groups [ 31 , 34 , 48 ], older adults [ 19 ], patients in patient group programmes [ 21 , 27 ], academic faculty and researchers [ 40 ], and mental health practitioners [ 16 ], among others.…”

“…Several activities were focused on the establishment of new teams, committees, and networks, including the formation of a newly established team specialising in sex, gender, and vulnerable populations (GVPs) [ 30 ]. Additionally, initiatives such as The Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) [ 44 ], a PBF Communities of Practice (CoP) [ 43 ] and Village Health Sanitation and Nutrition Committees (VHSNCs) [ 46 ]. Furthermore, a Task Force on Community Preventive Services published recommendations from an investigator-led review of community-based depression [ 19 ].…”

IJHG review 27.1

“…This issue of IJHG contains seven articles that explore or discuss different areas of health governance. Papers by Sharma et al (2022) and Zalvand et al (2022) report on ubiquitous health governance issues. While Sharma et al assess community health governance, Zalvand et al explore the problem of balancing hospital expenditure while achieving quality healthcare.…”

“…Odisha, Uttar Pradesh and Rajasthan were selected because these areas had already been identified as intervention zones in a project into maternal and child health. Sharma et al (2022) used a quantitative survey design to assess six key features of 140 VHSNCs across 9 districts. Findings indicated that similar problems existed across all districts including issues preventing the VHSNCs operating as effectively as envisioned in the original National Health Mission plans.…”

“…These are congruent with findings by Schneider and Nxumalo (2017) in South Africa concerning the importance of micro-level configuration of roles and responsibilities and the importance of accountability. Sharma et al (2022) suggest that increased supervision and mentoring as well as providing incentives for compliance could improve community health governance and transform it into an effective instrument to improve community health.…”