Social Accountability and community participation in Village Health Nutrition and Sanitation committees in Uttar Pradesh

Abstract

Background: A First step towards community involvement is Participation. The government of India under its flagship program, the National Health Mission, advocates and actively encourages community participation and has setup Village Health Nutrition and Sanitation Committees (VHNSCs) at village level. Aim & Objective: The objective of this paper is to examine “The Level of Community Participation in the Village Health Sanitation committees” in the state of Uttar Pradesh. Methods and Material: A cross-sectional mix method study was undertaken in 3 districts, covering 15 villages, in Uttar Pradesh between August to October 2019. The quantitative component included a pre-tested semi structured questionnaire. Further, Focused group discussion (FGDs) and key informant in-depth interview were undertaken for more information. Informed consent was collected from all the participants. The quantitative data was analyzed using SPSS 21.0 while the qualitative data was analyzed manually, based on themes. Results: The average size of the household was 5, 65% respondents were educated, 88% were Hindus, 47% were from other backward class and 50% had below poverty line cards. In the year 2019, 7% of the respondents participated in the Gram Sabha and 5% in village health nutrition and sanitation committee meetings. Statistically significant variations were noticed where less than 20% of the schedule castes and schedule tribes had lower participation than other castes in any of the village level committees. Lack of time was one the key reasons cited for non-participation. Conclusions: To ensure adequate participation from all castes it is important to schedule meetings at times convenient may encourage more community participation.