VILLAGE HEALTH, SANITATION & NUTRITION COMMITTEES (VHSNC)
VHSNC is one of the key interventions introduced by National Rural Health Mission, to take collective actions on issues related to health and its social determinants at the village level. It is a platform for improving health awareness and access of community for health services, address specific local needs and serve as a mechanism for community based planning and monitoring. The committee functions as a Sub-Committee of Gram Panchayat and functions under the overall supervision of Gram Panchayat. VHSNCs are formed at revenue village levels, in Karnataka, 26,084 VHSNCs have been formed up to December 2015.
OBJECTIVES OF VHSNCs:
1. To enable the community to address health through right based approach.
2. Enable community to participate in the planning and implementation of the programmes, and take collective action for attainment of better health status in the village.
3. Take action on social determinants and all public services that directly or indirectly affect health and health outcomes.
4. Provide support and facilitate the work of community health workers like ASHA and other frontline health care providers, who form a crucial interface between the community and health institutions.
5. Create awareness about nutritional issues and significance on nutrition as an important determinant of health.
6. Carry out survey on nutritional status and nutritional deficiencies in the village especially among women and children.
7. Identify locally available food stuffs of high nutritional value as well as disseminate and promote best practices (traditional wisdom) of local culture, capabilities and physical environment through a process of community consultation.
8. Inclusion of Nutritional needs in the Village Health Plan.
9. Monitoring and Supervision of Village Health and Nutrition Day to ensure that it is organized every month in the village with the active participation of the whole village.
10. Facilitate early detection of malnourished children in the community; tie up referral to the nearest Nutritional Rehabilitation Center (NRC) as well as follow up for sustained outcome.
11. Supervise the functioning of Anganwadi Centre (AWC) in the village and facilitate its working in improving nutritional status of women and children.
12. Act as a grievances redressal forum on health and nutrition issues.
PROCESS OF FORMATION OF VHSNCS:
1. The ASHA and ASHA Facilitator/Mentor will hold meetings in the village to discuss the role of the VHSNC and its composition.
2. The Gram Panchayat members, ASHA, ASHA facilitator/Mentor and Junior Health Assistant, Female will then select members through a consultative process with the community at village level.
3. This list will have to be approved with inclusion of further suggestions, at the next Gram Sabha meeting.
4. The term of a committee shall be co-terminus with that of the Gram Panchayat where it is located. Therefore the VHSNC will be re-constituted after a new panchayat is elected.
5. There is no bar on reselecting those who have proved active and effective as VHSNC members, or dropping those who have not been active.
6. VHSNC can select new members to replace non-active members or add a new member within the norms, by two thirds majority.
COMPOSITION OF VHSNCS:
The VHSNCs have about 15 members, out of which 50 % of the members should be women members. Its members constitute the following:
1. The local Gram Panchayat member will be the president; all other Gram Panchayat members will be the members. Preference is given to women Panchayat Members to be the president, first preference being women SC/ST members.
2. All ASHAs of the revenue village are its members, and one ASHA will be selected on consensus as the Member Secretary.
3. The Junior Health Assistant (Female), Anganwadi Worker and the village School Teacher (preference shall be given to female teachers).
4. Members from Community Based Organizations like Stree Shakthi Sangha, Women Self-help Groups, Youth Organizations and other groups will be members.
5. Representatives from religious groups, minority groups and other disadvantaged groups will also be the members.
6. PHC Medical Officer, ASHA Facilitator/Mentor, ICDS Supervisor, Zilla Panchayat Member/Taluk Panchayat Member and PDO can be special invitees.
All VHSNCs have a Joint Account, in the nearest local Bank, in the name of the VHSNC President and Member Secretary. Every year, Rs 10,000 is provided as Untied Fund to these VHSNCs, by District Health & Family Welfare Society under National Health Mission.
VHSNC Untied Fund can be used for the following activities:
1. For any purpose aimed at improving the health of the village like nutrition, education, sanitation, environmental protection and other public health measures.
2. The fund shall be used for activities that benefit the community and not just one or two individuals. However in some cases such as that of a destitute women or very poor household, the Untied Grants could be used to meet their health care needs and facilitate access to care.
3. In special circumstances the district could give a direction or a suggestion to all VHSNCs to spend on a particular activity and all such activities should be approved the VHSNCs.
As VHSNC members may include illiterates, neo-literates and community members of all walks of life, their capacity to comprehend the guidelines and monitoring health of their village may not be adequate. Hence, once new VHSNC committees are constituted, training and capacity building of these members will have to be organized, the first such VHSNC capacity building of about five lakh members was conducted through a three days’ training program during 2010 to 2012 and the orientation of new VHSNC members would be conducted during 2015-16 and 2016-17, by engaging consultancy firms.