Sector Wide Approach to Strengthening Health (SWASTH) programme Bihar
Year - 2010 - 2016
Client - Department for International Development (DFID), UK
The objective of DFID supported SWASTH programme is to design and implement cutting-edge reforms for the health, nutrition and WASH sector in Bihar, to bring about lasting changes in the health and nutritional status of the people, particularly the poorest and socio-economically marginalised. The goal of SWASTH is to improve the health and nutritional status of people in Bihar, particularly among the poorest and excluded.
Consortium of Care International, Options Consulting UK and IPE Global Limited through a Bihar Technical Assistance and Support Team (B-TAST) are assisting the Department of Health (DoH), Social Welfare Department (SWD) and Public Health Engineering Department (PHED), Government of Bihar in successfully implementing SWASTH programme in Bihar.
We took a leaf out of our previous projects, developed and expanded on the concept of participatory learning and action approach (PLA) to create a platform - Gram Varta. Gram Varta is essentially about building human capacity. There is no infrastructure involved, nor are there costs that have to be paid out, beyond what is incurred in training and technical expertise. The intervention leverages the existing platform of village womens Self Help Groups. Since it is designed as a community endeavour, it has low cost implications. The approach is scalable and replicable, since it partners with leading self-help promoting organisations.
Gram Vartais a participatory learning and action approach to mobilise women through Self Help Groups to improve family health, nutrition, water, sanitation and hygiene (HNWASH). Through participation in the groups, women are facilitated to identify and prioritise local health problems, and develop strategies for action. This reflective approach will nurture women's self-confidence and enhance solidarity among the group. This helps women negotiate new practices with family members, share information among their family and peer networks, and foster community support for action. Gram Varta acts as a catalyst for increased use of services and entitlements offered by government programmes and contribute to improved outcomes in line with SWASTH and the RMNCH+A strategy.
Since its inception, Gram Varta activities have invigorated communities to take control of improving their health and nutrition outcomes. While it has increased demand for and access to community services, it has strengthened the responsiveness of community level services providers as well. Gram Varta is now being implemented through 78,261 groups reaching to 9,39,132 households and approximately 46,95,660 members of the population.
Gram Varta has been accepted as an efficient way of engaging with the community by both the donor as well as the state government. In Madhya Pradesh (MP), IPE Global implemented a similar model in partnership with the DFID supported MP Rural Livelihood Programme (MPRLP) and MP Technical Assistance Support Team (MPTAST).
Kamla (SHG) facilitator under Gram Varta, states, "previously I was very hesitant to go outside and felt low confidence in speaking with outsiders; now it is not the same. I can convince not just group members but also my family in following certain health and nutrition practices".
Babiya Devi, President Maner Federation, reveals "overall health expenses have declined ever since women have started participating in these meetings".