The project proposal, “Training Women Health Workers,” was sent by SATHI/CEHAT, a NGO who has worked with a rights-based perspective on health and health care for over a decade. Socially relevant and rigorous academic health research, advocacy and action undertaken by SATHI is for the well being of disadvantaged masses, for strengthening peoples health movements, and for realizing right to health and healthcare. CEHAT acts as an interface between progressive peoples movements, social policy, and academia.
SATHI has been involved with Kashtakari Sanghatana in Dahanu village of Thane district in training women community health workers (CHWs) who provide hamlet level health care to the people in this tribal district for the past year. Having a local primary care facility allowed villagers to more readily seek care, and also saved money used to travel and pay for hospital visits. The program involved government support in terms of providing the cost for medicines, while the SATHI team works on preparing training manuals and conducting the training sessions. This project was funded by AID-Pittsburg and AID-Bay Area several years ago. Due to a public interest litigation pushed by SATHI team, recently, the government of Maharashtra agreed to expand this “Dahanu model” to 8000 hamlets in five tribal districts of Maharashtra.
The proposal received by AID-NM is for streamlining the Dahanu model which worked very well in 50 hamlets to 2500 hamlets in Thane district. The government has agreed to bear the costs of medicines, trainings, manuals, and CHWs’ honorarium (300 Rs/month). The government is also conducting a master training session for the CHWs, as well as insuring that only women can hold the position of a CHW. SATHI in collaboration with various Peoples’ Organizations conducts the remaining training sessions, including a session on herbal medicine. The training manuals are mainly pictorial and easily understood. The women are tested after each training session and after the completion of the full training. This final exam is given by SNDT University in Mumbai and successful CHWs are given certificates.
CHWs are selected based on attitude, prior knowledge and how quickly they learn. They are selected by a village body with the help of peoples organizations like Kashtakari Sanghatana. Having women health workers gives a much more personable attention to the patients, especially since some of the manuals talk about the reproductive health of women; hence its better if the health worker is women who can explain this to other women. These CHWs are also aware of their limitations and know when to send a patient to the hospital.
The budget for the project is about $6000 and a large portion of the funds is for salary of a training supervisor whose primary responsibility would be to connect with other peoples organizations in Thane district and extend the project to 2500 hamlets in Thane. His other responsibilities are conducting the demonstration training, supervising master trainings, and helping in the selection of the CHWs. The funding is asked for a year and the hope is that the program will need lesser and lesser external input as the government steps in.