Streamlining Health System Service Delivery based on Community Need Assessment

Involving the community is a fruitful way for developing effective and sustainable public health services. This exercise not only empowers individuals, but helps to design and promote tailored health interventions by utilising community’s local knowledge and valuable insights into their own health needs, their cultural practices, and challenges faced by them. This increases the likelihood of community acceptance of a program as they feel they have a voice and stake in the process, which instils trust and establishes credibility.

Being entitled to receive services, community feedback and information on existing health infrastructure, accessibility to services and potential barriers are crucial for planning, streamlining and allocating resources efficiently.

Community insights utilised to improve health services

Community engagement is a crucial element in programs’ implemented by World Health Partners (WHP), essentially because they are the key stakeholders who would be the ultimate service receivers. In all its recent projects – managing COVID-19 and mental health issues, eliminating Tuberculosis (TB), and addressing behavioural issues for improving health and hygiene, a major operational strategy has been to ensure that the programs are people-centric and participatory in framework. As part of Systems Approach for MNCH focusing on Vulnerable Geographies (SAMVEG) Project, WHP has been carrying out supportive supervision activities since January 2022, which involves assessment of a detailed set of indicators/ services in various health facilities of 25 aspirational districts across Jharkhand, Uttarakhand, Haryana, Himachal Pradesh and Punjab. The gaps and findings are brought to the notice of health officers for addressing the issues urgently. This initiative has proved to be effective in strengthening the health services at the community level.

Community assessment is one of the several processes used for assessing the services at sub-centers and anganwadi centers (AWCs), during Village Health, Sanitation and Nutrition Day (VHSND) under SAMVEG. So far, 183 community assessments have been conducted providing an objective picture and gaps in services. Discussions gave insights like lack of listing of high-risk pregnancies (HRP), family planning services and counselling for institutional delivery. Other concern areas included supply issues like non-availability of iron tablets for children, ORS, etc. at the AWCs, and lack of financial and nutritional support to TB patients and awareness on TB symptoms and free TB services. Inadequate follow-up visits to monitor low-birth weight (LBW) babies and special new born care unit (SNCU) discharged babies were highlighted among others. Advocacy with the concerned medical officers’ in-charge and block project managers, resulted in several positive measures crucial for addressing the concern areas. Overall, community assessment has made a significant contribution in reviewing over 100 facilities/indicators and addressing majority of the emerging gaps. ??

In WHP’s #TB project, community assessment is done for patients who are initiating their treatment. These patients are approached in their respective community settings and information is collected with due consent in a digital tool. These patients are followed?throughout their treatment and are provided services for mental health and substance use if required.?WHP aims to incorporate community assessment across its interventions to ensure its services are responsive to community needs.