Connecting local responses around the world
Background: In 2015, 3ie supported Public Health Foundation of India (PHFI) and Constellation to carry out a rigorous evaluation of the effectiveness of the Stimulate, Appreciate, Listen and Transfer (SALT) and community life competence process in 3 districts of Assam, India.
In every village, there is an ASHA (Accredited Social Health Activist) who is responsible for creating awareness on health, mobilise the community and increase the use of existing health services. In Assam, the burden placed on the shoulders of the ASHAs is large. The challenge for the facilitator of the SALT approach is to engage the ASHA so that she sees the SALT approach as a methodology that reduces her burden, makes her job easier. Gradually over the year, Auxiliary Nurse Midwife (ANM) and ASHA have begun to recognise the importance of community led action.
In in Village Kadamguri, Udalguri district, Assam, SALT meetings have enabled the mothers to meet regularly and the action plan has motivated some women to take up responsibility of informing others about the immunization schedule, notes the ASHA- Nikunja Damaria. "The village is very big in size and I am not able to cover all houses and inform the mothers on the vaccination. I don’t have to go to each and everyone. My workload now has reduced as communicating about immunization has been taken up by women from the communities.”
And what motivates women to take action? The women shared that through the visits by Amrit, the SALT facilitator, they have realized that they have some common concerns. This has unified the women. A network is developing. The ASHA tells 2-3 women about immunization schedule and the women inform others. Sonashi Mishra, a young mother, follows up those who miss the vaccination. Anita Dumari, another mother noted, “I should let other mothers know about immunization. Every child in my village should be healthy, it is my moral responsibility to help others.”
These meetings are a learning opportunity says a young mother. I never missed a schedule of vaccination but never bothered to ask why it was given. If everyone learns about this no one will miss an immunization schedule of their babies says the smiling young woman in a pink saree.
It is important that this kind of community conversation and action is replicated in other villages affirms the ASHA of the village, “My work burden has been shared by the community, the vaccination rate is going up. I want other villages to also adopt this approach of coming together, talking to each other. Therefore, today I have invited ASHA of village Batabari number 2 so that she can learn what we are doing and if this can be done in her village.”
Thanks to Jyotika and Amrit from VHAA for this post.