Community monitoring: A strategy to watch out for

Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy


India’s National Rural Health Mission (NRHM) was launched in 2005 on a nationwide scale with a vision to provide universal access to equitable, affordable and quality health care. In particular, it aims to meet the health needs of the poor and vulnerable in mostly rural areas, such as women, children and the elderly. The Mission is distinguished by in-built flexible mechanisms, so that local needs and priorities can be identified and addressed and local initiatives promoted. Central to these mechanisms is the role of community ownership and participation in management, which is seen as an important prerequisite within the NRHM.
This article explores the development and use of community-based monitoring (CBM), which involves drawing in, activating, motivating and capacity building so that the community and its representatives can directly give feedback about the functioning of public health services, including input to improving planning of those services. The focus of this monitoring process is mainly on ‘fact finding’ and ‘learning lessons for improvement' rather than on ‘fault finding’. This article describes the objectives and stages of CBM and also discusses its current status and challenges. The most important reasons for the success of CBM are strong civil society engagement, the involvement of public health personnel as well as the community as principal stakeholders, adequate geographic representation and the crucial role played by the Monitoring and Planning Committees.
Community-based monitoring of health services is a key strategy of the NRHM to ensure that services reach those for whom they are intended. This framework is consistent with the ‘Right to Health Care’ approach since it places health rights of the community at the centre of the process. It also seeks to address gaps in the implementation of various programs, thereby enhancing transparency down to the grassroots level.

Keywords: Community, community mobilisation, community monitoring, community ownership and participation in management, health care, public health

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