A comprehensive rural health project in Jamkhed (India)

Abstract

In this discussion of a comprehensive rural health project in Jamkhed India attention is directed to the following: how the project was conceived and initiated; the project area; the original health situation; the methods adopted (food and water take priority over health staff recruitment and training the health team approach the village health worker and the health center); the project in operation; the progress made (results of the project in a typical village and financial aspects; and current standing of the project (community involvement cooperation with the government coordinating the efforts of other agencies the multisectoral approach the use of community volunteers the use of income from curative services to support community health programs the changing role of the physician and the integration of indigenous practitioners). The following criteria were formulated for establishing a viable and effective health care system: local communities should be motivated and involved in decision making and must participate in the health program; the program should be planned at the grass roots and a referral system to suit the local conditions should be developed; local resources should be used to solve local health problems; and the community needs total health care and promotional preventive and curative care must be totally integrated. In 1961 the population of Jamkhed was 73153; it had risen to 86592 by 1971. The comprehensive rural health project at Jamkhed serves 40000 people in 30 villages. The project has penetrated all 30 villages and has reached the target population of the area. Adequate staff are recruited trained and reoriented for the task at hand. 20 villages have village health workers (VHWs) and more and more volunteers are coming forward to serve the remaining villages. Community kitchens are becoming popular and there are now 20 villages caring for 2500 children. Most children under age 5 are immunized with triple antigen and poliomyelitis vaccine. Villagers notice that their children are gaining weight and this had led individual farmers to make 350 acres of land available for nutritional programs. All 30 villages get safe drinking water from 40 deep tube wells. 522 women are regularly using oral contraceptives and 748 women and 301 men have undergone sterilization operations. The VHWs have convinced the mothers to accept antenatal care with over 50% of the pregnant mothers in the area receiving this care regularly. The project has been able to integrate leprosy care completely with general health services.