People Reclaiming the Public Health System: Community-based Monitoring and Planning in Maharashtra

Abstract

Community-based monitoring and planning (CBMP) of health services is being implemented in selected areas of Maharashtra with support from National Rural Health Mission since 2007. CBMP processes are organised at village, Primary Health Centre, block, district and state levels by a network of nodal civil society organisations working with the State health department. Key components include multistakeholder monitoring committees at various levels; community-based data collection and filling of health report cards; organising public hearings and periodic state level dialogues, with community-based planning focused on appropriate utilisation of untied funds. Various indicators show positive impact of these processes in CBMP areas such as significant rise in positive ratings of public health services over time, increase in utilisation of PHC services in Thane district and numerous positive ‘stories of change’. However, key policy decisions are now required to ensure optimal effectiveness, generalisation and sustainability of such community action processes.