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Community managed health and nutrition interventions under NRHM. Society for Elimination of Rural Poverty 9.03.09. SHG federations in AP. 9,646,000 Rural Women in 22 Districts of AP. 810,000 Self Help Groups (10-15 women per group). 34,852 Village Organization - VO (approx. 20 SHGs).

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society for elimination of rural poverty 9 03 09

Community managed health and nutrition interventions under NRHM

Society for Elimination of Rural Poverty


shg federations in ap
SHG federations in AP


Rural Women in 22 Districts of AP


Self Help Groups (10-15 women per group)


Village Organization-VO (approx. 20 SHGs)

1098 Mandal Samakhya-MS

(Includes approx. 30-35 villages)

22 ZillaSamakhya-ZS

(constitutes 1 district)

1 State Office (State Project Monitoring Unit)

health value chain
Health Value Chain

Curative Care

Preventive & Promotive Health Care

Financing and Service Delivery

  • Human/Social Capital
    • Health activist/ASHA
    • Community Resource Person (CRP)
    • Health subcommittee

Case Managers

Microfinance Product for NUTRITION

Health Risk Fund/ Health Savings

Nutrition & Health Day (NHD)

Health Insurance

Community-owned Pharmacy

Making Services Work for the Poor – Accessing PHCs & Area Hospitals

Nutrition Centers

Community-owned Hospitals

Water & Sanitation

approaches adopted
Universal approach

Capacity building of stakeholders

Convergence with line depts.

Fixed NHDs

Screening camps for Women

Community managed interventions as proposed in Village health action plans.

Health Risk fund

Community kitchen gardens

Weaning foods

Safe water supply and sanitation to make ODF villages

Case managers at public and net work hospitals

Intensive approach

BCC through health CRPs

Establishment of Nutrition cum day care centers (NDCCs)

Provides balanced, complete meals to pregnant and lactating women and children <5 yrs.

Venue for delivery of other H&N Program services:

NH Day (immunization, growth monitoring, ANC)

Health Education (Films and Flip books and case studies etc.,)

Health Savings/Health Risk Fund

Discussion of Water & Sanitation activities

Community Kitchen Gardens

Introduction of weaning foods

Approaches adopted
process ndcc
Process: NDCC
  • The Nutrition cum Day Care Centers (NDCC) are entirely funded by the community – member/beneficiary and the VO – through a “pay-per-use-plan”. The cost of TWO MEALS PER DAY is Rs 25 for pregnant mothers and Rs 10 for children.
  • The cost of meal for the pregnant mother is SUBSIDIZED. The subsidy is funded by their respective VOs via internal accruals in the year 2007-08. Subsequently, the same is being dovetailed in the form of kind from ICDS which is a Government program targeting pregnant mothers.
  • The pregnant mothers are extended a micro loan to finance the cost of their meal program, through their respective SHG i.e., consumption smoothing via a consumption loan.
  • The loan will be repaid over 36-40 months depending on the cash-flow status of the beneficiary.
  • Adopted BCC strategy thru’ 900 Community Resource Persons (CRPs) and established 680 NDCCs in 63 mandals till the end of Feb 09.
  • Against Rs 2000 lakhs sanctioned under NRHM for both universal and intensive approaches adopted in the project, Rs 1993 lakhs was the expenditure till the end of Feb 09.
  • The Nutrition Center has lead to a reduction in no.of neonatal, infant and maternal deaths and a with improved nutrition seeking behaviour and adequate knowledge on maternal and neonatal care practices among the rural poor.
  • Impact assessment by SOCHURSOD, the external agency under the supervision and guidance of Dr.Drole, CRHP, Jamkhed and assistance from Interns from John Hopkins University, USA is under way.
  • Interim report (draft) results from 3 tribal districts is prepared.

Comparison of maternal and child health outcomes

*during current or most recent completed pregnancy, # includes children who were weighed within 3 days of birth.

** Birth weight recorded from the base register at NDCCs where the newly supplied weighing machines available are in working condition.

*** Birth weight recorded from the registers of AWCs where the weighing machines supplied are not in working condition.


Impact of H&N Program on utilization of government public health services

*during most recent complete pregnancy /delivery

**during most recent completed pregnancy or current pregnancy