Prosperous VillageProsperous VillageProgrammeProgramme

Jathika Saviya & Gama Neguma Jathika Saviya & Gama Neguma ProgrammeProgramme

GovernmentGovernment

of the peopleof the people

by the peopleby the people

for the peoplefor the people

- Abraham Lincoln- Abraham Lincoln

Thailand ExperienceThailand Experience 1960s -1960s - Initiation of community participation Initiation of community participation

in in health development programme health development programme through village volunteersthrough village volunteers

1975 -1975 - Creation of a nation-wide village Creation of a nation-wide village volunteers system to form the volunteers system to form the backbone of the National Primary backbone of the National Primary Health Care ProgrammeHealth Care Programme

1982 -1982 - village self managed Primary Health village self managed Primary Health Care Programme Care Programme

19831983 “Basic Minimum Needs” programme to “Basic Minimum Needs” programme to improve the quality of life of people improve the quality of life of people

““Basic Minimum Needs” ProgrammeBasic Minimum Needs” ProgrammeSlogan “ Health is a part of socio-Slogan “ Health is a part of socio-

economic development”economic development”Village is the key development unitVillage is the key development unitEight basic minimum needs with 32 Eight basic minimum needs with 32

indicatorsindicatorsManagement of micro development Management of micro development

projects by the peopleprojects by the people Inter-sectoral actionInter-sectoral action

HealthHealthAgricultureAgricultureEducationEducationInteriorInterior

Pillars of Self-Reliance in BMNPillars of Self-Reliance in BMN

Community organisation

CommunityFinancing

system

Communitymanpower

Experiences of Other CountriesExperiences of Other Countries

ChinaChinaCommunity led managementCommunity led management

IndiaIndiaKeralaKeralaTamilnaduTamilnadu

IndonesiaIndonesiaWomen’s organisationWomen’s organisation

Sri LankaSri Lanka

Change agent programmesChange agent programmes Participatory rural development programmesParticipatory rural development programmes Family health action programme - HEBFamily health action programme - HEB Mahaweli volunteer programmeMahaweli volunteer programme Model health village programme - AnuradhapuraModel health village programme - Anuradhapura Mother’s society programme – HambantotaMother’s society programme – Hambantota Sabaragamuwa Suwasetha – RatnapuraSabaragamuwa Suwasetha – Ratnapura ECCD community action plansECCD community action plans Etc.Etc.

PATHWAYS TO IMPROVED OUTCOMESPATHWAYS TO IMPROVED OUTCOMES

Government Government policies & policies & actionsactions

Health system Health system & other & other sectorssectors

Households Households communitiescommunities

Health out Health out comescomes

Health outcomes

Community factors

Household resources

Household behaviours

& risk factors

Supply in related sectors

Other parts of health system

Health service supply

Actions in other

sectors

Health reforms

Delivery of Health ServicesDelivery of Health Services

EquityEquityRight based approachRight based approachResponsivenessResponsivenessCommunity mobilisation & Community mobilisation &

empowermentempowerment

What is newWhat is new

Political leadershipPolitical leadership Holistic approachHolistic approach

Spiritual developmentSpiritual development Infra structure developmentInfra structure development Social and economic developmentSocial and economic development

Participation of the community Participation of the community JanasabaJanasaba concept concept

Cost reduction by using local manpower, Cost reduction by using local manpower, other resources and technologyother resources and technology

““GAMA NEGUMA” Development GAMA NEGUMA” Development ProgrammeProgramme

A project of paramount importance as A project of paramount importance as envisioned in Mahinda Chinthana.envisioned in Mahinda Chinthana.

Ministry of Rural Livelihood Development Ministry of Rural Livelihood Development co-ordinates with line Ministries, state co-ordinates with line Ministries, state institutions, provincial councils, local institutions, provincial councils, local government bodies and community based government bodies and community based organizations with the active participation of organizations with the active participation of the rural communitythe rural community

Planning and implementation commenced on Planning and implementation commenced on 2424thth March 2006 March 2006

VisionVision

To develop the village as the centre of To develop the village as the centre of national developmentnational development

MissionMission

To create comprehensive development To create comprehensive development in the villages through a network of in the villages through a network of community based organizations formed community based organizations formed in the rural community with active in the rural community with active participation of its members and to participation of its members and to implement them with proper implement them with proper coordination and transparentlycoordination and transparently

ObjectivesObjectives

To ensure community participation by To ensure community participation by motivation, organization, and community motivation, organization, and community empowerment for total development of the empowerment for total development of the rural community based on self reliancerural community based on self reliance

To introduce a formal mechanism for To introduce a formal mechanism for participatory decision making and project participatory decision making and project planning at village levelplanning at village level

To obtain optimum benefits from the To obtain optimum benefits from the development programme by implementing development programme by implementing integrated village development plans to avoid integrated village development plans to avoid duplicationduplication

ObjectivesObjectives Co-ordination of human resources which is crucial Co-ordination of human resources which is crucial

for rural development, other rural, and external for rural development, other rural, and external resources, through an efficient mechanism of resources, through an efficient mechanism of resource allocationresource allocation

To introduce a results based participatory progress To introduce a results based participatory progress review and evaluation mechanism at village levelreview and evaluation mechanism at village level

To ensure improvement of living standards of the To ensure improvement of living standards of the village communities through development of the village communities through development of the physical, economic, social and cultural environmentphysical, economic, social and cultural environment

To create total development of the village under a To create total development of the village under a community based, planned development community based, planned development programmeprogramme

Development StrategyDevelopment Strategy

1.1. To prepare integrated village development plans To prepare integrated village development plans with community participation targeting all with community participation targeting all development efforts to achieve a common development efforts to achieve a common objectiveobjective

2.2. To make opportunities for the rural community to To make opportunities for the rural community to participate actively in their economic, social, participate actively in their economic, social, cultural and spiritual development effortscultural and spiritual development efforts

3.3. To organize and empower rural community to To organize and empower rural community to ensure their total commitment and contribution in ensure their total commitment and contribution in the development processthe development process

4.4. To pool all resources utilized in village To pool all resources utilized in village development, and implement productive development, and implement productive transparent integrated village development plans transparent integrated village development plans for proper co-ordination at village and divisional for proper co-ordination at village and divisional levellevel

Development Strategy (contd.)Development Strategy (contd.)

5.5. To transform the rural community to a group of To transform the rural community to a group of activists with ideological and comparative thinking activists with ideological and comparative thinking abilities and enhance self determination by abilities and enhance self determination by developing their abilities and skills demand for developing their abilities and skills demand for sustainable development dependant on self help, sustainable development dependant on self help, while changing the subsistent mentality with an while changing the subsistent mentality with an orientation towards achieving targets.orientation towards achieving targets.

6.6. Simultaneous rural livelihood development, with Simultaneous rural livelihood development, with infrastructure development for economic infrastructure development for economic resurgence and social developmentresurgence and social development

GAMA NEGUMA Community GAMA NEGUMA Community ActivitiesActivities

1.1. To educate all state officers at village level and the To educate all state officers at village level and the rural community on GAMA NEGUMA Development rural community on GAMA NEGUMA Development strategystrategy

2.2. To identify village level problems, disparities, local To identify village level problems, disparities, local resources, livelihood development, opportunities resources, livelihood development, opportunities using surveys of resources and information, the using surveys of resources and information, the methodology of participatory rural appraisalmethodology of participatory rural appraisal

3.3. To establish a data base of To establish a data base of 1.1. Rural needsRural needs2.2. Rural resources / scarcitiesRural resources / scarcities3.3. Identification of required external assistance Identification of required external assistance 4.4. Preparation of rural development plansPreparation of rural development plans

GAMA NEGUMA Community GAMA NEGUMA Community Activities (contd.)Activities (contd.)

5.5. Preparation / updating of profiles of families and village Preparation / updating of profiles of families and village resources resources

6.6. Co-ordination of financial allocations for project proposalsCo-ordination of financial allocations for project proposals

7.7. Establishment of suitable mechanisms for implementation, Establishment of suitable mechanisms for implementation, evaluation and review of development projectsevaluation and review of development projects

8.8. Co-ordination of institutions involved in project Co-ordination of institutions involved in project implementation with Divisional and District Secretariats.implementation with Divisional and District Secretariats.

9.9. Establishment of ‘JANA SABHA’ Establishment of ‘JANA SABHA’

JANA SABHAJANA SABHA

The principal organization responsible for The principal organization responsible for implementation of ‘GAMA NEGUMA’implementation of ‘GAMA NEGUMA’

A JANA SABHA will be established in every A JANA SABHA will be established in every village with the participation of village with the participation of -- religious leadershipreligious leadership-- community based organizationscommunity based organizations-- political leadershippolitical leadership-- state officialsstate officials-- rural communityrural community

Drafting of statutory laws for establishment Drafting of statutory laws for establishment of JANA SABHA is in progressof JANA SABHA is in progress

Community Action Planning ModelCommunity Action Planning Model ‘‘JanasabaJanasaba’’ Training of Community Health workersTraining of Community Health workers

((Praja Saukkya SevikaPraja Saukkya Sevika)) Assessment of the needsAssessment of the needs Decide on the objectivesDecide on the objectives Assessment of the available resources Assessment of the available resources Identify the activities & responsibilities Identify the activities & responsibilities Identification of resources & time-frame Identification of resources & time-frame Develop an action plan for holistic Develop an action plan for holistic

developmentdevelopment Implementation & coordination Implementation & coordination Directing & logisticsDirecting & logistics Monitoring and evaluationMonitoring and evaluation

Five Precepts of SanitationFive Precepts of Sanitation Ensure access to supply of safe water Ensure access to supply of safe water

and the use of boiled cooled water to and the use of boiled cooled water to drink for all drink for all

Ensure home gardening of the Ensure home gardening of the householdshouseholds

Ensure sanitary disposal and recycling Ensure sanitary disposal and recycling of wasteof waste

Ensure the use of sanitary toilets by all Ensure the use of sanitary toilets by all including childrenincluding children

Ensure a clean, smoke free house with Ensure a clean, smoke free house with adequate light & ventilationadequate light & ventilation

Maternal and Child HealthMaternal and Child Health Ensure adequate care is received by Ensure adequate care is received by

mothers and childrenmothers and children Ensure proper nutrition including Ensure proper nutrition including

breast feeding and complementary breast feeding and complementary feeding of childrenfeeding of children

Assist in conducting Growth Assist in conducting Growth Promotion centres and MCH clinicsPromotion centres and MCH clinics

Follow-up of advice given by health Follow-up of advice given by health workers to ensure health of mothers workers to ensure health of mothers and childrenand children

Assist the health education Assist the health education programmes conducted in the programmes conducted in the communitycommunity

Maternal and Child HealthMaternal and Child Health

Ensure adequate post-partum care is Ensure adequate post-partum care is received by the post partum mothersreceived by the post partum mothers

Ensure all the children are receiving Ensure all the children are receiving adequate early Childhood Care for their adequate early Childhood Care for their optimal growth and developmentoptimal growth and development

Assist in providing / strengthening of Assist in providing / strengthening of infrastructure, equipment and consumablesinfrastructure, equipment and consumables

Promote child friendly environment within Promote child friendly environment within the family and the community the family and the community

Prevent child abuse Prevent child abuse Ensure adequate participation of male in Ensure adequate participation of male in

MCH careMCH care

Environmental healthEnvironmental health Assist health workers in educating the Assist health workers in educating the

communitycommunity Monitor the adequacy of the measures taken Monitor the adequacy of the measures taken

by the community to prevent communicable by the community to prevent communicable diseases in the communitydiseases in the community

Assist prevention of communicable diseases Assist prevention of communicable diseases including diarrhoeal diseases and dengueincluding diarrhoeal diseases and dengue

Inform health workers on the spread of Inform health workers on the spread of communicable diseases promptlycommunicable diseases promptly

Develop the occupational settings in the Develop the occupational settings in the community to be health promotivecommunity to be health promotive

Create an animal friendly environment by Create an animal friendly environment by motivating people to care responsibly for the motivating people to care responsibly for the animals such as dogs and cats by facilitating animals such as dogs and cats by facilitating immunisation of the dogs, family planning & immunisation of the dogs, family planning & encouraging caring practices etc.encouraging caring practices etc.

Food HygieneFood Hygiene

Assist health workers to educate Assist health workers to educate workers working in food processing workers working in food processing establishments and people about establishments and people about proper food hygieneproper food hygiene

Monitor food hygiene of the food Monitor food hygiene of the food processing establishmentsprocessing establishments

Promote locally available home based Promote locally available home based foodfood

Prevention of Non-Communicable DiseasesPrevention of Non-Communicable Diseases Assist health workers in educating public on Assist health workers in educating public on

non- communicable diseasesnon- communicable diseases Ensure prevention of abusive substances Ensure prevention of abusive substances

such as alcohol and tobacco in the communitysuch as alcohol and tobacco in the community Ensure reduction of home and other accidentsEnsure reduction of home and other accidents Promote mental health and prevent suicides in Promote mental health and prevent suicides in

the communitythe community Assist health workers in screening the Assist health workers in screening the

community for non-communicable diseases community for non-communicable diseases and referral of the patientsand referral of the patients

Follow-up of patients with non communicable Follow-up of patients with non communicable diseases to prevent complicationsdiseases to prevent complications

Promoting Health of the YouthPromoting Health of the Youth

Promote health of youth by forming Promote health of youth by forming youth clubs and sport clubsyouth clubs and sport clubs

Facilitate empowerment of youth to Facilitate empowerment of youth to improve their own healthimprove their own health

Create supportive environment for Create supportive environment for development of youth in the development of youth in the communitycommunity

Care of the ElderlyCare of the Elderly

Promote health of the elders by Promote health of the elders by facilitating day care centresfacilitating day care centres

Facilitate empowerment of the elders Facilitate empowerment of the elders to improve their own healthto improve their own health

Create supportive environment for the Create supportive environment for the care of elders in the family and the care of elders in the family and the communitycommunity

Rehabilitation of the Differently Rehabilitation of the Differently Abled PersonsAbled Persons

Assist health workers in rehabilitation Assist health workers in rehabilitation of the differently abled personsof the differently abled persons

Facilitate services provided by the Facilitate services provided by the Department of Social Services, other Department of Social Services, other sectors and NGOs to improve the sectors and NGOs to improve the health of differently abled personshealth of differently abled persons

Facilitate income generating activities Facilitate income generating activities by differently abled persons to by differently abled persons to improve their status of livingimprove their status of living

Other Social DevelopmentOther Social Development

Facilitate other social and economic Facilitate other social and economic development of the community to development of the community to improve their healthimprove their health

Liaise with other sectors and NGOs to Liaise with other sectors and NGOs to improve social and economic improve social and economic developmentdevelopment

Improve Access to Health Improve Access to Health ServicesServices

Filling of the vacancies of the public health Filling of the vacancies of the public health personnel in selected villagespersonnel in selected villages

Ensure easy access to MCH clinics Ensure easy access to MCH clinics Ensure basic facilities in PHC hospitals and Ensure basic facilities in PHC hospitals and

easy access to high quality curative careeasy access to high quality curative care Filling of the vacancies of PHC hospitalsFilling of the vacancies of PHC hospitals Screen people for chronic diseasesScreen people for chronic diseases Follow-up of people with chronic diseases to Follow-up of people with chronic diseases to

ensure regular treatmentensure regular treatment

Improve Access to Health Improve Access to Health ServicesServices

Ensure access to health information Ensure access to health information through planned regular health talks, through planned regular health talks, night film shows etc.night film shows etc.

Ensure access to screening of school Ensure access to screening of school children and proper follow-up to children and proper follow-up to ensure proper careensure proper care

Promote the school as a health Promote the school as a health promotive school and empowerment of promotive school and empowerment of school children through school health school children through school health societiessocieties

Next stepNext step Educate all MOOH and district level staff - Feb.2007Educate all MOOH and district level staff - Feb.2007 Survey of physical infrastructure/ equipment needs of the selected villages – Survey of physical infrastructure/ equipment needs of the selected villages –

Feb. 2007Feb. 2007 Develop an action plan to improve physical infrastructure with a budget – Develop an action plan to improve physical infrastructure with a budget –

Feb. 2007Feb. 2007 Communicate infrastructure development plan with the Janasaba, local Communicate infrastructure development plan with the Janasaba, local

political leadership and Divisional Secretary – March. 2007political leadership and Divisional Secretary – March. 2007 Training of Community health workersTraining of Community health workers Family survey – Feb-March. 2007Family survey – Feb-March. 2007 Formation of a Janasaba sub committee on healthFormation of a Janasaba sub committee on health Develop an action plan for the holistic development of the village – March Develop an action plan for the holistic development of the village – March

20072007 Implementation of the action plan – March – Dec 2007Implementation of the action plan – March – Dec 2007 Monitoring and reviewMonitoring and review

Monthly review of the programme at the Janasaba sub committee on healthMonthly review of the programme at the Janasaba sub committee on health Monthly conferenceMonthly conference Monthly review at the Janasaba meetingMonthly review at the Janasaba meeting Monthly Divisional level meetingMonthly Divisional level meeting Monthly District level reviews of the health sectorMonthly District level reviews of the health sector Monthly District level meeting with the District coordinating committeeMonthly District level meeting with the District coordinating committee Bi-monthly Provincial level reviewsBi-monthly Provincial level reviews

Ministry of Healthcare & NutritionMinistry of Healthcare & Nutrition

Coordination of Jathica Saviya and Gama Coordination of Jathica Saviya and Gama Neguma at national levelNeguma at national level

Issuing of policy directionIssuing of policy directionConduct quarterly review at National levelConduct quarterly review at National levelParticipate in Provincial level review Participate in Provincial level review

programmeprogramme

Go to the peopleGo to the peopleLive among themLive among themLearn from themLearn from themLove themLove themStart with what they haveStart with what they haveBuild on what they haveBuild on what they haveBut of the best leadersBut of the best leadersWhen their task is accomplished When their task is accomplished Their work is doneTheir work is doneThe people all remarkThe people all remarkWe have done it ourselves !We have done it ourselves !

- - Ancient proverbAncient proverb