Background and Objective: -

Kandhamal is mostly covered by the hilly terrain. Approximately 71% of the land in district is covered by forest. It is quite difficult for people in hilly and inaccessible regions to access medical facilities as Public Health centers are far from remote villages and private health system is almost absent in the district. Hence, even for the basic treatment or medicines people need to travel long distances, compromising their entire day wage or labour. Moreover, lack of knowledge and usage of basic preventive medicine, further deteriorates the health of the patients in tribal belts. Looking at such challenges a piloting of health kit was initiated and tested in 20 villages of Daringibadi, Kandhamal. 

Health kit is a concept where basic preventive medicine would be given to the community by the trained village based Swasthaya Sathi (Health worker). The broader objective behind the initiative was to locally sustain it by community contribution and active participation. Another objective was, linking the communities to the state and central government health schemes and entitlements. 

After experimenting health kits in Daringibadi Block, three more blocks have also been added after two years of learnings.  Those 3 blocks were namely:

  1. Baliguda
  2. Tumudibandha 
  3. Kotgarh

Process: -

After several rounds of meetings and discussions with field team and community leaders, the potential villages were identified. Later, team was oriented on filling the survey format. A detailed field survey was conducted in the selected villages by the jansathis, who were also certain about the health-related issues and the status of the identified villages such as type of diseases prevalent in villages, type of medicines used, availability of medical services, approximate expenditure of households on health etc. 

After completing the survey and its subsequent compilation to analyze the findings was completed, the survey findings were shared with the communities. Later, village committees were formed and the process of community contribution started. Similarly, two Swasthya Sathis, a male and a female were also identified and selected from each village. They were later trained and oriented on general health problems (Syndromatic treatment) maintenance of register, usage of general medicines as per the age group, equally focusing on good food habit and water & sanitation practices etc. at community level. After that, Swasthya Sathi purchased the medicine from medical stores and heath kit programme was started. The field level workers (Health Animators) followed up with Swasthya Sathis at regular intervals so that register is maintained properly and medicines are made available to the villagers. One Health animator is appointed block wise to coordinate Swasthya Sathis and monitor the entire process. The Training and orientation was given to new Swasthya Sathis on basic health problems and maintenance of register, usage of general medicines as per the age group and maintenance of resolution by the Swasthya Sathis for independently running the health-kit in the village to avoide the risk of license for administering the medicines without the required degree.

Challenges: Villages have no all weather roads, distance between two villages is high, and some areas are naxal prone, community’s response is poor despite continuous and regular dialogue with them.

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