Revamping village health sanitation and nutrition days for improved delivery of maternal and child health services at village level - Experiences from a pilot phase study

Abstract

Background: Village health sanitation and nutrition day (VHSND) was conceived under the National Rural Health Mission to deliver maternal and child health and nutrition services at the village level in the anganwadi center. Multiple challenges, including a lack of convergence of frontline workers, were affecting service delivery at VHSND. As a public-private partnership Piramal Foundation proposed to revive the concept of VHSND. Objectives: The present study was aimed to demonstrate a model of VHSND to provide primary care related to maternal and child health and nutrition at the village level in 25 aspirational districts across seven states of India. Methods: The descriptive study was undertaken as a pilot phase. Of the purposively identified 506 VHSND sites, monitoring data on delivery of six basic primary care services at VHSND, collected as part of routine operations were compared for 229 sites for the month of September 2018 (baseline) and January 2019 (endline). Results: In model sites, there was the increased availability of drinking water and functional toilets; a significant improvement of availability of equipment for providing antenatal care services, immunization, and growth monitoring. However, the supply of drugs at these sites did not show a statistically significant change. There was also a significant improvement in the engagement of the Village Health Sanitation and Nutrition Committee (VHSNC) in the villages of the model VHSND sites. Conclusion: The model demonstrated the significant changes with effective supervision and participation of VHSNC members, demand generation activities complemented with improved supplies and widening range of services at the VHSND are required to be undertaken.