Community Health Rights Programme
Promoting health entitlements and community-led monitoring of public health services in West Bengal.
About This Project
Supported by MEMISA Belgium, this project established community health rights groups in 30 villages across Birbhum and Murshidabad — two districts with persistently poor public health service delivery indicators. Groups of 15–20 community members, with a strong representation of women, were trained to monitor their local health facilities against government standards.
BITAN developed a simplified Community Score Card tool adapted for low-literacy users, allowing groups to rate their PHC against indicators such as drug availability, staff presence, cleanliness, and treatment costs. Scores were compiled quarterly and presented to block health authorities in joint review meetings — creating a formal accountability mechanism between communities and the health system.
Over five years, the project documented a measurable improvement in drug stock availability (from 52% to 81% adequacy) and a significant reduction in informal payments charged by PHC staff. Six PHCs were recognised by the district CMO for improved performance during the project period.
What We Did
- Formation of 30 Community Health Rights Groups (15–20 members each) across 2 districts
- Training in Community Score Card methodology — adapted for low-literacy participants
- Quarterly PHC monitoring visits — drug stock checks, staff attendance, patient interviews
- Quarterly joint review meetings between community groups and block health authorities
- Health rights education — entitlements under NHM, JSSK, and Swasthya Sathi schemes
- Grievance documentation and escalation — formal complaints registered with district CMO
- Annual district-level community health dialogue — sharing findings with state health officials
From the Field
Challenges & How We Addressed Them
Initial resistance from PHC staff — who viewed the monitoring as surveillance — was addressed by reframing the score card as a joint improvement tool rather than an audit. BITAN facilitated sessions where health staff could also raise their own resource constraints, building a more collaborative relationship that ultimately led to better outcomes on both sides.
“We used to be afraid to ask questions at the health centre. After our training, we know our rights. When medicines were missing, we wrote it in the register and brought it to the block meeting. Within two weeks the stock was replenished. We have a voice now.”
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