Institute of health management Pachod is the executive
body of the Ashish Gram Rachna Trust, a public trust, registered with
the Charity Commisioner in 1978. Preparations for establishing the Trust
began with the provision of curative health services in 1975.
The Marathwada is one of the most underdeveloped regions of Maharashtra.
This region experienced the worst famine of the century for a period of
three years, from 1971 to 1974. Aurangabad was one of the worst hit
districts. Women and children were effected the most by the famine. A
high prevalence of malnutrition and illnesses resulted in high maternal,
neonatal, infant and child mortality.
A young medical graduate keen to start a community health programme
heard about the need for health services in this drought hit region. The
challenge began in 1975, with the provision of curative health services
from a 5-bed hospital at Pachod, a small village in Aurangabad district.
The focus was on maternal and child health services.
It took one year to establish a self sufficient health facility. By
1976, a small group of committed individuals decided to register a
Public Trust to start a health and development programme in the area.
These were the founder trustees of the Ashish Gram Rachna Trust.
By early 1977, a team of health professionals consisting of two doctors,
a nutritionist and a demographer had got together to initiate a
Comprehensive Health and Development Project in 52 villages with its
base at Pachod.
Responding to the expressed needs of the community the health project
began with the provision of maternal and child health services through
Traditional Birth Attendants, Community Health Workers, and Auxiliary
Nurse Midwives.
The most impressive change was the reduction in mortality of pregnant
women and newborn children through interventions by TBAs. There are
hundreds of children and youth in the project villages today who might
not have survived even their first birthday had it not been for the
timely identification, primary levels service and referral provided by
these trained TBAs.
Another major change was the reduction in the prevalence of severe
malnutrition both kwashiorkor and marasmus as a result of nutrition
education, counselling and nutrition demonstration in the mothers'
kitchen with their own foodstuff. Gradually there were scores of fat
healthy children in the project area.
Starting in 1977, IHMP pioneered the training of TBAs, by undertaking
the most extensive study in medical anthropology using tools such as
KII's, FGD's, Body mapping, Freelisting and Ranking. These processes
documented by the Ford Foundation in the Anubhav series, were later
formalised as PRA techniques.
The Pachod Dai became a symbol of empowerment of rural women, which was
documented in 1984 by the Ford Foundation in the first set of "Anubhav"
series, a publication on ten innovative non government health projects
in India. Saminder bai a dai from village Dawarwadi, who represented
this empowerment has appeared since then on scores of VHAI and IHMP
publications.
Growth and Expansion After the initial success of the
programme there followed a stage of growth and expansion. The original 5
bed hospital was expanded to a 40 bed facility with excellent diagnostic
facilities. Construction of the new hospital was completed in 1983.
By 1986, the Trust had completed 10 years in providing health care in
rural areas. The trustees and partners of IHMP decided that this
experience should to be shared with other NGOs through training. In
1986, a national workshop was organised to assess training needs in the
NGO sector and the potential for starting a training centre. The outcome
was the establishment of the IHMP training centre that year. By 1990,
the IHMP had established itself as a reputed centre for imparting
practically oriented, hands on training in Community Health.
Consolidation and
convergence In 1997 it was decided to phase out the block and district level
involvements and consolidate the experience of the Institute through a
community-based programme planned along a life cycle approach. The
programme was planned with community involvement using PRA tools and
workshops and a high level of participation of all levels of the
Institute staff, over a period of one year. The Institute has acquired a
reputation for participatory planning and management in the field of
health and development.
Transition from rural to
urban By the early 1990s it was reported that 38 percent of the population of
Maharashtra was living in cities. It has been projected that by 2010
this will increase to over 50 percent. More than 50 percent of the urban
population is living in slums. There is no health infra-structure in
urban slum areas. People living in unrecognised slums suffer from
indescribable deprivation.
The Institute of Health Management
Pachod (IHMP) strives for the health and development of communities
through grassroots programmes, training and policy advocacy. The
Institute aims at the holistic development of the individual, family and
community and is deeply committed to the upliftment of marginalised
groups. Within the broad mandate of reaching the most disadvantaged
groups, it is committed to the health and development of women and
children.
The institute implements its programmes through organising and
mobilising communities toward self-reliance and sustainability.
Organising children and adolescents is a part of this mandate, which has
been conceptualised as health and development programmes for children,
implemented by them and through them.
IHMP has been working in the underdeveloped Marathwada region of
Maharashtra for the past 20 years. During this period, it has developed
and implemented several innovations in the field of community health,
IEC (information, education and communication), water and sanitation.
These innovations have provided policy options at the state and national
levels. IHMP's innovations are disseminated to the NGO sector through
its training programmes and to the government sector through policy
analysis, research and advocacy.
IHMP is an integral part of the larger NGO sector. It aims to strengthen
this sector through training, resource material and linkage with other
NGOs. Over the years, IHMP has successfully collaborated with NGOs
having expertise in non-health issues such as non-formal education,
agricultural development, vocational training etc. IHMP has provided
training to several hundred NGOs.
As a policy the Institute of Health Management, Pachod, undertakes
programmes with the aim of innovating new concepts, strategies and
methodologies of implementing health and development programmes in rural
areas and urban slums. The Institute believes that the role of the NGO
sector is to innovate and influence policy change in the formal
Government and NGO sectors. IHMP undertakes various activities directed
at provision of services, innovating, research, training and policy
advocacy.
The Institute of Health Management,
Pachod, (IHMP) is the executive body of the Ashish Gram Rachna Trust (AGRT),
which is a Public Trust registered under the Bombay Public Trust Act,
1950. In order to implement its programmes of health and development in
rural areas and urban slums of Maharashtra, AGRT has established the
Institute of Health
Management at Pachod (IHMP). All programmes and activities of AGRT are
implemented through this executive body, IHMP.
