The National Rural Health Mission (NRHM) was announced in April 2005 with the stated goal “to promote equity, efficiency, quality and accountability of public health services through community driven approaches, decentralisation and improving local governance”. These approaches were considered promising by the health movement in India and many individuals and organizations committed themselves to supporting this initiative out of a hope that it would better the health and lives of the most marginalized communities in India.
The State Health Resource Centre (SHRC), Chhattisgarh has been a key facilitatory agency for state wide health sector reforms in Chhattisgarh. In many ways, these reforms provided the experience that helped to fashion the NRHM. For instance, the Mitanin programme is largely recognised as the precursor of the ASHA programme that is a pillar of the NRHM. It was felt that the lessons learned from the SHRC should be used to motivate change in other parts of the country through an active engagement with the NRHM.
It was in this context that the PHRN was brought into being as a documentation and dissemination initiative of the SHRC Chhattisgarh with the support of the Social Initiatives Group (ICICI).It subsequently launched a pilot programme for capacity-building through a modular course on issues related to District Health Management in the states of Chhattisgarh, Jharkhand, Odisha and Bihar in order to accelerate and consolidate the potential gains from the NRHM. In particular, it focused on the NRHM elements of decentralized planning and communitisation that it considered could truly change the health scenario of disadvantaged people. PHRN has been active since 2005 and in 2008, it got registered in Delhi under Societies Registration Act 1860 (Act XXI)as Public Health Resource Society (PHRS) to lead and facilitate the activities of network with a team of full-timers. Many of its initial programmes are not currently in operation as it has refined and redefined its objectives and strategies periodically in accordance with the circumstances of its work as well as its experience. These are described briefly below in terms of their scope and outcomes:
- Distance Learning Programme (DLP): This programme aimed at strengthening technical capacities at sub-district, district and state levels to support processes that lead to achieving the NRHM’s goals of decentralization through district, block and village health plans and thereby accelerated moves towards effective, equitable, accessible and affordable health care for all. DLP was started in 2006 in four states of Bihar, Chhattisgarh, Jharkhand and Odisha. Across these states this programme had very useful outcomes that influenced the entire capacity building approach in NRHM. During a period of 6 years (till 2012) under DLP Programme PHRN provided training to 1051 students.
- Fast track Capacity Building of Public Health Professionals: The programme aimed to meet a sudden and vast human resource requirement for NRHM programme of the Ministry of Health and Family Welfare.It was implemented in several states where the state governments had shown willingness to go for “fast track “mode for capacity building of their staff, so that a large pool of public health personnel could be created in the states.The fast track capacity building programme was to be completed in three rounds for a particular batch. Each round was for six days with a gap of three to four months. The training covered a well-defined syllabus comprised of theory and \practical components.This programme was supported by the National Health Systems Resource Centre (NHSRC), and the state and regional level technical support/ resource agencies. A total of 1296 participants were trained till March 2012 under the Fast track capacity building programme.
- Post-Graduate Diploma in District Health Management (PGDDHM): Public Health Resource Network (PHRN) signed a MoU with Indira Gandhi National Open University (IGNOU) on 7th March, 2008 to realize its goal of building capacities of individuals, NGOs and government organizations engaged in the public health sector. This programme was specially designed for capacity building of AYUSH practitioners, Block Programme Managers, Divisional ASHA Coordinators, District Community Mobilizers, District Data Assistants and the health professionals engaged at the district level. According to the MoU signed, PHRN provided academic support to IGNOU which included providing counseling to the students enrolled, identifying counselors/experts, conducting contact programmes, providing study material, coordinating/facilitating the process of examination and assisting IGNOU in evaluating and quality assurance of the programme. PGDDHM was a one year distance learning programme organized in collaboration with School of Health Sciences, IGNOU. Four batches of PGDDHM Programme were completed up to 2013. A total number of 495 students were enrolled under the programme during 2009 to 2012 in 7 states of India namely Assam, Bihar, Chhattisgarh, Delhi, Jharkhand, Odisha and Manipur. Out of 495 students 145 were sponsored candidate of the state governments who were mainly working at the state and district level.
- Community Health Fellowship (CHF): The first batch of Community Health Fellowship (CHF) programme was launched in 2008 to strengthen the community processes in NRHM. It was an initiative by PHRN to support NRHM in partnership with the National Health Systems Resource Centre (NHSRC), the apex technical support institution for the NRHM; SEARCH, a pioneering NGO and the ICICI Centre for Child Health and Nutrition (ICCHN), a funding and research group. The CHF programme aimed at building a team of young professionals and dedicated youth with the perspective and skills to contribute to pro-poor community development work through the rest of their careers. It was a two year full time programme, which provided young development professionals a strong background in the field of community health. The programme nurtured, groomed and educated the fellows in the states of Rajasthan, Bihar, Jharkhand and Odisha towards enhancing and strengthening of community processes in the NRHM in the districts and grass roots level. Each fellow was linked to both, an academic mentor and a field level mentor.The first batch for the year 2009-2010 had 32 CHFs successfully completing the programme. Post fellowship the Fellows got placement in related fields e.g. NRHM contracts, allied services and NGOs. Some fellows started to work with PHRN. The next Fellowship Programme was implemented in 7 districts of Rajasthan with the financial support from Narotam Sekhsaria Foundation (NSF), Mumbai. This was a one year Fellowship Programme from February 2012 to January 2013. Initially, 10 Fellows had joined the programme, out of which 8 Fellows successfully completed the training programme.