Indian Journal of Public Health

BRIEF RESEARCH ARTICLE
Year
: 2013  |  Volume : 57  |  Issue : 1  |  Page : 43--46

Assessment of village water and sanitation committee in a district of Tamil Nadu, India


SR Ganesh1, S Ganesh Kumar2, Sonali Sarkar2, Sitanshu Sekhar Kar2, Gautam Roy3, KC Premarajan3,  
1 Postgraduate Diploma in Public Health Management (PGDPHM) Trainee, Puducherry, India
2 Assistant Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
3 Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India

Correspondence Address:
S Ganesh Kumar
Assistant Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry - 605 006
India

Abstract

A descriptive study was conducted among 75 members of five Village Water and Sanitation Committees (VWSCs) and 15 local residents in Tamil Nadu, India to assess committee«SQ»s formation and decision making process. There were 64% females and rest were males, all aged between 20 years and 45 years. A total of 50.7% of them passed 12 th standard and 29.3% belonged to self-help groups. Although, all of them were aware about presence of guidelines, none of them knew its contents. About 20% opined that meetings were not being conducted regularly. All members said that they had problems in attending meeting regularly, take decisions if at least 10 (67%) members are present and fund was not adequate for 1 year period. One-third of local residents did not know the committee formation process and none of them aware about guidelines. Formation and decision making process of VWSC should be improved to tackle the sanitation problem.



How to cite this article:
Ganesh S R, Kumar S G, Sarkar S, Kar SS, Roy G, Premarajan K C. Assessment of village water and sanitation committee in a district of Tamil Nadu, India.Indian J Public Health 2013;57:43-46


How to cite this URL:
Ganesh S R, Kumar S G, Sarkar S, Kar SS, Roy G, Premarajan K C. Assessment of village water and sanitation committee in a district of Tamil Nadu, India. Indian J Public Health [serial online] 2013 [cited 2019 Dec 14 ];57:43-46
Available from: http://www.ijph.in/text.asp?2013/57/1/43/111376


Full Text

The impact of water sanitation and hygiene on disease was reassessed in a more comprehensive way, which estimated that almost one-tenth of the global burden of disease can be attributed to water, sanitation, and hygiene. [1] In India, 65% of its rural areas are without sanitation facilities and large parts of rural India face acute water shortage. [2] According to Census 2001 around 40% of people in the country still have unsafe water supply and sanitation problems. [3] Decentralization and people's participation have been considered key strategies for making health-care services effective as mentioned in all significant documents articulating people's rights to health such as Alma Atta declaration, Bhore Committee Report, and National Rural Health Mission (NRHM).

The Village Health and Sanitation Committee (VHSC) is one of the nine institutional mechanisms under NRHM initiated by Government of India in the year 2005. [4],[5],[6] It comprises of village health workers, Panchayat Raj Institution representatives, and members of Community Based Organizations and special groups who are marginalized, have the capacity and competency to do an adequate situational analysis of the local health status. They will have control over finances and budgets with built in systems of transparency to the public. [7] The District Health Mission would guide the activities of sanitation at district level and promote joint IEC activities for sanitation and hygiene through VHSC. [5]

Limited studies had been conducted in past to assess formation and decision making process of VHSC in India. Studies of such nature will be useful for policy makers in understanding the situational analysis of the existing system and appropriate corrective measures. With this background the study aims to assess the formation, decision making process and training of Village Water and Sanitation Committee (VWSC) and awareness of local residents about it in Viluppuram District of Tamil Nadu, India.

It was a descriptive study conducted in randomly selected five villages out of 26 villages present in Omandur Primary Health Center area in Viluppuram district of Tamil Nadu, India during November and December 2010. VWSC of each village comprised of 15 members and all the 75 members from 5 selected villages were included in the study. Furthermore, to assess the awareness of the local residents who were not in committee and did not receive any training, 15 subjects with 3 from each village were included. Information was collected from the Panchayat President, Village Health Nurse (VHN), Health Inspector (HI), and other members of VWSC and local residents using the pre-tested questionnaire and interview.

Ethical clearance and permission from the respective authority was obtained prior to the study. The formation and functioning of VWSC's were assessed by the pre-tested questionnaire prepared by the investigator using the guidelines for VWSC issued by NRHM. The questionnaire included general information, formation, decision making, and training of VWSC members. With the assistance of HI and VHN of the respective village, the appointment for the interview was obtained from VWSC Members individually over telephone. After getting informed consent, interviews were conducted at the place of their convenience. Data were analyzed by SPSS version 16.

All the 75 members were aged between 20 years and 45 years. Out of 75 members, 27 (36%) were males and 48 (64%) females. Fifteen members were there in each VWSC and in four committees more than 50% of members were females. About 24 (32%) of them belong to Scheduled Caste. About 2 committees had 2 members and 3 committees had only one member each as a representation from Non-Governmental Organization (NGO) [Table 1].

About 15 (20%) of the members faced problems in selection process. Although all of them were aware about the existence of guidelines issued by NRHM, none of them seen the hardcopy or softcopy of it, or the contents and information given in the guidelines. About 15 (20%) members opined that meetings are not being conducted regularly at all and others said that if VWSC meeting could not be conducted in a month because of fewer members on that day, they would postpone it to next month either by separate or combined meeting. According to 45 (60%) members, VHN or HI would be communicating the message regarding the next meeting in person. All members felt that they had problems in attending the VWSC committee meeting regularly and take the decisions if at least 10 (67%) members are present in meeting.{Table 1}

All the members informed that they received funds from District Health Society through Block Primary Health Center and was kept in a bank account jointly operated by VHN and Panchayat President. A total of 60 (80%) members said they had no banking facility in their village and all members opined that the fund was not adequate for 1 year period. About 30 (40%) members informed that they individually used to decide and identify the health related events, however, 45 (60%) said that they identify it by discussing with VHN and HI. All members had opinion that paramedical people such as VHN, HI, and Anganwadi worker, Accredited Social Health Activist are voluntarily helpful in prioritizing the public-health needs of the village. According to 44 (58.7%) members, Medical Officer of the PHC would help them when asked, but 31 (41.3%) members admitted that he had no direct role in the committee. Almost all (98.7%) members had received orientation training and training modules. Duration of training received was 2 days for majority of the members (97.3%), however, they were not asked for any feedback during the training.

Out of 15 local residents who were interviewed, 10 (66.7%) of them were aware about number and details of members required in VWSC formation. However, all of them were not aware about the guidelines of VWSC issued by NRHM and they didn't have any idea about the process of receiving the funds for VWSC.

Sustainable behavioral change of the people in the community and prioritization of certain control strategies are important to improve the sanitation status of the country. [8],[9] VHSC is a facilitating body for all village level development programs and reflects the aspiration of the local community. [5] Our study highlighted the fact that certain deficiencies exist in forming and decision making process in the committees and also low level of awareness among local residents, which are crucial factors in implementation of program.

The NRHM guidelines for VWSC states that 50% of the members of the VWSC should be females. [7] Considering the low female literacy prevalent in Viluppuram district compared to Tamil Nadu (the female literacy rate of Tamil Nadu is 64.55% and that of Viluppuram is 52.38%), [10] it is a very positive sign that women are coming forward to be part of the national development program. However, the guideline regarding representation of a teacher from the local school was not at all followed in any of the committees. All the committees were having representatives from various communities as per the guidelines. However, there should be five persons from NGO in every committee in contrast to our study. The reasons may be due to the fact that members might have been unaware of the guidelines or there were not enough NGOs ready to come and work in these villages due to relative remoteness of these areas.

Regularity in meeting increases the efficiency of VWSC's as was found in a study conducted in Karnataka and Uttar Pradesh by Water and Sanitation Program. [11] A recent study conducted in Orissa found that most of the participants had not seen the guidelines regarding formation of VHSC. Realizing the gravity of the situation, the Orissa government conducted a month long communication campaign to create awareness among general population regarding the benefits of forming Gaon Kalyan Samiti (VWSC). [6] When people involvement is ensured in their own health development activities, it will result in drastic improvement in their health status, as was clearly seen in Keerapalayam experiment. [12] A study in Uttar Pradesh showed that in majority of the cases the decision regarding the utilization of untied fund was taken by Auxiliary Nurse Midwife herself instead of VHSC meeting in contrast to our study. [13]

The study cannot be generalized to other states because of difference in the socio cultural factors, regulatory mechanism and lesser representative sample size. Mass health education, regular training, and evaluation of members will help to understand the guidelines better in the local population.

 Acknowledgment



We thank State NRHM Mission Director and District Health Authority for helping us in planning and implementing the project work. We are thankful to study the participants for taking part in the study and sharing their experiences.

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