HEALTH AGENDA PANCHAYATH

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Title
HEALTH AGENDA PANCHAYATH
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S'?)7995

POLYPATH!
SCHEME OUTLIHE
FEATURES OF THU SCHEME:,

The Scheme distinguishes itself from existing

ones in the following respects:
It is inter-disciplinery and integrated in its

i.

approach to Health care, incorporating elements such

as education,training, sanitation,drinking, water,
people's organisation and income generation.

,

ii. It can be implemented by small .NGOs, at the
grass-.root level over a three year duration.

>iii. It is intended for intensive work in a relatively
small geographical units(as against coverage by other

NGO schemes) with a population of 10,000,20,000 and

30,000 in_rural areas.
It places special emphasis on Primary Health

iv.

Care and Family Welfare Programmes.

The scheme is multi-dimensional, in two respects:

v.

Firstly, it goes beyond mere health care, taking into

account important social factors as mentioned in (i)above.
Secondly, the scheme accommodates traditional
systems of medicine such as Unani,Ayurveda, rfiture cure
and Homeopathy which are already acceptable to and widely
practiced by local communities, alongside Allopathy.

The terpi"Polypathy" has been used to underscore the Multi­
dimensional nature of the scheme.

The
vi.

scheme is accompanied by a manual designed

to guide applicants both in the preparation of a Project

proposal and its implementation.
yii.The scheme will be implemented in areas having

iCPR less than 35 per cent.

However preference will be

' given to projects taken up on areas having significant tribal

population.
>2,

I.

s 2
of the Scheme.

Objectives

:

Develop health awareness among the people about

1.1

conditions such
well as

as diarrhoea,

anaemia as

malnutrition,

their prevention and cure.

Facilitate the proper utilization of family welfare

1.2.

and health care programmes/services of the Government

arid HGCs such as UIP,

ICD3,

information dissemination,

|

etc,,

through a proces of

education and motivation.

Avail of various government programmes such as the

1.3-

■ National family

lanning Irog-a-me and Diarrhoeal Disease

Control programme to provide preventive and

probative

health services.

To spread awareness in regard to available netbods of

1.4.

contraception andto promote the acceptance of the Ismail

family norm.

I

1.5s To provide adequate training to all categories of
workers to upgrade their skills for better dmplemdnt at ion
of the I-roject.
1.6:

To establish linkages with other projects/

institutions dealing with other Social Sector Programmes
which influence the health and FW activities, ^uoh as,

National Drinking water,
DWCRA, JLRD1-,

and Sanitation Programme,

JRY,

etc with a view to obtaining benefits for the

target pcpplation available under these programmes >

II.

Target i-opulation
All age groups

10,000 to 30,300 population.

be covered,

including children,

are to

adult men, women,

elders

and the disabled.

III.

Duration

Three- years.

IV tersonnel for 10000 population

The following stsffis envisagedt1.Iroject Coordirator - 1
He- should possess

a minimum qualification of graduation.

contd....3/"

- 3 -

2.

Health Provided 1

He should have a minimum qualification of 10th pass.

]

In cases- where local candidates wi* r this qualification I

are not available, th3s qualification may be relaxed to
middle pass.
I

I"
3.

Supervisors -

per cluster with 5000 population,
qualification of 10th pass.

He should have a minimum

Graduation will be a desirable

qualification.

Swasthaya Mitra(Village level health worker) One for each
village having 1000 population.

He should be literate.

Desirable qualification will be middle pass.
V,Pattern of assistance

V.1 Non-recurring
A non-recurring grant of Hs.72,000 for 10,000 population

will be made available for the following:
^Training of staff

. Purchase of 2 cycles & 1-moped
. Conducting baseline survey

. Pv^fahase of emergency medical kit
N.B.. The grantee institution will not be permitted to

use funds to create physical infrastructure).

_•

Cost breakdown
a. Training_of staff

52,000

b. Purchase of 2 bicycles

10,000

& 1 moped

o'. conducting base-line survey

.

d. Purchase of Emergency

..

2^000

.

72,000

.

8,000

medical kit

Total (inJis.) •

V.2 Recurring:

An additional grant of Rs.2,63,0OO will be available
for recurring expenditure for the following:

.'Estt.Expenditure for staff

. Transport,Fuel,maintenance of equipment
. Low-cost medicines.replenishment of medical kit.
Cost Breakdown ('Annual) :

a.

Estt.Expenditure for staff
..4.

- 4 Health provider © Rs. 1500 P.M.

18,000

Lupervisers(2)
@ is.2000 p.m.
Swasthya Mitras (l)

48,000
1,80,000

© Rs.1500 p.m.

2,46,000

Total

Cost of transport, Fuel

b.
c.

d.

6,000

Low-cost medicines,
replacement of medical kit etc.,

6,000

Information?ducation & Communication
activities in the field of family Welfare

5,000
17,000

•Total
Total (

Note:

in Rs.)

'


2,65,OO«

No provision has been made for the salary
of the project coordinator.

This must be

borne by the implementing agency.
V.5

Instalments:

Rs.

Y ear I

5,55,000

Year II

2,65,000

Year III

2,65,000

Total budget

Rs.8,61 ,000

The total cost for projects covering a population of

20,000 and 50,000 will be proportionately increased,.
The release of grant will bo on the basis of 80-90$

coverage of eligible couples, eligible women & Children In the
target population.

POLYPATHY
MANUAL FOR IMPLEMENTING NGO

This manual is an outgrowth of the concern that most schemes^
are complicated, and not self explanatory.

This leads to unnecessary

difficulty, delay and confusion in the preparation of project

proposals.

The scheme, entitled *Polypathy: An integrated Primary
Health Care-cum-Family Welfare scheme for small NGOs' has been
designed to encourage even non-health oriented NGOs to enter

into the area of Primary Health care and family welfare.

This

manual has been designed to guide them, both in preparing a
project proposal under the scheme, and more importantly, in the

implementation thereof.
Activity cheekiest for implementing NGO

This scheme envisages the following set of activities

..5.

■ 5
t o be undertaken by the



time-frame set out in the Activity Chart
1.

as

implementing FGC,

er the

(Annexure A).

frepartory ’’ork

This will entail the following:
1.1.

Contracting pre-existing community groups: To

secure people's participation by discussing the scheme

with them.

Where they do not already exist,

such grouP® ;

must be mobilized, with an attempt to involve women and
the neediest

1.2.

(see 3 ii.

Selecting personnel: For purposes

Swasthya Mitras
each village

should

and 4).

of selecting

(SMS) nominations should be invited from

and

then screened during a camp.

ideally be female,

Nominees

in the 3^“^^ age-group.

Hiring of technical staff such as nurses,

doctors and

nutritionists should be consciously avoided.

Their

services may be availed of provided they do not entail

any additional expenditure to the project from the Govt.
grant.
.Job discriptions :

Coordinator
♦Cversee day-to-day running of the project

♦Disburse and account for all aspects of finance
♦Coordinate various inputs and their utilization'within
the project

Community Organisers

(Supervisors)

.

♦ trovide supportive (supervision to SMs

♦Maintain continuous links-, with panchay at leaders,
govt,

officials and

ongoing Govt. /1TGG programmes in

the Social Sector.
♦Monitor project implementation
Swasthya Mitras
♦Undertake motivational,
activities

in the field

at regular intervals

educational,

and communication

of family welfare.

* Distribution of condoms and Oral pills.

c ontd...6/-

: 6

:

* provide promotive and curative heal'd! & nutritional

care services to the designated population,
distribution of ORS packets,

including

Iron Folic acid tablets

etc..

* Record vital events, isuch as births, deaths incidence
of infectious diseases or as

,

instructed from time to

time.

* Organise local comtnunity and village level groups
\e.g. mahila mandals

andyuvak senghs)

* Maintain linkages with the sub-centre for coverage
of Family Welfare schemes.

*x-rovide health and. nutrition euducation to designated

families.

* Maintain constant link with the TBAs

and other

workers of the locality.

*

Identify andinform the

local community about various

development schemes of tae government,

and assisting

them in getting benefits available under the So^eee

* Kelp Community

in providing safe drinking water,

clean environment by interacting with concerned
local Government

organisations Swasthaya Mitra may

draw samples from drinking water sources for testing
by the

authorities and taking remiedial action.

'He may also assist community in chlorinating the.
water to make it potable.

* Help community in any other way to improve their
health standards and

to reduce their family size.

Health Provider
* Prepare and dispense medicines

* frovide curative services
* irovide treatment for common ailments using low■

cost Medicines.
mnel

'•n

•-

-t

s

. ...?/-

: 7

i

1 .J Training of personnel to impart skills
following,areas:

in the

*,

preventive and curative health work, with
particular emphasis on primary health and family
we If are ;

*

Motivation,

education and communication particularly

in the filed of family welfare;
diagnos is;

*

Community organisation and

*

appreciate management of the project and its

education.

sustainables

Training should be imparted to personnel for skill
development in the above specialised fields and other
related fields

identified by the training institutions

which may contribute towards best management arid

implementation of theproject.
Training to Swasthaya Mitras will be imparted by
the institutions

identified by the State Governments,

Per practice for

all other NGO Schemes.

as

This training

will be of at least two weeks' duration for appreciating
components of

Government programmes being implemented in

the field.

Training to Supervisors would be organised

at

the

nearest health and family welfare centres for a period
two months so that appropriate management,

finance [and

t-rogramme delivery procedures could be understood b,y them.

Training to Health Providers would be organised in

the nearest

ISM institute for a period of 3 months,

dispensing basic Ayurvedic remedies,

as

some Hom,gepathic

remedies would need some basic knowledge to diagnoise

differences between fevers emanating from different
disorders.
attachment of

Regarding Allopathic remedies one month's
the Health provider to the Male Multi

purpose Wokers Training Institution would, be arranged.
Thus the total period

of training for the Health provider

would be 4 months.
....8/-

: 8

:

For imparting appropriate training to all above
categories of ’.ersonnel it would be necessary to be

prepare training modules.

These modules will be

prepared by engaging consultants
printed at Government expenses

NGOs.

These modules,

of MCH,

andthe same would be

and made available

to the

apart from training in the field

Family Planning and Health Care,

will provide

for specific linkages to be built up by Swasthaya
Mitras and the Supervisors with the DWCRA groups

including

setting up of DWCRA groups where they do not exist.

The

Swasthaya Mitra would also be made a member of DWCRA and

the income generation would be accounted for 'to make
this

scheme sustainable.

categories will be on one

The training of all the above

time basis.

Baseline survey: to establish programme priorities.

1.4

An appropriate

proforma for conducting this survey should

lie formulated prior to starting work within the target

area.

Attached

proforma,

as

1Annexure B'

is an illustrative

si

which should be altered to suit the needs of the

community in the project area.

The survey.should be so

designed as to generate sufficient data with res pec ; to

the Family Welfare Programme.

This,

in turn,

should

enable the beneficiary .organisation to evolve a

'Tailor-made'

programme to cater to the family welfare component of

this scheme .

1.5

Net working:

agencies

to establish linkages with existing

(including NGOs).

Functionaries

national level programmes such as

.Welfare Irogramme-,

ICDS,

of existing

National Family

DUDA scheme

Malaria control,

and

Ulk should be contacted and consulted periodically.

The following linkages may be established at different
administrative

levels :

* At District Level:
Chief Medical Cfficer, Health (CMOH)
District Health Of f icer ;DHO ) , for

Family Hanning c MCE

\

District Hospital (.for referrals;
Other NGOs.

c ontd... .9/-

- 9 * At taluk/subdivsion level:
Panehayat

Sub-divisional Medical Officer
other 1'KJOs
* At. Block level and below:
panehayat

Mahila Mandals
PHC

CD?O,ICDS, DWCRA, IRDP
Health sub-centre( for referrals)
Traditional Birth Attendants(TBA)
1.6

Arranging premises

1.7
Developing a system for record maintenance,
monitoring and evaluation. I
2.2.

,

Family Wei fare & Primary nealth services

2.1 Curative s°rvices:using alternative systems of



medicine, e.g homeopathy,naturopathy,unani and ayurveda,

alongwith allpathy,curative services are to be provided by
the implementing agencies, without duplicating existing
Government services.

This does not preclude the provision'

of basic curative services to take care of emergencies/
common ailments especially in remote areas.

Priority may

have to be given to valneiable/at risk groups-, such as women ahd

children with special emphasis on issues such as women's
health,

family planning for both men and women,immunization

for universal coverage.

A combination of traditional systems of medicine and
alltpathy can be used to advantage.

For instance, allopathic

drugs are effective in the treatment of shock,profuse bleeding,
' dehydration resulting from acute diarrhoea.

On the other hand,

ailments such as coughs, colds and virql hepatitis respond well

to traditional medicines.

Proper guidance,however, should be

sought from adequately trained personnel when deciding upon the
course of treatment.( see "AnnexureC" for an indicative, list of

ailments and remedies under different systems)
2.2 Referral services to the nearest health facility, whether
Governmental or non-Gover)imental, are to be an essential, activitity.

If necessary, outlays may be made 5o cover transportation costs in
emergency cases.
10-

: 10:
i’resure groups rust be built up so as to activate

2-3.

the existing health, machinery and ensure effective
utilization of available services.

Communication 5 Education

3« Motivation,
In order to:
a.

Build self-reliance

in health care within the

community &
b.

’1-eriodically upgrade the skills of health personnel

the following activities are suggested:

i.

H-alth awareness meetings/cam"s : These

organised on s ecific issues,

Hanning , diarrhoeal disease control,
sanitation,

should be

e.g. fa-ily welfare and

hygience &

water and food borne diseases.

Home visits and direct interaction with the people

ii.

through pre-existing community groups such as mShila
mandals,

yuvak sanghs,

etc.

school teachers,

Training programmes for skill development, of

iii.

indigenous practitioners and

Note:

A. considerable

traditional dais .

part of this programme will

emphasize health awamess in the people,
home visits as well as group contact.

to

hopefully lead
of

reventive and

the government.

puppet shows,
media

through

This will

improved knowledge and utilization
cromotive health care services of

For this: propose,

use of posters,

street theatre and other lowdost. folk

is to be encouraged.

4.Community Organisation

The formation of

effective communijnity groups for

self-reliance in health should be given priority.

Ifehila m?ndals,

yuvak sangs.,

farmer's cooperatives

are some such time-tested groups.

existing,

(jhere already

such groups can facilitate the selection of staff

for the project and assist in conducting the baseline survey/
needs assessment).

11

5. Monitoring & Evaluation
To be undertaken periodically.
General

1.

Cost recovery

Fees should be charged for services rendered and fixetj in
consultation with, .the community.

Over time, the' concerned NGO

should be able to generate income from other sources such as

private donation, income generatidn projects' such as poultry,

fishery and agriculture.

This will help in covering the estimated

deceit' flri£t'hpcbud'get''of ’ the- NGO^and: all ow-.conjtinuity jOf the
programme., a£tp.r, tihe, cess^lon^of Government funds. Ruining

costs should be kept at a minimum to. ensure continuity,
,2. Income generation

..

A

.

,

■■ I

.

. J- .

Concerted effort should be made by the implementing agency

to avail of existing income generation schemes for the :SMb to
help them become self-reliant in the long run.

3.

Placements of SMs



Some of the SMs may eventually be absorbed into th°-Government
health structure und.er. programmes such as the, ICDS as and when

vacancies arise.
4.

Eligibility conditions

a) All Son-Governmental organisations/lnstitutlinns registered
under the following shall be eligible to receive the grants

z

under the scheme:

x

1. Indian societies Registration Act i860 •
2.

A charitable non-profit making company.

3.

A public trust registered under a’lAw for" ths ■•tinfe-being inforce

4.

Any registered non-financial.organisation,.engage^

in the conduct and promotion of Social Welfare.
b) Grant under the scheme shall also be admissible to

othbr rioniGovernmental organisations working in other
social sector schemes, which have registration under any of

the Acts listed at (a)above.
5.

Monitoring and ^valuation

The monitoring of the project .activities will be done
by the Medical Uffic»r of the Primary Health Centre,Mid-term
Evaluation by the sub-Divisional °fficer(Civil)/Deputy

Commissioner and final evaluation by the population Research

C ent res.
.12.

: 12

o.

regress Report

The MGO will be required to submit a six monthly
progress report in the

at Annexure

'D'.

f eseribed proforma attached

This report should besubmitted Ito

the Department of Family "’elfare after signature of the

Medical Officer in charge of the -rimary Health Centre
or Chief Medical Officer of the District.

7-

Procedure for submitting application for grants

1-roposals for grant-in-aid

attached

at Annexure

Secretary (VOF) Department

in duplicate.

in the prescribed format

'3' may be submitted to the Under

of Family Welfare,

New DeIhi,

One copy should be sent to the Deputy

Commissioner with the requfist to forwerdedhis recommendation.'!
>

in consultation with Chief Medical Officer to the Departtment
of Family- Welfare indicating clearly that:

1. The

grant-in-aid

asked for is justified for the
r■

activities included in the

2.

project report:

The organisations ishaving a dependable track
record and

is' capable of implementing the

iroject efficiently and effectively:

3.

Documents/reports submitted by the organisation

have been verified

and found to be

in order.

contd . . . 13/-

:

13

:

Annexure A

Activity Chart
; Activity

Titre Frame

1
Selection

Quarterly)

Year I
Year II
2341
234

1

I Year III
2
34

of Personnel

Needs Assessment
Training of Personnel

Preparation/
Procurement of
Medicines
Treatment of Common
Ailments, Preventive
<x iromotive Sefwices

Jommunity Education
tollective Action

Organisation of
Village Level Groups
Sstablish Linkages
■with •:Existing
Health Services

Income Generation
Activifies

Monitor ing

contd

14/-

- 14 • ANNHXURE-B
BASELINE SURVEY:COMMUNITY HEALTH

'

A.GENERAL & SOCIO-ECONOMIC STATUS

,

1. Head of Family......................................... 2. Address
5.

4. Monthly Incoms in Rs J

Occupation................................................

5. Religion

6. Caste

...................................................

7.

Type of House....................................Kuccha Pucca...............................

8.

Source of Water a.
I.Dug
a.

Well

b.
Own
b.I.Dug well

Sanitary Latrine

10.

Family Composition

No.

Name

Age

Sex

Hand pump

Tube well

Disposal of excreta Open field

9.

Mixed

Community ................................... .. .................
Tube Well
Hand pump River
Pond
’ piped

i’iped
Sanitary haxsi

Service latrine
other

Relation Marital
withHOH Status

Education

Opcupation

B.NEEDS
11.We would like to know if you have any problems
if yes' ,what are they:

No

Yes

12.What are the problems pertaining to health?
13.

Which of those stated do you think is the
most important problem for you and your family?

14.How do you deal with it?

Do you think you need some Jielp to sort it out?

15.

No

Yes

c.sickness pattern
16.1s there any one in your family who has suffered from any
illness during the last one month Yes
IfYes',

a.

Name of the disease/Symptoms:

Duration
b.

of illness:

Treatment
c.

given,where and bjr whom:

17.1s there any one in the Family suffering from
Prolonged illness Yes
If 'Yes'
Name
a.

No.

of the disease/symptoms:

..15.

No.

:15

:

of illness:

Duration
b.

c.Treatment given,

where cnd by whom:

D.BIRTHS & DEATHS

18.Have there been any deaths in the
.family during last one year.
If 'Yes'

No

Yes

of the deceased member(s:

a.Age

b.l-robable cause of death:

c.Was

d.

it registered?

'Yes ' ,

If

Yes

No

when .

19.Have there been any births in the
gast year
If 'Yes'

a. - lace of Delivery

Subcentre

Home

Other
b.Who conducted the

When
d.

:

(Specify)

Untrained Dai

Nurse

IHC Health Worker(ANM)

Doctdi?

Other

y

it registered?

'rivate „
Nursing Home

Trained Dai

del ivpr v

Was
c.

Host ital

IHC

.

z

(Specify)

No

Yes

3.MATERNITY HEALTH & FAMILY .WELFARE

Is t her e any pregnant women in your
house

20.

If

Yes

No

'Yes'

a.Eas she been examined by
some trained person
b.By whom

No

Doctor

Nurse

ANN

Midwife

Other

.(Sre cif y)

c . Is she receiving Iron^ &
folic acid pills
‘d .Has she been given tetanus
toxoid injection?
g , By

Yea?

No

Yes

1 d ose

2 doses

None
at a 11

wh om and When :

, f.Has there been a house
- visit by health worker

Yes

1o

contd.15 next page

. u ■
family planning methods

Safe Period

Condom

Jelly

IUD
[srecifyl

_Cther

22. Are you using any contractive

If

No

'Yes',

Duration of use:

23.Have you usedany contraceptive

If

1 Yes',

No

Yes

type of

Duration

of Use:

■24.Usage discontinued because

Wants. Children

Had/afraid of side effects

25«3id you suffer from any
complication following use
contraceptive

If

'Yes',

Abdinal 1‘ain

Fever

Discharge

of
Yes

No

Excessive bleed:ng

Other

(s ecify)

contd............ 16/-

be-filled in_for-Children below. 2 years
OPV

2.

Jource of Is^uniz,ati&m Out-Cut reach

3

Booster

123

----------- BCG

Meas les

Booster

1,' C- Irinary health Centre Eos-Eospital

3C - -^ub-Centre

* Imte of Ir.nunisation

nny of the following services
'Yes1

are

available

to You?

indicate their qua.l.ity_______ ■____________ _____________ ______ ;_______________________ _________ ____
Very good

Good

Satisfactory

.

Foor

Very rpor

by health worker
- ----------------io. Jub—Centre
_______
_'
2‘X<
-------------------------------------------------------------------------------------------------------------------------------------------q.UGO
----------------Hos.-ital_
e.
L-rivate
f.
Lector.
2_______________------- - - -- -- -- -- -- -- -____

Otherg.

(S.-ecify)

_

contd

16 next page

-18-.b. How do you think these services

cen be improved? ...

g. health information............................................................................ ................................................................................................

28. Where do you get most of your heflth information from
Health worker
Radio '

Doctor
TV

Neighbour
NGO

Relative
other

Friend

Newspaper

29. When someone falls ill what do ycu normally do first:

Use any home remedy
Discuss with Neighbiur/Friend/rilative.&. do what they suggest

go to nearby chemist shop and buy some medicine

discuss with health worker
consult your doctor

H.OBSJ1VATIONS AND COMMENTS

Resjondent^Signature or Thumb ^impression)

....................................................................... .. ...............................

Investigator

D

..17,



I



Indicative List of Ailments and Remed ies under Different
Systems .

I.

AYURVEDIC REMEDIES
Ad u Is a
Kalp/Vas avaleh/Vararis th

1 .Simple cough
2

.Leucorrhoea

Musali Kh’and

3.Inadequate Lactation

Satavari chum

U.Burns

Dbatura Ointment

5-Dysentery
6.Malaria

Kutaj ghan Vati

♦KaranJ churan/Phitkari/Bhashm
Jvarakush ras
7-Typhoid
Sanjivini bati/Guruch/lCadha
Jwarankusb. ras
8.Sim.le cold & Fever .... .Tribhuvan Kirti ras/
Tulsi juice with honey
.... God anti bhashm

9.Influenza

.... Ram ban ras./Bel chur,an/juice of
Kangi leaves + Curd
Shank bati/Rbots of
bhatkatiya + gud

10.Diarrhoea

11.Stomach ache

12..He ad ache

.

... t Kapur/Eucalyptus Oil •+ Vaseline
(ointment) Godanti Bhashm
Juice of doov or arusal/
jrhitkari + Milk
health & Vitality '.'. . . Chavanprash

13-Bleeding from'.'
I^.Gehral gocd

<

II. ALLOPATHIC REMEDIES
1.

'

Worm infestation .

2.Diarrhoea

Piprazine citrate

....*..

.Fyrozolidine

3..Fever ...

.Paracetamol

^.xheumonia5-Asthma

1 .

6.Allergies

.

Co-t-rimoxazol
. .Aminophyll in/Solbutamol

..... Chla.ro phen erm in
Ma1liate

7-Scorpion bites

.

Lignocaste

.

8.Post Parturition bleeding.
9.Aches & Fever .
10.Biols',

.'

Methargin

.....'

Cuts, .abrasions.

11.Meliess.

;

.

." .

.Chloroquin,

.

Asprin
.Mercurochrome (Tincutre

Frimaquin

.18/-

III.HOMEOPATHIC REMEDIES

1. Common Cd>ld
* Sneezing, irritating discharge
'


Aresenicum Album,every
1 to 3 Mours

Watery coryza with w-eakness

according to severity
of tho case

* Hose blocked in children

Sambucus 30, every
3
hours

* Tendency to batch cold

Sulphur 200,
one dose for a week
Calcaroa carb 200, one dose for the

next week

2.

.........................................................
.

Tuberculimum 200, one dose for the
week after

...................................................

To be repented again this order

•—

Coughs
*>Dry,irritating cough..
justioia 30, every 1 hour
* very loose rattling cough
A.ntimoniun tartaricun 30 every 3 hrs.
*'cough with thick ropy expectoration, . 4. .■ oo»cus cacti 30,
every 2-4 Jirs.
I

2. Whooping cough

* In the oarly stag?

....................... Drosera, 3 doses every 4 hrs.

* Violent spasm of cough with face. ........ cuprum 30,every 2-4 hrs
turning blue
4.

Agthna

* As$hmn in children-1pe-cac 30, every 2 Jirs
* In difficult cases

with

.

balttn orientlis Q,alternately

..................... '.'IGrindelia robusta Q.5 drops in water
............... Every half an hour

5.

Headache

* Right sided headache may be
accompanied .by vomiting..

.

* Left sided headache hours according
to severity of case

sanguinaria 30, every 1 hr;
.. if relieved then every 2 Juts.

Spigolia 30, every
1-2 hrs

* Bursting, Violent headache with. .......Meliotus officimalis JO,
no apparent relief1
every one hour.

-^) -

* Head.-tche in tired woemn with

Sepia 30,ovary 4 .Jiourg

disturbed racnsus

6.,Vomiting

Ipoaac 30,Arsenicum Album 30
Alt ernat ely every 1' hr

* Vomiting with diarrhoea

* Vomiting of nilk in children.., Aothusn 6 every 3 hrs

Symphytum 30,every 4 hrs.

. * Vomiting during pregnancy
Pain in St orach and Abdonen

7.

* Pain in stomach after eating..

Abies nigra 6 evsry 1-2 hrs

* Pain in stomach,much acidity..

.Natrun phosphoricum 12 and
Calcarea

Heartburn

Phosphorica 12,alternately
every 2 hours

Colocynthis 30 every l/2 to
1 hr.

* Colic in infants

China 30,every 6 hours

8.Diarrhoea, worse from eating or
drinking anything, watery stool

* Diarrhoea in children during
Chamomilla 30, every 2 hrs.
dentition when they are irritable
* Chronic diarrhoea
Sulphur 30, in the moaning
Nux vomica 30 at bedtime,
Natrum sulphuricum 12x and
calcarea phosphorica 12,
every 6 to 8 hrs.

9.

Itysentery
* dysentery with high fever in

Aconitum 6 every 1'hr
early stages if better every
two hrs

Ipecac 30,every 1-2 Jirs

* Dysentery with great nausea

* In children when irritable



Chamomilla 30, every 6 hrs

10.Choiera
*Preventivo .. Cuprum arsenicosum 3 every.-i 2 hrs
i
*First remedy in case of cholera .. camphora 39,^ drops
in water dr sugar every
15 minutes

*In severe cases, where collapse occurs- carbo vegetabtillis
,
30 every 15 mins.

11.

Pev-TS
*simple fever....

ferrum phosphoricum 6x,kali Muriaticum fix,3 tablets
each every $ hrs,

..20.

Malarial fever with chill and
s.hivering on

intermittent fever with chill

Caesalpinia bonducella 6
every 4 hou re one day and the
other day appears with slight chill

Alstonia constricta 6 every 4 hrs

1 2. Preventives
* Measle

* Influenza



Pulsatilla 30 twice daily,
Morbilinum-200 once a week, Arsenicum
album 200
dose daily
Arsenicum album 200 1 dose daily

* Typhoid

Arsenicum album 200 1 dose in 4 days
Baptisa 3x,3 times daily

* Whooping cough

Pertussin 200, once in 4 days
Drosera 30 twice daily

* Di pt he ria

Diptherinum 200 once in four days
Mercuricus cyanatus 6x twice daily.

13.Wounds
* contused wound

Celendula Q locally, Arnica' 200 1
dose for
shock followed by calendula 30 every
2 hours

* Stings, insect bites

Ledum 30 every 3 hours

* Burris

Canthar is 30 every 4 hrs.

14 .Boils

* As a rutine remedy

Arnica 30 every 3 hours

* Very painful boils

Hepar sulphuris calcareum 30
every -2-4 hrs.

Progress Report of the work Done

Name and Addregg of the organisation
1.

-Period <?f the Report

Name of the Project

2.

Date of Commencement of the
Project

3.

Name of the office bearer of
organisation supervising the
project

4.

Needs assessment of the target ,
population as per the base line survey
a)
'General
and socio-economic status
b)
Sickness pattern
c)
Birth and death rates
d)
Mother and, child health and Family Welfare
e)
Health SAvvices f) I3C
-20-

- 23 ‘

5. Position of;
a)

Selection of personnel for the project and their training

b)

Preparation/Procurement of medicines

c)

Treatment of common ailmentspreventive and
promotive services element-wise figures to be given
community Education for collective action and
organisation of village level groups(the information
should specifically indicates number of meetings and gettogethers etc, and’the village level groups actually
organised^.

d)

6.

Details of linkages with H.3aith Services etc, established

7.

Details of income generation activities.
Performance for Family Planniig

8.

I)

Number of eligible couples motivated for acceptance
of ono of the following methods arid the humbar of them
who received necessary services from the Primary "ealth
Centre etc.,,
- Sterilisation

Tubectomy

Vasectomg

IUD Insertion

Oral Pills

Contraceptives

Iron folic tablets
2)

MCH
Total number of eligible women

Number motivated and referred to PHC/other
Hospitals for service with details
Actual number who received services with- details

3)

Total number I of eligible children No.Provided immunisation

as a result/motivation by the NGO information’£0 be given dose­
wise.
No.of ORS packets distributed

Name and signature of the General Secretary/President
of the organisation with seal of office

CERTIFICATE;

/ ’

Certified that after personal examination 6f the records
of tho Organisation and Primary Health Centre I have found
that the information given above about th j physical perform
the organisation is correct the IUD Insertion, sterilisatic
and MTP cases were done in the primary Health Centro with
motivation by the NJOs

Name and signature of the Medical
Incharge of Primary Health Centre
Medical Officer of the District

APL’LICATlor FORM

ANNEXURE-E

1. Name of the Organisation
2, Registered Address

Registration Number(with jlct/dtatute under
which! registered)

3.

i
4.

Financial status of the organisation
1)
Total income during the last three years
Total assests during the last three years

2)

5.

Details of Health/Family Welfare Infrastructure/personnel I
available tri.th the organisation

Health and Family Welfare workers in empljyment

6.

■ Designation
7.

Qualification whether on full time or part t_jjn.s_ba_g_i

Previls activities of the Organisation, especially in relation
to Family Welfare

Si.No,
8.

Nature of activities'place where undertaken with dates.

Amount of grant-in-aid required(item-wise
i) Recurring
ii) Non-Recurring

9.

Duration of the project

10.Project area
1) No.and name of the villages with population of each
2) complete addresses of the Centro from where the project

will ba implemented

11.Total population
1) Eligible couples
2) Couplss which arc already protected by
i) Sterilisation 11) Oral'pills (iii) IUD iv CC

1 1A Eligible women
11B Eligible children (position of coverage for MCH services by PHC)

■1

12.

Complete Address of the .-Primary Health Centre/Hospital/
Dispensary which will be providing services and materials.

13.

Targets to be achieved ••
1) For Family Planning
2) Treatment of common ailments and prevention of diseases

3)

Community Education & organisations of Village
level groups

4)

Establishment of linkages with existing
health setvicos/other NGOs

5) Income generation activities

6) Any other relevant information.

Name and Signature of the
General Secretary/President of the Organisation
■ with seal of office

Vs/-19895

POWERS , FUNCTIONS AND RESPONSIBILITIES OF PANCHAYAT IN HEALTH CARE

1. Assist in development of Taluk and district level hospitals.
2. Assist in identification of beneficiaries and supervision for the eradication of

Tuberculosis, Malaria, AIDS, Leprosy and other dreaded diseases.

3.
4.

Assist in establishment of dispensaries in Tribal areas.
Assist in identification of beneficiaries for benefiting under Mobile Medicare unit
services in the remote localities.

5.

Assist to identify beneficiaries and involve public in prevention and control of
diseases.

6.

7.

Involvement of NGOs in conducting Eye and Family Planning camps.
Implementation of construction, supervision and maintenance of primary health
centres and maternity centres.

8.

Creating awareness among the public about the importance of health
environment and control of diseases.

9.

Assist in providing financial assistance and identification of beneficiaries to
conduct training for Multi Purpose health workers of PHCs.

10.

Assist in implementation of immunization against Diphtheria and Polio for

school children.
11.

Implementation and supervision of maternity and Child health centers.

12.

Implementation of school health scheme.

13.

Implementation of Birth and Death registration.

14.

Implementation and supervision of sanitation activities.

1 5. Recommend and assist concerned officials in extending the service area of the
primary health centers and health sub centers.

16. Assist in training of the nurses and doctors and other employees of voluntary
organisation through District training teams for the benefit of the villagers.

1 7. Identify qualified and competent officials in extending the service area of the
Primary health Centres and health Subcentres

18.

Identify qualified and competent persons among the practitioners of Indian

system of Medicine and encourage the use of indigenous medicine.
19.

Render necessary assistance to health workers in compiling statistics relating to

pregnant women and women in reproductive age so as to provide health service

to the target groups.
20.

Collect data on causes of various diseases that affect children and inform the
concerned officials to take up remedial measures.

21.

Encourage visits by Junior Health Assistants and MPWs to households and create
awareness among public for proper utilisation of health services provided by the
health and Family welfare dept.

22.

Ensure availability of essential life saving drugs in the Primary Health centers and
sub centers on continous basis.

23.

Ensure regular health appraisal of primary and elementary school children,

maintain their health records and arrange treatment got the ailments , keep
health record of adolescent girls identify their nutritional needs and other
ailments, organise treatment and to promote health education and nutrition

education in schools. Ensure healthy , Nutrition and population education in

schools, and coordinate the services of the concerned departments in this
regard.
24.

Ensure and encourage periodical visits of the health team to schools to watch the

health status of the school going children.
25.

Form village health committees, comprising Panchayat president as Chairman,
Junior health Assistants, Traditional Birth Attendants, and other key people in

village to form the committee.

26.

Identify endemic and communicable diseases and also complicated diseases and

assist workers of Health dept, in providing necessary medical services and

arranging referral services.

27.
28.

Conduct village health and medical check up camps.
Village Panchayats may render assistance for implementation of Food

Adulteration Act 1954.

29.

Ensure chlorination of open water sources and clean them periodically. Ensure
cleaning of the private water tanks and community latrines and protect the

drinking water sources from getting contaminated.
30.

Construct and maintain drains to dispose of wastes and drainage water in order
to prevent the stagnation.

31.

Organise disposal of solid wastes from disused wells, tanks and ponds in order
to prevent hazards to health and also to protect the environment.

32.

Enforce provisions of Public Health Act 1939 in respect of drainage and

sanitation and thus protect Public health .
(G. O. Ms No. 220, Rural development (C.l) Department, dated 4.7.97.)

(G.O. Ms No. 272, Health and Family Welfare (L—1) Department, dated 5.7.97)

STRUCTURE OF PANCHAYAT RAJ SYSTEM IN
KARNATAKA

Minister of Rural Development and Panchayat Raj
Secretary Rll & PR Department

Chief Executive Officer- Zilla Panchayat

Executive Officer - Taluk Panchayat
Panchayat ^Extension Officer
( for every 10 panchayats)

Gram Pancnayat - Secretary
( deputed from Govt department)

Eligibility for Membership in Gram Panchayat

1. He / She should be of 25 years of age
2. He/ She should have a toilet in their house.
3. He/ She should not have any criminal records against them.
4

. He/ She should be domicile of that village.

Meetings of Gram Panchayat :

Gram panchayat should meet atleast once in 2 months. In this meting all the
programmes of the various villages in the panchayat are discussed.
Gram sabhas :

is meeting of all the electorate in the village . This meeting should discuss the
following : all the development programmes in the village during the last 6
months, planning for next six months and budget for the programmes.
Funds for the Gram Panchayat :

Every Gram Panchayat will receive the annual grant of Rs. 2 lacs from the
Govt. Apart from this they will also get the money from various development
schemes in the village like SGSY ( earlier called IRDP). But from this SGSY
grant atleast 25% should go SC/ST population of the village
Apart from these sources Gram panchayats also raise the money from taxes,
rents for the buildings etc.
Standing Committees : All the three tiers ( Zilla, Taluk, and Gram ) of

Panchayat systems Karnataka have standing committees as support to their
activities . These committees are Facilities committee : which look at all the facilities available in the village
like, schools , housing, lights, roads etc.
Social Justice Committee : which look into various litigation in the village.
Along with this, committee will also look into issues like Child Labour,
Devadasi system etc.
Production committee : Which looks into all the sectors from which Gram
panchayat can get the revenue, i.e Agriculture,Fisheries, etc.

Sankalpa

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- influencing educational governance at the Gram Panchayat level
the scope of this process to other districts in the state. This
took shape in the form of 'Sankalpa - a statewide
process to facilitate the role of GPs in the process of
education reform'.

Prajayatna's perspective on educational governance
The issue of governance in educational reform and the
associated concept of decentralisation have been integral
to the work of Prajayatna. The question of
decentralisation hereby is not seen only as an alternative
to an ineffectual centralised system but instead as the
only way of functioning.

Planning at the GP level
To initiate the process, it was decided that Prajayatna
would facilitate a process for Presidents and Secretaries of
both GPs and SDMCs in 19 educational blocks (of 18
identified districts). In addition to starting a discussion on
the role of Gram Panchayats in education reform, the
objective was to facilitate the training of Education Dept
functionaries - the Block Resource Coordinators (BRCs),
Block Resource Persons (BRPs), and Cluster Resource
Persons (CRPs) - as Master Resource Persons who would
take up subsequent processes with the GPs in the
remaining blocks and districts.

Inextricably linked to this proposition of a decentralised
framework is its approach towards measures of
governance - power, legitimacy and capacity to access
and utilise resources - distributed inequitably across the
different stakeholders, in the prevailing social and
political structure. It may be noted that in speaking of
decentralisation, there is the caveat of not treating it as an
oversimplified issue of efficient logistics or technicalities
of distribution of powers that would ensure immediate
results; since communities would first have to deal with
an education system, the design of which for several
decades now, has largely alienated local schools from the
local communities.

Raising primary concerns of 'how have we as communities
understood the education system1, and 'what is the
relationship between the community and the school', the
workshops with the GP and school committee members
began with a discussion on these issues in the context of
the status of education in the different Gram Panchayats.
The nature of discussions across the 19 educational blocks
varied, in keeping with the socio-economic and cultural
background of the area and the priority accorded to
education. For the first time, members of the Gram
Panchayats and School Development and Monitoring
Committees sat together to identify and prioritise issues
and discuss resource-mobilisation to effect change. The
meeting concluded with asharingofthe jointaction plans
by the GP and SDMC functionaries for every GR

The process would therefore entail sound institutional
arrangements that enable truly empowering terms of
engagement between the different stakeholders. An
empowerment that gradually engages the people,
depending on the level at which they currently are, and
gradually increases the scope of their responsibility;
rather than tokenistic participatory measures, left to the
discretion of existing structures and processes. The
engendering of a concept of governance that engages
the state and civil society through structures and
experiences where they assume responsibility, with a
sense of ownership, becomes expedient.

I

Taluka-level follow-up process
Subsequent to this process facilitated for over 680 Gram
Panchayats between Jan-Mar 2003, a follow-up process
was facilitated at the taluka level in each of the 19 blocks.
This process highlighted initiatives undertaken by almost
all of the participating GPs across the 18 districts, based
on the action-plan prepared at the first workshop. Many
of the activities undertaken towards school development
reflected for the first time a joint effort made by all the
stakeholders-the Gram Panchayats, the school
committees and representatives from the education
department (the cluster resource co-ordinators
representing 2 GPs). The work implemented includes
provision of drinking water, construction of toilets and
compound, registration of land, levelling of playground
among other issues. In case of issues not being resolved at
the Gram Panchayat level, efforts were made to ensure its
addressal at the Taluk and Zilla Panchayat (TP & ZP
respectively) level. Funds from the TP and ZP were
accessed and rooms constructed after identifying places
where extra rooms or school repair was required. As the
initial workshop also highlighted the availability of
resources in Sarva Shiksha Abhiyan scheme(SSA), many
infrastructural issues were addressed with the support of

Effecting educational governance at the GP level
It is based on this perspective of educational governance
and community ownership that Prajayatna, over the last 2
years, initiated processes with the Gram Panchayat (GP)
Presidents and Secretaries in 28 talukas (across its 6
districts of operation) to discuss their role in facilitating
education reform. The process involved a dialogue with
the GP members at the block level to share detailed GPwise school information, discuss the role of different
stakeholders and evolve a GP level school development
plan, both in terms of facilitating collaborative structures
with the SDMCs as well as enabling them towards more
efficient utilisation of GP funds for educational purposes.

At a meeting with the Commissioner for Public
Instruction, (Dept of Education, GoK), while sharing this
experience across the 950 Gram Panchayats and the
visible impact on school development, a similar concern
was reflected by the education department
functionaries - to enhance the role of Gram Panchayats in
education reform. Further meetings led to a partnership
between Prajayatna and the Education Dept to extend

Projj3.ij0H„a ; Nov 2005

I

this fund. Some of the Gram Panchayats also worked along
with the school committees to improve children's
attendance and enrolment, especially in areas where the
dropout rate was higher.

proximity to their district) and were supported in
understanding the issues from acommunity's perspective.
The feedback received from these district resource teams
included the following:
- Initially some of the functionaries had apprehensions
regarding the planning and implementation processes
initiated by the communities- in terms of whether the
communities could plan and implement by themselves.
Also in keeping with their experience they were not
very positive about the Gram Panchayats and school
committees being able to work together. The visitto the
Prajayatna's working district enabled the resource
persons to understand a new perspective about
community ownership which was not tokenistic but
more determining; the role of stakeholders becoming
clearer in the light of ownership, the kind of relevant
and accurate information required for effective
planning and what the process of facilitation actually
implied.
- They also shared that for the first time, this process was
more participatory ratherthan being pre-designed with!
little or no role for the participants. This they though"
was contrary to a classroom training process usually
conducted by the department wherein the participants
are mere recipients, who just have to implement what is
being instructed by the "master trainer."
- This kind of participatory learning process, they shared,
provided greater opportunities for learning and
understanding of issues based on their individual
learning approach. The entire programme was very
process oriented, which they thought enabled them to
understand more clearly why it was important for the
Gram Panchayats to play an important role in
educational reform, rather than as a scheme where a
certain number of trainings had to be implemented as
part of departmental targets.

Redefining the planning process
After the follow-up process, a planning meeting was held
with the Director and Joint directors -Primary Education,
Principals of the 6 Colleges for Teacher Education (co­
ordinating the Sankalpa process in the districts), DirectorDSERT, the State SSA team and Prajayatna. The meeting
was primarily to discuss the future course of action
following the impact of the Sankalpa process so far. While
initially, there was a discussion on extending the Sankalpa
process to newer districts, it was decided to first initiate the
process in the remaining talukas of the 18 identified
districts.
On Prajayatna's suggestion it was decided that rather than
plan the entire process at the State level, a district-level
meeting should be held in the 18 districts to plan with the
respective district officials and Edu Dept representatives
and the elected representatives at the district level, the
process of implementation in the remaining blocks of each
district. It was proposed that the meeting would also
include the identification of 5-8 individuals as resource
persons for the districts, who in turn would be supported by
Prajayatna to take the process forward. The process of
facilitation would require the district resource team to visita
Prajayatna working district (in their proximity) for a 3-day
programme. This would involve accompanying the
facilitators to field-level processes, observing initiatives of
Gram Panchayats and SDMCs, followed by discussion
about the implementation plan.
District level planning meetings
Over the next 2 months (Sep-Oct 2003), 18 district level
workshops involving the Chief Executive Officer, the Zilla
Panchayat President, all the Block Education Officers in the
district, the Block resource persons, DIET lecturers, Deputy
co-ordinator for SSA (district representative of the
programme) were facilitated. These meetings were the first
instance of joint planning between the bureaucracy and the
elected representatives, for a district programme on
education. It was observed that earlier even if there was a
district-level meeting, it was largely to discuss
implementation of already formulated plans. Planning
based on the feasibility and need of the district ensured that
the understanding of all the stakeholders regarding
implementation was inherent in the planning process itself.
In all about 1000 functionaries participated in these
meetings across 18 districts.

Taking the process forward
Prajayatna's framework of community ownership
represents a relationship between the state and civil ,
society that goes beyond either a lesser role of the State or
a condition where the state merely provides inputs within
its existing bureaucratic framework, leaving the rest to be
addressed by the community. In fact, it is posited that
community ownership necessitates a redefining of
relationships between the state and civil society that
operates within a structured non-statal framework, as
determined by the community's articulation of its needs.
Consequently, this would involve that the state finds
appropriate ways to relate to the new community
institutions, as shaped by the communities' articulations.
Operating from such a paradigm, Prajayatna would
continue to work towards playing a facilitative role to
evolve new structures and processes that would in turn
redefine relationships between the state and civil society.

District level facilitation of resource persons
Following the district level planning meetings, Prajayatna
facilitated 116 resource persons (including Block resource
persons, DIET lecturers, SSA team) from the 18 districts who
visited Prajayatna working districts (depending on the

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