Comprehensive Rural Health Project

The Comprehensive Rural Health Project (CRHP) is a non profit organization that provides health and development services to the rural communities in Jamkhed, India. Started in 1970 by Dr Raj and Mabelle Arole, CRHP today serves more than 300 villages and 500,000 people. CRHP is based on extensive community participation and concentrates on education, nutrition, water quality, sanitation, and health care services. Over the last thirty years the Comprehensive Rural Health Project has transformed the public health infrastructure in Jamkhed. Development indicators like maternal mortality and infant mortality are much lower than the national average. Incidence of malnourishment has gone down steeply.

History

The comprehensive rural health project was started Dr Raj and Mabelle Arole in 1970. After graduating from Christian Medical College in Vellore, India Dr Raj and Mabelle Arole obtained their residency training in medicine and surgery and Masters in Public Health at the Johns Hopkins University in the United States. During their training in the United States Dr Raj and Mabelle Arole conceptualized the idea of providing community-based primary health care to poor and marginalized communities in rural Maharashtra, India. After returning to India, the Aroles decided to work in Jamkhed, a poor and draught prone area in Maharashtra. The initial coverage of CRHP was limited to eight villages and a population of 10,000 villagers. But the program rapidly expanded and today covers close to 500,000 people across 300 villages. CRHP has received worldwide recognition for its development model. The model has been successfully replicated in other rural locations.

Jamkhed Model

CRHP has adopted a three-tier approach for providing health and development services.

• First Tier:

CRHP places bulk of its resources in community-based programs. This involves working with individual families at the village level to promote healthcare and socio- economic development. Community-based programs include health education, prenatal care, immunization and nutritional programs. A village health worker trained by CRHP administers the programs.

• Second Tier:

At the second level is CRHP’s Mobile Health Team (MHT). It acts as a bridge between the village project and the center at Jamkhed. The MHT consists of a nurse, social worker, paramedical workers and a doctor. MHT provides periodic support to the village communities and monitors project progress.

• Third Tier:

The third level is the hospital and training center located at Jamkhed. This location provides training to village health workers and community organizers on health topics. The center also provides surgical and

Training and Research

The Jamkhed Institute for Training and Research in Community-Based Health offers courses on community-based primary health care and development. The institute has successfully trained more than 10,000 grassroots workers, doctors, nurses, government workers, administrators, and students.

Community Programs

CRHP actively engages different community groups in their development programs.

• Adolescent Girls Program (AGP):

The adolescent girls program aims to empower girls in rural areas by improving their community participation. The program forms adolescent girl groups and educates them about health, social and cultural issues. This program has successfully reduced gender inequality and improved the status of girls in village communities.

• Child Development Program:

This program aims to support and encourage the development of disadvantaged children in village community. In Jamkhed, many families migrate in search for work. The Child Development program ensures continued education for their children. Along with education the program concentrates on balanced nutrition and proper hygiene.

• Appropriate Technology Initiative:

CRHP has pioneered the use of appropriate technology to improve the quality of life in the village. The use of solar cookers, solar water heaters and bio gas plants has provided the village communities with alternate forms of energy. CRHP has also developed a center for manufacturing prosthetic limbs, which empowers disabled people in the village.

• Farming and Sanitation Program:

The Jamkhed area is semi arid and drought prone. CRHP has helped improve farm yields by promoting modern agricultural techniques, encouraging farmer’s cooperatives and promoting techniques for water conservation. To reduce the occurrence of waterborne diseases CRHP has focused on hygiene and sanitation conditions. CRHP has introduced techniques like soak pits for wastewater management. They have also concentrated on changing behavior by disseminating information about good hygiene practices.

Expansion Plans

CRHP plans on scaling up its model and helping other non-profit organizations and government agencies to create similar projects.

• Bhandardara:

In 1990 some village health workers and CRHP field staff moved to Bhandardara to tackle health and malnutrition there. They helped facilitate the development of rural health clinics and launched development programs in the tribal regions around Bhandardara. With the help of local communities, pressing health and economic issues were identified and resolved.

• Adivasi Utthaan Program:

To improve health care access to tribal (adivasi) communities, CRHP, with the support of the Maharashtra government, developed health care programs in seven adivasi districts. The programs utilized the multi-tier approach, as followed in Jamkhed. Training topics include child health, nutrition, safe deliveries, and hygiene. The CRHP initiative also promoted government development programs targeted specifically towards tribal villages.

• Society for the Elimination of Rural Poverty (SERP):

In collaboration with SERP and the Andhra Pradesh government, CRHP has provided training to project coordinators, health professionals and grassroots workers from every district in the state. More than 14000 people have been trained since the program started in 2004. The lessons learned in Jamkhed are being applied to all the districts in Karnataka.

Awards

2011 Times of India Social Impact Award, Category: Health- NGO^[1]

2010 Gordon-Wyon Award for Excellence in Community-Oriented Public Health, Epidemiology and Practice^[2]

2005 Mother Teresa Memorial National Award for Social Justice

2004 Dr. Babasaheb Ambedkar Dalit Mitra Award for work among marginalized classes

2003 Diwaliben Mehta Award for Tribal Work

2001 Schwab Foundation Social Entrepreneur Award

2001 National Award for Work among Tribal People

2000 R.B. Hiwargaonkar Award for rural health service using Grassroots workers as Change Agents

1990 Padma Bhushan Award for Social Service

1988 National Council of International Health (now known as the Global Health Council) Award

1979 Ramon Magsaysay Award for Community Leadership^[3]

1966 Paul Harrison Award for outstanding work in rural areas

External Links

• http://www.jamkhed.org/
• http://www.prb.org/Articles/2007/LessonsLearnedCommunity-BasedProject.aspx
• http://articles.timesofindia.indiatimes.com/2011-09-26/lucknow/30203546_1_social-health-activist-jamkhed-magsaysay-award
• http://www.who.int/bulletin/volumes/88/10/09-064469/en/
• http://www.aarogya.com/index2.php?option=com_content&task=view&id=3112&pop=1&page=0
• http://ngm.nationalgeographic.com/2008/12/community-doctors/rosenberg-text/

References

1. ^ http://timessocialawards.timesofindia.indiatimes.com/organisation_details/9784867.cms
2. ^ Perry, Henry. "Recognition of Dr. Carl Taylor and Dr. Rajanikant Arole as Recipients of the Gordon-Wyon Award for Excellence in Community-Oriented Public Health, Epidemiology and Practice". American Public Health Association. http://www.apha.org/NR/rdonlyres/D7630DFD-3129-44E9-A240-67EEE738C64E/0/Carl_Taylor_Raj_Arole_2010.pdf. Retrieved 5 November 2011. 
3. ^ "CITATIONS for Rajanikant Shankarrao Arole and Mabelle Rajanikant Arole". Ramon Magsaysay Award Foundation. http://www.rmaf.org.ph/Awardees/Citation/CitationAroleRaj.htm. Retrieved 7 November 2011.