NISHTHA in partnership with Unilever aims to enhance positive behavior towards improved health and hygiene in target communities by leveraging the existing platforms and community level interventions. In view of this, NISHTHA is supporting state governments in leveraging the Health and Wellness Centers platform under the Ayushman Bharat program for health promotion and prevention during health days and wellness sessions, where communities are educated on the importance of healthy hygiene behaviors.
NISHTHA, a health system strengthening project funded by USAID and implemented by Jhpiego is supporting Ministry of Health and Family Welfare (MoHFW) in strengthening the delivery of comprehensive primary healthcare through the Ayushman Bharat Health and Wellness Centers program.
In an exclusive interview with the Financial Express Online, Dr. Swati Mahajan, Chief of Party, NISHTHA/Program Director, Jhpiego shares about the hygiene and sanitation practices in India and the way ahead. Excerpts
Tell us about project NISHTHA and it’s work specifically in promoting better hygiene and sanitation practices in India.
NISHTHA aims to transform Primary Health Care (PHC) in India to ensure that it is equitable, comprehensive, client-centered and improves health outcomes for India’s marginalized and vulnerable populations, especially women and girls. A well-resourced and well-equipped, resilient PHC system is better placed to manage COVID-19 and future public health threats.
Reaching the last mile: leaving no one’s health behind. What is NISHTHA doing in this regard
The objective of Universal Health Coverage (UHC) is to ensure that everyone, regardless of who they are and where they live, have access to healthcare services without experiencing financial hardships. The Government of India (GoI) launched Ayushman Bharat (AB) program, with an aim to bring quality and affordable healthcare closer to communities. Aligned with the Sustainable Development Goals (SDGs) rallying call of “leaving no one behind”, Ayushman Bharat strives to achieve UHC through two inter-related components – establishment of 1,50,000 Health and Wellness Centers (HWCs) by 2022 to strengthen PHC and a health insurance cover for secondary and tertiary healthcare to reduce out of pocket expenditure for poor and vulnerable families. To ensure last mile coverage, NISHTHA has been supporting the national and state governments in strengthening the delivery of Comprehensive Primary Health Care (CPHC) through HWCs.
Your views on power of partnership in achieving UHC
At NISHTHA, we aim to facilitate strategic partnerships between the public and private sectors through establishment of platforms, alliances and advisory groups for CPHC in India. Large-scale improvements such as increasing access to basic health care and sanitation necessitates collaborative efforts at the local level and strategic partnerships between public and private sectors. Partnerships strengthen the capacity of projects and services to broaden their reach, engage more stakeholders and achieve shared objectives.
Private and multi stakeholder partnerships can help reduce gaps, improve quality of programs and empower communities to achieve health coverage goals and produce outcomes that are often more sustainable and long-lasting. NISHTHA is working with the government along with private sector partners, like Unilever, to reach out to populations with the greatest need for improved hygiene and sanitation facilities.
What is your perspective on the issue of access among vulnerable groups and its impact on the promotion and adoption of positive health and hygiene behaviour amongst them
Barriers to access and inequity continue to exist with regard to Water, Sanitation and Hygiene (WASH) among vulnerable communities. Experience from the field suggests that certain vulnerable and marginalized sections of society have been disproportionately impacted by the pandemic and the generic guidelines on management of COVID-19 are not feasible for them. NISHTHA is working towards creating awareness among various specific vulnerable groups including elderly, persons with disabilities, women and girls on safe hygiene practices.
How can we integrate WASH in primary healthcare services?
The COVID-19 pandemic highlighted the importance of strengthening WASH services at primary healthcare facilities. More recently, the SDGs shed light on UHC and access to safely managed water and sanitation services as key pillars of human security. Primary health care, along with access to safe and affordable WASH services play a critical role in infection control and preventing community transmission of diseases. Greater attention and investments are needed for integrating WASH in primary healthcare facilities, as they are the first point of care to safeguard health, prevent infections in households, schools, and health care settings.
What are the awareness programmes and initiatives for bringing best sanitation practices?
As a health system strengthening project, USAID-NISHTHA is working with state governments to improve availability of safe and hygienic sanitation systems in primary healthcare facilities to raise the overall standard of care. We believe that access to clean water and sanitation, along with good hygiene practices and the ability to effectively manage water resources, are key to promoting sustained sanitation behaviors, and keeping people and communities healthy.
We are leveraging the Ayushman Bharat Health and Wellness Centres for promotion of healthy hygienic behaviours and also working towards empowering communities to become more resilient and take charge of their own health. In Chhattisgarh we recently launched a model on Micro Resource Mapping and Demonstrating Cross-Sectoral Partnerships for sustained Healthy Hygiene Behaviors. This model is designed around the community ownership and partnership approach as the primary framework and aims to explore the mobilization of resources by building cross-sectoral partnerships and capacitating community-level institutional mechanisms.
The active mobilization of provisions available under the various government schemes will enhance the availability of resources to increase program impact and long-term sustainability for healthy hygiene behaviors in targeted communities by leveraging the existing platforms and community-level interventions.
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‘This too shall pass away’ this famous Persian adage seems to be defeating us again and again in the case of COVID-19. Despite every effort