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Overcoming caste barriers, mobilizing communities and achieving integrated development: Community-based primary health care experience in Jamkhed, India

Ketan Sudhakar Chitnis, PhD1, Raj Arole, MBBS, MPH2, Connie Gates, MPH3, J. Pandit4, and Lalanbai Kadam, VHW4. (1) School of Mass Communication, Louisiana State University, 211 Journalism Bldg, Baton Rouge, LA 70803, 225-578-3145, ketanc@lsu.edu, (2) Comprehensive Rural Health Project, PO Jamkhed, Dist. Ahmednagar, Jamkhed, 413 201, India, (3) Jamkhed International Foundation, PO Box 291, Carrboro, NC 27510, (4) Jamkhed, Comprehensive Rural Health Project, PO Jamkhed, Dist. Ahmednagar 413 201, Maharashtra, India

Comprehensive Rural Health Project (CRHP), Jamkhed, India pioneered an innovative community-based primary health care, through training village health workers (VHWs) and facilitating community participation. This comprehensive model is based on principles of equity, integration and empowerment. Communities learn to assess their problems, analyze causes (especially poverty, extremely low women's status and the caste system - all firmly entrenched in the society for centuries), and develop appropriate actions. One of the poorest regions in India in 1970, today; Jamkhed, has one of the best children's and women's health indicators, including in poor communities, in the country. In India, communities face severe human rights violations due to the deep-rooted and zealously practiced caste system. Through the Jamkhed process, the project develops relationships with the community, identifies socially active people in different castes, and begins the process of breaking down the caste system. CRHP has carefully orchestrated strategies to overcome the caste barrier by organizing community-wide sports and building wells in low caste areas that brought different caste groups together. The training of VHWs from various caste groups also helped overcome barriers. Using in-depth interviews, observations and survey data we document how communities have became aware of their problems and causes, and understood the impact the caste system was having on communities. Now people from low and out caste groups participate in the community in social, economic, cultural, political, environmental activities. As the project expanded, the community members who had experienced this process of transformation helped spread it to other villages.

Learning Objectives:

Keywords: Community-Based Public Health, India

Related Web page: www.jamkhed.org

Presenting author's disclosure statement:

Any relevant financial relationships? No

Thirty-Five Years of Community-Based Primary Health Care - The Jamkhed Experience

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA