Healthy Communities: Women Village Health Workers in Rural India

BACKGROUND: Healthy communities in rural India are promoted through the work of local women Village Health Workers (VHW) who are part of the Comprehensive Rural Health Project (CRHP). For more than 40 years CRHP, begun by Drs. Mabelle and Raj Arole, continues to promote sustained physical and social well-being through health and development programs in Jamkhed, Ahmednagar Dist. CRHP addresses basic social and economic concerns identified by village communities, themselves, to eliminate preventable and endemic diseases. For example, in the first five years of the program IMR of 176/1000 was reduced to 52/1000 with applied practices of prenatal and infant care introduced by VHWs. This paper describes how women Village Health Workers participate in CRHP health and development projects and dramatically changed village profiles by managing basic health care, and establishing women's clubs and self help groups that contribute creating healthy village communities. METHODS: Anthropological ethnographic methods and life histories are used to compile data of women's lives and to examine generational change. 34 VHWs each representing one village of 132 eligible (26%) completed the full interview over a period of 3 years. RESULTS: VHWs participate reducing IMR to 24/1000; eliminating local endemic conditions like scabies and guinea worm; leprosy and TB reduced to negligible percentages; CBR decreased by half: 99% childhood immunizations; and 99% prenatal care. CONCLUSION: CRHP health and development programs reduced infant mortality, improved maternal health and through VHW generated women's clubs, and village health education projects promoted gender and caste equality creating sustainable healthy communities.