Improving the wellbeing of women throughout the lifespan: The Jamkhed, India, experience of sustainable community development

Since 1970 Comprehensive Rural Health Project (CRHP), Jamkhed, India, has been pioneering principles and practice of comprehensive, community-based primary health care, empowered communities building their capacity for overall development. Impact on over half million population has been dramatic on health status and social problems, including status and health of women. This sustainable model's foundation is principles of equity, integration and empowerment, especially women and marginalized. The value-based approach develops caring communities, working together to overcome obstacles and solve problems. CRHP staff facilitates effective community organizing and helps them identify and analyze problems, including social determinants, and develop local solutions. Villagers learn and work together across caste, class, and gender barriers, improving the lives of the whole community. Village Health Workers (VHWs), volunteers chosen by their communities, are key change agents and facilitators, sharing knowledge and skills and ensuring basic health care. Community groups participate in health education and care of children and pregnant women, and other development activities, especially for poor and marginalized. CRHP facilitates the process, giving continued support. VHW Puspha's village, Padali, is one example of sustainable change, especially for girls and women. Examples of issues addressed successfully include: reductions in violence in all age groups, sex determination abortion, no infant/child deaths or malnutrition past several years, increased school attendance, adolescent development including delayed marriage, overall prenatal care and safe deliveries, fewer pregnancies, independent income, women's groups for learning and support, living to old age, even as widows, accepted by and active in family and community life.