A Sustainable, Comprehensive, Community-Based Primary Health Care Approach: The Jamkhed Model

The Comprehensive Rural Health Project (CRHP), Jamkhed, has pioneered practice of comprehensive, community-based primary health care since 1970, using an integrated model of community health workers, a mobile health team, and a secondary care hospital. The Jamkhed Model is an active process by which communities are empowered to take healthcare into their own hands by identifying and addressing social determinants of health as well as imparting health education to community members. CRHP first identifies villages that request a partnership with the organization. CRHP’s Mobile Health Team spends time with the villagers, building rapport, gathering groups, identifying socially minded persons, and helping to organize community groups. These groups help choose one to two women in their village to be their Village Health Worker/s (VHWs). These VHWs attend health and social training at CRHP weekly. VHWs disseminate knowledge they learn to the rest of their village in community meetings and house-to-house sessions with villagers. Community group members and VHWs work together to identify community needs and develop local, sustainable solutions. With their training, VHWs can treat more than 80% of health conditions at the community level while the VHWs refer 20% to a secondary care hospital facility for outpatient or inpatient care.

There has been significant sustainable impact on health and wellbeing, especially in the poor and marginalized, and women and children. Since 1970, the infant mortality rate has fallen from 176 to 20 deaths /1000 live births; immunization levels are 98%; and prenatal care and safe delivery is 98%.