CBM and Healthcare in India

Jan Sunwais (Public Tribunals) are public events, attended by government officials and medical professionals in that region, where people are invited to report their experiences of poor health services and denial of care. The authorities present are then expected to respond to these testimonials.

Village health calendars/registers are publicly displayed monthly records, maintained by the VHSC, that compare mandated services to delivered services and note upcoming events such as immunization camps or visits by the health outreach functionaries ANMs and MPWs. They aim to track the delivery of services and ensure that village health and nutrition functionaries visit the village on the specified days and perform the stipulated activities.

The Indian National Human Rights Committee, with help from Jan Swasthya Abhiyan (the Indian arm of the international People’s Health Movement), organised a series of Jan Sunwais, otherwise known as Public Hearings on the Right to Health Care in 2004 and 2005. SATHI-CEHAT was at the time secretariat of the JSA and played the facilitated a series of Jan Sunwais.

The preparatory and follow up activities of Jan Sunwai were among the first systematic efforts towards communitising the agenda of Health Rights. The Indian media reported extensively on the poor condition of the public health system exposed during these events. Health advocacy organizations argued that the appalling experiences faced by many people when accessing public health services highlight the need for an official mechanism of citizen-driven accountability.

The 2004 and 2005 Jan Sunwais had a strong influence on the Indian Ministry of Health and contributed to the ministry’s decision to include CBM in the NRHM. Another important factor that contributed to the ministry’s decision was the capacity of CBM to generate information about health services that enables data triangulation.

CBM is rapidly increasing in popularity and has come to mean different things to different parties involved. The term CBM is relatively new and has thus far lacked a consistent definition, leaving it open to different interpretations. This flexibility in meaning has enabled groups with conflicting agendas to agree on its implementation but has simultaneously led to clashes or disappointment of some parties further down the line. In the case of CBM within the NRHM, policy makers at the government level assumed that the main purpose of community monitoring would be to generate data. In contrast, civil society stakeholders (NGOs and people’s organizations) envisioned CBM as a mode of facilitating grassroots health activism.

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