Objective="Maintaining good health of the people through preventive and curative health services."
Details for Reform Option "Khoj Project, Manipur"
In Manipur, about five major communities live as brothers and sisters from times immemorial. Unfortunately, at an early part of 1990’s, a misunderstanding suddenly sprang up between two communities resulting into ethnic clashes. As soon as this came back to normal situation, another similar incident took place and this time the wave of violence spread in the hill districts of Manipur making life of the simple hill people miserable.
At this critical juncture, the Manipur Khoj (Search)Project was conceived under the guidance of Executive Director of Voluntary Health Association of India (VHAI), New Delhi as a mission to bring back normalcy and peace in Manipur. Five Khoj field units were taken to include all sections of the warring communities in 5 neglected pockets of the most backward areas of the 5 districts of Manipur through activities on health and social development.
Khoj is an effort to generate a series of integrated and comprehensive health centered projects in areas, which have abysmally low health status for a variety of reasons. The project is expected to lead not only an increase in awareness about health improvement but also increase in the general well being of community in the targeted areas. The approach aims to encourage community action oriented not only towards raising the health status of the people through health care services but also improving the overall socio-economic, politicaL and environmental milieu which creates conditions non-conducive to health of an individual. KHOJ efforts are not to provide ready-made solutions for the people's problems. It is an effort to involve people in a programme aimed at their own well being so as to foster a sense of self-reliance amongst the people that they can initiate an implement.
The objectives of the project were:
i) To reduce mortality and morbidity through Mother Child Health (MCH) services.
ii) To impart health education and awareness to the general population to reduce the incidence of diseases which are preventable.
iii) Promotion of folk media for the purpose of sensitising health to the general population.
iv) To set up health centres wherever necessary as referral centres of the Field Unit Out Patient Department (OPD) centres to provide MCH services.
v) To implement innovative programmes of health promotion in schools.
vi) To undertake social activities like water and sanitation, total literacy campaign, improvement of inter village roads and support to women society clubs, local schools and village library.
vii) To impart skill training and to extend financial help to the rural people and tribal population to enable them undertake socio-economic activities and to
viii) Promote traditional system of healing.
Main activities under the programme were:
i) Maternal care services – antenatal, intra natal and postnatal care.
ii) Under 5 child care-immunization, diarrhoea management, prevention from malnutrition and vitamin A deficiency.
iii) Health education and awareness programmes included training of Community Health Workers (CHWs); Training of Traditional Birth Attendants (TBAs); health awareness including prevention of AIDS and small family norms.
iv) Regular OPD services in all the 5 Khoj Field Units namely Sandangkhong, Sagang, Khelakhong-Irong Chesaba, Awangkhul and Keithelmanbi.
v) Deliveries and simple treatment also carried out at the health centres.
vi) For school health teachers and senior students were engaged to take up village health camps and exhibitions.
vii)Construction of low-cost sanitary latrines and programmes on safe drinking water.
The community of five Khoj areas have now raised their voice to authorities to meet their health needs like supply of drinking water. Tangjeng village under Sandangkhon Khoj Unit has got drinking water facility under rural water supply scheme of the Government which was commission by Agriculture Minister.
i) There has been reduction in common ailments in all Khoj areas.
ii) 905 children(under 5 years of age) have been immunized.
iii) Malaria has been totally eradicated in Keithelmanbi Khoj Field Unit which was earlier malaria prone area claiming 30 lives every year.
iv) Two health centres were started as referral centres (i) one at Sandangkhong for both Sagang (Churachandpur District) and Sandandkhong (Bishnupur District) and the other at Awangkhul (Tamenglong District).
v) Health education has covered 80% of the population.
vi) 152 Traditional Birth Attendants (TBAs) have been trained under the Khoj programme.
vii) 115 teachers have been given orientation in school health with follow up activities in all local schools.viii) Community Health Centre (CHC) building at Sandangkhong has been constructed by the community by raising funds from the public.
Sandangkhong, Sagang, Khelakhong-Irong Chesaba, Awangkhul and Keithelmanbi (the 5 neglected pockets of the most backward areas of 5 districts of Manipur).
Community Participation: It is a community action oriented programme involving the community at large for the various programmes within the project.
Holistic Approach: The programme is not only addressing the health needs of the community but it also has social and economic activities, literacy campaigns and women’s empowerment programmes.
Focuses on Local Needs: Focussing on local needs especially of the underprivileged sections is an integral component of the project.
Disruption in program due to floods: Many areas of Manipur faced flood problems due to incessant rains and this disturbed the programme.
Law and order situation: The law and order situation in Manipur also disturbed the program to some extent.
Meeting the expectations: Meeting the expectations of the people in Khoj areas has also been a challenge due to certain limitations. For example it has not been possible to construct low cost latrines for all households or construct many inter village roads.
Who needs to be consulted
Manipur Voluntary Health Association.
To ensure sustainability inputs are provided in the initial stages. The large role of community participation in the programme also ensures sustainability.
Chances of Replication
The programme has been replicated in U.P, M.P, Jammu & Kashmir, Orissa, Bihar, Tripura, Sikkim and West Bengal.
Prabha Sati, Research Consultant, European Commission Technical Assistance, New Delhi, March 2007.