Roles, Responsibilities of Village Health and Sanitation and Nutrition Committees (VHSNC) and its future scope of opportunities in improving access to care – A Qualitative Evidence Synthesis and Participatory Rural Appraisal

Introduction:

Right since the Alma Ata Declaration in 1978, community participation is considered as one of the core principles of primary healthcare. (1) The government of India under the National Health Mission (NHM) has emphasized the involvement of local communities in improving access to various national health programs. To facilitate the same in 2005,  Village Health Sanitation and Nutrition Committees (VHSNCs) were constituted as a key mechanism to augment health governance in India. VHNSCs are local bodies formed at a revenue village level and act under the Gram Panchayat. (2) They are envisaged as being central to the “re” under NHM, facilitating decentralized health planning. VHNSCs hold meetings every month at the anaganwadi centre, discussing opportunities for community-level action pertaining to health, nutrition, early child development and sanitation. (3) VHSND brings together representatives from different departments including Health and Family Welfare (DHFW), Women and Child Development (DWCD), Social Welfare (DSW), Panchayati Raj Department, Rural Development (RDD), Drinking Water and Sanitation Missions and community-level stakeholders including VHSNC members, self-help groups (SHGs), and other Community-Based Organizations (CBOs).

However, there are wide disparities in the performance of VHSNC across the country. The recent twelfth common review mission revealed that only fewer VHSNCs are functional, and there is lacunae in clarity of roles and responsibilities of VHSNC members. (4) In addition, the VHSNC meetings are irregular, infrequently organised, and there is poor utilisation of untied funds. Considering the limited evidence and the need to study the roles, responsibilities and future opportunities of VHSNCs, thereby aiding its implementation, our paper intends to fill research gap. (5) In the present review, we aim to systematically review articles that has explored on the roles, responsibilities, functions, good practices of VHSNCs from India, and do qualitative interviews among various stakeholders to venture newer opportunities for its better  implementation towards access to health care.