Community involvement in reproductive health: Findings from research in Karnataka, India

In 1996, the government of India decided to provide a package of reproductive and child health services through the existing family welfare program, adopting a community needs assessment approach (CNAA). To implement this approach, the government abolished its practice of setting contraceptive targets centrally and introduced a decentralized planning strategy whereby health workers assessed the reproductive health needs of women in their respective areas and prepared local plans to meet those needs. They also involved community leaders to promote community participation in the reproductive and child health program. Since 1998, several evaluation studies have assessed the impact of CNAA on the program’s performance and community participation. These studies showed that the performance of the maternal health-care program improved, whereas the functioning of the family planning program initially declined but later recovered. The approach achieved little in boosting community involvement. This project tested a new model of health committee to help stimulate community participation in reproductive and child health activities at the village level. The experiment, described in this report, was conducted in the Hunsur block of the Mysore District in Karnataka for two years. Researchers evaluated the impact in terms of community involvement and utilization of reproductive and child health services.