By Sangeetha Lakshmanan, Research Analyst – ICTPH
and Rufin Jenila, Research Assistant – ICTPH
When we opened our first Rural Micro Health Centre (RMHC) in Alakkudi, we selected women Community Health Workers (“Nala Oli”s – Light of health) based on their social inclination and soft skills. The voluntary nature of their work, coupled with family responsibilities, slowly resulted in wavering interest and focus. They were unable to dedicate much time to their role. Further, we learnt that interventions would be more successful if we touched every household in the village rather than operate through only community-based models. A combination would be more beneficial to both individual households and the village collectively. Hence we took a conscious decision to re-design and re-structure our selection process. A process that would be fair, systematic and organised. A process that would involve the SughaVazhvu Nurse (SVN) to choose her Nala Oli (now rechristened as SughaVazhvu Guide (SVG)!). To learn more about our Guides and the selection process, read on…
The SughaVazhvu Guide proactively participates and monitors people’s health to ensure that each individual, family and household in her village is made conscious of their health, thereby creating behaviour change that is sustained for generations to come. She is able to achieve this by personally visiting each household in her village, performing basic health screening through the Population Level Screening Protocol (PLSP) to understand individual and family health needs, and disseminating messages of preventive and promotive health. A Guide who rests when her constant follow-ups have translated into successful management of her people’s health conditions.
Setting a sound criterion for selection was highly crucial. We wanted to keep it simple so that we could invite as many applications (see here) as possible and not miss out on women who were really waiting for an opportunity like this to serve their communities while furthering their learning capabilities. Based on an application procedure, we decided to hold a simple written test to gauge the knowledge of basic mathematics, anatomy and diet (see here) followed by a personal interview (see here) with the SVN and SughaVazhvu Doctor.
Following this, we readied our communicational release – a poster (see here) calling for applications from women across our catchment area. With support from all the Panchayat presidents, we had our posters displayed at prime locations across the five villages (Panchayat office, village library, school, village temple, provision store, bus stop, Public Health Centre, local tea shop etc). We also distributed our posters to the local Self Help Groups to increase the reach of our message.
Within just five days, we received an encouraging response from 56 applicants, who sat for the written test. The test was held simultaneously in the respective villages in schools, temples, the Panchayat office and the village library. While our supervisors (field coordinators) enjoyed their role of invigilating the candidates, we were anxious about the outcome. We wondered if the questions we had drafted were too complex or too simple. We waited patiently for the exam results…
And we were astonished with the scores! While most fared well in simple mathematics, a majority also demonstrated sound knowledge in diet and human anatomy. The time came to screen the candidates based on their scores and we were now left with 29 candidates who successfully made it to the interview. Interviews were held two days after the written test at the respective villages. This time too the locations selected were informal – we sat by the village pond, temple to a chat (see here) with our candidates. It was heartening to hear how some of the women were already involved in healthcare related activities and had demonstrated experiences of helping others in need. Some had even organised emergency medical help, while others had experience working with the Government in distributing medicines at the village level. At the same time we also found young women who had applied for the role, assuming it would entail only curative care; and they expressed their concerns to us about the difficulties of changing health-related behaviours, such as drinking/ smoking.
Unexpected rains, limited resources and a large catchment area did not deter us from enjoying the two testing days and our close interactions with the candidates. It was a wonderful experience for all of us involved in the process. We would return home everyday talking excitedly about our little dialogues with the candidates, and how each one of us thought we found prospective stars who could join us in our journey to build healthy villages. There was a feeling of oneness, and a sense of goodness that seemed to take over, and none of us could wait for the results of the entire process.
Unexpectedly, the scores were too close for decision-making, and forced us to initiate a fresh round of screening to our existing selection process – the training round! The introductory training to the public health system, human anatomy and germ theory got the candidates to work in groups through role play and related exercises. We screened the candidates based on their communication skills, involvement, creativity and attitude. This round proved to be useful as it showed the participants’ keenness to learn. To be honest, some of us were disappointed to see some of our favourite candidates not participating as well as we had hoped during the training.
As the names of the 12 successful SVGs were announced, each of us reflected upon our interactions and felt a sense of satisfaction. Today, every time we sit down over an informal cup of tea with the SVGs, we always recollect the time when we set out in small teams and embarked upon the journey to identify these women who were willing to join us in realising our vision. As we move forward, we believe that it will be this set of strong willed and motivated women who will help us transform the way people view health, seek care at the appropriate time and consciously manage their condition at the village level itself.