Connie Gates, MPH¹, Raj S. Arole, MBBS, MPH², and Shobha Arole, MBBS². (1) Jamkhed International Foundation, PO Box 291, Carrboro, NC 27510, 919-929-0650, connie@jamkhed.org, (2) Comprehensive Rural Health Project (CRHP), PO, Jamkhed, Dist. Ahmednagar, 413 201, India

Since 1970, CRHP pioneered community-based primary health care, building capacity of communities to assess their own problems, analyze causes, and develop appropriate actions. Eighty percent medical problems can be prevented or treated by villagers. This sustainable, comprehensive model, based on principles of equity, integration and empowerment, especially involves women. This value-based approach develops caring communities, working together to overcome obstacles and solve problems. Women’s status is improved; caste barriers overcome, poverty reduced, poor and marginalized integrated into the community. IMR is 20/1000 and 95% ‘safe’ deliveries. Village Health Workers, chosen by their communities, are key change agents, sharing knowledge and skills and ensuring prenatal care, safe delivery and infant care. Community participation in child care reduces malnutrition, diarrhea and pneumonia, and other activities benefit the community, especially the poor and marginalized. ‘Typical’ developing country diseases (e.g. malnutrition, diarrhea, leprosy, TB) are brought under control, social and cultural issues dealt with, other aspects of development (e.g. income-generation, agriculture, watershed management) included, then other health problems (e.g. chronic diseases, HIV/AIDS) and other groups (adolescents, elderly) are addressed. CRHP gives ongoing support and encouragement to the villagers. During 25 years, work spread to 250 villages and two new areas, reaching over 400,000 people. Expansion was accomplished mainly by villagers. Older VHWs mentor new ones. Villagers and staff are trained as trainers. Thousands of people from India and the world have come to learn. New features and continuous progress motivate villagers and staff. This is an important model for sustainable community health and development.

Learning Objectives:

• Describe the successful community-based primary health care approach of CRHP, Jamkhed.
• Identify the elements that contribute to long-term community interest and to sustainability.
• Describe the process of expansion by the villagers and the Jamkhed Institute.

Keywords: Community-Based Health Care, Sustainability

Related Web page: www.jamkhed.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.