Ratna Kamble, MA¹, Mukta Pol, VHW¹, Shobha Pawar, VHW¹, Raj S. Arole, MBBS, MPH¹, and Connie Gates, MPH². (1) Comprehensive Rural Health Project (CRHP), Dist. Ahmednagar, Maharashtra, Bhandardara, India, 91-2424-257014, crhp@jamkhed.org, (2) Jamkhed International Foundation, PO Box 291, Carrboro, NC 27510

Since 1970 Comprehensive Rural Health Project (CRHP), Jamkhed, India, pioneered community-based primary health care. Two decades of successful implementation of women-centered programs created confidence among village women to spread the program to other areas. A tribal area was chosen for a different poor context. Its approach was adapted to not establish its own clinic but focus on developing capacity of villagers in health knowledge and skills, attitudes and values, and improving their economic status. The villagers accomplished in 3 years what staff had taken 8 years to do in Jamkhed. The experienced Jamkhed village health workers (VHWs) were key to transferring knowledge and skills, as they spent time in Bhandardara and new VHWs stayed in Jamkhed villages. These VHWs could relate better to the tribals, sharing their experiences and common problems, than staff could. Staff played a supportive role in training VHWs, meeting with community members, connecting with other agencies, developing referral systems. The project began in June 1991, initially 20 villages, another 10 the next year (25,000 population). Within 2 years, trained VHWs were sharing their knowledge and skills; community groups were actively assessing their problems, analyzing causes, and developing their own appropriate actions, mobilizing local resources and networking with other programs. Government schemes, which had not reached these communities, were accessed. Income-generating programs were benefiting 750 women. After 3 years significant health improvement was already evident (statistics will be given; 1998 IMR 23 from 100, 80% immunizations). Now project is spreading similarly to new areas.

Learning Objectives:

• To describe the process of replication.
• To identify the key elements that made replication successful

Keywords: Community Building, Community Health Promoters

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.