Summer Training

At
National Health Mission, Rajasthan

Assessment of working of Mahila Arogya Samiti (MAS)

& suggestions regarding their better profiling for outreach health activity
(April 11th 2022- June 3rd 2022)

By
Dr. Samiksha Arun Rushiya
MBA Hospital & Health Management 2021-2021

Under the guidance of

Ms. Sunita Nigam
 ACKNOWLEDGEMENT

I am most grateful to my family for their patience and moral support.

The success and outcome of this project required a lot of direction and help from a lot people
and I am greatly favored to have got this all along the completion of my work. ”All that I have
done is due to guidance and help hence I would not forget to thank them....”

I would like to firstly respect and thank Dr. Jitendra Kumar Soni (MD-NHM), for giving me
an opportunity to do the summer training work in NHM Rajasthan.

I owe my heartfelt gratitude to our State Program Manager and my organizational coach Dr.
Lokesh Chaturvedi to give me all support all through the project & Vatsala Sharma (NHM
Health Manager) for introducing me to the organization National Health Mission, Jaipur,
Rajasthan.

I am grateful to and blessed sufficient to urge consistent support, back and direction from Dr.
Romil Singh (State Nodal Officer - NUHM, Rajasthan)

It will be my pleasure to address the name of Dr P.R. Sodani (Pro president, Dean Academics,
& Dean Training -IIHMR UNIVERSITY) in my report for his relentless guidance and his
patience to guide me during this time.

My special thanks to our alumni Mr. Amit Jain (WISH Foundation) for his encouragement and
suggestions during Process Documentation of the project work.
 TABLE OF CONTENTS

TITLE PAGE NO

Abbreviations

About the Organization

Organizational structure of NHM

Organizational learnings

Background/Rationale

Structure of Health System, India

Literature Review

Objectives

Methodology

 Study Design
 Description of the Sample Population
 Data Collection
 Data Analysis
 Methodology Framework

Introduction of Mahila Arogya Samiti

 Objectives of MAS
 Role of MAS in Convergence
 Who are the vulnerable groups?
 Role of MAS in Vulnerability Assessment and Mapping
 Process of MAS Formation
 Documentary evidence for MAS formation includes:
 Characteristics of members of Mahila Arogya Samiti:
 Opening of Joint Bank Account of MAS
 Coverage
 Major Activities of MAS
 Key Support Activities undertaken by MAS
 Results & Findings

Observations

Limitations

My Learnings

Conclusion

Suggestions

Capacity Building

Sustainability

Glimpse of Field Visits

Annexures
 Annexure I: Resolution for MAS Formation
 Annexure II: Letter to Bank for Opening of Bank Account:
 Annexure III: MAS Registration Sheet

Questionnaire on Mahila Arogya Samiti

References
ABBREVATIONS
 About the Organization

NATIONAL HEALTH MISSION

NHM was launched nationwide on 1st May 2013 by Government of India which consists 2 sub
missions National Rural Health Mission (launched in 2005) & National Urban Health Mission
(launched in the year 2013) .The National Health Mission (NHM) is an effort to deliver effective
health care a variety of involvements of the particular household of the individual, public and very
importantly at the level of health system. Significant advances of the health from past limited periods
in the terms of increasing life expectation, reducing the
death rate (mortality) and the rate of illness or diseases
(morbidity) remain major target as their challenges. They
vary widely from the area to area of the state and even
within states. The country's public health budget allocation
has actually decreased from 1.3% of GDP in 1990 to 0.9%
in 1999. One tenth of the population has some form of
health insurance, which puts the vast majority at risk of
indebtedness if the family becomes seriously ill. The
working alliance in policies and the programs which are
amongst the different vertical programs in the sector of the
health and between the health the other linked sectors like
drinking water, the sanitation and the nutrition which is
been limited, resulting in the absence of general health proposal. Several states, particularly in the
northern, eastern, and northeastern portions of the country, have the health indicators which are
stationary and last to struggle with the important illness and deaths. The reasons of these are mainly
to be found in socio-economic factors, the poor performance of the organizations of health and a
feeble established agenda. The public Minimum National Scheduler describes about the
government's assurance for the increase in budget spending on public health and improve the health
system's capacity to absorb higher spending in order to achieve an overall improvement in public
health services. Providing the useful and needful healthcare services to the rural populations,
especially deprived people, counting the females and the children, enlightening the contact, ensuring
possession and request for the service, making public health system stronger for the effective
services and delivery of the services, promoting the equity and the responsibility and upgrading the
dissolution.
Goals of NHM: -

• Reduction in Infant Mortality Rate and Maternal Mortality Ratio by at least 50% from
existing levels in next seven years
• Universalize access to public health services for Women’s health, Child health, water,
Hygiene, sanitation and nutrition
• Prevention and control of communicable and non-communicable diseases, including locally
endemic diseases
• Access to integrated comprehensive primary healthcare
• Ensuring population stabilization, gender and demographic balance.
• Revitalize local health traditions and mainstream AYUSH promotion of healthy life styles

Core strategies of NHM: -

• Increasing Community ownership by vesting

responsibility with PRIs
• Decentralized village and district level health planning
and management
• Appointment of Accredited Social Health Activist
(ASHA) to facilitate access to health services
• Strengthening the public health service delivery
infrastructure, particularly at village, primary and
secondary levels
• Mainstreaming AYUSH
• Improved management capacity to organize health
systems and services in public health
• Emphasizing evidence-based planning and
implementation through improved capacity and
infrastructure,
• Promoting the non-profit sector to increase social
participation and community empowerment,
promoting healthy behaviors, and improving
intersectional convergence

Objectives: -

• To reduce infant and the mother death rates by fifty percent from the current stage over
the coming 7 years.
• Generalize the approach for the public health services for the health of the females and
the child, proper sanitation and the nutrition and clean water for the drinking.
• Prevent, combat transmissible and the non-transferrable diseases, including local
endemics.
• Acquire combined basic services
• Ensure the stabilization of the population, sex and population stability.
• Revive the local traditions of the health and incorporate with AYUSH.
• Advancement in the lifestyle which is healthy.
 ORGANISATIONAL STRUCTURE OF NHM

ORGANISATIONAL LEARNINGS

MATERNAL & CHILD HEALTH:

 1. JANANI SHISHU SURAKSHA KARYAKRAM (JSSK) Service guarantees and elimination
of out-of-pocket expenses: Janani Shishu Suraksha Karyakram (JSSK) is an initiative under
the overall umbrella of NRHM that aims to reduce out-of-pocket expenses related to maternal
and newborn care.
2. The scheme implemented across the country entitles all pregnant
women delivering in public health institutions to absolutely free
and no expense delivery, including caesarean section.
3. Similar entitlements are in place for all sick newborn (first 30 day
of life) accessing public health institutions for treatment. Free
assured transport (ambulance service) from home to health
facility, inter-facility transfer in case of referral and drop back is
an entitlement under JSSK.
4. This provision of the scheme addresses level I delays on account
of transport availability. Vehicles with provision for advanced life
support, trained staff and equipment are made available with the
ambulance to manage emergencies during transit.
5. In 'hard-to-reach areas the last mile' connectivity requires innovations and use of informal
transport methods to reach the health facility or to an access point from where ambulances
can transport pregnant women to the health facility.

RBSK:

1. The early stages of life play an important role in the overall development of any child.
2. The Government of Rajasthan is committed to reduce infant mortality and child mortality and
to achieve Millennium Development Goal (MDG-4).
3. In view of this, with the objective of promoting health security and overall health of every
child in the state, the launch of "National Child Health Program"
(RBSK) is a new initiative by which timely identification of 38
main diseases identified in children and appropriate treatment is
provided.
4. The purpose of this program is mainly to 4 disorders of child
development (4D- Birth Defect, Deficiencies, Disease, Disability)

RKSK:
1. Rashtriya Kishor Swasthya Karyakram (RKSK) was launched on 7
January 2014.
2. Adolescence is a period where there is huge window of opportunity to influence them to
become a constructive force for social and economic transformation and contribute to the
sustainable and inclusive growth.
3. The health of the adolescents during this period is paramount
to achieve this and the RKSK aims to achieve the same
through a comprehensive package of strategies and
intervention.
4. The new adolescent health (AH) strategy focuses on age
groups 10-14 years and 15-19 years with universal coverage,
i.e. males and females; urban and rural; in school and out of
school; married and unmarried; and vulnerable and under-
served.
FAMILY WELFARE:
1. Family planning means planning by individual or couples to have only the children they
want, when they want them, this is responsible
parenthood. Family welfare includes not only
planning of birth, but they welfare of wholes family
by means of total family health care. The family
welfare program has high priority in India because
its success depends upon the quality of life of all
citizens.
2. It was started in the year 1951, in 1977, the
government of India redesigned the NATIONAL
FAMILY PLANNING PROGRAMME as the
NATIONAL FAMILY WELFARE
PROGRAMME also changed the name of the ministry of health and family planning to
ministry of health and family welfare.
3. It is a reflection of the government anxiety to promote family planning through the total
welfare of the family. It is aimed at achieving a higher end i.e. to improve the quality of life
of the people.
4. India is the first country in the world that implemented the family welfare program at
government level. Health is a part of concurrent list but centers provides 100% assistance to
states for this program.

IMMUNIZATION:
1. Immunization Program in India was introduced in 1978 as ‘Expanded Program of
Immunization’ (EPI) by the Ministry of Health and
Family Welfare, Government of India. In 1985, the
program was modified as ‘Universal Immunization
Program’ (UIP) to be implemented in phased manner
to cover all districts in the country by 1989-90 with
the one of largest health program in the world.
2. Immunization is the process whereby a person is
made immune or resistant to an infectious disease,
typically by the administration of a vaccine. Vaccines
are substances that stimulate the body’s own immune
system to protect the person against subsequent
infection or disease.
3. Immunization is the process whereby a person is
made immune or resistant to an infectious disease, typically by the administration of a
vaccine. Vaccines stimulate the body’s own immune system to protect the person against
subsequent infection or disease.
4. Immunization is a proven tool for controlling and eliminating life-threatening infectious
diseases and is estimated to avert between 2 and 3 million deaths each year. It is one of the
most cost-effective health investments, with proven strategies that make it accessible to even
the most hard-to-reach and vulnerable populations. It has clearly defined target groups; it can
 be delivered effectively through outreach activities; and vaccination does not require any
major lifestyle change.
5. India’s UIP provide free vaccines against 11 life threatening diseases - Tuberculosis,
Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to
Haemophilus Influenza type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and
Rotavirus diarrhea. (Rubella, JE and Rotavirus vaccine in select states and districts)

QUALITY ASSURANCE:
A QA program assures laboratory management and project
investigators that documented standards for the quality for
facilities, equipment, personnel training, and work performance
are being attained, and if not, to identify and report the areas that
need improvement to meet those standards. A laboratory’s QA
program should be described in the laboratory’s quality
management plan (QMP). The QMP should describe the
laboratory’s policy for management system reviews, quality
control and data quality objectives, QA project plans, standard operating procedures, training,
procurement of items and services, documentation, computer hardware and software, planning and
implementation of project work, assessment and response, and corrective action and continuous
improvement. A QA system should consist of a minimum of six components, namely:

1. A formal Work/QA Project Plan that describes all work, QA, and quality-control activities
associated with a project is developed for each study..
2. Up-to-date standard operating procedures (SOPs) that describe all technical activities
conducted by the laboratory.
3. A program to ensure and document that all project personnel are fully trained and qualified to
perform project activities before independent activities may begin. Personnel training records
should be maintained by the QA unit and should include records of qualifications, prior
experience, professional training, and internal training procedures.
4. A documentation and records system that facilitates full sample and data tracking.
5. A quality assessment program for all projects, conducted through management system
reviews, technical system audits, performance evaluation samples, data validation, laboratory
inspections, and independent data audits. An independent QA unit within a laboratory should
conduct the latter two activities.
6. A continuous improvement program, facilitated through quality assurance audits; a formal
corrective action program; and routine, laboratory-wide performance assessments and
reviews.

INTEGRATED AMBULANCES:
1. We are living in a time when the emphasis on preventing damage is greater than ever, the
provision of pre-hospital care will be the key to ensure that the lives are not lost due to
avoidable circumstances.
 2. This acute need to have emergency services in Rajasthan motivated and encouraged 108
Ambulance Scheme to be announced in the State Budget 2008-09. Scheme was
conceptualized to provide Emergency Response Services to people of Rajasthan.
3. Government of Rajasthan, Ministry of Health and Family Welfare, under National Rural
Health Mission initiated Emergency Response Services, popularly known as “108
Ambulance service project 108-Ambulance Services which is being run in PPP mode in the
State.
4. 108 Ambulance Project was launched in September 2008 with 5 Ambulances. The scheme
was planned in a phased manner to cover the entire State. Presently a fleet of 741 ambulances
are running across 34 Districts and 249 Blocks in the State. Fleet of 741 Ambulances also
includes 14 ambulances provided by Disaster Management Authority.
Sense
Any person in need of emergency help can dial a toll free number 108 from any landline or mobile
set. This call is attended within three rings by specially trained communications officers, who after
understanding the nature of emergency; connect the caller to the dispatch division.
Reach
The dispatch officer immediately identifies the ambulance nearest to the site and contacts the driver
and guides him to the mishap site.
Before the ambulance reaches the person in emergency, a virtual
hand holding is also carried out, by putting the caller on a
conference call with the Emergency Medical Technician (EMT)
and/or the physician available 24/7 in the Emergency Response
Centre.
Care
The ambulance reaches the site and rushes the victim to the
nearest hospital during the trip, EMT provides the victim pre-
hospital care.

HEALTH & WELLNESS CENTRE:

1. Since Financial Year 2015-16, Rajasthan had initiated a project in two districts, Baran and
Churu under Universal Health Coverage. Under this Project, OPD and Diagnostic services
are being provided through weekly OPD in the evening by AYUSH Medical Officers along
with Lab Technicians from the same PHC. The basic purpose was to increase the services
available at sub centers.
2. It was implemented in 150 sub
centers of two districts and up to
March, 2017, more than 27,511
patients were benefitted.
3. This similar project has been up-
scaled by Government of India in the form of “Health and Wellness Centers”. The
Government of India has mandated that by 2022, all sub centers must be converted into
Health and Wellness Centers.
4. They have also evolved the concept of “Community Health Officer”. Nurse / AYUSH
doctors will be trained for six months at prescribed centers, recognized by IGNOU in order to
work as Community Health Officers. These Community Health Officers will then be posted
at sub centers and then regular services will be provided by them to the nearby population.

Services expected from these centers:

 1. Care in Pregnancy and Child-birth.
2. Neonatal and Infant Health Care Services
3. Childhood and Adolescent Health Care Services.
4. Family Planning, Contraceptive Services and other Reproductive Health Care Services
5. Management of Communicable Diseases: National Health Programmes
6. General Out-patient Care for Acute Simple Illnesses and Minor Ailments
7. Screening, Prevention, Control and Management of Non-communicable Diseases
8. Care for Common Ophthalmic and ENT Problems.
9. Basic Oral Health Care
10. Elderly and Palliative Health Care Services
11. Emergency Medical Services including Burns and Trauma
12. Screening and Basic Management of Mental Health Aimentl

NON COMMUNICABLE DISEASES (NCDS):

In India, Non-Communicable Diseases (NCDs) like Cardiovascular Diseases (CVD), Cancer,

Chronic Respiratory Diseases and Diabetes are estimated to account for around 60% of all deaths,
The Government of India has been implementing National Program for Prevention and Control of
Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) since 2010 up to District level
under the National Health Mission. NPCDCS has a focus on awareness generation for behavior and
life-style changes, screening and early diagnosis of persons with high level of risk factors and their
referral to appropriate treatment facilities i.e. Community Health Centers and District Hospital for
management of non-communicable diseases including cardiovascular diseases. The strengthening of
infrastructure for screening, early detection, treatment and referral is also envisaged .
Objectives
 Health promotion through behavior change with involvement of community, civil society,
community based organizations, media etc.
 Screening at all levels in the health care delivery system from sub-centre and above for early
detection of diseases covered under the program including management and follow up.
 To build capacity at various levels of health care for prevention, early diagnosis, treatment,
rehabilitation, IEC/BCC, operational research and rehabilitation.
 To provide logistic support for diagnosis and cost effective treatment at primary, secondary and
tertiary levels of health care.
 To support for development of database of NCDs through Surveillance System and to monitor NCD
morbidity and mortality and risk factors.

NUHM:
1. In Rajasthan, NUHM was launched in December 2014 the
Ministry of Health & Family Welfare has formulated
National Urban Health Mission (NUHM) as a Sub-Mission
under an over-arching National Health Mission (NHM)
during the 12th Five Year Plan. National Urban Health
Mission (NUHM) was approved by the Union Cabinet on
1st May, 2013 for providing equitable and quality primary
health care services to the urban population with special
 focus on slum and vulnerable sections of the Society.
2. NUHM seeks to improve the health status by facilitating their access to quality primary
healthcare.
3. The National Urban Health Mission therefore aims to address the health concerns of the
urban poor through facilitating equitable access to available health facilities by rationalizing
and strengthening of the existing capacity of health delivery for improving the health status of
the urban poor.

Top ten activities to focus under NUHM

1. Mapping of urban vulnerable populations and understanding their special needs

2. Service delivery to urban poor and vulnerable population through proximal U-PHCs and U-
CHCs
3. Outreach through Urban Health and Nutrition Days (UHND) and Special Outreach Camps to
address special and community specific health needs.
4. Improving ambience, signage, patient amenities, infection prevention protocols should be
prioritized at U-PHCs & U-CHCs
5. Defined reporting mechanism under various health programs. Maintenance of requisite
records and registers at urban health facilities.
6. Special focus on urban specific health needs such as Non - communicable Diseases –
diabetes, hypertension, cardiovascular conditions, substance abuse, mental health etc. in
addition to routine RMNCH+A services.
7. Robust and assured referral mechanism with systematic follow up by U-PHC of the referred
cases (to FRUs and specialized services for NCDs etc.)- Integration of National Health
Programs at the U-PHCs.
8. Convergence with Urban Local Bodies (ULB), with clearly defined roles for the State Health
Department and the ULB in NUHM implementation for each city
9. Financial strengthening under NUHM- Registration and transfer of funds under NUHM
through PFMS, formation and registration of RKS et
10. Implementation of Public Private Partnerships where public services are weak and
innovations to improve service delivery with limited resources.
NUHM envisages setting up of service delivery infrastructure which is largely absent in cities/towns
to specially address the healthcare needs of urban poor and provides:-

Components of NUHM:

A. Service Delivery Infrastructure

Urban – Primary Health Centre (U-PHC):

New U-PHCs are planned as per gap analysis, as per norm of one U-PHC for approximately 50,000
urban population for providing preventive, promotive primary healthcare services and basic lab
diagnosis, drug /contraceptive dispensing services, counseling for all communicable and non-
communicable diseases etc.
Total 105 existing dispensaries are upgraded in urban PHC and 140 new Urban PHCs are planned to
be newly constructed in the state
Urban-Community Health Centre (U-CHC):
30 bedded UHCs are planned for providing inpatient care in cities with a population of above 5
lakhs. The Urban CHCs are designed to provide referral health care for cases from the Primary
Health Centers level and for cases in need of specialist care approaching the centre directly. Total 13
Urban CHCs are planned in the state.
Outreach services:
NUHM has provision of conducting outreach services (outreach camps and Urban Health Nutrition
Days) for targeted groups particularly slum dwellers and the
vulnerable population for providing preventive and promotive
healthcare services at the household and community level.
Health Kiosks:
In unserved slum and vulnerable areas where infrastructure is
not available, health kiosks are planned in such areas. It is a
prefabricated structure which will be used to provide basic
primary health care services by ANM. Total 36 Health Kiosks
are planned in the state. Key Features of Health Kiosk are as
follows:
ANM of nearby PHC will be posted at Kiosk
Mobile Medical Unit:
The National Urban Health Mission (NUHM) has provision of Mobile Medical Units (MMUs) to
provide a range of health care services for populations living in slum and un-served areas mainly
with the objective of taking healthcare service delivery to the doorsteps of these populations. Total 4
MMUs are planned in the State.
Mobile Medical Units are envisaged to provide primary healthcare care services for common
diseases including communicable and non-communicable diseases, RCH services, carry out
screening activities and provide referral linkage to appropriate higher faculties

In addition, the MMU is also expected to:

- Provide point of care diagnostics: Blood glucose, pregnancy testing, urine microscopy, albumin and
sugar, Hb, Height/Weight, vision testing etc
- Screening of population over age of 30 for Hypertension, Diabetes and Cancers and undertake
follow-ups during the monthly visits

B. Community Process:
Targeted interventions envisaged under NUHM for the slum dwellers and urban poor population are
as follows:
1.Urban ASHA
One frontline community worker (ASHA) serves as an effective and demand–generating link
between the health facility and the urban slum population. Each urban ASHA has a well-defined
service area of about 1000-2,500 beneficiaries/ approximately 300 households. Total 4672 urban
ASHAs are sanctioned in the state.
The role of an ASHA is that of a community level care provider. This includes a mix of tasks:
facilitating access to health care services, building awareness about health care entitlements
especially amongst the poor and marginalized, promoting healthy behavior and mobilizing for
collective action for better health outcomes and meeting curative care needs as appropriate to the
organization of service delivery in that area and compatible with her training and skills.
Major roles and responsibilities would be as follows:
1. ASHA will take steps to create awareness on social determinants and entitlements related to
health and other related public services. She would provide information to the community
with special focus on the vulnerable groups, on determinants of health such as nutrition, basic
sanitation and hygienic practices, healthy living and working conditions, information on
existing health services and facilities and the need for timely use of health services.
2. She will counsel community on birth preparedness, importance of safe delivery,
breastfeeding and complementary feeding, immunization, contraception and prevention of
 common infections including Reproductive Tract Infection and Sexually Transmitted
Infection (RTIs/STIs), care of the young child, National Health Program services, substance
abuse, prevention of domestic violence and sexual violence.
3. She will work with the Mahila Arogya Samiti to promote convergent action by the committee
on social determinants of health and take action to increase access of vulnerable groups for
various public services.
The ASHA will fulfill her role through five activities:
a. Home Visits
b. Supporting UHNDs & Outreach Camps
c. Visiting Health facilities
d. Promoting MAS
e. Records management
2. Mahila Arogya Samiti (MAS)
MAS in one of the key interventions under National Health Mission aimed at promoting community
participation in health at all levels, including planning, implementing and monitoring of health
programmes. MAS is expected to take collective action on issues related to Health, Nutrition, Water,
Sanitation and social determinants at the slum level. It is envisaged as being central to ‘local
collective action’, which would gradually develop to the process of decentralized health planning.
One MAS covers approximately 50-100 households and act as community based peer education
group in slums. MAS has been formed to facilitate community mobilization, monitoring and referral
with focus on preventive and promotive care and facilitating access to identified facilities.
 BACKGROUND/RATIONLE
STRUCTURE OF HEALTH SYSTEM, INDIA
Union Ministry of Health and Family Welfare

AYUSH (Dept. of
Directorate General of Ayurveda, Yoga &
Health Family Welfare Naturopathy, Unani,
Health Services Siddha and
Homoeopathy)

State Directorate of State Department of State Director

Medical Education & State Directorate Health & Family (Ayurveda) & Director
Research of Health Services Welfare (Homoeopathy)

District level Health and Family Welfare office, District Hospital

Office of Assistant District Health and Family Welfare officer

For every One Urban ‐Community Health Centre

250,000‐500,000 population Inpatient facility with 30‐50 beds

For every 50,000 population

Urban ‐Primary Health Centre
Total Staff ‐ 16

For every 10.000 population

1 ANM (Auxiliary Nurse Midwife)
Outreach sessions in area of every ANM on
weekly basis

200 – 500 Households (HHs)

(1000 – 2500 population)
ASHA Workers

50 – 100 HHs
(250 –500 population)
MAS
Total 4708 MAS has been formed in 61 cities of Rajasthan.
NUHM has provision to provide untied grant of Rs. 5000 per MAS per year.
LITERATURE REVIEW:
I conducted a literature review using a systematic approach. The aim was to establish an appropriate
context and build a theoretical framework for the innovations used in the NUHM. Findings of the
literature review were also used in developing interview guidelines for the qualitative study.

OBJECTIVE:
ASSESMENT OF WORKING OF MAHILA AAROGYA SAMITI (MAS) & SUGGESTION
REGARDING THEIR BETTER PROFILING OF OUTREACH ACTIVITY.

METHODOLOGY:
STUDY DESIGN:
A qualitative exploratory approach is deemed appropriate to answer these study’s research questions,
as qualitative research allows capturing the lived experience of Mahila Arogya Samiti members.
The study is exploratory in nature as it aims to discover the personal contexts of the MAS members,
and to understand how their personal views are embedded within these contexts, So a cross sectional
descriptive study is undertaken to complete this study.
SAMPLING STRATEGY:
Inclusion criteria: MAS meetings being conducted in the district Jaipur II with the MAS residing in
the area of Sanganer, Manoharpura, Kundannagar, Jagatpura.

DESCRIPTION OF THE SAMPLE POPULATION:

Mahila Arogya Samiti (MAS) as the name suggest are local women’s collective. They are expected
to take collective action on issues related to Health, Nutrition, Water Sanitation and its social
determinants at Slum/Ward level. They were particularly envisaged as being central to ‘local
community action’, which would gradually develop to the process of decentralized health planning.
DATA COLLECTION:
Data was collected in the month of May. Several meetings with MAS members done.

DATA ANALYSIS:
The qualitative data from the interviews were gathered with the help of a framed questionnaire and
common responses were grouped and coded and analyzed also. The codes were then categorized and
grouped into content or themes. Also the data was entered in MS Excel and it was analyzed and
summarized in the forms of tables and graphs. The responses around the resulted theme provides the
basis for the recommendations and conclusions surrounding perceptions, experiences, sustainability,
of MAS members.

Sample Mahila Arogya Samiti (MAS)

Phenomenon MAS members & their working in support of basic health services.
of Interest

Design Data collection methods will include; Interviews, document analysis and
observations

Evaluation Knowledge, Working, Experiences, perceptions

Research type Qualitative

Methodology Framework
 INTRODUCTION

Mahila Arogya Samiti

MAS in one of the key interventions under National Urban Health Mission aimed at promoting
community participation in health at all levels, including planning, implementing and monitoring of
health programs. It is envisaged as being central to ‘local collective action’, which would gradually
develop to the process of decentralized health planning. Thus MASs are expected to act as a
leadership platforms for woman’s and focal community group in each slum area for improving
awareness and access of community for health services, support the ASHA / Front line health
worker/ ANM, to develop health plans specific to the local needs and serves as a mechanism to
promote community action for health.
Main purpose of Mahila Arogya Samiti (MAS) includes,
demand generation, ensuring optimal utilization of services,
establishing referral linkages, increasing community ownership
and sustainability and establishing a community based
monitoring system.

Objectives of MAS:

The major objectives of MAS are to:

a. Provide a platform for convergent action on social
determinants and all public services directly or indirectly
related to health.
b. Provide a mechanism for the community to voice health needs, experiences and issues with access
to health services.
c. Generate community level awareness on locally relevant health issues and to promote the
acceptance of best practices in health by the community.
d. Focus on preventive and promotive health care activities and management of untied fund.
e. Support and facilitate the work of community service providers like ASHA and other frontline
workers who form a crucial interface between the community and health institutions.
f. Provide an institutional mechanism for the community to be informed of various health programs
and other government initiatives and to participate in the planning and implementation of these
programs, leading to better health outcomes.
g. Organize or facilitate community level services and referral linkages for health services.

Role of MAS in Convergence:

MAS is an appropriate body to take collective action on issues related to health, nutrition, water,
sanitation and other social determinants at community level. Therefore, MAS members can
undertake following activities to perform these functions effectively.
1. Monitor the situation of water, sanitation, food, housing and education services in your area.
2. Arrange a monthly and quarterly meeting with all relevant stakeholders to discuss the community
issues and devise a convergence plan. Coordinate with ANM and anganwadi worker and supervisor
to arrange a meeting with the above mentioned stakeholders.
3. Seek support for the use of community structures like municipal community centers for education
sessions and promotion of behaviors related to health and health determinants.
4. Utilize the provisions under various government development schemes to advocate with the local
authorities for construction of community based health centers, community toilets, water drains,
sewerage, drainage and disposal system in the area.

Who are the vulnerable groups?

We can categorize the vulnerable urban groups based on the nature of their vulnerability
Residential/Habitat- based vulnerability, Social vulnerability and Occupational vulnerability as
shown below:

RESIDENTIAL SOCIAL

 People living in slum/slum like  Old Age

locations  Widow/deserted women
 Homeless People living on  Women/child headed household
roadsides, under bridges, flyovers,  Differently abled
along railway tracks  Debilitating illnesses- TB, Leprosy
etc.

OCCUPATIONAL

 Unorganized/informal
 Seasonal workers/migrants
 Hazardous occupations such as Rag
 Pickers, Rickshaw pullers, Head
loaders, Construction workers, Daily
wage laborers

Role of MAS in Vulnerability Assessment and Mapping

  Divide the total target area and allocate around 10-12 households to each MAS member for
effective tracking and follow up.
 Identify and map vulnerable households/individuals based on the vulnerability assessment
tool, in coordination with ASHA.
 Categorize the households based on the criteria of location, social and occupational
vulnerability and make a list. Find their specific health problems/needs.
 Discuss with ASHA and make a weekly/monthly plan to address their specific health needs
and burdens.
 Follow up with ASHA in next meeting and visit the identified vulnerable
households/individuals/ groups again on intermittent rounds to monitor delivery of care.

Process of MAS Formation

The ASHA and the ASHA

facilitator/
Community
organizer play a key
role in the process of
MAS formation.
Various steps
involved in the
formation of MAS are
depicted below:

Step I: Constitution of a team at the slum level

In order to mobilize the community for formation of
Mahila Arogya Samiti, firstly a team has to be
constituted at the slum level. The ASHA, ASHA
facilitator/Community organizer with support of NGO
field functionary (if any), AWW and ANM will
 1 slum level 2 Slum Women 3 committed
women 4 selection of its
office bearers

constitute a team for selecting the MAS members. Each ASHA will supervise the formation of two-
five MAS.

Step II: Initial meetings with slum women

The team (ASHA and others) conducts a series of meetings with women from the slum, parents
visiting Anganwadis, service users, participants of various vocational training programs, informal
community associations etc. to understand the health conditions and to sensitize the women to work
towards improving the health of the men, women and children in the slum. It is generally observed
that the initial meetings have a large number of slum women attending mainly due to curiosity or
with expectations to get some benefits (monetary).

Step III: Identification of active and committed women

At least a gap of 1-2 weeks is given for the women to reflect, discuss with others and determine their
commitment to serve their community. Generally towards the 3rd or 4th meeting, the number of
women attending the meetings falls and only interested women come for the meeting.

Active, interested and committed women are identified and over a period of time, are encouraged to
work collectively on community issues to form the base of the Mahila Arogya Samiti. It may be
borne in mind that each community responds differently and takes its own time to crystallize, and
interventions would have to be designed, keeping in alignment with the community. Social
acceptance should be ensured by talking to family members

Step IV: Formation of MAS and selection of its

office bearers
Once the women decide to work as a local
collective, a resolution is passed for formalizing
the MAS formation. The newly constituted MAS
is oriented about its roles and responsibilities and
the names and details of MAS members are
recorded in the MAS registration sheet. Thereafter,
ASHA facilitates the selection of the Chairperson
of the MAS unanimously by the group members.

Documentary evidence for MAS formation

includes:
Resolution copy
MAS registration sheet.

Chairperson: MAS members will unanimously elect the chairperson of the group; who will:

1. Be responsible for ensuring that MAS meetings are held regularly on a monthly basis.
2. Lead the monthly MAS meetings and ensure smooth coordination
among members for effective decision making.
3. Develop the community health plan for the slum/ coverage area in
consultation with all MAS members.
4. Ensure that the all the records and registers of MAS are adequately maintained.
5. Represent the MAS and voice concerns of the area during interface with
 service providers and representatives of various government departments.
6. Support the member secretary in her functions

Member Secretary: ASHA will be the Member Secretary and Convener of

MAS because of the following reasons:

1. ASHA can play a very important role in providing a more organized support
mechanism and more sustained capacity building of MAS.
2. She also has better community ownership and acceptance.
3. She has been involved in health related issues over the past few years.
4. For successful achievement of her objectives especially health promotion,
prevention and community mobilization, the ASHA also requires
support from MAS.

As the member secretary of the MAS, she will:

1. Fix the schedule and venue for monthly meetings of the MAS.
2. Ensure that MAS meetings are conducted regularly with
participation of all members.
3. Draw attention of the samiti on specific constraints and
achievements related to health status of the community and enable
appropriate planning.
4. Make arrangements for the Urban Health and Nutrition Days
(UHNDs).
5. Ensure utilization of untied fund as per the decisions taken by MAS
through regular disbursal of funds jointly with the Chairperson and
undertake regular update of the cashbook.
6. Provide information on activity wise fund utilization to the MAS
every month and with bills and vouchers / documents on a
quarterly basis.
7. Work with the Chairperson for the bi-annual presentation of the activities and
expenditures of MAS in the meetings of urban local bodies (ULBs).
8. Work with the Chairperson for preparation of annual statement of
9.
expenditure (SOE) and utilization certificates (UCs)

Characteristics of members of Mahila Arogya Samiti:

The membership in the group would be a natural process, guided by ASHA and others. Therefore
the following parameters not be seen as eligibility criteria but it can be used for preferential
inclusion of members
 1. Woman with a desire to contribute to ‘well-being of the community’ and with a sense of social
commitment and leadership skills.
2. Woman’s age is not being kept as a barrier as the role of the woman in the house and the
community is either as a target beneficiary or as an influencing force.
3. If a group is being formed over a number of pockets of different communities, membership
from all such pockets shall be ensured.
4. Service users like pregnant women, lactating mothers, Mothers with children of up to 3 years
of age and patients with chronic diseases who are using the public services should also find place
in the MAS.

Opening of Joint Bank Account of MAS:

Once the MAS has been formed, it needs to open a joint account in the nearest
nationalized bank. In case, some issues occur during opening of new bank account
by MAS, the local authorities will facilitate the MAS in opening the bank account.
The annual untied fund of the MAS (Rs. 5000/-) shall be credited to this bank
account. It is up to the MAS to decide in which bank it wants to open the account.

COVERAGE:

The MAS is to be formed at Slum level, will approximately covers approximately 50-100
households. However, this can be modified based on the ground realities in each slum area, e.g.
small slum of less than 50 families or presence of disparate groups within each slum. In case of
existing Anganwadi Centers in the slum, the coverage of each MAS should be aligned with the
coverage area of the Anganwadi Centre and has to cover all pockets of the slum.
Major Activities of MAS

The major activities of MAS can be classified into the categories in the figure. However, it is clear that not all
MAS can undertake all activities until such time as they are well trained, well supported and have active and
committed members who are willing to undertake all these activities. Thus, MAS will add on activities
gradually as they become mature.

Accounting for
Untied fund
Facilitating Monthly
Service Meetings
delivery in the
community

Health
Maintenance
Resource
of Records
Mapping
Activities
Of MAS

Community
Monitoring Management
of health of Unitied
care facilities fund

Organizing
Monitoring
local collective
and facilitating
action for
access to
Health
public services
Promotion
KEY SUPPORT ACTIVITIES UNDERTAKEN BY THE MAS:

 Support ASHA in mapping and listing slum households and

preparing resource maps in the communities
 Monitor and facilitate access to essential public services related to
health, water, sanitation, nutrition and education
 Support the ASHA, Anganwadi Workers (AWWs) and Auxiliary
Nurse Midwives (ANMs) in organizing
 Urban Health and Nutrition Days (UHNDs), and in mobilizing
women and children for outreach sessions
 Generate demand for health services including FP
 Support ASHA in counseling family members on health issues,
when required
 Ensure access to health entitlements for the community
 Ensure access to health facilities including accompanying women
when required
 Lead collective action and self-help initiatives at the community
level
 Support ASHAs and AWWs in the distribution of health supplies
including FP methods. They can also be depot holders for condoms,
OCPs, ORS etc.
 Use untied funds to address health needs of the community
 Participate in health campaigns, special events and drives
 RESULTS & FINDINGS

A study was conducted with the help of a framed questionnaire related to working of Mahila Arogya Samiti.
The following graphs shows various findings, regarding their routine work schedule, responsibilities & their
knowledge related to MAS:

Members keeping information about their allocated household 60

Members regularly coordinating the service providers 60

Outreach Camps held in your slum last month 100

Functional community toilets in the slum 60

No
Functional garbage disposal mechanisms in slum 40 Yes

MAS regularly conducting home visits and providing relevant

counselling 100

Records and registers are updated after meetings 100

Organizing Monthly meetings regularly 100

All members received training 100

Assessment of working of MAS in their respective area (in %)

 Out of the study conducted, 60% of MAS members were keeping information about their allocated
household
 60% of members were regularly coordinating the service providers
 There are functional toilets in 60% of the slums
 40% of functional garbage disposal mechanisms are present in the slums
Location of 20 MAS Meeting

40
 Above figure shows the
location of MAS
meeting

 Out of the study conducted

40% of the meetings are held
in Anganwadi Centre &
nearby Temple
40
 The remaining 20%
meetings are held at
house Anganwadi centre Temple House of a MAS Member of any MAS member

20

80

Above Rs. 300/- Below Rs. 300/-

Statement of Expenditure (SOE)

 Above Expenditure is showing the Statement of Expenditure (SOE) of last month

 Out of the study conducted 80% of the MAS have an expenditure less than Rs.300

 Out of the study conducted 20% of the MAS have an expenditure more than Rs.300
 28.6

42.9

28.6

Mobilization of Elderly Patients

Coordination with ANM/ASHA
Mobilization of pregnant women from marginalised families

Contribution of MAS members to the Outreach Camp

 As the study conducted, it showed 28.6% of MAS were in coordination with ANM/ASHA
 Whereas, 42.9% of MAS participated in mobilizing elderly patients
 The remaining 28.6 of MAS were a part of mobilizing pregnant women from marginalized area

40

60

Health Checkup camp Vaccination

Theme of Camp

 Out of the study conducted, 60% of the camps were General Health Checkup & 40% were Vaccination
camp
 100

U-PHC

Camp organizing authority

 It has been noticed that all Camps were organized by Urban Primary Health Centre (UPHC)

22.2 22.2

22.2 22.2
11.1

Prevention from Dengue/Malaria Seasonal Diseases Family Planning

Sanitary Pads Disposal methods Booster Dose Vaccination

Key Discussions done

 The 11.1 % of MAS discuss on the topic of Family Planning

 The others discuss on Seasonal methods, Booster dose vaccination, sanitary pads disposal methods &
Prevention from Dengue/Malaria
 40

60

Chairperson Secretary

Individuals assigned to lead the Activity of Month

 60% of the MAS activities were led by Secretary

 The remaining 40% of activities were led by Chairperson

OBSERVATIONS:

 It has been found that, though the MAS members consists of a majority of illiterate & semi-illiterate
women, then also the women from such marginalized communities are very active & know the good
for the welfare of society.
 MAS have become a platform for women empowerment
through social recognition.
 MAS supports the service delivery of front line workers
i.e. ASHA, ANM and AWW.
 MAS has increased awareness on Health & Sanitation in
community as members works as a change agent in
community.
 There have been seen behavioral changes & acceptance
in community for the MAS, with respect to community
recognition (some places sooner & some later).
 Reach of health services broadened and uptake of public
health services has increased, such as outreach camps
(special & outreach), Urban Health Nutrition Day,
immunization services, etc.
 MAS has certainly increased community participation in implementation of health programs/activities
(Such as gathering masses, spreading awareness, etc.)

LIMITATIONS:
  The MAS have been asked by the concerned higher authorities to mandatorily spend their funds
on one Weighing machine (for Children) per MAS, which has made the UNTIED FUND into
TIED FUND.
In such way mismanagement of funds has been seen without its monitoring.
 MAS has a majority of semiliterate & illiterate members & thus not all MAS can undertake all
activities until such time as they are well trained, well supported & encouraged by the health
authorities.
 MAS members itself comes from different socio economic backgrounds, which indirectly lessen
their time towards their regular health activities & responsibilities.
 MAS has to face refusals & delays by banks to change the assigned Chairperson/Secretory on
documents.
 Non-availability of working ASHAs willing to form MAS in non-slums areas.
 MAS can only informed the concerned health authorities to initiate the appropriate actions(like
functional garbage disposable mechanisms, community toilets,etc)

MY LEARNINGS:

Menstrual cups & Tampons have been available for decades, but their use in India is limited because of lack of
awareness and popularity of sanitary pads. Since they are reusable, they reduce solid waste and are
environment friendly. The need of the hour is education, awareness, and availability of the eco-friendly
practices when it comes to managing menstrual waste effectively.
Once that is taken care of, it will be easy for anyone to make a green switch. Most women in India trust the
sanitary pads over menstrual cups & tampons, but a majority is still unaware of the other options. Since cups &
tampons have to be inserted into the vagina, people are often unsure of trying it. Then there is the obvious
emphasis of the Indian culture on a woman's virginity and the myth that using a cup would make her lose her
virginity. Many menstruators are, therefore, unwilling to use cups.
I am privileged & felt proud that I was involved in spreading awareness and helping women manage their
periods with dignity by introducing menstrual cups & tampons to them.
They were curious & eager to understand the instructions, had numerous queries regarding it, I hope I tried to
answer them as much as I could.
The smile on their faces says it all, & in the end when one lady said, “ it’s good to know about how to use them
because at least we can teach this to our daughters & unlike us they can play, do their routine just normal, as
they won’t fear the stain,” there I smiled too.
In this way, we conclude that menstrual cup needs promotion in India. To boost the adoption rate of menstrual
cups, youth should be targeted, who are more open to the idea of environment-friendly products. The
Government must conduct awareness programs in the rural areas and work constantly spreading the message
across all socio-economic sectors.

MAS members reaction:

’’Mahavari me PADS ke alawa aur
bhi chizo ka istemal karte hai, ye
aaj pata chala’’
CONCLUSIONS:

With this cross sectional observational study we can account the following factors attributed to the success of
MAS:
 Willingness and concern of administration
 Coordinated efforts of all front line workers
 Social recognition of MAS and its members
 Active involvement of community ensured through trainings & orientations and continuous
hand-holding
 Effective supervision of field activities by NUHM staff
 Potential use of effective IEC
 Effective utilization of untied fund

“It is good to focus on successes

rather than on failures, as it will keep
the morale of the group high.”

SUGGESTIONS:

Suggestive Roles & Responsibilities towards better Health Activity & Strengthening of Mahila Aarogya Samiti
(MAS):

CMO/CMHO/CDMO:
 Planning & budget for MAS
 Reviewing formation & functioning of MAS
 Ensuring that MAS trainings are conducted as per calendar
 Ensuring opening of bank accounts & disbursements of untied funds for MAS
 Ensuring participation of MAS representatives in city coordination meetings

NODAL OFFICER-URBAN HEALTH:

 Providing IEC materials & health supplies to MAS(such as Family Planning supplies)
 Ensuring implementation of all directives by the CMHO/CMO/CDMO
 Rewarding & recognizing well performing MAS

DISTRICT PROGRAM MANAGERS/COMMUNITY PROCESS MANAGERS/URBAN HEALTH

COORDINATORS:
 Facilitating implementation of MAS activities in coordination with the Nodal Officer-Urban Health
 Rewarding & recognizing well performing MAS

MEDICAL OFFICER IN CHARGE – UPHC:

Ensuring that ASHAs are performing the following activities to form & strengthen MAS:
 Facilitating the orientation of community women regarding the establishment of MAS
 Encouraging MAS members to use IEC materials & health supplies
 Facilitating the participation of MAS members in training, UHNDs, outreach camps
 Ensuring representation of marginalized segments in the MAS

ASHA FACILITATOR/ANM:
 Mentoring ASHAs in conducting MAS meetings
 Conducting periodic progress reviews of MAS with ASHAs in their area
  Preparing & submitting reports to MAS to the Urban Primary Health Centre(UPHC)

NGOs/PRIVATE HEALTH SOCIETY:

 Harnessing their skills as additional technical capacity in training and supporting the ASHA and MAS.
 Training and support of ASHA and MAS in areas where support systems are slow in being established
specific zones

Capacity Building of MAS:

1. Capacity building of MAS is a continuous process.

2. The knowledge base of the members needs to be strengthened for clear understanding of the objectives,
functioning and roles and activities of MAS.
3. The training of MAS should be conducted through quarterly workshops of two days and shouldaim to
develop their capacities.
4. All ASHAs, ANMs and ASHA Facilitator/community
organizers/district level support structures should be
given prior training to build their capacity for
formation, supporting and facilitating the MAS and
also do the supportive supervision role. These trainings
should be conducted at the U-PHC level as a part of
induction training for ASHAs, following which they
will support the training of MAS members.
5. MAS trainers from each district should be trained by a
group of state trainers identified by the state.

SUSTAINIBILITY:

Creating sustainability of MAS is a long-term process, which requires on-going training and supportive
supervision by ASHAs and other health functionaries. It also requires linkages to various income generation
schemes of the government as well as the annual budget provisioning through the PIP. Reward and recognition
to well performing MAS can provide motivation for their continued activities.
 SOME GLIMPSE OF FIELD VISITS

UPHC Kesar Vihar, Jagatpura

UPHC Sanganer

UPHC Jagatpura
 Meeting with Kantadevi (Chairperson)
& Sunitadevi (Secretory) of MAS
Jagatpura

Meeting with Asha (Chairperson) & Rita

(Secretory) of MAS Kundannagar

Meeting with Seema (Chairperson) &

Arti (Secretory) of MAS Manoharpura
 Training session for Mahila Arogya Samiti
Kundannagar about
‘Introduction & steps to use Menstrual cups &
Tampons during mensuration.”
 Annexures

Annexure I: Resolution for MAS Formation

Name of the city:

Name of the slum:

Date and time of the meeting:

Venue of the meeting:

The first meeting of the Mahila Arogya Samiti of …………………………………… slum in ward
number………… of..............................................................city/town was held under the supervision of Ms./
Smt.………………………………, working as ASHA. The meeting was attended by members. The
objectives, activities, roles and responsibilities, fund management and utilization, record maintenance etc. of
MAS were discussed in detail during the meeting. Smt. /Ms. ……………………………………was
nominated as Chairperson of the MAS and Smt./Ms.......(ASHA of the slum) will act as the Secretary of
the MAS. Rs. 5000/- will be sanctioned to MAS under the National Urban Health Mission (NUHM) to
implement various health related activities in the slum. To facilitate the same, it was decided to open a
joint account in the nearest branch of
……………………………………. bank.

It was agreed that a copy of this resolution along with a letter of request would be submitted to the Branch
Manager,................................................................................................bank for opening of the joint bank
account in the name of MAS. The following persons will operate the bank account:

1. Smt./Ms. Chairperson

2. Smt./Ms. Secretary

It was decided that the functioning of the MAS would be governed by NUHM guidelines and the MAS would
meet every month.

Signatures of the MAS members present in the meeting

1.
2.
3.
4.
Annexure III: Letter to Bank for Opening of Bank Account:

To The Branch Manager

___________________

Sub: Opening of the Bank Account in the name of Mahila Arogya Samiti

Sir,

We would like to inform you that ………………………………….. Mahila Arogya Samiti (MAS)
……………………………… (Name of the slum) is formed to implement health, nutrition and sanitation
related activities in ward no. …………… of …….……………..… city/town. To facilitate the funds
transaction, it was decided in the Mahila Arogya Samiti to open a saving bank account in your bank. The
account will be jointly operated by

Smt./Ms Chairperson

Smt./Ms Secretary

The resolution of the meeting held for MAS formation and opening of bank account in name of MAS is
attached herewith for your reference. We request you to open the bank account in the name of
………………………………………MAS in your bank.
The account opening form duly filled in is also enclosed with this letter.

It is therefore requested to immediately open an account in your bank in favor of our Mahila Arogya Samiti.

Yours faithfully,
Chairperson,
MAS
Annexure II: MAS Registration Sheet

Name of the MAS: __________________________________________________________________

Date of formation: ____________________________________________________________________

Total members in the MAS: ____________________________________________________________

Name of the Slum/ coverage area: _______________________________________________________

Total no. of households in MAS coverage area: ____________________________________________

Name of ASHA: _____________________________________________________________________

Name of ASHA facilitator/ Community organizer: ___________

Sl. No. Name of Age Address Designation Signature Photo

MAS
member
Annexure VIII: MAS Monthly Meeting Attendance Record

Mahila Arogya Samiti, Slum: ___________________________________________________________

Ward Number: __________________________________
City: ___________________________________
Meeting Date: ________________________________
Meeting Time: ______________________________
Meeting Chaired by: ____________

Serial No. Name Slum/Cluster Signature

 QUESTIONNAIRE ON MAHILA AROGYA SAMITI (MAS)

Date:

Slum Name
Ward Number
City
Total Number of Volunteers (MAS Members)
Name of Chairperson
Name of Secretary

1. When was the last meeting held? (DD/MM/YY)

2. What was the Location of last meeting?

i) Anganwadi Centre
ii) U-PHC
iii) House of Mass Member
iv) Community Centre/School
v) Others

3. Have all members received training?

1. Yes
2. No (Specify the reason)

4. Are you organizing Monthly meetings regularly?

1. Yes
2. No (Specify the reason)

5. Are records and registers are updated after meetings?

1. Yes
2. No (Specify the reason)

6. Are members of MAS regularly conducting home visits and providing relevant counselling?
1. Yes
2. No (Specify the reason)

7. Are members regularly coordinating the service providers to ensure reach of services to the vulnerable and
marginalized population?
1. Yes
2. No (Specify the reason)

8. Are there functional garbage disposal mechanisms in slum?

1. Yes
2. No
9. Are there functional community toilets in the slum?
1. Yes
2. No

10. Are all members keeping information about their allocated household?
1. Yes
2. No (Specify the reason)

11. Did the last month Expenditure was below or above Rs. 300/-?
1. Above Rs. 300/-
2. Below Rs. 300/-

12. Whether the Outreach Camps held in your slum last month?
1. Yes
2. No

13. If yes, Camp was held, then who organized the Camp?

14. What was the theme of Camp? (Please Tick whichever is applicable)
1. Health Check-up
2. Eye Care
3. Vaccination
4. Others

15. How did MAS contributed to the Outreach Camp?

1. Mobilization of elderly patients/pregnant women from marginalized families
2. Coordination with ANM/ASHA
3. Others

16. Were there any major incidents that MAS noted in their slum?
1. Yes
2. No

17. If Yes, Incidents happened, were they informed?

1. Yes
2. No

18. What are the topics to be covered this month?

i. Health/Hygiene Awareness
ii. Routine Immunization drive
iii. Diarrhea Monitoring (According to Annual Calendar)
iv. Others
19. What are the Key discussions done? (In support or objection of the topics)

20. Who will be the responsible individuals assigned to lead the Activity?
(Rotation of members suggested)

21. What will be the plan for upcoming month’s activity/agenda? (Brief introduction)
REFERENCES:

Guidelines for ASHA and Mahila Arogya Samiti in the Urban Context: National Urban Health Mission

The Challenges of Urban Health: G. Ernest Leslie Research Officer, Rcues, Ou Hyderabad 7 June 2017

Strengthening of Mahila Arogya Samiti : The Challenge Initiatives

Induction Module for Mahila Arogya Samiti (Available from - https://nhm.gov.in › NUHM ›
Mahila_Arogya_Samiti )

Ministry of Health and Family welfare. National Urban Health Mission: Framework for implementation.
Government of India: New Delhi; 2010

Ministry of Health and Family welfare. National Urban Health Mission: Framework for implementation.
Government of India: New Delhi; 2010