People-Centric Approach To Health: Jan Swasthya Sahyog’s Work

by | Nov 10, 2022

Koshika Team (L to R): Neeta, Prashant, Sonia, Nikita, Nilesh and Nivedita (author)

I, along with my team at Project Koshika (my fellowship host organisation where i am working for 18 months in a community based role) had the opportunity to travel to Anuppur, Madhya Pradesh for a three-day exposure visit to Jan Swasthya Sahyog (JSS). JSS is a voluntary, non-profit society of health professionals running a low-cost, effective, health program providing both preventive and curative services to people from the tribal and rural areas of Bilaspur in Chhattisgarh and Annupur in Madhya Pradesh. They run various community health programs and a rural health center, which includes a hospital. 

Our primary interest was in finding out more about their interventions, getting a sense of the community they work with, learning about their difficulties and successes, etc. This blog post will try and encapsulate my experience and learnings from the visit. 

A group of like-minded medical professionals from the All India Institute of Medical Sciences (AIIMS), New Delhi, founded JSS in 1996. They all had a similar urge to take action to improve the health conditions in rural India, which were marked by a severe lack of resources and access to even the most basic care. Together, they made the decision to create a community-based healthcare system that would be easily accessible to the rural underprivileged and serve as a model for the provision of care in resource-constrained environments.

JSS has created simple technological advancements that have aided in the administration of the community health programme. The ones that I found most interesting were –

  1. A device with an H2SO4 solution that allows anyone to test the quality of water. It was used during an outbreak of waterborne illnesses in the region to identify safe sources of drinking water. The technique involved incubation of the water sample in the H2S Paper Strip Test bottle to detect feacal contamination. If there is any degree of contamination, the water turns black, and if there is no contamination then the water remains yellow and clear. It’s simple enough for anyone at the village level to use this. 
  2. A kangaroo mother care blouse for preterm newborns with low birth weight. The blouse is made of warm fabric and has a separate pocket on the inside of the blouse to keep the newborn. The blouse helps to maintain skin-to-skin contact between the mother and the newborn in order to maintain warmth. Developed in the 1970s, kangaroo mother care is used as an alternative to conventional incubator treatment for low birth weight infants.
  3. Usual thermometers are difficult to read for those health workers who have limited literacy levels. An easy-to-read thermometer created by JSS has the abnormal temperature range highlighted in red for both low body temperature (which can cause hypothermia) and fever (above 100.2 Fahrenheit). White indicates a normal range of temperature making it easy to decipher by the groups of health workers.

This catalog contains the details of some of the instruments, tools, and diagnostics kits developed by JSS.

It is not uncommon for people based in remote geographies, with low levels of medical infrastructure around them to rely on age-old healing practices for a wide array of diseases. Similar is the case with Koshika’s field area, which is based out in the buffer zone of Panna Tiger Reserve in Madhya Pradesh. This prompted me to understand how JSS has navigated the community’s connection with traditional healing methods. What seemed to work out for them was to collaborate with the traditional healers rather than outright imposing modern treatment on the people. “Both must work together”, says one of the teammates of the community health program. The example that was given to me was about a baba who healed snake bites in the community. What JSS did was quite interesting.

I also got the opportunity to speak with the community leaders and workers in Sakariya village. One of the many highlights was witnessing the follow-up of a high-risk pregnant woman firsthand. Following the check-up, the ANM mentor, a skilled professional from JSS’s team, discussed numerous symptoms that they consider when checking on pregnant women. This prompted me to reflect on Koshika’s metrics and consider ways to widen the scope of follow-ups in order to improve maternal health in our own community. Weekly follow-ups also mean that one-on-one counselling would happen more often and not just on Village Health and Nutrition Day. Thus contributing towards identifying high-risk patients in a shorter span of time.

A meet-up with one of the ANM mentors on field

I also got the opportunity to visit one of the phulwaris in Karpa village, Annupur. The principal goal of the Phulwari program is to combat malnutrition in children between the age group of 0.5-3 years. Since its inception, the Phulwari program has expanded significantly and JSS now runs 86 ‘phulwaris’ with an enrolment of twelve hundred children.

A phulwari in Sakariya village, Annupur

To combat the issue of malnutrition, Phulwaris provide wholesome meals consisting of sattu (wheat, barley and peanuts), khichdi (rice and lentils), and boiled eggs along with clean water. The Phulwaris also provide nutritional supplements (iron and folic acid), together with essential vaccines. Alongside, they have separate playing and napping areas for the children. Crèche workers are trained in basic hygiene, childcare, and nutrition and in managing common illnesses like fever and diarrhoea. A very thoughtful idea was to run the creche from the Phulwari karyakarta’s (worker) home for her own convenience rather than opening a separate centre for the same.

In a nutshell, our team returned with numerous learnings and takeaways. The internal discussion post made us realize that, given the various contexts and geographies in which we operate, not everything JSS does can be blindly adopted. However, a few things, such as training frontline workers, collaborating with the district hospital, using quality check enhancement tools, and so on, can be examined and implemented within our own programme. Overall, it was inspiring to see how the organization places people at the centre of its design and approaches health through the lens of socioeconomic challenges that the community faces. 

Stay in the loop…

Latest stories and insights from India Fellow delivered in your inbox.


Submit a Comment

Your email address will not be published. Required fields are marked *

%d bloggers like this: