Poor health education and the prevailing cultural practices of those living in rural areas of Chattisgarh led to high levels of disease and a low use of health services. The community needed to be encouraged to address its own health needs by requesting and taking part in health programmes as well as using the health services already on offer. The Mitanin programme is the latest in a long series of approaches to government conducted community health volunteer programmes. In parallel to the ups and downs of community health volunteer schemes in the government sector the community health worker schemes have played an important role in health action by civil society. The Mitanin programme is essentially an attempt to scale up the community health worker experience to the macro –scale of a full state.
The initial programme was launched in May 2002 and subsequently the selection and deployment of Mitanins was initiated in two phases: 81 development blocks are covered including 16 pilot blocks under Phase-1 of the programme (launched between September and December 2002). The programme was expanded to the remaining 65 blocks of the state during Phase-2 (launched in December 2003). The initial estimate was to have 54,000 Mitanins in the state. Gradually, the total number of Mitanin selected has reached 60,092 (around 32,000 in phase-1 and about 28,000 in phase-2). Of these, 55,830 have now had various levels of training and training for the rest is to be initiated soon. Of the 55,830, more than 29,101 have completed 15 days of training (5 rounds) and another 24,275 have nearly completed 8 days of training (3 rounds). About 20,000 Mitanins from Phase-1 have started to provide first contact care using Mitanin Dawapeti (drug kit) and the remaining Mitanins will be provided with this after achieving the appropriate training level.
(i))70 per cent of Mitanins are visiting every single newborn family on the first day of childbirth
and delivering a package of health messages/practices to the new parents.
(ii) About 60 per cent of Mitanins meet every pregnant woman's family in the last month of pregnancy to ensure the birth is planned for and Antenatal Care is completed. However institutional delivery is being contrained by supply side problems.
(iii) Children with diarrhoea and fever are being visited and many being referred.
(iv) More than 75 per cent of Mitanins are taking part in Immunisation Days, bringing new children and women to be vaccinated.
(v) More than 60 per cent of practicing Mitanins are delivering appropriate counselling to mothers with malnourished children and carrying out home visits.
(vi) Some Mitanins are delivering Directly Observed Treatment Short courses (DOTS) for TB patients (about 15 per cent).
(vii) About 48 per cent of Mitanins are holding hamlet level health meetings.
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