Village Health Planning: Insights from the Field of Rural Haryana

Background: The National Health Mission (NHM) promotes decentralized planning through Village Health, Sanitation, and Nutrition Committees (VHSNCs), but implementation remains limited. This study documents the process, findings, and challenges of village health planning in a rural primary health center (PHC) in North India. Materials and Methods: We developed village health plans for 11 villages served by a rural as recommended activity under NHM. We used the “Community Action for Health User Manual,” with modifications for practical implementation. The process involved sensitizing health workers, mobilizing the community, and conducting VHSNC meetings. Data were collected through group interviews, focusing on service quality assessment and identifying local health concerns. A village health report card was created, categorizing services using a traffic-light coding system. In addition, a cause-of-death analysis for 2023 was conducted through verbal autopsies. Results: Key health issues identified included poor sanitation and cleanliness (63.6% of villages rated poor), inadequate tuberculosis care (54.5% rated poor), and antenatal care deficiencies. Additional concerns included substance abuse (54.5%), malnourishment (36.4%), excessive pesticide usage in farming, and water contamination. The cause-of-death analysis highlighted myocardial infarction as the leading cause of mortality, followed by cancer and suicide. Community mobilization, data collection, and time management were challenging in this process. Certain problems required multisectoral collaboration and interventions at higher authority levels. Conclusion: Through village-level health planning, we identified specific issues that are often overlooked in policies and by higher authorities. The study underscores the importance of integrating grassroots perspectives into health planning to enhance the relevance and effectiveness of healthcare interventions.