Sure Start works in complete synchronization with government programs, improving access to vital health care services

History is full of iconic figures who have transformed our world. We read about them in books, watch their biographies on television, and see them celebrated in our newspapers. However, there is another category of heroes whose stories we do not always hear—the unsung heroes. These are the ordinary people who quietly and persistently dedicate their lives to building a better life and world for their communities.

Sure Start’s mission is to provide support and tools to everyday heroes like these, allowing them to flourish and continue to provide extraordinary service to the community by fulfilling the aims of national-level government initiatives.

Addressing the gaps

These initiatives accomplish a great deal. It is undeniable, however, that people often fail to fully utilize the available services. Often, this failure is due to a lack of awareness caused by inadequate communication or a gap between communities and government. Sure Start works toward bridging these gaps, enabling far greater use of government services. The regular implementation of monthly village health and nutrition days, for instance, helps create awareness about the need for and the availability of government services.

Strengthening delivery of public health services in Maharashtra

In Maharashtra, Sure Start is effectively engaging with the issues that the forthcoming National Urban Health Mission (NUHM) addresses. Project staff have been invited to participate in planning the mission for the state.

Working with NUHM toward strengthening public health delivery systems, Sure Start has identified systemic shortfalls. A unique Management Information System is generating accurate data. The project is also working toward building capacities of municipal bodies. More fundamentally, NUHM’s agenda underlines the importance of combining multiple issues under a common umbrella program. In Pune, Sure Start is testing a model that combines maternal and newborn health care with HIV/AIDS services—a project that is successfully integrated with the government’s Reproductive and Child Health Program.

Supporting government objectives in Uttar Pradesh

In Uttar Pradesh, Sure Start supports the objective of the National Rural Health Mission (NRHM) to make substantial improvements in the lives of village communities. The program has worked to strengthen the skills of thousands of Accredited Social Health Activists, helping to fulfill the mission’s provision for incentive-based health volunteers. Sure Start has contributed to the mission’s goal of increased emphasis on public–private partnerships by strengthening local capacities and partnerships with nongovernmental organizations and private providers.

Additionally, Sure Start aims to create a free flow of information and knowledge. The project has developed a two-way channel of information through the Management Information System’s reporting and feedback mechanisms. The project has also created platforms for accountability and for interaction between government officials and community members. Since key officials are able to communicate regularly with the community, these open channels of communication ultimately help build the community’s trust in government mechanisms. Through communication, the officials receive insight and feedback into the initiatives and their results.

Creating demand for existing health services

As a government worker at a primary health center in the Hardoi district, Dr. Rana Pratap has been providing health services to socially and economically disadvantaged communities for many years. Despite the numerous government plans that offer much-needed assistance in providing better health care, Dr. Pratap had often felt that his patients missed out on some services. Undoubtedly, he felt, this disconnect had been created by a lack of awareness—both about the various schemes available and the many ways a health center could assist local people and their families.

Once Sure Start arrived at his center, Dr. Pratap noticed a remarkable change. For one thing, he became busier. “Due to the extensive effort put in by the Sure Start team, the people of this community are now more aware of issues relating to maternal and newborn health,” he says. “Sure Start creates demand for our services amongst the people. Of course, this makes my job more difficult,” he adds with a laugh, “but the community receives substantial benefit.”

A significant step toward decentralization

Dr. Pratap explains that the government’s new thrust seems to be decentralization. “Sure Start has helped this process immensely by strengthening Village Health and Sanitation Committees,” he says. “Health plans and reviews have to be effectively conducted at the village level by the communities themselves. I now have to attend community meetings and participate in reviews. Many times, I have to explain why the primary health center is unable to deliver certain services.”

Dr. Pratap welcomes his community’s questions because, quite simply, questions mean that people have taken the time to think about the issues, and that they ultimately care both about their own lives as well as those yet to come.

Photos: Lakshman Anand.