Addressing the social determinants of health: A case study from the Mitanin (Community Health Worker) programme in India

dc.contributor.authorNandi, Sulakshana
dc.contributor.authorSchneider, Helen
dc.date.accessioned2015-11-18T16:29:01Z
dc.date.available2015-11-18T16:29:01Z
dc.date.issued2014
dc.description.abstractThe Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme- specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organiza- tional factors. A qualitative comparative case study of successful action by Mitanin was conducted in two ‘blocks’, purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women’s collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the explanatory framework may provide general lessons for programmes in similar contexts.
dc.description.accreditationWeb of Scienceen_US
dc.identifier.citationNandi, S and Schneider, H. Addressing the social determinants of health: A case study from the Mitanin (Community Health Worker) programme in India. Health Policy and Planning 2014; 29(2): ii71-ii81. doi: 10.1093/heapol/czu074en_US
dc.identifier.urihttp://hdl.handle.net/10566/1983
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherLondon School of Hygiene and Tropical Medicineen_US
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.source.urihttp://dx.doi.org/10.1093/heapol/czu074
dc.status.ispeerreviewedtrue
dc.subjectCommunity health worker (CHW)
dc.subjectChhattisgarh State, India
dc.subjectMalnutrition
dc.subjectPrimary healthcare (PHC)
dc.subjectViolence against women
dc.subjectGender-based violence
dc.titleAddressing the social determinants of health: A case study from the Mitanin (Community Health Worker) programme in Indiaen_US
dc.typeArticleen_US

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