Exploring role of SHGs to maintain healtcare infrastructure in Sondwa Block, Alirajpur district

Abstract

The Sondwa block, nestled within the Alirajpur district of Madhya Pradesh, India, presents a critical case study of the multifaceted healthcare challenges confronting predominantly tribal regions. This area is characterized by significant healthcare infrastructure deficiencies, compounded by severe accessibility gaps that are exacerbated by its geographical isolation, rugged terrain, and the pervasive socio- economic disparities faced by its inhabitants. Despite persistent governmental initiatives aimed at ameliorating these conditions, systemic barriers including the remoteness of settlements, deep-seated socio-economic inequalities, and insufficient community participation in healthcare management continue to substantially impede the effective and equitable delivery of essential healthcare services. This research undertakes a comprehensive exploration into the pivotal and underutilized role of Self- Help Groups (SHGs) as dynamic and sustainable catalysts for the crucial enhancement, maintenance, and strengthening of the local healthcare infrastructure. This research addresses the question: How can Self-Help Groups (SHGs) contribute to maintaining and improving healthcare infrastructure in this tribal region, aligning with sustainable development principles? The aim was to plan for sustainable development for Sondwa block, focusing on assessing the role of SHGs in maintaining healthcare infrastructure. This was pursued through objectives including: studying sustainable healthcare development frameworks; identifying underserved tribal pockets using spatial analysis; assessing SHG potential in healthcare maintenance; and providing planning recommendations. To identify healthcare gaps, a mixed-methods approach was employed. This involved spatial analysis using Geographic Information System (GIS) tools, buffer analysis of existing facilities, network analysis to model travel times and delineate service areas, and weighted overlay analysis incorporating population density, road networks, and terrain to determine optimal locations for new facilities. This was complemented by primary data from household surveys, SHG member surveys, key informant interviews with healthcare providers and officials, and Focus Group Discussions (FGDs) with community members and SHGs, alongside secondary data from Census reports and health surveys. Key results indicate SHGs' significant potential to improve healthcare access; for instance, 60% of surveyed SHGs believe their initiatives would contribute to improved accessibility, with 40% reporting enhanced community awareness and 30% providing financial assistance. Collaborations between SHGs and local health workers like ASHAs and ANMs were reported by 50% of SHGs, leading to improved healthcare delivery (40% of these SHGs) and increased awareness of government health programs (35%). The enhanced community trust and ownership through SHG engagement were evidenced through qualitative insights from stakeholder consultations and FGDs, revealing increased community willingness to participate in and support local health initiatives when SHGs are involved. Based on these findings, the study proposes a comprehensive, community-centric framework for integrating SHGs into healthcare infrastructure improvement and maintenance. The core components of this framework include: An SHG-Based Health Surveillance and Data Management System utilizing trained SHG members ("Health Didis") for data collection and facilitating teleconsultations; Sustainable Infrastructure for SHG-Led Health Entrepreneurship, establishing SHG managed micro-enterprises for essential health products within retrofitted Community Health Hubs; A defined Mechanism for SHG Integration in facility maintenance, outlining engagement principles (voluntarism, skill-based task allocation, performance-linked payments), SHG selection criteria, defined roles and responsibilities using Standard Operating Procedures (SOPs), targeted capacity building, and transparent resource allocation; A robust Inter-Departmental Coordination and Governance Structure, featuring a Block Level Coordination Committee (BLCC) with representation from the Health Department, NRLM, and PRIs; and A Participatory Monitoring, Evaluation, and Sustainability Framework using Key Performance Indicators (KPIs) and community feedback mechanisms like scorecards. The formal and systematic integration of SHGs, supported by these structured measures, is essential for developing inclusive, resilient, and sustainable healthcare systems capable of effectively serving tribal regions like Sondwa. Keywords: Sustainable Development, Healthcare Accessibility, Self-Help Groups (SHGs), Tribal Regions, Community-Based Planning, Spatial Analysis, Health Infrastructure, Participatory Planning.