State Health Resource Center

The operational unit of the programme is a block. Fourteen blocks run directly by seven select NGOs provided the pilot experience .The programme was then expanded to 80 blocks as the first phase and the last 66 blocks were taken up as the second phase.

The Mitanin programme is made up of seven key steps or processes.

Building up an understanding of the programme at state, district and block level and building up state civil society partnerships to implement the programme at the state, district and block level. This was done through a well defined process as per a set of guidelines that has considerable flexibility but which needs to be changed only in consultation with the state programme management.
Facilitated selection of the Mitanin by the community & Building understanding of the programme at the village level : The facilitator that after the all the families of the habitation are adequately informed and interesed in this programme they sit together and select the Mitanin. As part of this a team of carefully selected and trained facilitators with a known public service record, visit the villages and interact with local communities to help the community identify a woman in each hamlet who is willing to be trained and function as the Mitanin on a voluntary basis and has the family support to do so. The accompanying media campaign and kalajathas ensure that many women volunteer for becming Mitanins. They also identify and build up a group of active women who would support her. Special emphasis is paid to involving the panchayat and its health committee in this task and the panchayat officially and in writing endoreses the Mitanin selected..
Training Mitanins on Child health so that they can :
1. Ensure that child health components of the ANM and ICDS programme reach the children ( done in coordination with the health dept and the ICDS programme)
2. Identify children( below five years at risk) by weight for age measurements as well as all children in the first year and counsel and support mothers of such children to prevent infections and optimise feeding practices.
3. Ensuring that all families with children below three are visited on the day of child brith, on the first day of a diarrhoea, ARI or fever and appropriate advice given.

The first round of training also helps the Mitanin understand the objectives and organisational strategy of the programme. It also informs her about existing public health care facilites and how to go about educating the community on this.

Training Mitanins on Womens health:
1. Help women especially adolescent girls understand the causes and determinants of womens health problems
2. Ensure that government programmes to train dais, and to provide care in pregnancy are effective and accessible to the public.
3. Ensure that there is a capacity to identify commons womens health problems and provide relief for them

Training Mitanins to organise community initiatives for the control of Communicable disease in coordination with the health department. Special focus initially on three diseases – malaria, tuberculosis and Hansen’s disease- where existing government programmes would be modified to utilise these initiatives and made more effective. A special programme on control of water –borne disease would be undertaken also.

Training Mitanins to maintain and use a simple medical kit, supplemented by home and herbal remedies, to provide care for minor illness and first aid.

Training Mitanins to help the local women health committee maintain a basic village health register that acts as an instrument for programme monitoring and local health planning.

Local capacity building and local planning : the womens health committee, the elected panchayat members , the panchayat health sub committee and other interested persons would develop an understanding of health and health care services by participation in the above programmes as well as special training camps organised for this purpose. This capability combined with tools like the data from the village health register and processes like the collaboration with the health department would help in the identification of local health priorities and the drawing up of local health plans.

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