The Integrated Rural Development of Weaker Sections in India (WIDA)


Health is a right of every individual. Health concerns of the people were always related to their access to information. Whatever information on health being passed on for eyes is being carried. if anybody falls ill, the people immediately say, it is his fate, God's punishment, evil eye or karma. In February 1982, a community health programme was undertaken. They settled in the villages the field staff already was working. They were identifying the diseases and the people's attitude towards sickness. They were asked to identify indigenous medical practices and to study their cultural implications. The health educators were involved in studying their attitudes towards modern medical practice, and also give first aid treatment to patients and explain to them the follow up measures in the future. The major thrust of the health programme is to make the people pay for their medicines and treatment. The health educator is constantly motivating the people to be partners of the programme to promote the standard health in the villager by paying medicines for treatment and cooperating in other health measures (personal hygiene, drinking water etc.) The Development committee in each village is responsible for collecting the dues.

Training of Health Educators/Co-ordinators

The selected health educators underwent training in the Christian Rural Health Programme. Doliambo during 1981. A second training programme was undertaken in June and July 1982 in clinical approach. in 1986, in a period of 6 months, a training programme was undertaken for 32 health educators, 22 native doctors, 29 village dhas and 37 women groups, conducted by the mobile health team.

To be trained on symptoms of disease, early diagnosis and simple treatment, a training programme, organised by the mobile health team was conducted in 1989 for the health co-ordinators.

Health Education

In 1982 the health educators were involved in building rapport with the people and conducting health education on preventive health measures in the village. The health educators stays in the village and the doctor visits the village periodically. They undertake the following responsibilities:

  • -To study health related problems in the village
  • -To impart relevant health education programmes to the people
  • -To enroll family health cards and screen 2 to 3 families a day
  • -To run the village level clinic
  • -To introduce simple practices
  • -To refer the patients either to mobile health team or to the nearest primary health center
  • -To identify people suffering from chronic diseases and refer to government hospitals for treatment
  • -To identify and train village level traditional birth attendants and native medical practitioners
  • -To initiate discussion on sickness, treatment and health with the local witch doctors (Gurumis, Gunniyas and Disaris)
  • -To identify mal-nourished children, adults particularly pregnant women and to take follow up action, and in general to raise the health consciousness.

In many villages, due to constant health education, people have started to drink boiled water and also trying to keep the house and its surroundings clean. The sixteen health educators (as of 1982) had been conducting health education programmes in 71 villages of 15 blocks and meeting 436 people. Following issues are brought up and discussed:

In 1988, a community health survey was undertaken covering 4 blocks. In each village 15 households were interviewed. From 21 villages 315 families responded. The purpose of the study was to assess the work what the project had done and comparatively study and understand the status of health from the villages where the project is not working.

In 35 villages in 1990 a health education programme was organised on prevention of malaria, TB, diarrhea, Leprosy, cleanliness, personal hygiene, drinking water, preparation of food, kitchen garden, balance diet, Child care, ORS, antenatal and postnatal care.

The project conducts regular health education classes, and in 1991, 303 such classes were held and attended by 4434 people from the villages.

Health education was imparted on children in 3 schools in 1997 in order to create health awareness. During the school health programme 135 children were screened and out of them 24 children suffered from vitamin deficiency. The health team provided medicines and educated the children on personal hygiene and sanitation.

Mobile Health Team

A mobile health team was organised to visit the villages once in a month and was active from August 1982. During the visits the team treats diseases as well as gives health education. Charts, flannelographs and posters are used. It was with great difficulty we were able to launch the mobile health visits, because the mobile was very narrow. We were operating in a big area of hilly terrain with lack of vehicles. At a period of six months in 1984, the mobile programme was cancelled, because of these reasons.

In 1985 covered 6 villages in the different block and made regular visits once a week and nearby by villages reported to the team in the covered villages.

The following programmes are implementing during their visits. To support the health work (clinical) carried out by the village health cadres, health educators and block health guides.

The dependence of the patient doctor relationship is avoided Health education is given to the patients.

Training of the field level health personnel carried out Immunization of U/5 children and pregnant women are carried out In each visit it is attempted to screen 5 or more families and necessary treatment and health education are imparted.

The mobile health team continues to visit the villages once a week for check-up, identification of diseases and give health education.

Health Cadres

The village community and the represented development committee are responsible of identifying local health worker. This identified volunteer is trained on community health and the training expenses are shared partly by the villages. The training of the village health workers commenced from June 1983, with resulted in the cadres given a medical kit with 10 verities of medicine which they can handle easily. The village cadre also keeps liaison with the village native doctors and village dhais.

A one month training programme was designed in JELC Hospital in 1984, for the cadres to be trained in community health aspects. 12 cadres from 11 villages completed the training successfully yet another programme was organized at the field office in similitude, where 7 cadres were trained. conducted by health educators and village native doctors. They are trained in the following aspects:

Need and role of a village health cadre
Relationship with the local medical practitioner village native doctor, village dhais, government health worker etc.
Basic aspects of health (food, economic condition)
Health education (Preventive and promotive aspects of health)
To cure basic illnesses
To identify the diseases earlier and give information on health aspects to the whole community and to the government, in case of epidemic etc.
Basic aspects of health (food, economic condition)
Health education (Preventive and promotive aspects of health)
To cure basic illnesses
To identify the diseases earlier and give information on health aspects to the whole community and to the government in case of epidemic etc.

Village Dhais

Village dhais or otherwise called traditional birth attendants undertake the delivery of a child in the village. They are traditionally trained and learn from their mother and pass in on to their daughter. Every community social group has their own women and in case the village does not have one they bring from other villages.

These women are identified in the village and are trained in simple way of health delivery and to give up their crude method adopted. They are motivated to be in contact with the pregnant women and refer them to the clinic. In some village women are also trained by the government. They play a vital role in communication to village women on family planning issues.

154 Traditional maternity attendants were so far identified in 1986.

In the month of April 1989, training for village dhais was organized at the central office. 6 traditional birth attendants attended and discussed care of pregnant women and childcare. The village dhais were also trained at the clinic by the mobile health team.

As it is important to work through the village dhais (traditional birth attendants) who are accepted by the community, they are trained on nutrition, ante and postal care, infant care and delivery.

Follow up and regular training programmes is conducted for the dhais. They are trained on how to conduct delivery, use of TBA kit, Health and nutrition, hygiene etc.

Village Native Doctors

In every target village, it is noted that there is one or more native doctors. He treats the patients in the village with local lessees and roots. the people respect and go to these doctors. and they are paid by their patients in terms of kind or money for their services. We had in 1985 identified 96 native doctors, and some of them were in contact to share their experiences with the trained health cadres or health educators. but they did not reveal the names of the medicines (leaf, root or banks) used for treatment. with a great difficulty, we were able to contact and mobilize them for the benefit of the people. in 1986, the identified native doctors had increased to 141, and the health educators after their efforts, co-operated with them effectively.

Training for 4 village native medical practitioner was conducted at the center in 1989, in the meetings, strengthening of native medicinal practices and development of herbal gardens were discussed.

Follow-up and regular training programmes is conducted for the village native doctors to strengthen the local medicine and strengthen the practice of village native doctors.

Community Health Meetings

From February 1982 the health educators were organized health meetings on different topics (scabies, diarrhea, malaria, TV, family planning, immunization and nutrition.) The field worker will be building report with the local medical practitioners and try to find out the native medical treatment, which would be more effective than the modern medicines.

Patients Treatment

The health educator in the village treats the patient and is provided with a medical kit to treat basic illnesses early reporting to the personnel is emphasized in the prgroamme in the beginning the people reported only when they were unable to work meanwhile, the disease becomes complicated, the patient loose working days, become less productive and need effective drugs thus the treatment becomes more expensive. The health educators are able to treat in general the following diseases. Diarrhea, dysentery, worms, scabies, sore eyes, malaria and other injuries. if the health educator is unable to diagnose the disease, the patient is referred to the nearest PHC of the government. During Jan-June 1985, 1390 patients were treated.

The first six month in 1989, the mobile team visited each health center 20times and were able to treat 1232 patients. in 1994, a total of 5925 patients were treated.

The project is planning to organize camps for treating leprosy, tuberculosis and other diseases through regular coordination with primary health center and local mission hospitals.


WIDA is giving medical and health services of personnel but the people are requested to pay for the medicines. Many poor people could not pay immediately for the medicines but we are encouraging them to pay in due course. This also made them think why they do not have money to take care of their own health. 1i 1989, the people paid for the medicines to an extent of 63% of the total medicines disbursed. In 1994, market clinics were organized on every Friday at Kunduli market to provide clinical service to the patients and general health education to the people. This continued and in 1995 the market clinic was organized 26 times. The mobile health clinic was organized in 48 villages.

Family Health Cards

The health educators are involved in recording the health data of the each family in the villages. They screen everyday two to three families to get to know the day to day health problems in the family and in the village. To record this information, we established family health cards, which they started to use in 1985. This system ensures the family report to the health personnel whenever they fall ill.

The health educators in the villages are involved in recording the details of the family social, economic and health status. family health cards are being used patients treatment card, health education card, family immunization. native treatment, nutrition card and individual immunization card. The health educators and other health personnel record the details of the work carried out of each family in the family health card. As of 1985, in 77 villages details of the families were recorded and followed up by the health personnel and during 1993, 2199 people from 900 villages were screened and followed up.

Drinking Water

In 1982 a study of the operating villages showed that they are not supplied with protected drinking water although the government had dug wells in some villages, people were not using them. Hence the health educator was asked to conduct health education programmes on drinking water. as a result, in some of the villages the people cleaned the wells and began to use the well water.

The DC requested the public Health department in 1983 to sink bore wells and to repair bore wells already sunk. WIDA has also dug wells in eight villages as of 1983, and the DC also purifies the existing wells with chlorine.

Sanitation and Chlorinating

During 1982-83 the project tried to motivated people to have dug-wel latrines at low cost. The staff worked as a model for the villages, Due to hygiene education, people in many villages keep their cattle in a separate place and also try to keep their house and surroundings clean.

As of 1991, the programme had constructed 14 low cost latrines.
During 1993 about 80 villages were covered under a chlorinating programme. Bleaching powder was supplied to the villages for for chlorination of drinking water sources such as spring protection, drinking water dug wells and hand-pumps.
Cleaning of the villages, cleaning of cattle shed and cleaning of the drainages were undertaken by the people.
In 1994, 51 villages were cleaned with the active participation of the village people in making a pit to put cow dung and other garbage etc.

Immunization Programme

We found after a study undertaken in 1983 that in none of the villages we were operating the government has implemented the basic immunization programme. Hence, the project operated a mass immunization Programme after discussion with the people. The village people were cooperating in sending their children to take the basic immunization. A special team was organized to help the doctor. They visited the villages, convened community meetings and educated the families on the advantages of immunization. DPT and Polio was given.

In 1985 yet another mass immunization programme was taken place in 60 villages, at total of 251 children under DPT and 739 under polio were immunized. 57 pregnant women and 11 injury cases TTO was given. In 9 centers in 1989, 19 pregnant women were administered TTO was given. In 9 centers in 1989, 19 pregnant women were administered TTO. vaccines and technical assistance personnel are provided by the government and immunization programme is carried out by the mobile health team. This attempt has ensured proper implementation and the utility of the health schemes of the government. in 44 villages 1397 children were immunized against DPT, polio, DT, BOG, measles, TTO etc. in 1991, the immunization programme covered 79 villages. in 1997, a national pulse polio programme was organized by the government and 9 staff participated in the programme. 1228 children were immunized. against pulse polio.

Herbal Garden

Ten women were in 1989 trained in the use of herbal medicine and in one village the women came forward to start herbal garden in the village. in 1995 herbal medicine plants were collected by village native doctors from 4 villages and planted 27 plats in their herbal garden. A central level herbal garden in similitude is maintained in 1999. Whenever people and herbal medicine parishioners require medicines they come to the garden and collect the necessary plants. They also bring herbal plants to be planted in the herbal garden. A document is maintained on herbal medicines.

Kitchen Garden

1983 a community kitchen garden was planned with the people, and as a result of nutrition and health education nearly 567 families had, in1 985 started kitchen garden for their own consumption. Seeds are preserved by each family to continue kitchen garden. WIDA has distributed 20 kinds of seeds to the families to develop their kitchen garden.

In 1989, 252 families had undertaken kitchen garden programmes, and in one village community kitchen garden was organized.

From 20 villages, 520 families were identified to have u5 children and pre natal mothers in 1997 to prevent vitamin deficiency 12 varieties vegetable seeds were supplied to grow in their kitchen garden as supplementary food.

Nutrition Programme

In the month of July 1982 we started nutrition programmes in 3 blocks where an intensive study was undertaken to find out the standard of nutrition in the village. The programme is implemented through the health educators and they teach people, especially women, on the availability of low cost nutritious food and also introduce vegetable growing, planting of full trees and also change the mode of cooking without loss of nutrients. A detailed household survey was undertaken during the year 1982-83 stressing n nutrition list of food, vitamins and their resources were covered in the questionnaire.

The health educators by motivating the village women were able in 1983 to collect money, buy seeds of green leaves, papaya and other vegetables for planting in the villages. The village women also applied to the government for supply of plants of fruit bearing trees etc.

In 1985, the programme was carried out in 7 villages in the two operating blocks, and 83 families and 182 women are being contacted. Several meetings were held with the village women to discuss the following subjects.

Better food
Healthy family
How to get Good Food.
Why people doesn't have enough food.
Cooking methods.
TO identify local available nutritious food.
Infant care and identify malnutrition children and women.

Pre/Post Natal Care

48 pregnant women were identified in 1993 and 26 of them were administered with Tetanus oxide injection to prevent TBs, The rest of the pregnant mothers were covered under government programmes. The pregnant women and lactating mothers were given education on childcare, care during pregnancy, food habits, nutrition, and balance-diet during and after pregnancy. These women were taken care of by the village traditional birth attendants.

In 1995 216 pre-natal women were identified and 61 women were administered with TTO to prenatal tetanus. By mobile health programme and from government ANMs, 751 lactating mothers were given education.

U/5 Care

A Chart came into action in 1982 and indicated the standard of health of children under five in the villages the age, weight, height, arm measurement, color indication and finally through screening by the doctor. In 1983, a total of 109 children were completely checked up. By using the road to the health chart the malnourished children mothers are educated to take care of their children properly.

In 1988. A Community nutrition survey was conducted. They identified 97 malnourished children and they screened 534 children in the 27 villages. The parents of the 97 children were educated to take care if the children with the locally available food. In 1989, yet another 159 children were surveyed.

A School health programmed was organized for the children in 1990 to share information on nutrition and oral dehydration solution. This was organized for the children in 1990 to share information on nutrition and oral folifor tablets were distributed to U/5 children in 1990.
As worm infection is one of the major problems in children de-worming was doe to 132 children in 1995. In some cases the mal-nourished children were provided with supplementary food and vitamins. Nail cuttings was introduced in the villages. for several mal-nourished children the staff contacted the ICDS of the government for follow-up.

A demonstration was taken up in 30 villages in 1997 to treat dehydration during the time of diarrhea. 95 male children from 83 villages were referred to ICDS to get the government for follow-up.

A demonstration was taken up in 30 villages in 1997 to treat dehydration during the time of diarrhea. 95 male children from 83 villages were referred to ICDS to get the medicine from the PHC doctor.

Anti-meningitis Campaign

In 1989, due to and outbreak of an epidemic-meningitis nearly 9 people were reported dead in similitude block immediately the project through the mobile health team and the health coordinators organized anti meningitis campaign. Relevant charts were made on meningitis and they were distributed in 28 village, covering 4000 people, and 12 people who were suffering from the disease were immediately shifted to government hospitals.

Plantation Programmed

A plantation programme was also organized in 1986. Yound papaya plats were distributed to five villages. A part from papaya, mango, cashew, gova and jackfruits were also distributed.
To prevent vita a deficiency for the U/5 and pre-post natal mothers, 19 village were distributed papaya plants in 1995.592 plants were distributed to 100 families.

Feeding programme
The care feeding programmes run by government was streamlined. In 1989, the project undertook a feeding programme in one village and a school was sanctioned. A milk feeding programme for 3 months in 1989 was organized in yet another village. 50% of the expenses was met by the people and the other half by the project.

Training Programmes

Training programmes were organized at the field office in similitude for the health educators and the village women. Special training programmes were organized on decision making, participation on equal wages, liquor and unsociability.

In 1985, weekly meetings were held on various issues at the field office. As of 1985, 50 women had been trained on nutrition. They can identify diseases and maturation disorders in child and women. They refer them to the local clinic and educate the families on nutrition. The trained women in turn train other women in the villages through dialogue or group meetings.

The training helped women to identify diseases like anemia, deficiency of proteins (vitamin A, Vitamin B, Vitamin C and iodine). The women are also able to make up the deficiencies to some extent by supplementing with locally available nutritious food.

As of 1987, a total of 337 women had been trained.

A special education programme was organized in 1988 for pregnant women and mothers to take care of malnourished children.

All Rights Reserved