The community health volunteer scheme in India: an evaluation

In this paper, we have placed the discussion of community health volunteer (CHV) scheme within the larger context of the evolution of primary health care organization in India. Drawing on a national evaluation study and a micro village level study, we have outlined the key issues in the design and implementation of the CHV scheme. These issues relate to the range and quality of services, the characteristics of clients served, nature of health problems attended, community participation, extent of help rendered by CHV to PHC staff, and problems of logistics and supply of manuals, kits and medicines. Our analysis shows that the CHV scheme has succeeded in bringing primary curative care to the doorsteps of the people. To a smaller extent, it has also helped in improving related services such as family planning, immunization and detection and treatment of malaria. Both the village community and the field staff of the regular health care organization find the CHV as a useful link between the community and the primary health center. Also CHVs are not confining to only a privileged few but they are catering to a cross-section of different caste and class groups in the village community.