| Abstract: |
In social development and health sector, India’s performance is still lagging
behind many Sub-Saharan African countries. There are also disparities between
the urban and rural sectors and between privileged upper class and the
socially disadvantaged groups. Widespread illiteracy, avoidable morbidity,
premature mortality and deep-seated inequality of opportunity are still
prevailing in India. India’s achievements in dealing with life expectancy,
elementary education, nutritional well being, protection from illness, social
security and consumption levels has been substantially and systematically out
passed by many other developing countries. Compared to other countries, social
sector expenditure is negligible in India, especially when compared it with
UNDP recommended ratio. In the case of Indian state we can see that
accelerated growth rate does not to have led to a corresponding change in
living condition of rural poor. Here lies the importance of participatory mode
of approach. The provision of social security cannot rely exclusively either
on market forces or on the state initiative. There is an urgent need for
participation in the distribution of social security measure. The move towards
participatory growth calls for an integrated view of the process of economic
expansion. The UN has defined community participation as ‘the creation of
opportunity to enable all members of a community and the larger society to
actively contribute to and influence the development process to share
equitable the fruits of development’. This participatory mode of development
views village community as the site for intervention. In this process it has
to mediate through agencies working at that level. This is most commonly done
through NGOs. In this broader context of Indian state’s commitment to
liberalization, present paper attempts to study the participatory intervention
of NGO in community health. For a detailed study, success story of AWARE - NGO
working among the marginalized people in rural Andhra Pradesh is selected. The
paper does not project NGO as viable alternative to fill the space vacated by
state. But it only tries to establish that the objective of “Health for All”
can be achieved only through community participation. The present paper is
divided into 4 parts. The first part briefly outlines health sector
performance and trends during the post reform era and its outcomes. The second
part analyses the status of health sector in Andhra Pradesh, major indicators
and initiatives. The third part in detail discusses the sustainable strategy
of AWARE and its impact on health sector in rural Andhra. The final part
contains major findings and concluding remarks. |