| Abstract: | In South Madras, India, Voluntary Health Services (VHS) operates under the concepts that prevention is an important as cure, the family is the unit for medical care, and community participation. It uses a voluntary health plan as a means to provide preventive and curative health care for residents who pay a fee based on their income. Subscribing to this plan allows them access to preventive and curative services at the nearest VHS regional health center and hospital care at the VHS Medical Centre at Adyar, Madras, in India. Since the inception of this plan, VHS has expanded to rural areas using the Mini Health Centre (MHC) model. This model was developed at the St. Thomas Mount Community Development Block of Chingleput District of Tamil Nadu State in the mid-1960s and put into operation in the late 1960s. A male and female multipurpose worker in the MCH serves 5000 people. A physician is there at least 3 hours/day for 3 days/week. A lay worker staffs a health post and attends to 1000 people. The MHC provides maternal-child health, family planning, and referral services; health and nutrition education; control of communicable disease activities; curative care; and environmental sanitation. Community participation includes provision of buildings and minimal furniture, financial support (e.g., the community provides 33% of the total budget resources), and a nonpolitical local action committee. The state of Tamil Nadu and the central government provide financial incentives to other voluntary group to set up MHCs (as of June 1993, 261 MHCs existed). Vital statistics indicate that MHCs improve the health status of the population (e.g., infant mortality rate in 1977 = 134 and in 1989 = 36.5). Some weaknesses with MHCs are unmotivated medical officers, high turnover rate of staff due to low pay scales, and financial obstacles. |
