Uttarakhand Cluster of Community Health Programs
The Uttarakhand Cluster of community health programs (UKC) is a network of charitable community health programs located in North India. The cluster has 24 programs and represents a catchment area of up to 3 million people. Dr Nathan Grills, during a 6 month secondment to the Nossal Institute from the Victorian Department of Human Services, was responsible for facilitating these community health programs to come together for mutual benefit and program strengthening. Dr Grills is continuing this work as an associate of the Nossal institute.
What is clustering?
The model of clustering community health programs is an approach to enable mutual support, sharing of materials, peer-to-peer learning and improved advocacy power and program effectiveness. Additionally the convening power and visibility of the network enables members to better engage with the formal health care sector in India. Ultimately then networking aims to strengthen the Primary Health Care system in India and work towards the 2008 World Health Report goal of universal healthcare access.
The UKC was inaugurated at a recent meeting in Dehradun from the 16-18th October, 2008. The outcome of this inaugural cluster meeting was that a “Declaration of Intent” signed by 17 community health programs. There are now 24 member programs in the UKC. In addition to a number of collaborative activities, twice yearly cluster meetings are planned.
Anti-tobacco campaign
To show the effectiveness of the cluster, the Uttarakhand Cluster (UKC) collaborated to address a the major public health issue in India: tobacco consumption. 55% of adult Indian males use tobacco products and in the mountains of Uttarakhand this figure is closer to 80%. In India tobacco kills just short of 1 million people a year which is more than HIV and Malaria combined. The UKC collaboratively commissioned and produced an awareness DVD to raise awareness about the dangers of smoking. This was a great example of what a network can achieve when they work together. It had local actors, local dances, and global message to QUIT. The DVD drew on different skills from different programs. One cluster program was involved in videography, another program in song writing, another program helped with the links with the government, and still another with the actual health message.
This DVD was launched at a high level event in Dehradun to which they health secretary and other senior figures attended. The anti smoking campaign was covered in 10 newspapers and 2 TV channels. This best practise example demonstrated how small programs, by networking, can undertake significant projects, produce substantive public health materials and effectively engage the formal government sector.
Nossal provided personnel and technical support to assist in the production of the DVD.
Documenting the clustering model through research In addition to Dr Grills’ facilitation of the cluster, the Nossal Institute is involved in documenting and researching this model of networking between programs. If the model is effective then we need to document and prove this in order to facilitate knowledge translation and transfer to other settings. Funding has been applied for from the Australia India Council to support the documentation of this networking model and the dissemination of any findings.
Collaboration with Community Health Global Network (CHGN)
Nossal is collaborating with the Community Health Global Network (link to website) on this project.
The Nossal Institute is providing the research expertise whilst the CHGN is facilitating the operational formation of the clusters. CHGN is an initiative of InterHealth Worldwide, a UK-based centre for travel medicine and international health. Ted Lankester co-founded this in 1988 on return from India. CHGN started in 2005 as a separate project under InterHealth led by Ted and Dr Nick Henwood. Through an interactive website (www.chgn.org) and the formation of regional clusters, CHGN aims to:
Activities under development: At the UKC meeting in March 2009, the cluster decided to work more in disability and to produce some materials to help promote awareness about disability. The disability unit at the Nossal institute produced a disability situational analysis for this meeting. The Nossal Institute, in collaboration with CBM Australia, are helping the cluster to organise a training and awareness program for the cluster members. This will be held in March 2010. Mrs Sana Haidry, an MPH student, and Dr Sophia Samuel are assisting Nossal and CBM to develop this training module.
Possible future Nossal Institute involvement in cluster activities:
Brief Biographical information on Dr Nathan Grills
(DPhil [Oxford], MBBS [Honors], MPH [Oxford], MSc)
Dr Nathan Grills completed his MBBS in Australia and was awarded the Rhodes scholarship in 2002. He completed an MPH and then PhD in Public Health at Oxford University on the topic of civil society groups responding to HIV in India. As a researcher with the WHO (Geneva) and the CDC (Chennai, India) he undertook work on “Partnerships in responding to HIV”. Dr Grills has also worked with the Australian Aid program (AUSAID) to Nepal and with health charities in India, East Timor, PNG, Fiji, Kenya, Thailand, and Mozambique. More recently he has assisted the Community Health Global Network to facilitate the Uttarakhand Community Health Cluster of community health programs. He is currently employed as a public health fellow by the Department of Health in Victoria, Australia and is seconded to the Nossal Institute of Melbourne University. Dr Grills will also complete his public health physicians training later this year.