A Pathway Towards Holistic Health in Raigad District

Health Promotion Trust’s Future Grassroots Initiatives

Since 2009, the Health Promotion Trust, in collaboration with 18 partners, has been implementing a grassroots preventive health programme in the impoverished rural tribal communities of Raigad district. Most of these people are daily wage earners, whose health expenses average nearly Rs 3,000 to 4,000 a year, which is a huge financial burden. Till date, HPT's programmes have empowered more than 5,000 tribal people to take charge of their health using affordable health practices incorporating their own traditions. 

HPT's COVID-19 interventions shed light on serious health issues in the Raigad district, which prompted HPT to re-evaluate its current health and social interventions in the area. Hence, with the help of 25 health workers, HPT conducted a survey in 2022, covering 2,345 families from80 villages in 16 talukas.

The major findings determined the prevalence of the following:

•  A wide incidence of TB (70% of respondents), and other diseases like cancer and leprosy (25% of respondents)

• Emerging problems including diabetes, blood pressure, kidney stones, liver inflammation and heart ailments

• Upper respiratory infections like cold and cough among all age groups

• Reproductive issues, anaemia and backaches among women

• Arthritis, physical weakness, upper respiratory infections among seniors

• Early child marriage and early child-bearing resulting in poor health of girl children

• Superstitious practices that deter people from seeking medical help

On a positive note, the survey highlighted the significant beneficial impact of services provided by community health workers from government agencies and the Health Promotion Trust.

On June 10, 2023, HPT met with several key stakeholders to discuss the Raigad study findings and brainstorm new approaches to preventive healthcare among the neediest urban and rural communities. The stakeholders included Dr Aman, National Institute of Naturopathy, Pune; Fr Nigel Barrett, Archdiocesan Communication Centre; Ms Clara D'Souza, Adhata Trust; Dr Lidwin Dias, Principal, College of Social Work; Fr Richie Quadros, Director, SarvaVikas DeepKendra, and close associates of HPT, namely, Ms Merlyn D'Souza, Ms Clipsy Banji, Mr Sanjiv Ferreira, Dr Sheryl John, and Prof. Sonia Rodrigues.

Based on the stakeholders' recommendations and the Raigad findings, HPT has developed a progressive set of interventions ranging from addressing chronic diseases to the need for alternative healthcare practices, timely preventive health education for youth, and continued training of grassroots leaders.

Proposed Preventive Health Interventions

• To address the TB issue, HPT will network with Snehavardhini, Roha in creating a pilot programme for a group of 10 to 15 patients. The patients should be part of the DOT (Direct Observation Treatment) program, and will be identified in collaboration with local government health centres. HPT health workers will assess their socio-economic and other factors, and accordingly design a nutrition plan. They will monitor the patients' recovery based on specific indicators – reduction in symptoms, weight gain, increased appetite, improved strength and stamina. 

• To address common ailments, HPT will continue its ongoing two-year preventive healthcare training modules that build on traditional healthcare practices.

• To increase health workers' skills and knowledge, HPT will create a new training module in collaboration with Sarva Vikas Deep, Mangaon. Attendees will include ASHA workers and Anganwadi workers selected with the approval and support of government officers (Block Development Officer).The module will consist of nine topics on health interventions based on Naturopathy and legislative remedies against social evils that undermine a community's health. Trainers will include Naturopathy doctors from the National Institute of Naturopathy, Pune and social activists. Since the attendees already enjoy a large-scale outreach in their communities, they will be able to effectively promote alternative systems of healthcare among the tribal people.

• To educate the youth about their health, HPT health workers in 18 partner centres will conduct training for groups of 10-15 adolescents on various health topics, including mental health. At a joint Bal Melawa of all the Centres, the children will be invited to share the knowledge they gained with their parents.

• To provide timely health education to school students, HPT will pilot a Health Club in a government school for Class 7 and Class 8 students, where they would attend health awareness programmes, and learn to grow a kitchen garden within the school premises. 

• To help women with their reproductive health issues, HPT will organise a camp to identify current anaemia levels, and accordingly plan an intervention, for example, aspecialised nutrition programme for women with low haemoglobin. HPT would collaborate with its partnercentre at Tala, Raigad for a monthly review. 

• To focus attention on herbal remedies and organic produce, the health workers (with the support of HPT staff)will be setting up at least five kitchen gardens in the villages where they work, as well as a herbal garden at their centre. This will help both to promote a healthy environment and encourage the people to consume and sell organic foods. 

• Other programmes will include developing a healthcare module for care leavers; connecting with schools for healthcare talks; conducting regular programmes on various lifestyle diseases; and stepping up the promotion of the Naturopathy Wellness Centre at Khandala among parishes and other groups. 

HPT's new interventions will serve as a benchmark to enable them to design future programmes in the field of preventive and promotive healthcare services.

HPT is very grateful to all its partners and grassroots health workers who are helping to bring affordable and accessible holistic health services to people at their doorstep.

Health Promotion Trust Team