Introduction
The Village Health and Sanitation Committee (VHSC) is a vital community-based body formed under the National Health Mission (NHM) to improve health, hygiene, and sanitation at the village level. It acts as a bridge between the community and the public health system, ensuring that people’s health needs are heard, addressed, and monitored effectively.
The VHSC represents the idea that health is a shared responsibility — not only of government agencies but also of the community itself. It encourages local participation in planning and implementing health and sanitation activities, especially those related to maternal and child health, nutrition, safe drinking water, and environmental cleanliness.
By bringing together representatives from different sectors — including local government (Panchayati Raj), health workers (ASHA, ANM), Anganwadi workers, teachers, and community members — the committee ensures that diverse voices contribute to improving village health outcomes.
In essence, the VHSC serves as the foundation of decentralized health governance, promoting awareness, accountability, and cooperation within the community to achieve a healthier, cleaner, and more responsible rural environment.
Objectives of the Village Health and Sanitation Committee (VHSC)
The main objective of the Village Health and Sanitation Committee is to empower the community to take charge of its own health, hygiene, and sanitation needs. It ensures that health planning and decision-making start from the grassroots level, making services more relevant and effective for the local population.
The following are the key objectives of the VHSC:
1. Improve overall village health and sanitation:
The committee works to promote cleanliness, safe drinking water, waste disposal, and proper sanitation facilities to prevent diseases and improve the overall quality of life.
2. Strengthen maternal and child health services:
VHSC ensures that pregnant women, lactating mothers, and children receive proper healthcare, immunization, and nutritional support through close coordination with health workers.
3. Promote health awareness and behavior change:
It conducts awareness activities and campaigns to educate villagers about hygiene practices, nutrition, vaccination, and disease prevention, encouraging healthy habits in daily life.
4. Facilitate community participation in health programs:
The committee motivates local residents to take active roles in planning, implementing, and monitoring government health initiatives, ensuring that programs truly reflect the community’s needs.
5. Monitor health services and resources:
VHSC keeps track of the availability and quality of health services at the village level, such as outreach clinics, immunization drives, and use of untied funds.
6. Prepare and implement the Village Health Plan:
Based on local data and priorities, the committee identifies key health issues and develops an annual plan for improvement, integrating it with the Panchayat’s development plan.
Composition of the Village Health and Sanitation Committee (VHSC)
The Village Health and Sanitation Committee (VHSC) is a multi-sectoral and community-driven group formed at the village level to ensure that all sections of society have a voice in local health and sanitation planning. Its composition reflects inclusiveness, ensuring representation from various community groups, especially women and marginalized populations.
The composition of a typical VHSC includes:
1. Elected Panchayat Representative (Chairperson):
Usually, the chairperson of the Gram Panchayat or an elected member serves as the Chairperson of the VHSC. They lead meetings, approve village health plans, and ensure coordination with local governance structures.
2. Accredited Social Health Activist (ASHA):
ASHA acts as the Member Secretary or Convenor of the VHSC. She plays a vital role in linking the community with health services, mobilizing villagers for health programs, and maintaining health records.
3. Auxiliary Nurse Midwife (ANM):
The ANM provides technical guidance to the committee, supports immunization, maternal care, and family welfare activities, and helps in identifying local health problems.
4. Anganwadi Worker (AWW):
The AWW represents the nutrition and child development sector. She provides insights into children’s growth monitoring, supplementary nutrition programs, and early childhood education.
5. School Teacher:
A teacher contributes by promoting health education and sanitation awareness among schoolchildren and helps organize school health programs.
6. Representatives of Women’s Self-Help Groups (SHGs) and Youth Groups:
Members from local SHGs and youth organizations ensure active community participation and help in spreading awareness campaigns at the grassroots level.
7. Community Representatives:
These include local elders, persons from marginalized groups (Scheduled Castes, Scheduled Tribes, minorities), and respected community members to ensure equity and inclusiveness in decision-making.
8. Health and Sanitation Workers:
Local sanitation staff, such as village cleanliness workers or water supply officials, may be included to coordinate hygiene and sanitation activities.
In short, the VHSC’s strength lies in its diversity. By bringing together health workers, educators, elected leaders, and community representatives, it ensures that every decision reflects local needs and priorities.
Functions of the Village Health and Sanitation Committee (VHSC)
The functions of the Village Health and Sanitation Committee (VHSC) revolve around planning, implementing, and overseeing activities that improve the health and hygiene standards of the village. Each function is designed to ensure that health services are accessible, effective, and inclusive, reaching even the most vulnerable populations.
The major functions of VHSC include:
1. Health Planning and Implementation:
VHSC prepares and executes a Village Health Plan based on local needs and priorities. This plan covers areas such as maternal and child health, sanitation, nutrition, immunization, and disease prevention. It ensures that health interventions are tailored to the village’s specific problems and resources.
2. Organizing Village Health and Nutrition Days (VHNDs):
The committee helps conduct monthly VHNDs in coordination with ASHA, ANM, and Anganwadi workers. During these sessions, immunization, antenatal care, and health education activities are carried out to raise community awareness and improve service delivery.
3. Promoting Health Education and Awareness:
VHSC regularly organizes health awareness campaigns on topics like handwashing, menstrual hygiene, safe drinking water, malaria prevention, and waste management. These campaigns encourage behavior change and promote healthier lifestyles.
4. Monitoring Health Services:
The committee keeps track of the performance of health workers, availability of essential drugs, and the quality of services at sub-centres and Anganwadi centres. It also ensures that no household is left out of key services like vaccination and maternal care.
5. Sanitation and Environmental Health:
VHSC works actively to improve the village’s sanitation infrastructure, such as public toilets, drainage systems, and waste disposal. It also monitors water sources and promotes household-level cleanliness to reduce disease outbreaks.
6. Fund Management and Utilization:
VHSC receives untied funds under the National Health Mission (NHM) for small-scale health and sanitation needs. The committee decides how to use these funds for local improvements—like repairing wells, maintaining cleanliness around health centres, or organizing awareness events—ensuring full transparency in expenditure.
7. Supporting Vulnerable Groups:
The committee identifies and supports families that are economically or socially disadvantaged, ensuring they get access to free or subsidized health services, nutritional support, and social welfare schemes.
8. Strengthening Community Participation:
VHSC encourages collective decision-making and community ownership of health programs. It ensures that every villager, especially women, is involved in improving health outcomes and maintaining sanitation standards.
In short, the VHSC functions as the operational heart of village health governance. Through its planning, monitoring, and community engagement, it transforms government health initiatives into meaningful action at the grassroots level.
Meetings of the Village Health and Sanitation Committee (VHSC)
The following points explain how VHSC meetings are conducted and why they are important:
1. Frequency of Meetings:
VHSC meetings are generally held once a month at a fixed venue, usually in the Panchayat office, Anganwadi Centre, or Sub-centre. Regular meetings help maintain continuity in planning, monitoring, and implementation of health activities.
2. Participation and Attendance:
All VHSC members — including the Panchayat representative (chairperson), ASHA (member secretary), ANM, AWW, school teacher, and community representatives — are expected to attend. Their active participation ensures that health decisions reflect local realities and community priorities.
3. Agenda of the Meeting:
Each meeting follows a structured agenda, which may include:
- Reviewing health and sanitation activities carried out in the previous month.
- Discussing local health problems such as outbreaks, malnutrition, or poor hygiene.
- Planning for upcoming Village Health and Nutrition Day (VHND) activities.
- Monitoring the use of untied funds and approving expenditures.
- Identifying households that need special health attention, especially among vulnerable groups.
4. Record Keeping and Reporting:
ASHA, as the Member Secretary, maintains the meeting records, including attendance, discussions, and decisions taken. Minutes are documented in a register, ensuring transparency and accountability. These records also serve as references for district or block-level reviews.
5. Decision-Making Process:
Decisions are made collectively, usually through consensus. Every member, regardless of position, has an opportunity to voice opinions and propose solutions. This democratic process strengthens trust and cooperation within the community.
6. Review and Follow-Up:
At the beginning of each meeting, previous decisions are reviewed to assess progress. Pending actions are discussed and re-assigned, ensuring that tasks are completed efficiently and without delay.
7. Community Involvement:
Occasionally, VHSC invites community members, especially women and youth, to attend open meetings. This promotes transparency and encourages people to take an active role in improving their own health and sanitation conditions.
Village Health Plan
The Village Health Plan (VHP) is the most important output of the Village Health and Sanitation Committee (VHSC). It serves as a blueprint for improving the health, nutrition, and sanitation status of the village, based on local needs and priorities. This plan ensures that community health efforts are systematic, data-driven, and aligned with the broader goals of the National Health Mission (NHM).
The preparation of the Village Health Plan involves several thoughtful steps:
1. Assessment of Community Health Needs:
The VHSC begins by assessing the current health situation in the village. This includes collecting data on births, deaths, diseases, maternal and child health status, sanitation conditions, and water supply. Information from ASHA, ANM, and Anganwadi workers helps identify gaps and challenges faced by families.
2. Identifying Priority Areas:
After assessment, the committee identifies the key health and sanitation issues that require immediate attention. Priorities may include malnutrition, poor sanitation, maternal mortality, low immunization coverage, or lack of safe drinking water.
3. Setting Objectives and Targets:
Based on these priorities, VHSC sets clear, achievable objectives — for example, increasing institutional deliveries, ensuring full immunization, or promoting 100% toilet coverage. These targets provide a measurable direction for the committee’s efforts.
4. Planning Health and Sanitation Activities:
The committee outlines specific actions to achieve the set objectives. Activities may include organizing health camps, cleanliness drives, nutrition awareness sessions, repairing hand pumps, or monitoring school health programs. Each activity is assigned to responsible members or departments.
5. Budget Allocation and Use of Untied Funds:
The VHSC plans how to use available financial resources, particularly the untied funds provided under NHM. Expenditures are prioritized for low-cost, high-impact interventions such as repairing sanitation facilities, arranging clean drinking water, or conducting awareness campaigns.
6. Integration with Panchayat Plans:
To ensure coordination, the Village Health Plan is integrated with the Gram Panchayat Development Plan (GPDP). This alignment helps mobilize additional resources and ensures that health goals are part of the broader village development strategy.
7. Monitoring and Evaluation:
Once implemented, the VHSC regularly reviews the progress of the plan. Indicators like reduction in disease incidence, improved sanitation coverage, or increase in institutional deliveries are tracked and discussed during monthly meetings.
Financial Resources and Untied Funds of the Village Health and Sanitation Committee (VHSC)
To empower local health governance, the government provides untied funds under the National Health Mission (NHM) — giving the committee flexibility to address small but critical health and sanitation needs at the village level.
The financial resources and utilization process are designed to encourage accountability, transparency, and community ownership.
1. Source of Funds:
Each VHSC receives untied funds, usually around ₹10,000 per year, provided through the Health Department under the NHM. These funds are not restricted to any single activity — hence the term “untied” — allowing the committee to respond quickly to local needs and emergencies.
2. Purpose of Untied Funds:
The main purpose of these funds is to support low-cost, high-impact health and sanitation interventions. They are meant for immediate local action rather than large infrastructure projects. The focus remains on preventive and promotive health.
Common uses include:
- Repairing or cleaning hand pumps and wells to ensure safe drinking water.
- Conducting village cleanliness and sanitation drives.
- Purchasing basic supplies like soap, bleaching powder, dustbins, or health education materials.
- Supporting Village Health and Nutrition Days (VHNDs) through banners, refreshments, or logistics.
- Minor repairs to Anganwadi Centres or health sub-centres.
- Providing emergency support for maternal or child health needs until referral services are available.
3. Fund Management and Operation:
The untied fund is jointly managed by the ASHA (Member Secretary) and the Chairperson of the VHSC (usually a Panchayat representative).
A joint bank account is maintained in a nearby bank or post office, ensuring transparency. All expenditures are decided collectively during VHSC meetings and recorded in the minutes book and cash register.
4. Financial Accountability:
To prevent misuse, all spending must be properly documented with vouchers, bills, and receipts. The VHSC submits periodic financial statements to higher authorities, such as the Block Health Office or the Panchayat.
5. Encouraging Community Contribution:
Apart from government funds, VHSC also motivates the community to contribute resources voluntarily — such as labor for cleanliness drives or materials for health awareness events. This strengthens ownership and sustainability of village health activities.
6. Challenges in Fund Utilization:
Sometimes funds remain underutilized due to lack of training, delayed release, or hesitation among committee members to take financial decisions. Capacity-building sessions and regular monitoring help overcome these challenges.
In summary, the untied funds give VHSCs the power to act swiftly and independently, turning community decisions into concrete action.
Challenges Faced by the Village Health and Sanitation Committee (VHSC)
Despite being a powerful tool for community-driven health improvement, the Village Health and Sanitation Committee (VHSC) often faces several practical and administrative challenges that limit its effectiveness. These challenges arise from gaps in training, coordination, resource management, and community engagement. Understanding them is essential for strengthening the committee’s role and ensuring long-term success.
1. Lack of Awareness and Training:
Many VHSC members, especially from rural and marginalized backgrounds, are unaware of their roles, responsibilities, and powers. Without proper orientation and capacity-building programs, they struggle to prepare health plans, manage funds, or monitor health activities effectively.
2. Irregular Meetings and Poor Attendance:
VHSC meetings are supposed to be held monthly, but in many villages, they occur irregularly or with poor participation. Health workers may be busy with other duties, while community members often lack motivation or clarity about the purpose of these meetings.
3. Inadequate Utilization of Untied Funds:
Although untied funds are available, many committees either fail to use them or spend them ineffectively due to a lack of financial management skills or fear of audit issues. Sometimes, delays in fund release from higher authorities also affect implementation.
4. Weak Coordination Among Departments:
VHSC activities require collaboration between multiple sectors — health, sanitation, water supply, and local governance. In reality, coordination between these departments is often weak, leading to fragmented or duplicated efforts.
5. Limited Community Involvement:
In some areas, participation remains restricted to health workers or panchayat members. Ordinary villagers, especially women and youth, are not actively engaged, which reduces the community’s sense of ownership and accountability.
6. Inconsistent Monitoring and Record Keeping:
Poor maintenance of registers, lack of performance indicators, and inadequate data collection make it difficult to measure progress or identify problem areas. Without reliable data, the VHSC cannot make informed decisions.
7. Shortage of Technical Support:
Committees often need expert advice on planning, budgeting, or public health practices. However, limited technical support from higher health authorities and lack of regular supervision lead to weak execution of plans.
8. Socio-cultural Barriers:
Traditional beliefs, gender inequality, and social hierarchies sometimes discourage open discussion and participation, especially from women or lower caste members. This undermines inclusivity and weakens collective decision-making.
9. Political and Administrative Interference:
In some villages, local political influence affects fund allocation or decision-making. As a result, priority shifts from genuine health needs to personal or political interests.
10. Lack of Motivation and Recognition:
Since VHSC members work voluntarily, motivation often declines over time. The absence of recognition, incentives, or visible results further discourages active participation.
In summary, the VHSC faces a mix of structural, administrative, and social challenges. Yet, these issues can be overcome with proper training, regular supervision, stronger community mobilization, and consistent support from local authorities.
