The Comprehensive Rural Health Project (CRHP) is a non profit non-governmental organisation located in the Ahmednagar District of Maharashtra State in India.
Before founding CRHP in 1970, the couple worked in the Marathi Mission Hospital in Vadala from 1962-1966 and spent time in the US completing their medicine & surgery residencies, well obtaining MPH degrees at Johns Hopkins University.
The idea of CRHP was born during the Aroles’ time at Johns Hopkins and was based on their prior experiences with the rural poor.
They decided that they needed to provide holistic care and create empowering framework that galvanized communities to come together to solve their problems sustainably.
[1] To understand the link between poverty and health, the Aroles decided to live on the same amount of money that an average village family earned, which was approximately US $7.00 per month [5].
Over half of the training time is dedicated to personal development in order to build self-esteem, confidence, and skills necessary for community organization and effective communication.
The rest of the training is spent developing clinical knowledge and skills that equip the women to function as primary health care workers.
VHWs provide basic preventive healthcare and knowledge to their villages and help organize and facilitate Women’s Groups and the Adolescent Girls Programs.
The integration of the team and skill sharing allows for flexibility and creates resiliency in our system in the face of unpredictable absences and personnel shortages.
MHT members help lead and provide support for the Adolescent Boys and Girls Programs, Women’s Self-Help Groups, and Farmers’ Clubs.
In addition, the MHT members work with trainees and researchers from all over the world to collect village data and educate others about the Jamkhed Model.
When the Aroles first arrived in Jamkhed, they planned to stay a few years, set up a mobile hospital, remedy the health situation, and move on to another area.
During discussions with community members, Village Health Workers address issues such as child care, family planning (contraception use increased from less than 0.5% in 1970, to nearly 60% as on 1999), adequate birth spacing, nutrition, hygiene, sanitation and safe drinking water [9].
With the institution of these workers, there has been a significant reduction in child malnutrition, diarrhea, pneumonia, leprosy, HIV/AIDS, tuberculosis, and malaria, along with other common diseases associated with standing water from the lack of sanitation and liquid waste disposal systems [6].
In some cases, the Village Health Worker would illegally sell the drugs to the highest bidder or refuse to give treatment without payment.
CRHP trained the Village Health Workers particularly in the methods pregnancy care, such as monitoring blood-pressure and checking for anemia, and in safe and hygienic childbirth.
Most female villagers were married before the age of 10, started having children before 14, were beaten by their husbands (according to a 1996 UNICEF survey, up to 45% of men in India acknowledged physically abusing their wives), and eventually abandoned by them [2][11].
The program teaches girls, ages 12–18, health education and personal development, and self-defense, and fosters discussion and creative activities in order to promote self-esteem and a sense of empowerment [15].
As a result, more women are postponing marriage until 18, the use of contraception and voluntary hysterectomies have reduced family size, and more girls are attending school [2].
Additionally, CRHP helps village women to receive micro-credit loans from local banks and provides them a means to become economically independent.
The Aroles chose young women as Village Health Workers to begin the process of breaking down gender inequality, but contributing factors are still heavily present—socioeconomic class, son preference, early marriage and pregnancy, and violence.
A 2010 study used qualitative methods and surveyed 18 Village Health Workers and found 6 themes consistent with a successful approach to empowering women.