Emerging Project Lessons
People with a history of self-employment and dynamism are better candidates to become successful entrepreneurs (VHCs). Selecting and training the VHCs proved challenging. Hiring proceeded in batches and before long it was apparent that at least one third of those hired were probably not able to meet the requirements of the training. Issues ranged from the women being migratory (often following husbands to other villages), to not having basic work skills such as good attendance at trainings, to the belief that the opportunity may not be lucrative enough. Because the deployment of the HHD was delayed, this had an adverse impact on being able to fully train and get VHCs out in the field, resulting in higher attrition.
Setting up a VHC program from scratch is a tremendous undertaking, complicated by the training requirements of using the HHD. VHCs need continuous training, including refreshers. Social prestige and recognition are powerful motivators for VHCs in addition to attractive compensation. Initially VHCs receive 6 days of training followed by 3 days every other month to receive 5 modules over 10 months. The goal is to train VHCs to the level of a nurse at the end of 1 year, upon completing all envisioned clinical training modules. CARE continued to adapt to the realities of the field by implementing the following measures:
- The social prestige of being a VHC is emphasized (it is not just a job to make money)
- Women with a background in self-employment are sought
- Interpersonal skills, including confidence and communication are evaluated and reinforced.
It is difficult to get specialist doctors to visit the hub clinic when patient volume is low, and difficult to attract patients to the clinic without an array of specialists. One way in which CARE will address this challenge is to again use technology. Video conferencing will be implemented to allow remote consultations by specialists and to obtain support for visiting specialists at CARE Nagpur hospital.
Date of last Learning Journey update: April 2012