VHAI’s deep concern to find breakthrough in the health status of the people, particularly living in remote and difficult areas and generally having extremely low economic status, led to an innovative approach of tackling health and development issues, called KHOJ. The philosophy of KHOJ is to search for innovative methods and strategies to combat community health related problems in remote areas. KHOJ also aims to search for viable alternatives to the existing health care development model being followed by the government and also some voluntary organisations. To ensure that the health and development programmes have a lasting impact, VHAI emphasises on sustainability as an essential feature of such projects. The focus has been on the strength of panchayats. Their multi-faceted approach, individuality and problem-solving capabilities have been encouraged.
The thrust areas of work of development initiatives taken up under this programme have been classified as follows:

Since the beginning, health interventions were used to develop rapport with the community so as to ensure their fullest participation in the overall development process for the area. The curative services were provided by a team comprising of village health workers, a trained supervisor, and a medical doctor. To take care of the emergencies and provide supervised care, a small KHOJ Health Centre has been established in most of the projects for indoor admission and a small field laboratory managed by a qualified doctor and nurse. In most of the places, villagers or panchayats provide land either free or at a nominal cost. In addition, health camps and relief camps in epidemic like situations such as malaria, diarrhoea, etc. are organised from time to time. Each project has developed linkages for proper referral of complicated cases. The projects have also developed rapport with some of the local doctors to provide specialized care on a regular basis. The health impact of the KHOJ Project can be summarised as:

All the projects have taken effective steps to organise people’s groups at different levels in the project villages. These groups are mainly in the form of Women’s Groups (Mahila Mandals), Youth Groups and Farmers Groups. The formation of these groups has ensured a comprehensive relationship between the project and the community. In most of the projects apart from these groups there are also Village Health Committees where representatives from different groups come together and decide the future plans and strategies for health and development related work to be undertaken in the villages. This process has also ensured that community has a say in the decision-making process. This has also given a strong feeling of ownership to the community and has enhanced their involvement an all stages of the project. Some of the positive outcomes of these processes are:

Mobilisation of Village Committees: Village communities have been mobilised at various levels i.e. villages, blocks, panchayats, etc. and are aware of and making efforts for improving their conditions.

Formation of Social Action groups to optimize Govt. resources: in most of these areas, it was found that existing large govt. health infrastructure was not operating optimally. Subsequently, over the time the local communities had lost faith in it and the facilities were being hardly utilised, except for dire emergency and occasional preventive health work. Keeping in view the fact that large amount of govt. expenditures are incurred to maintain these facilities, it was necessary to ensure that they were operating at an acceptable level of performance.

Effective Linkages with Panchayats: The projects have been able to establish good working relationships with local panchayats with the result that health has become an important aspect of panchayat activities. The micro plans being developed by local panchayats are more relevant and available to the local needs. Panchayat members are also functioning as effective change agents.

Education: In many of the KHOJ projects literacy level is extremely low and no other NGO is working for education in those areas. Some of the KHOJ projects have initiated non-formal education centres for school dropouts. This has proven to be a very successful programme. It has helped not only in improving the literacy level but also developing rapport between the community and the project.

Though KHOJ is a health initiative, but from the beginning it has tried to address the conditions responsible for ill health. Major strategies adopted for community development are capacity building, income generation programmes and education.

Capacity building: The process of capacity building involved vocational training, training for other income generation activities, more effective utilisation of locally available resources and entrepreneurship development. To make relevant information available to local villages many projects have set up Village Information Centres to meet information needs of remote difficult areas.

Income Generation Programme: include vocational trainings, promotion of local crafts and entrepreneurship development.

Formation of Self-help Groups: Self-help group is usually a group of women ranging from 7 to 10 in number who are encouraged for periodic savings. Each project has initiated such groups. The saving made by the group is put in a nationalised bank and member women themselves manage the money. In many places, projects have also contributed a matching grant to women’s savings.

Sustainability is an essential feature of KHOJ Projects. Right from the very beginning, conscious efforts were made to select sustainable interventions. Some of these efforts are in the direction of: