Rural Effective Affordable Comprehensive Healthcare

REACH Protocol
REACH Questionnaires
REACH Monthly Fact Sheet

The project is a working model of Proactive health care delivery system that offers promotive, preventive and primary healthcare to rural population.
One of SHARE remarkable programs REACH (Rural Effective Affordable Comprehensive Health Care). A model of universal, comprehensive rural health care that provides health education, immunizations, antenatal care and primary to tertiary care for a population of 45,000 in 42 villages in the Ranga Reddy District of Andhra Pradesh. Local residents with at least a sixth grade education are trained by MediCiti staff and charged with the task of visiting each home in their assigned territory at least once a month. These Community Health Volunteers (CHVs) collect birth and death data.


Universal health care to rural population.
Effective (not Nominal) health care.
Affordable (within the economic means of Indian society at large).
Comprehensive (Should include promote, preventive, primary and secondary care).
Sustainability (Accessibility and affodability contribute to substance, growth and development).


Reduction in infant and maternal mortality rates in conformity with national goals.
Stabilisation of population growth.
Prevention of vaccine preventable diseases.
Preventing diseases due to nutritional deficiencies.
Control of blindness due to cataract.
Promotion of reproductive and child health.


To improve nutrition and health of the women particularly pregnant and lactating mother and to empower them through increased awareness to take better care of their personal and household health and nutrition needs.
To reduce low birth weight babies and premature births and infant mortality thereby improving the quality of the population.
To improve the nutrition health psycho social status of children 0-6 years of age with particular emphasis on preventing malnutrition and to reduce infection by immunisation.
To eradicate night blindness by vitamin A supplementation,anemia by iron supplementation,goitre by iodine supplementation.


To strengthen and enhance the quantity and quality of maternal and child health programme through Integrated Child Development Services.
Identification: To identify pregnant, lactating and children under 6 in every village Their Demographic Profile and Health and Medical Record to be Tracked on a Computer.
To prepapre a crisp and flexible model the field workers to achieve the desire results.
To cause delivery of an ambulatory care to the villagers with help of Mobile units.
To provide Proctively health and medical services and not wait for the individual or the patient to seek the services.
To train the field staff to enhance their skills (Capacity Building).
To plan, organise and step up nutrition education (IEC - Information, Education and Communication).
To be in close liaison with the public health and medical authorities.
Step up health education for empowerment of women to maintain family and community health.


1. Tatineni A., Vijayaraghavan K., Reddy P.S., Narendranath B, and Reddy R.P., Health Metrics Improve Childhood Immunization Coverage in A Rural Population of Andhra Pradesh. Indian Journal of Public Health, 2009, 53:41;43. Health Metrics Improve Childhood Immunisation


A census type of Family Health Survey was undertaken during 2008-09 in all the 40 REACH (Rural Effective Affordable Comprehensive Health) project villages in Medchal mandal of Ranga Reddy district in the State of Andhra Pradesh .The main objective of the survey was to provide estimates of fertility, contraceptive prevalence, infant and child mortality, maternal and child health, child immunization, morbidity and health care, and utilization of ICDS services by children under six years of age, pregnant women and lactating mothers.

The need to undertake a cross-sectional National Family Health Survey (NFHS) type of survey in Medchal mandal was keenly felt for two main reasons:

1) REACH project has been in operation in Medchal mandal since 1994 and so far no systematic independent evaluation of the project has been carried out. It was thought that a cross-sectional census type of survey would help cross-check and validate the results of the on-going REACH project.
2) A survey of this type would generate good quality data on key demographic and health indicators, provide baseline information as well as facilitate needs assessment for any future interventions in the project area.
Instruments of Survey
Two types of questionnaires (Household Questionnaire and Women’s Questionnaire) were developed keeping in view the objectives of the study and the nature of information needed to be collected. The questionnaires were translated into Telugu and were also back-translated to verify the accuracy and authenticity of translation. The printed questionnaires contained the questions both in English and Telugu.

The Household Questionnaire was used to list all usual residents plus any visitors who stayed in the household (HH) the night before the interview. Socio-demographic characteristics of all listed persons were collected. Information was gathered at HH level on the prevalence of asthma, tuberculosis, diabetes, goiter, malaria and jaundice, as well as three lifestyle indicators - chewing paan masala or tobacco, drinking alcohol, and smoking. Information was collected on birth registration in respect of persons under 5 years of age. In addition, the household questionnaire envisaged collection of information on HH conditions, source of lighting, cooking fuel, ownership of agricultural land and livestock as well as ownership of consumable durable items.

The Women’s Questionnaire was formulated to collect information from all currently married women age 15-49 years who were usual residents of the households or visitors who stayed in the household the night before the interview. Information was obtained on the background characteristics of women, their reproductive history, contraceptive use, antenatal care, delivery and postnatal care, child immunizations and child health and utilization of ICDS services.

Investigators A survey team consisting of three supervisors and 12 investigators conducted the fieldwork in REACH villages during October 2008 – February 2009. All the investigators including the Supervisors underwent training for a period of about 2 weeks in the administration of questionnaires. The training included, apart from classroom lectures and discussions, role play, field visits and mock surveys. Read More.....