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: 1.013_GOV Community Participation in Health: Factors Associated with Active Health Facility Committees in Nagaland, India A. Kaplan, K. Rao, A. Bhatnagar, N. Changkija, P. Mullen; Johns Hopkins, Maryland, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, Public Health Foundation of India, New Delhi, India, Nagaland Health Project, Kohima, India, World Bank, Washington, USA Background: Community participation in health service delivery is a way to improve the accountability of providers, responsiveness of health services and quality of care. While community participation in health can take many forms, a common approach is to establish health committees where community members take an active role in health service provision. Existing reviews in low and middleincome country settings have concluded that factors associated with the health committee, the community they serve and the health facility they manage contribute to effective health committee performance. However, there are currently few quantitative studies that examine the relative impact of these factors. This study therefore examines factors associated with active health committees in Nagaland, India after committees were established at local health facilities under the statewide Communitization of Public Services and Institutions Act. Methods: This study uses survey data collected from 97 purposively selected health facilities and 15 randomly selected households from a village within the catchment area of each facility. Bivariate and multiple logistic regression assess the likelihood of a health committee implementing an activity to improve health facility performance within the past 6 months in relation to features of the health committee, health facility and community. Findings: Just over half of the health committees had implemented an activity to improve health facility performance within the six months preceding the survey. These committees most commonly implemented Village Health and Nutrition Days, provided drugs and made facility repairs. After controlling for features of the health facility, health committee and community, the odds of implementing an activity were greater if the health facility head was a member of the health committee and the health committee approved the annual budget for the facility. Interpretation: Features of the health committee are critical to improve health facility performance, as having buy-in from health facility leadership and handing over financial oversight to the health committee increases the likelihood that a health committee takes action to improve services. These findings suggest that improving the leadership skills of the health facility head and the financial management skills of health committee members could lead to more active health committees, which could in turn improve health service delivery. Source of Funding: World Bank. Abstract #: 1.014_GOV: 1.014_GOV