Community health programme ‘Sehat Aapaa’ identifies women and children in need of medical intervention

On some days she has the door slammed in her face, on some days she is treated with suspicion. There have been mishaps on the job, and several unpleasant instances, yet, each time she reaches out to a woman in need of help, all misgivings are forgotten.

Meet Shabnam -- also known as ‘Sehat Aapaa’-- a community health worker who goes door-to-door identifying expectant women and children in need of medical intervention in Delhi’s Nizamuddin basti. “Sometimes people don’t allow me in, sometimes women are suspicious and want to know why I offer to take them to a dispensary for check-up or help them procure medicines. It is hard to cajole pregnant women and their families to agree for health checks and proper medication,” said Shabnam, who is one of the nine others who work as ‘Sehat Aapaa’ as part of the community health programme being run by the Aga Khan Trust for Culture under its Nizamuddin Basti Urban Renewal Initiative. The community health care project was started in January this year, after the Trust learnt of poor maternal and children facilities in the basti.

“Nizamuddin basti is about 5 km away from AIIMS and Safdarjung Hospital but access to healthcare remains an issue. The public amenities, utilities and services are overburdened and coupled with unhealthy and insecure environs for the residing population make for a rather complex social environment,” said Jyotsna Lall, senior programme officer, Aga Khan Development Network (AKDN).At the grassroots of this project, being funded by the Sir Dorabji Tata Trust, is the health contact called ‘Sehat Saheli’ for up to 50 households. The Sehat Saheli is the closest link with the community and the person who is the source of information on health and associated issues for the community. From amongst the Sehat Sahelis, the project has built a team of 10 frontline workers called Sehat Aapaa to reach out to approximately 250 households in their locality.

The Sehat Aapaas are trained in inter-personal skills, group interaction and public speaking, and even dealing with conflicts. The AKDN in a health profile conducted by it found that 75 per cent deliveries are institutional, while the remaining 25 per cent deliveries are not always assisted by trained birth attendants. Also, there is high incidence of prevalence of chronic diseases. “A baseline survey conducted by Aga Khan Foundation in 2010 revealed that the average age at marriage is 19 years; age at first pregnancy is 20 years and 53 per cent pregnant women are anaemic and 48 per cent women facing problems during pregnancy,” said Ms. Lall. The Foundation began mapping pregnant women and children under six. “There was a polyclinic in the area run by the Municipal Corporation of Delhi. Immunisation programmes were being run as well, but there was lack of awareness. Our Sehat Apaas, assisted by the part time contractors, called Sehat Sahelis began tracking and monitoring expectant women and ensured immunisation and other necessary investigations were carried out. We also counsel the women on nutrition as that is a huge health determinant,” said Ms. Lall.

Dr. Haider, the resident medical superintendant of the MCD polyclinic, said the health workers have been able to bring the services of the polyclinic to resident’s attention. “With low awareness of disease and proper medical cure amongst the community of the Nizamuddin basti the health workers engaged by AKF with the Tata Trust support play a critical role in ensuring follow up — saving precious lives with timely care,” he said.

The project also strengthened the MCD polyclinic by providing advanced equipment for eye and ENT specialists’ services. Further, human resources were also added through the provision of a gynaecologist, paediatrician, pathologist, lab technician and an ANM,” said Ms. Lall.

Today a satellite maternal and child health centre for antenatal and immunisation service is run within the MCD polyclinic twice a week. Women are informed about maternal and newborn care, child health and nutrition, health and hygiene and control of communicable diseases.

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