The rising rates of maternal and neo-natal mortality are a concern and effective ways to stem the incidents are being sought after. One such attempt was made through a pilot project in Rasoolabad block of Kanpur Dehat district in Uttar Pradesh
Located in a belt known for its high maternal and infant mortality rates, Rasoolabad suffers from the lack of quality rural health centers. But through the project, approximately 30 per cent reduction in maternal mortality has been achieved in the block, according to project coordinator Shivani Singh. “Although detailed data analysis is still continuing the available information indicates a 30 per cent reduction. There is also sporadic evidence of a decline in mortality of newborns,” she says.
Voluntary organisation Shramik Bharti launched a project called Home Based Post Natal Care (HBPNC) that provides better training to women community health workers (ASHAs) and family members to recognise post-delivery life threatening conditions at an early stage; provide some initial care and then rush for institutional medical help.
It is known that the first six weeks are of critical importance for a mother’s life and the first four weeks are equally so for a newborn’s life. The first 24 hours are regarded as extremely critical for both. However, over burdened conditions at rural health centers that lack in essential facilities force mothers to leave (or are asked to leave) them soon after child-birth. As a result post-delivery complications for mothers and children are quite common, the most frequent complaint being excessive bleeding. This is a frequent cause of maternal mortality.
In order to address this, Janni Suraksha Yojna has provided for regular visits by ASHAs to the homes of new mothers to provide them essential care before and after delivery.
As the ASHAs are not adequately trained to recognise life-threatening symptoms among new mothers and newborns in their training, the HBPNC project prepared a training module where 200 ASHAs of Rasoolabad were trained for thee days. Since ASHAs are encouraged to keep in touch with transport owners and community leaders in the village for emergencies, short training and orientation programmes were also arranged for them.
When the condition of Ranno, a mother of Sithaumitana village deteriorated rapidly, an ASHA named Bitaan provided initial care and rushed her to the community health centre. As the complication increased, the ASHA took her first to the district hospital and then to a city hospital in Kanpur, providing first-aid when needed. This helped to save the life of Ranno although at one stage she had lost all hope.
Geeta was bleeding very badly after child-birth. It was well past midnight and the doctor could not come at the health centre. In this situation an ASHA named Rekha played a very helpful role in providing initial care till the arrival of the doctor.
About 35 such cases of life-saving roles played by ASHAs have been documented. A somewhat higher number of interventions to save the life of newborns have also been documented.
