Women volunteers offer personalised health-related services

The induction of a group of women health volunteers or Accredited Social Health Activists (ASHAs) into the health system to offer personalised health-related services in the coastal areas of the district can be a step in the positive direction.

Despite the general good health indicators that the State projects, the coastal and tribal belts have always been vulnerable pockets without any sustainable health care programmes. Poverty, illiteracy and poor accessibility to health care services can be a difficult combination to tackle and this has been precipitating new challenges for the health system.

ASHAs were envisaged under the National Rural Health Mission to take health care services directly to the people in tribal, coastal and urban slums. These women health volunteers, who are trained to deliver health education as well as help with ante-natal and immunisation services, are expected to bring more women to health care delivery centres.

Poor nutrition, high levels of anaemia among the coastal population, congested living conditions and waterlogging are the main reasons for the frequent outbreaks of malaria and dengue fever. Outbreaks of water-borne diseases such as diarrhoea and cholera are also not uncommon. The high level of gynaecological morbidity among the women in the coastal area is something that all health care activists have been worried about. In 1997, a United Nations Development Programme study report said that most of the women in the coastal area suffered from various reproductive tract infections and pelvic inflammatory diseases. However, they suffered in silence because of poor accessibility to gynaecological services and lack of awareness of the health consequences.

Lack of drinking water and sanitation facilities were pointed out as the two main causes that aggravated reproductive morbidity among the women. According to one study conducted in Vizhinjam by Aarati Kelkar-Khambete, a public health researcher, 41 per cent of the women did not seek medical care for their problems and resorted to home remedies.

Though the health services has an entire network of health workers who are supposed to take up field-level activities, often they are unable to visit all households. Every ASHA will be expected to cover around 250 households every month, which will make it possible for them to visit all households at least twice a month. It is hoped they might be able to improve the health-seeking behaviour of coastal women.