Mother and Child Healthcare - Savitri Rural Development Project
Partner
OJUS Medical Institute
www.omi.org.in
Goal
Create a sustainable model for healthcare services in 34 rural tribal villages in Maharashtra.
Vision
Every woman should have access to a trained birth attendant and effective antenatal and postnatal care.
Mission
To train and mobilise village healthcare workers, nurses and traditional midwives to provide basic healthcare and mother and child healthcare services to rural communities who are below the poverty line.
Duration
2010 – 2014
Overview
The population of the project area (Dindori District) faces many challenges. Illiteracy rates are very high, malnutrition is rife, healthcare sub-centres are only partially active and a doctor is rarely seen in the villages. Due to the poor conditions of roads and lack of facilities, 95% of deliveries in 2007 were carried out at home by untrained attendants.
The Savitri Trust has co-designed this four year project to target the issues around mother and child healthcare, in order to reduce infant and maternal mortality and morbidity in the area.
The continuum of care project focuses on:
- Training community health workers to deliver door-to-door care, paying particular attention to women and children
- Promoting institutional delivery and providing emergency transportation
- Training traditional midwives on safe and hygienic delivery and providing them with access to safe delivery kits
- Training the competent community health workers to become auxiliary nurses, who can then be hired to re-activate a defunct government sub-centre
- Linking the project trained health workers and nurses with vacant government positions to provide a sustainable model of healthcare
- Providing health and hygiene education for specific community groups
- Improving access to a sustained level of antenatal, safe delivery, postnatal and child care services
- Improving the referral systems
- Providing a supplementary feeding programme for anaemic pregnant women and undernourished children
- Mobilising the women of the area to understand their rights and demand proper healthcare from their leaders
Achievements
This project was implemented in January 2010. By December of the same year, the team had already made great progress by ensuring the following:
- 100% of pregnant women received at least 3 antenatal checks by a community health worker
- 96% received at least 1 check by a doctor or nurse
- 100% of pregnant women received iron and folic tablets and necessary injections
- 71% delivered in an institution
- 100% of traditional midwives had undergone training and have access to a hygienic delivery kit at all times
- 100% of delivered babies were seen by a health professional within 24 hours
In 2009 award-winning photographer Sophie Gerrard joined the Savitri Trust on our visit to SRDP to document the lives of the midwives, mothers and children who have been affected by the work of the project.
Case Stories
Traditional Midwife Story: Koambi
Savitri Rural Development Project is first and foremost promoting institutional delivery. The project has seen a tremendous change in the Government’s antenatal and delivery care facilities; however, there are circumstances when a pregnant mother is unable to reach an institution. To bridge that gap the Trust works with traditional midwives to ensure that the mother receives a safe and hygienic delivery.
“Before we would not wash our hands to deliver a baby, we would use any sharp object we could find in the household to cut the cord, we sometimes would apply ointment to the cord stump….now our eyes have been opened. I cannot express in words what you have done for us, the training and help you have given us is amazing. We have seen a hospital for the first time in our lives. We now understand that we need to wash our hands four times with soap before helping to deliver a baby, must never apply anything to the cord, and to always use a fresh sterile blade. I arranged for one of my pregnant mothers to go to hospital, even though I knew the journey would be very risky. When we arrived the doctor asked me to assist in the delivery room as he appreciated my experience and input. I felt very honoured. I would not have had the courage to do what I did without the help of this project.”
Camini’s Story
Delays are the primary cause for delivery complications.
Camini is from Chaphyacha village in the remote rural Dindori District of Maharashtra. Camini is 20 years old and 9 months pregnant with her second child; like so many other young mothers in the area she does not have a say as to where she will deliver her baby and how. The decision makers are her husband and mother-in-law. Camini is told to carry on working in the fields, wash dishes, cook and collect water. She is exhausted but does not say anything.
The Community Health Worker for her village has instructed the family to register with the healthcare sub-centre and make arrangements for transport to the hospital for delivery. Unfortunately on 6th October 2009 at 3am their transportation fell through and the labour had come so quickly that the traditional midwife had to step in. Fortunately for Camini, their midwife had attended the SRDP training and she delivered a healthy 2.8kg baby boy.
The child was registered and Camini received a further three visits for postnatal care to ensure that she was resting and feeding properly. Whilst Camini could not make it to an institution to have her baby, she was able to receive the informed knowledge and support that was vital in keeping her comfortable and safe during a very stressful time, which will prove invaluable to the continued health and comfort of Camini and her baby.
