A communications initiative for a balanced, planned and stable population
Making Change Happen
AMCHI promotes community participation in social development activities at the village level
Over the past few months, we have been sharing with you the impact of our various interventions involving the media, youth and community to promote a positive image of the girl child.
Simultaneously, we have also been making a difference in the lives of the villagers of 35 villages of the Shahapur block in Thane district through our AMCHI project. Action for Mobilising Community Health Initiatives (AMCHI) is our field-based primary health care project, which aims to:
- Mobilise communities to encourage preventive and promotive health care in families and communities
- Create demand for quality services from service providers
- Strengthen the communication skills of the service providers and reinforce their role as change agents
Shahapur is one of the six tribal blocks, which are extremely socially and economically backward despite their proximity to the metropolis.
Given the aims of the project and the abject poverty and backwardness of the area, we adopt intervention techniques that are participatory in nature and motivational in impact. The micro-planning process involves intense interaction at the community level, after eliciting the cooperation of all important players in the community and the five important grassroots workers at the village level viz., Auxiliary Nurse Mid-wife (ANM or health worker), Anganwadi worker (pre-school teacher), Sarpanch (representative of local self-government institution at the village level), school teacher and the sanitation worker.
The micro-planning process often leads to issues other than health as a priority for the villagers, such as quality of water, state of the school building, quality of teaching or implementation of the mid-day meal scheme in the Anganwadi centres. Though we try to keep our focus on health, it often becomes more of a village development programme, which is as it should be, because health cannot be pursued as a goal independent of overall development.
We measure our success by the emergence of local leadership and the revitalization of the local institutions. Only then are the action plans owned and pursued by the community on a sustainable basis.
We have been working in the villages since October 2006 and are proud to say that there has been a tremendous impact – measured quantitatively through decrease in malnutrition, increase in institutional deliveries and attendance in Anganwadis and schools and qualitatively through the community demanding services and accountability from authorities.
The results may not appear grand but are very satisfying and give us the incentive to pursue our efforts despite setbacks and heartbreaks. We are working on our experiences to streamline the processes and hope to soon standardize this model for replication across the country.
We share some of our success stories with you in this issue.
Making Motherhood Safe
Women avail Janani Suraksha Yojana Scheme in Chinchwadi
Chinchwadi is one of the villages adopted by Population First under AMCHI. One of the major problems identified during micro-planning was maternal and infant morbidity and mortality. The reason was that the villagers did not register pregnant women with the Primary Health Centre (PHC) for ante-natal care (ANC) nor did they go in for institutional deliveries. There was a mid-wife who assisted the deliveries if necessary at home.
The reluctance was due to the following difficulties faced by the villagers for availing the facilities at the PHC:
- Distance – it was 2km away and they needed a vehicle to get there and they did not have the money to pay for it
- Nobody at home to look after the kids during the hospitalization of women
- Expenses involved in hospitalization
- Lack of knowledge about the Janani Suraksha Yojana (JSY) under which the every pregnant woman is paid Rs. 100.00 on registration and Rs 700.00 on institutional delivery
- No ANM at the Dehne sub-centre, which caters to Chinchwadi
This was in June 2007
Resolving the issues
All the above issues were brought to the notice of the district authorities and the Medical Officer at PHC Dolkhamb, who assured the villagers that an ANM would be appointed shortly.
In August 2007, Ms. Desle joined as ANM. In the first week of September 2007, the first-ever meeting of all ANC and Post-Natal Care (PNC) women was held with the ANM. The benefits of pregnancy registration, blood tests, nutrition, rest, vaccinations and institutional deliveries were emphasised. The incentives offered by the Government under JSY were explained.
Dinesh Patkar in Dehne, a neighbouring village had a vehicle and he agreed to lend his vehicle when he was told that he would be paid for transporting the pregnant woman to the sub-centre/ PHC (under the National Rural Health Mission).
Another meeting of the ANM with the women was held last week of September 2007 where the women who were eligible for the incentive under JSY were paid accordingly and the telephone number of Mr. Dinesh Patkar was given to the women. In October 2007, of the six deliveries in the PHC, four were of women who had delivered their earlier children at home. In December 2007, all the four deliveries took place in the PHC. Dr. Dhere, Medical Officer, PHC Dolkhamb said Your (PF) interaction with the villagers and counseling on health issues has greatly facilitated our work
Today all deliveries are in the PHC.