An Initiative to Improve Women and Child Health in Gondia district of Maharashtra

An Initiative to Improve Women and Child Health in Gondia district of Maharashtra

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Project Implementation Area:

The proposed project will cover 50 backward villages of Sadak Arjuni Taluka, of Gondia district in Maharashtra. Total Population of Sadak Arjuni Taluka in 50 villages is about 2, 12,263. This project will cater to women and children living in Sadak Arjuni,Keshalwada,Rengepar,Pandarwani  Dalli  ,Shenda , Ushikheda, Koylari, Bhamni,Rajguda/Mongra Kodamedi,Tidka, Kohamara,Kokna,Chikhali, Sawangi,Khoba,Kosbi,Wadegaon,Parshodi,Dongergaon,Ghatbori(teli), Khajri, Chirchadi,Bothli,Duggipar,Girola,Murpar/ram,Putadi,,Dunda,Gongle,Palasgaon,Baudhnagar,Futala,Kosamtondi,Raka, Sinhipar,Bhusaritola, Dawwa, Pandhai, Sitepar, Bopabodi,Dhanori,Kaneri, Mhaswani, Ghategaon, Mundipar, Khoditola, Ghoti,Heti,saledharni.

Target Beneficiaries:

The proposed project will target 5000 beneficiaries including 3000 women in the age group of 15 - 45 years together with pregnant and lactating women and 2000 children falling under the age group of 0-5 years as direct beneficiaries. The project will benefit the rural population at large.

 

Goal

 

To improve the health indicators of women (with special focus on maternal health) and children in Gondia district.

 

Objectives

 

  • To sensitize the community on women and child health issues.
  • To improve the quality of health services provided by the Government health care providers.
  • To facilitate health and immunization services.

 

Outcomes

 

  • Increased institutional deliveries and usage of temporary family planning methods (TFPM).
  • Reduction in pre natal and post natal reproductive problems as well as incidence of malnutrition, and increase in the immunization rate.
  • Increased availability and accessibility of public health services with the community demanding accountability for provision of quality healthcare services.

 

Project Duration

 

The envisaged project will be implemented for a duration of twelve months.

 

Methodology and Key Approaches

 

The delivery mechanism used for the proposed project will be preventive, specific, participatory, attainable & time oriented in nature. The methodology has been designed keeping in mind the cultural & socio-economic beliefs existing amongst target population. The following interventions will be carried out as part of project implementation:

 

Collection of base data on basic maternal & Child health Indicators

 

For collecting the base data, active community members will be identified as community mobilizers from the respective villages in the initial first month (first two weeks) of the project period. Village women will be selected based on certain criteria  e.g. who can read and write and has good rapport building skills, married women and adolescents Community mobilisers will be trained by Project Manager on the tools and methods to collect base data in the community.

 

The qualitative as well as quantitative data will be collected from  the implementation area with the help of grassroots level Govt Health functionaries like Aanganwadi workers and Asha workers on various health indicators like proportion of safe delivery (either institutional or home deliveries), status of early registration of  pregnancy, ante natal check -ups, post-delivery complications, proportion of fully immunized children, menstruation problems and proportion of malnourished children etc. It will be conducted in the initial one month of the project period. The CNA will be conducted through administration of interview schedule and questionnaires which will be developed with the help of team. The information based on existing pattern like availability of health resources, number of pregnant women, lactating women, number of children etc. will also be gathered during need assessment. The interview schedule will be designed in such a way so as to gather other information as well like accessibility of target population to primary health care and quality of services rendered by these centers.

 

During the study qualitative data will also be collected through case studies of community people having major health problems or experiences they have felt while availing facilities in the government health institutions. These case studies will help in accessing the community’s experiences regarding maternal and child health problems and their views on accessing delivery services from government health institutions.

 

Post study, in the second month of the project, the data collected will be analyzed by the project manager following which the detailed activities will be chalked out. During this phase, the potential beneficiaries will also be identified.

 

 Furthermore, a capacity building training for the identified 10 community mobilisers will be conducted. There will be 5 training sessions which will be held in the last two weeks of the first month of the project period. The trainings will be imparted by the project manager. The topics of the training sessions will include:

 

  • Common women (with special focus on maternal health) and child health problems and its prevention.
  • How to avail different government health programs/schemes of State Government.

 

Awareness Generation and Sensitization

Meetings: The meetings involving village Pradhan, opinion leaders and community people representing different lanes will be conducted at a convenient place.They will be sensitized on the health problems existing in their community and importance of the interventions that are going to be conducted as part of project implementation. Four meetings will be conducted which will help in building rapport with community people and it will be conducted for two months post community need assessment.

 

Rallies: 9 Rallies will be organized to spread awareness on importance of institutional deliveries, nutrition and immunization etc. Rallies will involve school children and community people who will assemble post conducting rallies in their respective lanes.

 

Behaviour Change Communication (BCC): A Behavior Change Communication (BCC) package will be developed consisting of IEC resource materials like posters, leaflets, booklets, pregnant monitoring chart and flipcharts to help disseminate health information and generate awareness in the community. Pamphlets and leaflets in the local language will be distributed to sensitize and aware the community people about the problems faced by women and children during pre-natal and post-natal stages and inform them on public health programmes/schemes available. The effective IEC materials will be developed with the help of technical experts and will be distributed during IEC sessions.

 

10 IEC sessions will be conducted focusing on interpersonal communication, one on one and in small groups which will be the backbone of BCC. The communicators will be actively engaged in developing and field testing the tools. These sessions will be conducted with different groups including target women. During the sessions, women will be sensitized about the importance of ANCs & PNCs, nutrition, iron & folic acid etc and linkage with Government schemes available like JSY (Janani Suraksha Yojana) and IGMSY (Indra Gandhi matritva sahyog yojana) will also be formed.

 

Capacity Building Training Of Health Functionaries:

 

Proper training would be provided to the village dais / midwives and lady health workers. They would be encouraged to undergo midwifery training under government schemes. This will help in intervening directly at the community level and play a key role in community mobilization. Besides, a team would regularly visit the homes of community people to keep the record of pregnant women, their due dates, adolescent girls and newly born babies and the children who comes under the age group of 0 to 5 years and bring the target groups for monthly check ups in health camps for iron supplementation, essential vitamins etc. to prevent malnutrition and keep themselves free from STI problem etc.

 

Service Delivery

 

Health cum Counseling Camp:

 

Entire project area will be divided in clusters; cluster wise camps will be organized. Each cluster will comprise of 5 villages. Total of 10 camps will be organized in 10 months duration by treating 5000 patients in one year. Community friendly health services will be designed. Specialized health cum counseling camps will be organized quarterly. Pre publicity of the camp will be done through Pamphlets distribution and announcements made prior to the camps to aware the community. The service will provide counseling in addition to consultation/check up and dispensing of medicines. Specialist doctors (gynecologist, pediatrician & 2 general physicians) will be hired. Check ups and treatments will be done at a very nominal and affordable rate for the community. Alongside the checkups, vaccination and free counseling related to Reproductive health will be imparted to the persons who attend the camps. Trained counselors will provide proper counseling on pre & post marital issues, benefits of small & planned family, delivery care and emergency obstetric care, antenatal and postnatal care, maternal health, and awareness on STDs, RTI/STIs. This counseling will be open to male members of the family as well, so that they become aware of the issues and can share responsibilities on the same. The clients identified as high risk in the camp will be referred to the nearby Government facility providing high-end services. For the same, liasoning will be done with the systems beforehand.

 

Free medicines along with condoms, oral contraceptive pills, ORS, iron, calcium and folic acid supplements will be provided by specialist doctors/counselors to expecting women, adolescents & women suffering from anaemia. Post the initial registration and checkup, a health card will be allotted to them for enabling them to keep a tab on pregnant women in order to access them easily for monthly checkups. This is expected to better the health status by reducing stigma, increasing potential points of contact with family and thus increase familiarity and perception of friendliness.

 

The linkages with Public Health system will be strengthened through the project. For example, linkages with Integrated Child Development Services (ICDS) department, Government of India will be strengthened for newborn weight monitoring and its importance within 24 hours of their birth.

 

Linkages will also be established with nearest PHC/CHC and civil hospitals for referring the severe patients as well as involvement of ANM for conducting immunization of children & TT vaccination will be provided to Pregnant during camp day .

 

Following testing facilities will be provided during camp day:

 

  • HB test of pregnant women , pregnancy test , sugar test
  • BP, Height and weight measurement as part of ANC Check-ups

 

 

 

Activity Schedule

 

 

S N

Activity

M1

 

M2

M3

M4

M5

M6

M7

M8

M9

M10

M11

M12

1

Identification and training of community mobilizers

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Base data collection, compilation and its analyses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 Awareness Generation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Capacity Building training

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Health cum counseling camp

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

Monitoring

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Project Implementation Team

 

  • Project Manager (1): S/he will be responsible for overall management, strategy formulation, liaising with the donor and coordination in the project.
  • Monitoring officer (1): S/he will be responsible for regular monitoring of the project.
  • Accountant (1): S/he will be hired for managing the day to day accounts of the project.
  • Field Coordinator (5): S/He will be reporting to the project manager. Each field facilitator will be overlooking the activities of two community mobilizers.
  • Community Mobilizers (10): S/he will be reporting to the field coordinator. They will be responsible for project implementation at the field.

Risk & Assumptions and Their Management

 

During conception of this project it is assumed to have some inherited risks as:

  • Lack of openness and traditional mindset on the part of rural community regarding sensitive RH issues.
  • Women may abstain from attending health camp due to family compulsions.
  • Community may prefer to take services from local quacks and traditional healers.

To overcome the risks/challenges, the following strategies will be adapted:

  • One to one counseling sessions with women will be done on a regular basis to  help them overcome their hesitation to openly discuss their sexual health & related problems.
  • One to one counseling will be done with husbands and in-laws of the women.

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