Phoola Bai, a 60 year old woman living in the remote village of Balichowki at Mandi district in Himachal Pradesh, had never visited a health facility for giving birth. A common practice in these parts where going to a health facility was perceived as arduous and unnecessarily time consuming.
Thus, it was quite natural that when Phoola Bai’s first daughter-in–law Durga conceived for the first time, her family opted for home delivery. But the winds of change had reached their village. Now the village had an ASHA worker, Nirmala, who started visiting the family regularly as soon as she heard of the pregnancy. She counseled the family on safe pregnancy care and delivery practices, explained potential life-threatening risks and ways to prevent them. She introduced the family to Misoprostol a drug that can prevent excessive bleeding after delivery. Phoola Bai’s initial response was a complete denial, she felt “This is dirty blood, which has to flow out. It should not be stopped.” But Nirmala persevered, and through regular interactions kept explaining the benefits of preventive care, misoprostol use and institutional delivery especially for a first delivery.
Even though Durga finally delivered at home, it was Phoola Bai, who helped her to take Misoprostol. Today both the mother and baby are doing well. A significant first step had been taken, change accepted. By the time Phoola’s second daughter-in-law’s got ready to deliver her first baby, Phoola Devi ensured an institutional delivery. She even carried the Misoprostol tablet, in case the delivery takes place enroute to the hospital. Phoola Bai’s turnaround is only one of the stories from these remote hilly areas.
Nirmala is one among the 123 health-workers who were trained by Vriddhi to reach out to expecting mothers in the far-flung hilly areas of Jhanjheli block to distribute the lifesaving Misoprostol and counsel mothers. A colorfully illustrated flipbook in their local language has been a useful tool that helps them to counsel and convince families that are steeped in tradition and face tremendous challenges of access.
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