- Yogesh Menaria, Block Programme Manager - RajPusht, Co-authored by Shivani Saraf, Behavior Change Communications Expert
It comes as no surprise that frontline workers like ASHAs, ANMs and AWWs are the lifeline of community healthcare in rural India. We are familiar with how challenging their job already is; and can only imagine a crisis situation like COVID-19 further intensifying the hurdles they face in their day to day routine. Maternal and child nutrition counselling is an imperative to break the intergenerational cycle of malnutrition, and gains even more importance during a pandemic situation to ensure families don’t falter on nutritional intake while grappling with the economic and social impact of such an exigency. These frontline health workers have continued offering their services, not allowing COVID-19 to come in between them and their end beneficiaries. Project RajPusht’s field team is proud to report one such inspiring story of determination, grit and selfless service.
Padrada is a tribal dominated sector, situated 25 kms away from Gogunda block headquarter and 70 kms away from Udaipur district headquarter. 28 AWCs belonging to this sector serve a population size of 22789 within this area. Garasia tribes are native inhabitants here and their livelihood depends on farming and other daily wage labour activities. People living here have low literacy levels. Due to the treacherous terrain of this geography, many service providers including those belonging to Government functionaries avoid visiting this area post sunset.
Citizens residing here have limited access to health and nutrition services. Transportation facilities are also restricted, making dealing with emergency situations a huge challenge. Due to all these factors, some pregnant women prefer delivering at home, if labour related emergencies are reported during late evening and beyond. During January to March 2020, 23 home deliveries were reported from this area.
As the entire nation struggled with the lockdown, AWW and ASHA of this sector came up with a brilliant idea of mobile based counselling, to continue engaging with pregnant and lactating women. The purpose was to ensure that pregnant women did not face any problem in reaching the hospital for their institutional delivery. The frontline workers prepared a due list of expected deliveries and reached out to them via mobile phones to confirm the exact status of their pregnancy. They provided key messages about preparedness for institutional delivery. In addition to this, the frontline workers also had prepared a list of contact numbers of local drivers providing transportation services. They were simultaneously informed that some families might call them in an emergency situation to prime them to be alert to such calls. They also sent the local taxi drivers’ contact numbers to pregnant women nearing due date and their families. As a contingency plan, the frontline workers also shared this information with local panchayat members of respective villages. This ensured complete accessibility in timely arrangement for local transport to reach a government facility for institutional delivery.
The idea of having mobile based communication was initiated by AWW of 6 AWCs; namely: Jethrani, Piprani, Tengda, Richwada, Kundalwas and Mamadev. The idea spread quickly and was adopted by other AWWs and ASHAs of the sector. As a result of this effort, most of the pregnant women delivered safely in government hospitals. During April and May 2020, most of the deliveries reported were in government institutions and only 6 out of 167 deliveries reported at home. A commendable feat to achieve! Here’s how Mrs. Indra Gameti, wife of Mr. Ramesh Gameti expressed her heartfelt gratitude towards this initiative:
मैं इन्दिरा गमेटी जेतनादी (Jetnadi) गाँव की निवासी हूँ। कोरोना के समय हमारे छेत्र मे बाहर से आनेवाली गाडियाँ पूरी तरह से बंद हो गयी थी। इसी दौरान आंगनवाड़ी कार्यकर्ता एवं आशा दीदी द्वारा अधिकृत गाड़ियों की जानकारी मिली। प्रसव पीड़ा होने पर उनके द्वारा दिये गए मोबाइल नंबर पर कॉल करके गाड़ी मँगवाई और फिर उसको लेकर उदयपुर गए जहां ऑपरेशन से प्रसव हुआ था। मैं आंगनवाड़ी कार्यकर्ता एवं आशा दीदी का आभारी हूँ जिन्होने मुझे कोरोना के समय मदद की।
About RajPusht: To address Low Birth Weight and Wasting, Government of Rajasthan (GoR) in partnership with Children’s Investment Fund Foundation (CIFF) is implementing project RajPusht. RajPusht combines two interventions to reduce LBW and Wasting. These are 1) direct cash transfers to pregnant and lactating women to invest in food for self and their young children; and 2) making positive change in knowledge, attitudes and practices around consumption of nutrient dense food by Pregnant Women and Lactating Mothers (PW &LM) and children <3 years. IPE Global Ltd is implementing RajPusht in the State.