Dantewada district situated in the Bastar Division of Chhattisgarh is bestowed with rich natural resources and cultural diversity. It is always in news for all the wrong reasons be it the causalities due to Left Wing Extremism or the poor coverage of education and health care services in the remotest part of the district. While access to the dark zones is an issue, the District Administration has put numerous efforts to mainstream development efforts in these areas especially health care services.
Challenges like high degree of Anemia, Malnutrition among children and pregnant women and poor access of emergency Maternal and child health services has been a concern for the district.
The District Collector Sh. Deepak Soni, an IAS of 2011 batch has always emphasized that Access to Health, Nutrition and Education is a right of every citizen and the Govt is duty bound to provide these services with quality. Improving quality and access to the services will happen only when the frontline workers and district administration work with unity and a single goal.
Sh. Soni along with the Health Department officials and Mr. Basant Kumar, Aspirational District Fellow deputed by Tata Trusts, has made concerted efforts towards access and quality of maternal health services in the district. Regular conduct of Village Health, Sanitation and Nutrition Day, Health clinics and camps during Haat Bazar, Health facility upgradation, deployment of trained resources for birth attendance, maternal and child health checkup in PHC and CHC, Sugam Swasthya Dantewada Pogramme for emergency referral transportation to nearby health facilities are few initiatives worth mentioning.
The team experienced that, there are challenges in awareness and sensitization of community on maternal health especially on importance of health check-ups, nutritious diet, Consumption of IFA Tablets etc. With celebration of VHSND, the ANC registration has increased.
However, more efforts were needed to sensitise community on the importance of minimum 4 ANC health check-ups. Missing ANC sometimes kept the mother unaware about the due date, the risk of C section, complications of pre and post child birth etc. The core challenge is in bridging the communication gap by regular engagement with the pregnant women, making them aware on the safe motherhood.
Yuva BPO; a critical means for Information Dissemination
A Yuva BPO functioning in the district where local youths fully conversant with local dialect were engaged to provided information dissemination of various Govt schemes. Realising the potential, the BPO has to reach out to the beneficiaries, the Health Department planned to create a dedicated cell by engaging few executives from the BPO.
Five executives were identified and provided 3 days training on Maternal Health services. All relevant guidelines, info graphics and communication material on Maternal Health, Motherhood etc were provided to the team. The cell was operationalised using the Innovation Fund under National Health Mission. The core objective was to improve the institutional delivery in the district, reduce maternal and infant death by way of timely dissemination of information and communication and awareness building.
From Antenatal Care to Immunization; End to end engagement for service delivery:
The trained call centre executives have internalised the role of communication in the entire motherhood cycle starting from ANC registration to Immunization of the infant. The list of pregnant women are made available to the Call Centre Executives. The team prepares a call roster to reach out to the pregnant women for sensitising them on healthy dietary practice, health check-ups, precautions etc. On an average 50 calls are made every day to the Pregnant women. In addition, calls are made to the Mitanin, Anganwadi Worker, ANM, PRI representatives to check for any challenges.
The pregnant women are advised to reach the nearest Health centre with institutional delivery facility at least 5days before the expected date of delivery. The High Risk cases are given special attention. The centre coordinates with respective health functionaries for institutional delivery. Pregnant women are provided necessary counselling on delivery and early child care, breast feeding etc.
In cases where emergency referral transportation is required, the call centre also coordinates with Ambulance services. Maleria is prone in the district and hence, the centre also provides precautionary message on Maleria prevention. Availability of beds and shelter for Pregnant women has remained a challenge. The district has created 5 pre-birth waiting rooms as part of facility augmentation to provide shelter to all the women reaching the health facility prior to delivery.
In the time of COVID-19 pandemic, the Call Centre has also helped the District in the "Integrated Disease Surveillance Programme". The Call Centre based out reach and communication has started yielding results. It is planned to expand the work in Information, Education and Communication outreach in other health service domains.