Education  India Project #30530

1000 days - Education & Support for Mother & Child

by Dignity Freedom Network
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child
1000 days - Education & Support for Mother & Child

Jenitta is a CHW in South India. One day she visited a mother who had delivered a baby boy 45 days previously. The child had had diarrhea for 2 days passing green stool more than 10 times a day. The baby’s mother thought that this was due to the heat and had not taken the child to hospital, but Jenitta was concerned about the risk of dehydration. She persuaded her to take the baby to the primary health center. Teaching her against the advice of her family to keep breast feeding the child on the way. The baby was admitted seriously ill and stayed in hospital for a week on an IV. Jenitta very probably saved this baby’s life.

In addition to the 1,000 Days project’s focus on early life, our workers extend their care to children of all ages. Since January 2019, we’ve seen the following results:

  • 36 girls saved from trafficking vaccinated against cervical cancer
  • 15,000 school children dewormed
  • 1040 antenatal checkups conducted
  • 17,000 school children’s growth monitored
  • 6,000 school children received vision screenings

Your partnership with us is making a huge difference in the live of these dear children!

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A key part of the Dalit Freedom Network's projecct to transform the lives of mothers and their children are our Community Health Workers.  We have more than 100 CHWs around the nation delivering health, hygiene and preventative medical services to the poorest of the poor.

To give an example of the good work of these health workers, we take you to the North Indian state of Rajasthan.

We have five Community Health Workers working at DFN's Good Shepherd Schools. They each manage a minimum of around 150 students in their respective schools. These school children come from Lambadi and Harijan communities. Most of their parents in work as sweepers and labourers earning daily wages. The majority of the people are landless labourers and hence work in agricultural fields and herd sheep and goats. Their struggle to meet the basic needs of their family is real. Many of them have to support their elderly and extended family. The children in these school often face diarrhoea, stomach infections, fever, malnutrition, abdominal discomfort, malaria, and typhoid.

These difficult circumstances led our CHWs to step in with care to help treat the children. They gave talks to both the children and their parents about health and hygiene, hand washing, drinking clean water, good nutrition. They distributed deworming tablets periodically. The CHWs did vision screening tests for all the children. Gradual improvement was observed both in their health and in their studies.

Our Community Health Workers monitored all the children in the year 2018 in the following ways:

  1. Recording of height, weight and general health of the children.
  2. Imparted health education regarding clean drinking water, techniques of proper handwashing, simple remedies for head lice, dietary sources of Vitamin A, basic healthy nutrition, maintaining clean toilets and  home management  of diarrhoea.
  3. Identification of the Immunisation status of all the children and immunisation of the unimmunized. Around 450 children were immunized.
  4. Provided deworming tablets for every child in the school which helped reduce the incidence of reinfection in the children and thereby preventing them from anaemia and malnutrition.
  5. Conducted Vision Testing on the Children once a year. 
  6. The Health Workers also worked in various communities, particularly focusing on the health of pregnant mothers and young children. Within the communities, they acted as advocates for the Good Shepherd School. 

As a result of this move by the CHW’s around 754 children were given deworming tablets and had undergone the vision screening tests in Rajasthan. 

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The Dalit Freedom Network is thrilled to see the progress of its Community Health Workers across India who bring hope to women and children in at-risk situations.

Women in marginalised communities in India often know very little about pregnancy or the methods available to control spacing between pregnancies. A woman may not be aware that she is pregnant for many months resulting in delays in accessing appropriate antenatal care. During village visits Commuity Health Workers (CHWs) meet many young women who report tiredness and dizziness. A pregnancy test is one of the first actions the CHW will recommend. As a result, we receive many stories of newly diagnosed pregnancies because of a CHW visit.

Mala, a CHW working in South India, visited Mary, a young mother with a 12-month-old son. Mary mentioned that she was feeling sick and dizzy all the time and was struggling to manage with household work as well as provide care for her son. Mala suggested a pregnancy test, but Mary was shy to do this as she felt that she could not be pregnant so soon after the birth of her son. However, the test was positive and Mala was able to counsel Mary about the importance of attending for antenatal check ups at the local Primary Health Centrer She was also able to calculate the expected date of delivery of the baby using the pregnancy calculator she had been trained to use on her most recent CHW update training. Mary was thrilled to learn so much about pregnancy, how to stay healthy, the importance of regular antenatal check ups and even the expected date of delivery of her baby. She commented ‘No one would spend time with me at the Health Centre explaining all these things to me. Thank you for visiting me and caring for me’.

The community health worker Amutha, while visiting a village which is 7 kilometres away from one of the Dalit Freedom Network's school, met a 25 year old woman who has a year old boy. The woman expressed to the CHW that “I am feeling dizziness and vomiting and I do not know why.”  She was unaware that she is pregnant again.  So the CHW asked her to go for pregnancy test. 

The woman felt very shy because of less spacing from the first baby. However she did the test with the help of the CHW and came to know she was three months pregnant.

The CHW continued her talk about good nutrition and iron contained food with the flash cards. The CHW explained about go food, grow food and Glow food and why she needs to eat all these healthy food.

Meanwhile the woman wants to know about the due date calculation. The CHW explained and taught her how to do with help of the flash cards. She felt so happy about learning pregnancy calculator.

This woman said “I did not know how to find out the due date now I learned it. Even if I go to the hospital for check-up, I will not get this teaching. You visited me and taught me very patiently. I will never ever forget this help.”

Then CHW smiled and checked her blood pressure immediately which was normal.  

The CHW asked her to eat healthy food till she delivers her baby and even after delivery. “I will come and visit you again” said the CHW.

Then left the village with great joy in her heart.

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GlobalGiving 1000-Days Report June 2018

Dear Friend,

You subscribed to email updates from 1000 days - Education & Support for Mother & Child by the Dalit Freedom Network, a project on GlobalGiving. Here's the unedited update from the field:

Importance of Postnatal Care

By Leah Kadwell, Strategic Partnerships

For many women in rural India there is little opportunity to learn about the pregnancy, delivery and postnatal period when they attend their antenatal checks. Medical check-ups are focused on ensuring safe healthy pregnancy and delivery, but there is often no education given to the mother about what to expect and, most importantly, how to look after the newborn baby. The family is the source of information for the mother. Most of the time this is helpful with information passed from generation to generation. However, there are some traditions that do not provide the best opportunity for newborn babies to thrive. One of these is the belief that it is not good to give the first milk (colostrum) to the baby and that, therefore, breast feeding should be delayed until milk starts to flow. This belief and practice means that newborn babies are denied the important antibodies from the mother which are in the colostrum and help to prevent newborn infections. In addition, early breastfeeding helps stimulate the milk to flow and is very helpful in establishing successful breast feeding.

The Dalit Freedom Network’s Community Health Workers play a key role in educating mothers about the importance of early breastfeeding, helping them to feed and encouraging them to exclusively breastfeed for six months to provide the best nutrition for the baby.

Our Community Health Worker Sarla visited one lady who had delivered a baby by caesarean section eight days previously. In the hospital there had been no encouragement to breastfeed, so the family had given the baby formula milk. By the time the CHW visited, that mother’s breasts were engorged and painful and she was upset at not being able to breastfeed. Sarla spent time with her, helped with the pain and taught the new mother how to breastfeed. This was difficult at first and required perseverance, but eventually the baby learnt how to suck. Now mother and baby are happy and content and the whole family are grateful to Sarla for all her help. Sarla commented, “Even when the mothers do not get good care in the hospital, CHWs can provide this care and the communities are very happy.”

Esther visitied Nanthini, a 21-year-old lady who had delivered her first child, a baby girl, by caesarean section a few days before. Nanthini did not know how to care for her baby, but her mother was with her helping and teaching her. Her mother told her that breastmilk was not enough for the baby and started giving the baby bottles of formula milk in between the breast feeds. Esther was able to use her ‘flash cards’ on breastfeeding to explain the small size of the baby’s stomach and to convince Nanthini and her mother that breast milk alone was sufficient for the baby. Now mother, baby and grandmother are all happy with exclusive breastfeeding and are grateful to the CHW for taking time to explain about the best way to feed the baby.

Sometimes, even with the best efforts of the CHW, the family will persuade the mother not to breastfeed the baby. Mamta had given birth to a baby boy a few hours earlier and the baby was crying. Her mother-in-law would not allow Mamta to breastfeed but gave him honey and boiled water. Anjali, Mamta’s niece, was home from school. She attends one of DFN’s Good Shepherd Schools where Survana works as a CHW. Survana had taught the students the importance of vitamin A for good health, especially healthy eyes. She had explained that, for newborn babies, the vitamin A that they need comes from the mother’s milk. She had also explained the importance of early breastfeeding in providing natural ‘immunisation’ to help the baby fight diseases. Anjali explained this to her grandmother and persuaded her grandmother to allow Mamta to breastfeed the baby. The CHW congratulated Anjali when she reported the story the next day in school. She was very happy that, even though her teaching to the family directly had not persuaded them to breast feed early, her teaching in the school had had a wider impact than the children she had taught.


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Global Giving 1000 Day Report February 2018

Dear Friend,

You subscribed to email updates from 1000 days - Education & Support for Mother & Child by the Dalit Freedom Network (formerly by RED International), a project on GlobalGiving. Here's the unedited update from the field.

Thanks to your support, the Dalit Freedom Network was able to continue funding its Community Health Workers (CHWs) as they play a key role in caring for antenatal and postnatal women. The 77 CHWs working for our partners, the Good Shepherd Health Initiative and the Good Shepherd Schools, send regular reports of how they have helped women take better care of their own health and the health of their babies.

The probability of a good pregnancy outcome is greatly increased if antenatal women attend local primary healthcare facilities for basic antenatal care. However, often these clinics are busy and focused on delivering key interventions, such as tetanus vaccination and iron and folic acid tablets. The staff do not have time to spend with the women themselves to address their understanding of pregnancy and care of the new-born.

This is where the CHWs can really make a difference - as these stories from the CHW Radika illustrate:

Whilst visiting Bondugula village she met a 34 year old woman who was pregnant. The woman asked Radika to check her blood pressure, which she did. She also checked that she had visited the PHC for antenatal check-ups and a tetanus injection. The woman replied that she had. However, Radika was concerned that she appeared to be anaemic so got out her flash cards on nutrition and spent time with the woman explaining the key aspects of a healthy diet, particularly iron rich foods. She also encouraged her to take the iron and folic acid tablets that she had been given at the Health Centre.

She explained to the lady that healthy diet, as well as her iron and folic acid tablets, is very important if she wants to deliver a healthy baby. She left with the encouragement to visit the PHC for her second tetanus injection.

When her returned the following month she found that the woman had followed her advice – she looked bright and healthy. She asked to go through the flash cards again as she wanted to understand more of the information the Health Worker had given her.

The woman said,” I have not heard about this kind of teaching and for the first time I am hearing. I am five months pregnant now.” The CHW said, “Follow the same things till you deliver your baby and even after delivery. I will come and visit you again.”

The pregnant woman said to the CHW “Thank you so much for coming.”

On a different day Radika visited the same village and visited a 27 year old lady called Jyothi, who had delivered a baby boy three months previously. Both mother and baby appeared pale and weak so Radika asked in some detail about the diet Jyothi was eating. She discovered that Jyothi’s diet was very low in vegetables and iron rich foods. She reached for her flash cards and taught Jyothi about healthy eating and its importance for the breast feeding mother. Both Jyothi and her husband listened carefully and when Radika had finished and the discussion was over, Jyothi said:

“Now I understood what will happen to my baby if I do not eat healthy food. I want my baby to grow healthy. I will only breast feed my baby. I do not want to lose my baby. So to have enough milk I will follow good healthy diet as you taught me”

Twenty five days later the CHW visited them again. Both the mother and baby gained little bit weight. The CHW did the normal check-ups and bid bye to the family.

The woman touched the CHW’s toes and thanked her for her teaching and visit. “It is been a great help to her and the baby. We as a family will never forget your help, said the woman.”

Based on the figures obtained from 365 reports from 65 health workers collated over a period of twelve months, it can be estimated that each health worker sees approximately 9 antenatal or postnatal women each month. This represents 28% of their time spent with individual patients.

This was estimated as follows:

  • 3,288 contacts reported from 365 reports = 9 contacts per month for each health worker.
  • 3,288 ANC / PNC contacts as a proportion of the total number of patient contacts, 11,604 = 28%

For 77 health workers, this equates to over 690 contacts for every month that they visit villages, or over 6,900 antenatal / postnatal contacts per year. Health workers check blood pressure and signs of pregnancy complications. Antenatal teaching at individual or group level is facilitated by visual aids provided by the health worker project.


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Organization Information

Dignity Freedom Network

Location: Virginia Beach, VA - USA
Website:
Facebook: Facebook Page
Twitter: @DFN_USA
Project Leader:
Leah Kadwell
Oswestry, Shropshire United Kingdom

Funded Project!

Combined with other sources of funding, this project raised enough money to fund the outlined activities and is no longer accepting donations.
   

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