Improved Maternal & Child Care in the Himalayas

 BACKGROUND

Aarohi, a not-for-profit organisation, was founded in the year 1992, with the aim of creating development opportunities for the rural Himalayan communities.  Keeping an integrated approach to development, Aarohi, for last 25 years, has been committed to creating sustainable livelihood opportunities, providing quality health care and education services to the rural mountain communities.

In August 1992, Aarohi was founded by Oona, a development professional and Sushil, a doctor, with the mission of “creating development opportunities for rural Himalayan communities through quality education, health care, promotion of livelihoods and other development interventions.

Working primarily in the Kumaon region of Uttarakhand, Aarohi reaches 141 villages in the remote mountain districts of Nainital, Almora and Bageshwar through its varied development initiatives, covering a population of 65,000. Considering the remoteness of the area, poor infrastructure and over all low development indicators, Aarohi’s interventions have bridged the gap in existing government structure and provided essential services to the people from the region.

SUMMARY 

Committed to providing quality healthcare services to the rural communities from the Himalayas, Aarohi’s community health programme, focussing on maternal and child care, caters to the health needs of 70 (currently working) villages, covering a population of 34,168.  This project is implemented in 70 villages in the Okhalkanda block in Nainital District of   Uttarakhand.

 We currently have a well-trained cadre of 24 village supervisors who are leading the project at the village level covering every pregnant woman in the area. A grassroots team constituting 76 village health workers and 89 Traditional Birth Attendants (TBA), trained by Aarohi on all aspects of maternal and child health, are reaching the remotest parts of these mountains. 

Reducing the maternal & child mortality and morbidity in the region is the primary aim of the project Arogya.  As of 31^st June 2017, there were 257 pregnant women in the project area, benefiting from various health interventions made under the project Arogya.  A total of 2,709 children between 0-5 years are being monitored for malnourishment, in the project area.

PROGRAMME OVERVIEW

 Maternal health

1. Early registration of pregnancy

Early registration has increased to 88% from 74% in last six months period. Total 250 pregnancies were registered in this six months period of which 220 pregnancies were registered within 16 weeks of gestation.

2.  Antenatal coverage and antenatal care services

Antenatal coverage has reached more than 90% which means 90% pregnant women received antenatal checkup by a skilled care provider at least once during pregnancy. High-risk pregnancies are referred to the higher health centre for the treatment of complication and advised for institutional delivery. It is noteworthy that almost 50% of the antenatal care for the villages is provided through a Gynaecologist during the MMU visits. Her checkups are supported by ultrasonography examinations also provided by the MMU.

 3. Postnatal coverage

The proportion of women who received first postnatal care within 48 hours of delivery was 76.6%.

 4. Early and exclusive breastfeeding

 Early breastfeeding rate has increased to 83% which means 83.3% newborns were given breast milk within one hour after delivery. Similarly, the rate of exclusive breastfeeding was 72%.

 5.  Community Mobilisation

82 Matruh Samuh (Mother’s groups) meetings were organised in the period reported, with a total participation of 4351 women. In 49 of these meetings, short films on various health issues were screened. Films on diarrhoea and safe drinking water, the importance of ANC check up, the importance of growth monitoring of 0-5 years children in Aaganwadi (government pre school) centres, the importance of immunisation, institutional delivery, immediate newborn care had a considerable impact on the audience.

14 Village Health Sanitation and Nutrition Committee (VHSNC) meetings were also organised in this period. Use of untied fund was discussed in the VHSNC meetings. This has been a major achievement considering the almost defunct state of these committees.

Eight health fairs were organised in different villages through which the community was made aware of the issues related to maternal and child health. The importance of institutional delivery, post partum complication such as post partum haemorrhage, the importance of taking iron folic acid during pregnancy, the importance of antenatal check-up and danger signs during pregnancy were discussed during these health fairs.

 6. Vital events

In these six months, one maternal death was reported which was due to postpartum haemorrhage (PPH).  Seven neonatal deaths and two infant deaths and one child death were also reported.

Clinical HEALTH

The Aarohi Arogya Kendra (AAK), continues providing state of art clinical facilities. A total of 6,853 patients benefited from the services provided through AAK, the specialist medical camps and the Mobile Medical Unit (MMU) during the period January to June 2017.

Taking the health services to remote mountain villages, the MMU  continues to ply on some the toughest mountain routes in the region. A total 39 medical camps were held during the period. A total of 2,970 patients were treated during these medical camps.