Community based approach to improve health and nutritional status and to reduce deaths of tribal of Melghat, Maharashtra
(Report April to June 2021)
MAHAN (Meditation, AIDS, Health, Addiction, Nutrition) is a non-government organization established in 1998 to improve health care in Melghat region. MAHAN was touched by Gandhian teaching that “youths should go to the villages to serve as real India is in villages”. Melghat is the hilly forest area in the beautiful Satpuda mountain ranges. Population is 300,000 & 75% of them are tribal. Korku is the major tribe of Melghat. Most of the tribal (>90 %) are farmers or laborer, living below poverty line (>80%) & very hard life in huts (>90%) mostly without electricity & illiterate (>50%). Medical facilities are grossly inadequate in Melghat as compared to rest of Maharashtra. Due to lack of proper medical facilities & superstitions, tribals go to traditional faith healers/quacks (pujari & bhumkas) for treatment of illness. Skin is burnt with red hot iron rod for reducing pain known as Damma. This lead to very high under 5 children mortality (>100 per 1000 live births) especially Malnutrition related deaths and very high mortality in age group (16-60 years) & maternal mortality. Moved by such things, we started the project in Melghat in November 1997. MAHAN Trust has dedicated its work to reduce malnutrition and mortality among under-five children, women and economically productive age group through various programs like HBCC, MCPEPAG and SAMMAN. Below is a snapshot of our achievements in these projects aided by our generous donors.
SAMMAN (Community based Management for Severely Malnourished Children)Aim of the Project
To reduce prevalence and death of severe malnutrition in under 5 children (SMC) (SUW & SAM) using local therapeutic food (LTF) distributed by Village Health Workers (VHWs).
Activities and Impact (32 Villages)
Particulars (June 2021)
Total 0-5 years Children
Anthropometry of 0-5 Year Children (measured)
Total Prevalence of SMC (June 2021)
Total SMCs treated in SAMMAN
Case fatality rate (CFR) of Treated SMC
Case fatality rate (CFR) of overall SMC
Hence, we achieved the target of prevalence of SMC <15%.
There was not a single death amongst treated SMCs and hence we could achieve WHO target of CFR of <4%.
One 2 years 4 months of age, girl from Chaurakund village was suffering from severe malnutrition ( MAM/SUW). Her weight was 8.00 kg and height was 83 cm on 28-10-2020. VHW treated her with local therapeutic food (LFT) for six months and after that she recovered from Severe Malnutrition. On 28-04-2021 her weight was 9.440 kg and height was 84 cm.
HBCC (HOME-BASED CHILD-CARE Program)
Aim of the Project
To reduce under 5 children mortality rate and prevalence of malnutrition.
No. of 0-5 years patients treated by VHWs=2205
Under 5 Mortality Rate. =67.8
One 4 years 2 months of age, girl from Sawarya Titamba Village was complaining of cough, fever. She was brought to village health worker (VHW) for the treatment. VHW diagnosed her as probable case of Pneumonia as temperature was 101.8 F, Respiratory Rate 45 per minutes. VHW started her with syrup Cotrimoxazole and syrup Paracetamol for five days and she recovered from the symptoms.
MCPEPAG (Mortality control program for economically productive age group, 16-60 years)
Aim of the Project
To reduce number of deaths in 16-60 years age group from 32 villages.
Activities and Impact
This program involves treatment of patients suffering from hypertension, malaria, diarrhea, asthma and referral of patients of TB, heart diseases, etc. to hospital.
Impact achieved –
Total number of 16-60 years treated
Total Behavior change communication beneficiaries
Age specific mortality rate per lakh population
1) A 50 years old male from Pohara, was suffering from hypertension since 2 years. His first Blood Pressure was 155 / 100 mm Hg as per record of VHW. After constant health education by VHW and BCC supervisor, along with medicine, Tab. Amlodipine 5mg once a day, his Blood Pressure reduced to 133/85 mmHg. Constant follow up by recording weekly blood pressure is done by VHW and medical supervisors.
2) A 22 years poor tribal female farmer patient, from village Sawarya Titamba, complained of fever and breathlessness. She came to Village Health Worker (VHW) for treatment. VHW checked her SPO2 (98), Pulse rate (89), temperature (99.8-degree F) and respiratory rate (25 per minute). VHW diagnosed her with pneumonia, and treated her with antibiotics and tablet Paracetamol 500mg. Along with the treatment she also gave her health education on Pneumonia and basic hygiene for prevention. She is normal now.
1) Hospital care Beneficiaries (OPD)=814
2) Total Hospital Inpatient Beneficiaries (IPD)=135
3) Critical Care Beneficiaries (ICU)=85
We saved very serious young poor tribal patient suffering from Covid-19 with bilateral pneumonia with ARDS with sepsis with CAD with pulmonary embolism with hypo-tension with hyponatremia with hypokalemia with anemia with severe hypoxia with encephalopathy. He was on ventilator for nearly 15 day and on high flow oxygen upto 35 L per min for another 15 days. Since one month he is normal without oxygen. Thanks to MAHAN staff and donors.