Women secure their maternal health entitlements in Bihar

Women secure their maternal health entitlements in Bihar

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Women secure their maternal #health entitlements in a village in #Bihar. Know more. http://bit.ly/1eosLkM

Hundreds of women in a village in #Bihar are now unhesitant to go to a hospital for child birth. Read more http://bit.ly/1eosLkM

When most girls are going to school and dreaming of their life ahead, Masooma Begum was giving birth to her first child at the age of 16 in early 2012.

Even today, the horror of that experience is clearly etched in her mind. 

A resident of Mahesmara village, Pothia block in one of Bihar’s most backward districts, Kishanganj, Masooma  was left emotionally vulnerable and physically weak after going through a painful and complicated delivery at home.

 “There is a government health centre at Damalbari, three kilometres from our village, but it has never been functional. So, we have to go to the one at the block level in Pothia, which is 25 kilometres away.  Hiring a vehicle costs at least Rs 800 to Rs 1,000. My husband simply could not afford it. I had an unassisted delivery at home and somehow my daughter and I survived,” recalls the young mother.

Masooma is 18 now and expecting her second baby. But she is not panicking this time because not only is she better informed and prepared, even the state of healthcare in her area has improved. 

“I am aware that I can avail of the free ambulance service to the Primary Health Centre (PHC). I also know that after delivery I will get Rs 1,400 under the Janani Suraksha Yojana (JSY). These days, I make sure that I get my weight and blood pressure checked periodically and I am no longer anaemic because I have been regularly taking the iron pills,” said Masooma with bright smile.

This transformation in Masooma – as well as hundreds of other women in Pothia block – has been brought under the Department of International Development (DFID)-supported Global Poverty Action Fund initiative, ‘Improving Maternal Health Status in six states in India’, launched by Oxfam India in October 2012. 

Across Bihar, the intervention has reached out to women in 70 villages of three districts, Kishanganj, Supaul and Sitamarhi.

What was the problem?

When the Bihar Voluntary Health Association (BVHA), a partner of Oxfam India, started working in the 22 project villages of Kishanganj the first thing that came to light was that the entitlements under the scheme were being misappropriated and not reaching the new mothers.

“During the discussions held with the community someone pointed out that a woman in the neighbouring village had collected the cash incentive given under JSY twice within nine months. Subsequently, it came out that several women in Mahesmara had, in fact, received nothing. We questioned our Accredited Social Health Activist (ASHA) and followed it up at the panchayat level as well. What came out from the inquiry was quite shocking – cash had been paid out against all the names registered for institutional delivery although none of the actual beneficiaries had got it,” shares Noorbano Begum, President of Mahesmara Village Health, Sanitation and Nutrition Committee (VHSNC) set up by BVHA under the guidance of Oxfam India.

While auditing the functioning of the scheme, another startling discovery was made – money had been issued in the name of local women who had gone to neighbouring West Bengal for their delivery. 

“There is a big hospital in Islampur, West Bengal, which is 10 kilometres away. Many couples go there for delivery even if they are registered with the local Auxiliary Nurse Midwife (ANM),” said Mustaq Alam, another VHSNC member.

People claim their rights

The people of Mahesmara decided to fight the corruption. Its VHSNC members wrote to the Pradhan of Jahangirpur gram panchayat, the district Medical Officer in Charge (MOIC), the Civil Surgeon and the District Magistrate regarding the anomalies in the disbursement of JSY funds.

The result was swift. In the last two years, there has been a marked improvement in pregnant women’s access to facilities such as free ambulance service, cash incentive and check-ups done at the anganwadi centres. The VHSNC members, however, are not resting on their laurels, as there is still a lot that needs to be done.

Here’s why there is a need to ensure smooth implementation of JSY in the region. 

Kishanganj has a low literacy rate of 57.04, with female literacy at a low 47.98. Among the Muslim community the female literacy rate is still lower and most girls are married before 18. This has an impact on the infant mortality rate here which is 56, while the maternal mortality ratio is as high as 349 (Annual Health Survey 2012-13).

The progress in improving maternal health parameters at the grassroots has been slow but steady. While the community has moved forward and decided to protect the interests of pregnant women and newborns, more work needs to be done to ensure better service delivery.  

Written by: Ajitha Menon/Women's Feature Service (WFS)

Photo credit: Ajitha Menon/Women's Feature Service (WFS)