Bihar Voluntary Health Association (BVHA)

Project Theme

Health

Target Group

Women

Project Period

01 Apr 2014 - 31 Mar 2015

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Introduction

The health and demographic indicators of the Bihar shows that Maternal Mortality Ratio (MMR)- Bihar 261as per SRS 2007-09 is much higher than the all-India level and reflect a poor health status in the State. The Human Development Index (HDI), a composite of literacy, life expectancy and per capita income, has increased for Bihar like the rest of India. In view of the large population size, high poverty ratio, and high decadal growth indices in the State, Bihar is one of the States covered by the National Rural Health Mission. The indicators primarily relates to primary health care infrastructure and reproductive and child health care, the State ranks 35th in the country. On a similar basis, the districts in Bihar have also been ranked lower amongst the districts which are lagging behind in the State are i.e. Seohar, Supaul, Samastipur, Kishanganj, Jahanabad, Nalanda, Khagaria, Araria, Sitamarhi, and Pashchim Champaran. Out of 10 districts, two districts Kishanganj & Supaul are operational areas under this project. During the period BVHA will intervene on maternal health care specially focused on marginalized & unreached community within the project operational area.

Impact by partner
  • Formation and training of VHSNCs in all 32 project villages.
  • WASH mela in all intervention villages to sensitize the community on nutrition, anemia, locally available vegetables to increased intake of iron, importance of full ANC and PNC.
  • Interface meetings with the district and state officials regarding fully costed referral transport system for pregnant women.
  • Social audit of Health, ICDS and PDS services.
  • Jan Sunwai (public hearing) at district and state level on the findings of the social audit.
  • Sensitization meeting with the community and PRI members on MH entitlement, Institutional and safe delivery.
  • Training and meeting with Adolescent groups in all 32 intervention villages on anemia, health and hygiene, problems and solution of adolescence.
  • Mapping of the most marginalized households who have been denied entitlements from ICDS and PDS services.
  • Meeting with relevant stakeholders to include the names of the most marginalized identified above.

Case Study

About the Health Sub-centre and its Past/Current Status:

The service area of the Sub-centre at Mahigaon covers about 26000 populations under 13 Wards. Majority of the people residing under the service area of this Sub-centre belong to minority community (Muslims), who lead miserable living due to poverty. Moreover, the centre is located at a remote location (about 11 kms away from the Block/District Headquarters). Road communication approaching to the Centre from town is in bad condition. The people of the area invariably suffer from flood in rainy season and health services during flood times become very much critical. Earlier when the Sub-centre was non-functional, the people had to suffer a lot to approach to PHC or District hospital.

Before the intervention under the current project entitled “Improving Maternal Health”, the above mentioned Sub-centre was almost defunct. It remained virtually closed. ANM seldom used to come to this Sub-centre. Villagers never used to attend this Sub-centre for seeking health care and they were almost indifferent about the functioning of this Sub-centre. So the villagers never raised any issue relating to non-functioning of the Sub-centre. ANM, at her own suitable time, used to open the Centre once in a month. The building was in wretched condition. There was seepage in the top floor. Small plants and shrubs grew around the walls and entire area was unclean/dirty. Tables, chairs for the health workers and doctors and benches for patients were conspicuously absent. There was no provision for safe drinking water and electricity.

Actions Taken under the Project:-

Several actions have been undertaken under the above mentioned project targeting to improve the maternal health in the project area. First of all, Village Health and Sanitation Committees (VHSCs) were formed in all the villages covered under the project. At the same time these VHSCs were coordinated with the Gram Panchayat level VHSCs duly recognized by the state Government. Several group meetings were organized with the adolescent, youth, women, CBO and other group members to orient/aware them (group members) with the health services available in the government run health Sub-centres; which have resulted into community sensitization and empowerment. Then, the community people along with VHSC, PRI members started raising the issue (pitiable condition and non-functioning of the Sub-centre) before the higher officials (BMO, CMO, etc) compelling the grassroots health functionaries including the ANMs to be punctual in their duties. This is how; the deadly Health Sub-centre was made functional or streamlined.

Improvement:-

Due to effective implementation of the ongoing project, health seeking behaviors of the pregnant women and lactating mothers as well as overall maternal health status in the village have been gradually improving. This gradual improvement has been registered primarily due to the people’s initiatives (after they were made aware of the role of health Sub-centre in improving maternal/community health and facilities available there) released after project intervention. The Health Sub-centres, that remained closed most of the days in a week, are now open in due time and remain functional whole day. Earlier there was only one ANM posted in the Sub-centre, now two ANMs are posted there. Doctors visit the Centre regularly. At present there are two beds for patients. Besides, it (Sub-centre) is equipped with two delivery tools, adequate medicines, provision for fixing Copper-T and adequate supply of condoms. Pregnant women and newborn babies are properly examined and they are timely immunized.The new situation emerges as a fresh venture towards improvement in the maternal health/ sanitation status in the village and combat against poverty.