© 2014 John Nicholson, SPRING Project, Courtesy of Photoshare

Voices

Home away from home: Helping expectant mothers access institutional care

  • Jindi Devi lives in remote village in the Mandi district of Himachal Pradesh, she was due for her delivery on March 1, 2017. Radha, the village ASHA visited her in April gave her misoprostol tablet under the SURAKSHA initiative by the project VRIDDHI, and explained the benefits of delivering in a health facility. She also informed the family that the district had set up a birth waiting home to help expectant mothers like her who have to travel long distances to reach a health facility. She suggested that the family take Jindi to the birth waiting homes by the February 21-22 that is seven days prior to her expected due date and offered to accompany Jindi to Mandi. The family felt that with the ASHAs support they could try to try for an institutional delivery for Jindi Devi and ensured she reached Mandi birth waiting home well in time. Jindi was transported to District Hospital Mandi when she went into labour and delivered delivered a healthy baby girl on March 02, 2017. Jindi Devi’s family was pleased with the services at the birth waiting home and found it a very convenient linkage between the hospital and their village, they also mentioned that they would spread the message to in the village and encourage others to utilize these birth waiting homes as a transit facility. Government of Himachal Pradesh has set up Birth Waiting Home in districts with difficult hilly terrain and issues of access with and objective to improve access to health facilities by pregnant women living in remote and tribal areas. In Mandi district, this innovative concept was initiated in July 2016 and since then till February 2017, 108 pregnant women including Jindi Devi have availed this service. This initiative is being supported and facilitated in the high priority districts by project VRIDDHI team.

Implementing active management of third stage of labor

  • Sukhwinder Kaur, a nurse posted in CHC Dhanuala, has been in the profession for over 8 years. She knew about Active Management of Third stage of Labour and even practiced it, she however, had not given importance to administering Injection oxytocin within one minute of delivery. During the district level CaB training she learned not only how important the injection and its timing were but also discussed with her colleagues how to overcome day to day barriers to make this start happening. Now she is feeling very satisfied and says ‘since I have started practicing AMTSL as taught in the training, I have observed that there is a reduction in PPH cases in the facility as a result of administering injection oxytocin within one minute after birth’.

Respectful Maternity Care

  • Sushila a Staff Nurse from Chain Rai District Women Hospital, Haridwar found respectful maternity care a novel concept. She says ‘while we underwent the care around birth training we heard about the seven rights of a mother’. This was an eye opener and we started making an extra efforts to listen to our patients and resolve their concerns especially about maintaining their privacy. We also set up screens in the labour room to provide privacy for our patients, and started allowing birth companions. We try our best to give mothers as much information as we can, we connect them with family planning counsellors to explain to them basket of choices and we have also displayed posters on key RMC messages across the facility.’ She feels that these efforts have led to many benefits such as mothers feeling comfortable about sharing their misgivings and women being more cooperative during labour.

Improving Essential Newborn Care

  • Rupinder Kaur from CHC Dhanuala, Punjab shared her experience of improving essential newborn care practices in her facility after undergoing the care around birth trainings. She says ‘one very critical practice we learnt during the training is ensuring immediate skin to skin contact between the newborn and the mother and delayed cord cutting. This practice ensures immediate breastfeeding after birth, which helps us in curbing local practices of feeding the newborn water, honey and other non-recommended food items. The immediate skin to skin contact between mother and baby has helped us to take care of the dyad even as we continue procedures for the mother, earlier sometimes the newborn used to get neglected. We find that the mother is much more relaxed when her baby is close to her.’

Improving post-natal monitoring

  • Neha Kumari Kesari from CHC Palkot, Jharkhand is a champion health worker whose dedication and hard work has taken post-natal monitoring to another level. In Neha’s words "I got trained in the district on care around birth and I learnt many new things during the training. Earlier as a part of post-natal care we used to check mothers’ blood pressure and vaginal bleeding a few times, but all this changed after the training, we learned the different nuances of postnatal monitoring the timing, intervals, parameters and the need to record findings. We started on a trial basis as per our commitment during the training and gradually started a systematic postnatal monitoring and documentation. Support from VRIDDHI staff helped us to ground the intervention. This approach is very helpful and we have easily incorporated the practice in our routine."

Suraksha: Protecting Mothers through Community based Distribution of Misoprostol

  • 55-year old Hira Devi, an ANM works in Jhanjheli Block in Mandi District of the Himalayan state of Himachal Pradesh, India. She travels upto 18 Kms each time she goes to assist an expecting mother for a safe delivery at home. Her zest to serve is what helps to break the barriers of age as she traverses the challenging terrains to reach the scattered households in the hills. But despite her unfailing efforts, mothers have lost lives due to excessive bleeding after delivery – a factor which was beyond her control.

    The situation changed when the Government of Himachal Pradesh initiated the program ‘Community Based Advance Distribution of Misoprostol tablets to prevent Postpartum Haemorrhage’, and her block Jhanjheli of Mandi District was selected for the intervention ‘Suraksha: Protecting Mothers’. Hira Devi along with her 123 co-workers were trained by VRIDDHI to reach out to expecting mothers in the far flung hilly areas of Jhanjheli to distribute the lifesaving Misoprostol and counsel mothers. They also received a flipbook in their local language to help them explain ways to have a safe delivery and the use of Misoprostol tablets.


    “I feel proud to be part of Suraksha because I feel that it helps me to save lives of mothers. This project does a great service by protecting mothers from dying. I think we are blessed that this project came to our block!”

Reducing Moderate Anaemia Among Pregnant Women in Jind District,Haryana

  • “I was feeling weak and unwell in the 6th month of my pregnancy and after the checkup the doctor informed me that the HB level is 6.2 and prescribed four injections over a period of time. After taking the treatment I feel much better and healthy and better prepared for my delivery. ” - Santosh, Client, PHC Chattar Jind, Haryana

Operationalisation of Nbcc in Labor Room (Sadar Hospital Simdega) by Repairing of Radiant Warmer. Jharkhand

  • “The Newborn Care Corner in the labour room have helped us take care of resuscitate asphyxiated newborns, this is helping us save lives.” - Labour Room Nurse, District Hospital Simdega, Jharkhand

Improving Quality of Care Through Re-organization of Labour Rooms in Barnala District of Punjab

  • “The reorganization of the labour room area is helping us conduct the delivery in an organized manner, we have pre prepared seven trays, partition curtains which are helping us do our work more efficiently.” - Labour Room Nurse, District Hospital Barnala, Punjab.
Top