Making Motherhood Safe
Women avail Janani Suraksha Yojana Scheme in Chinchwadi
Chinchwadi is one of the villages adopted by Population First under AMCHI. One of the major problems identified during micro-planning was maternal and infant morbidity and mortality. A poster announces the importance of 'safe motherhood' during a session on the topic. Such sessions and close interaction with the villagers has resulted in more safe deliveries and better mother and child health. The reason was that the villagers did not register pregnant women with the Primary Health Centre (PHC) for ante-natal care (ANC) nor did they go in for institutional deliveries. There was a mid-wife who assisted the deliveries if necessary at home.
The reluctance was due to the following difficulties faced by the villagers for availing the facilities at the PHC:
Distance - it was 2km away and they needed a vehicle to get there and they did not have the money to pay for it
- Nobody at home to look after the kids during the hospitalization of women
- Expenses involved in hospitalization
- Lack of knowledge about the Janani Suraksha Yojana (JSY) under which the every pregnant woman is paid Rs. 100.00 on registration and Rs 700.00 on institutional delivery
- No ANM at the Dehne sub-centre, which caters to Chinchwadi
This was in June 2007.
Resolving the issues
All the above issues were brought to the notice of the district authorities and the Medical Officer at PHC Dolkhamb, who assured the villagers that an ANM would be appointed shortly.
In August 2007, Ms. Desle joined as ANM. In the first week of September 2007, the first-ever meeting of all ANC and Post-Natal Care (PNC) women was held with the ANM. The benefits of pregnancy registration, blood tests, nutrition, rest, vaccinations and institutional deliveries were emphasized. The incentives offered by the Government under JSY were explained.
Dinesh Patkar in Dehne, a neighboring village had a vehicle and he agreed to lend his vehicle when he was told that he would be paid for transporting the pregnant woman to the sub-centre/ PHC (under the National Rural Health Mission).
Another meeting of the ANM with the women was held last week of September 2007 where the women who were eligible for the incentive under JSY were paid accordingly and the telephone number of Mr. Dinesh Patkar was given to the women. In October 2007, of the six deliveries in the PHC, four were of women who had delivered their earlier children at home. In December 2007, all the four deliveries took place in the PHC. Dr. Dhere, Medical Officer, PHC Dolkhamb said “Your (PF) interaction with the villagers and counseling on health issues has greatly facilitated our work”Today all deliveries are conducted in the PHC.
Harbingers of Charge
The Women Self-Help Groups of Alyani
Alyani is a village under Kinhavali PHC in the Shahapur block, which already had eight Self-Help Groups (SHGs) when we began our work there. The micro-planning process revealed that the SHG groups had no understanding of the operational details of micro-financing. It was found that even though some of the SHGs had been in existence for more than two years they had received no grant or loan for lack of knowledge that this facility was available. Thus the SHGs were inactive and in some cases defunct.
It was clear that the villagers did not appreciate the concept and the benefits of SHGs. For empowerment of the women, it was necessary to revive and revitalize the SHGs. A melava (fair) was organized in Alyani in the community temple in August 2007. About 200 women from the 10 villages – Alyani, Devlichapada, Vithalgaon, Gegaon, Kahrivali, Gundyachapada, Chikhalgaon, and Vachkhole – participated in the melava.
The concept of SHGs, the benefits to the individual, group and community and how it can empower women was explained. Following intense discussion and thrashing out of issues and doubts, the SHGs of Alyani came forward and sought assistance in checking their records, understanding the records/ accounts and how to maintain them. This process revealed that there was misappropriation of funds in some SHGs. Vandana Walimbe, president of Mahalakshmi Group pointed out that this happened where there was interference from the men. Each woman was encouraged to understand and seek accounts and accountability from office-bearers and members. After the melava we were happy to see women come forward and ask the secretary for the records.
The process had been set in motion.
Some days later when the PF team visited the village, a group of men lead by Dilip Pashthe, president, Pani Purvatha Samiti (Water Supply Committee) threatened them saying “Why did you need to give all that information to the women? We are capable of managing our affairs.” We reported this to the Gram Panchayat members and Deputy Sarpanch who immediately reprimanded Pashthe and told him “whatever they (PF) are doing is at our behest and for our development. The effort should be supported by all.” The women of the village also confronted Pashthe and warned him against misbehaving with the PF team. The Extension Officer’s visit to the village motivated the women.
“It is only because of the micro-planning process and efforts of PF that such a programme was held in our village and the Extension Officer, Panchayat Samiti visited our village for the first time. More such programmes should be organized by the Gram Panchayat” said Usha Godvinde, Membe of Mahalakshmi SHG.
Saving Precious Lives
Community tackles child malnutrition in Chinchwadi
In April-May 2007, the micro-planning exercise in five villages (which includes weighing the pre-school children to detect malnourishment) identified malnourishment as a major issue. Unfortunately the Anganwadis which were entrusted with the responsibility of looking after cases of malnutrition were not working effectively and the number of malnourishment cases recorded by them in the official records was public weighing of children is in process at a anganwadi.
We found that 38 children were in Grade III and IV i.e. severely or critically malnourished. Of these 38, 25 were from Chinchwadi. The reasons were many but for the village and these children it was important to change the situation.
How was this done?
- Our team made home visits to each of the families.
- The signs and symptoms of malnutrition and the consequences were explained.
The importance of the following were explained:
- Regular attendance at the Anganwadi
- The role of the Anganwadi worker
- Taking the children to the special camps organized by Health Dept., for malnourished children.
- They were told to demand and feed the children jaggery and peanut ladoos given free under the Integrated Child Development Scheme (ICDS).
- The Anganwadi worker was motivated to play her role effectively and give the necessary attention to the malnourished children
- Meetings were held with the head of the Self Help Groups (who are responsible for preparing the food for the anganwadi), Anganwadi supervisor and worker and the important villagers. They were explained the importance of the ingredients and the quantity of the khichdi, how it should be made and given to benefit the malnourished children.
- The information about the malnourished children was provided to the Health Dept., and after a check-up, medicines were made available through the Anganwadi.
- It was ensured that the Anganwadi regularly gave medicines to the children in Grade II and III.
- Parents of children who were critical were convinced to admit them in the Rural Hospital and follow-up with regular visits to the PHC.
“Because of your counseling, I admitted my child to Rural Hospital. Thanks to your efforts, he is getting proper attention and service from the medical staff of RH and his health is improving.” Janki Khair, Mother of a severely malnourished child
The weight of the children was regularly monitored and the improvement - very slow but steady – was sustained. In November 2007, the number of malnourished children in Grade III and IV was reduced to 4.
Ensuring a better tomorrow for the children
Anganwadi enrolment initiative in Vihigaon
While preparing for the micro-planning in Vihigaon, the PF team was walking through the village to observe the daily activities and get acquainted with the villagers. In the most interior portion of the village they observed that all the children who should have been in school or the Anganwadi were at home. During the survey, it was found that this part of the village is inhabited by Katkari tribe. They are basically agricultural labourers and barely earn enough to eke out an existence. Anganwadi, school, education had no meaning for them.
There were only 17 children in the Anganwadi on March 12, 2008 when we visited them.
To initiate the micro-planning process, it was decided to call the first meeting on March 13, 2008 in the adivasi pada. The villagers, pada workers, members of Gram Panchayat, Gram Sevak and youth groups attended the meeting. After explaining the objectives of micro-planning, our team presented the case study of Triyambak Ganga Bhoi and his family. He had three sons, all of whom were married and had 11 grandchildren between 3 and 7 years of age. But none of them had ever been to an Anganwadi or school.
Triyambak was asked whether he liked his work as a labourer. He replied in the negative adding, “Since I could not get a job I had no option.” When asked why he could not get a job, he said, “Because I was not educated.”
The same discussion was carried out with his 3 sons. Through this, the point was brought home to the villagers that education is necessary for understanding the environment, resources, opportunities, and for improving the standard of living. In their present condition despite 4 men in the family working as labourers, they were barely able to sustain the family. And by not educating their children they were perpetuating this cycle of poverty.
Information about the role of the Anganwadi and facilities available were explained in detail and the community was urged to utilise them for their benefit.
Poklewadi Demands Better Education for its Children
During Micro planning process in Poklewadi village in the month of March 2012, the household survey revealed that many children dropped out from school after the 4th standard. The Zila Parishad School at Poklewadi village has classes up to 4th standard and for the next level of schooling children had to go to the school in the adjoining village which is located 3-4 kilometers away from this village. It was also pointed out by the community that the performance of the school teacher of Polklewadi was not up to their expectations. Further in the discussion people complained that teacher never came to school on time and did not teach properly. Even the 4th standard students were not able to read or write properly. This placed them at a disadvantage when they went to higher classes making it difficult to cope with studies forcing many of them to drop out.
After discussing the issue at the Gramsabha, the problem was placed before the Shalya Vyawasthapan Samiti (school Management Committee). A meeting was held with the teacher of the Zila Parishad School, but he was not willing to change his attitude and said that he was already over burdened with work. So, a complaint was filed with Block Education Officer in Sahapur block, for replacing the existing school teacher. But no action was taken and the same teacher was continued in the new academic session. The entire village Community stood up against this decision and decided to lock the school. The administration had no option but to respond to the demand, not just of the parents but the entire village community, for better education for its children. The Zila Parishad School of Polkelewadi has a new school teacher since August 2012.
It proves once again that accountability and quality in service delivery is possible only when the stakeholders are conscious of their entitlements and are willing to demand the same.
The cost of micro-planning and follow-up exercise per village works out to Rs. 84000per year. If you wish to support micro-planning in a village of Shahapur block of Thane district, click here