Arogya Project

We started in 2021 under the `Arogya’ Project for Maternal & Child Health, aiming to strengthen the public health care delivery system by improving the of quality of care for pregnant and lactating mothers and their children under 5 years of age.

 

This we are doing by creating ideal delivery points of the 4 government SHCs (Sub Health Centres) of Pati Block namely Paniya, Khetikhan, Devidhura, and Chaudamehta in Champawat District, Uttarakhand. All infrastructure inputs, including renovation of buildings, gap-filling of essential equipment will be done. One ANM, a multipurpose worker and a helper (mostly TBA) will be appointed as support staff in each SHC to conduct safe deliveries. A population of 52,000 will be covered through training and mentoring support of all the 19 government ANMs,41 AWWs, and 29 ASHAs of the block under these 4 SHCs. Improved services and health outcomes will result through training and mentoring support of these FLWs (Front Line Workers), improvement of health care services for safe deliveries at the institutional level, timely recognition and referral of high-risk pregnancies and complications of labour; and improved health of children and mothers at the community level through greater awareness and better nutrition.

 

Permission for such collaboration has been obtained from the District Government. At the end of 2 years, we will attempt to do advocacy to include maintenance and running expenses of these SHCs with the State Government in their PIP (Project Implementation Plan). Successful implementation will create a sustainable collaborative model for expansion in the whole district.

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Prior to starting of the above-mentioned intervention, we conducted a study on “Maternity care provision in five Indian Himalayan sub-centres, barriers, and opportunities”. It was a 6- month study from February – Jul 2020, in collaboration with Northumbria University, United Kingdom. The study assessed the strengths, gaps, and challenges in 5 health SHCs namely Chaudamehta, Khetikhan, Paniya, Devidhura, and Mantande.

 

Interventions for capacity building of ANMs, ASHAs, and AWWs have been designed on the findings of the study. State and central government approved safe delivery and skills lab training modules are being used by our trainer.

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What we did:

• During antenatal care clinics, pregnant women underwent complete antenatal checkups. ASHAs were trained to do ANC checkups, including abdominal examinations.

• Antenatal care counseling with birth preparedness was done for each antenatal mother.

• The need and dose of iron and calcium supplements were explained to mothers.

• ASHAs counseled mothers on lifestyle and dietary habits, including beneficial traditional practices and the importance of locally grown food.

• ASHAs and ANMs were introduced to the concept of 'Respectful Maternal Care' and how they could practice it in their day-to-day lives.

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Currently:

 

In February 2022, we started infrastructure development plans for the Paniya SHC as a safe delivery point. All infrastructure inputs, including renovation of the broken labour room, and gap-filling of essential equipment is being done through the Arogya Project. One ANM, a multipurpose worker, and a helper (probably a Traditional Birth Attendant) will be appointed as support staff to conduct safe deliveries.

 

• A detailed assessment of the Paniya SHC revealed that the walls of the labour room had major cracks and the roof leaked. It was unsafe for use.

• In partnership with `Space Matters’, a Delhi-based architecture firm, a plan was made to demolish this structure and rebuild it in a modern way, incorporating guidelines for Labour Rooms laid down by the Ministry of Health and Family Welfare.

• Approval was taken for these plans for renovation from the District Administration.

• A junior architect was appointed to stay on-site and supervise the execution of the job.

• In May 2022 a contractor was appointed to execute this job.

• Civil work started on 07 May 2022.