Real evidence that infant & mothers’ health issues can be turned around in India
This was a trip where I really got a close look at how primary healthcare is structured in India.
There seems to be a 3-tier structure at work. Primary Health Centers( PHCs) cater to population of around 30,000- with 2 doctors & 6 beds. There are ‘Sub-centers’ for every 5000 population, and this comprises a building with Auxiliary Nurse-cum-Midwife( ANM), and a Multi-purpose Worker( MPW). For smaller populations- 1000 nos.- there is the Anganwadi Worker( AWW).
I met Anganwadi worker, Usha tai, now in her 11th year, at Village Mahunale( 137 H/H). She tracks births/deaths/immunization/deliveries, and her persistent efforts are now achieving 100% hospital deliveries.( Incentives are also helping: 700/- for hospital delivery). She is certainly well-regarded for her good work.
I found similar evidence at Tirthwadi’s anganwadi( population 1000). AWW Lalita Ghote & Helper Pangave Baburao ensure great care for 47 kids( aged 3-6). They gave me a beautiful demo of how an entire community is now familiar with the importance of tracking growth indicators( height, weight, etc) for infants and kids.
At Sub-center Jagalpur, it was immunization day when we landed there, and a constant stream of families was coming in to meet ANM S.S Kudi Metha, Health Asst N.A Tripati & MPW P.M Tripati. (This Sub-Center won prize for best sub-center in ’07).
I suspect that these locations I went to are among the better ones you’ll get to see. The 3-tier structure; the committed, motivated delivery of services; the interfacing with Unicef and NGOs- its all so robust that it appears fail-safe.
If only, this model- which is truly sound, on paper- were executed with equal thoroughness elsewhere in the country, healthcare would not be a big issue any longer.
Growth-for-All’s task will be to benchmark other locations against this seemingly near-ideal situation.
