Monday, October 22, 2007

Fategarh health centre in Guna, MP helps save lives

Anil Gulati

Through UNICEF’s support, this primary healthcare centre has become a round the clock maternal and childcare service delivery centre. The Fategarh model has inspired and has been replicated in six more institutions in Guna.

PRIMARY HEALTH CENTRE, Fategarh village, District Guna, Madhya Pradesh, India: Fategarh is a panchayat village about two hours drive on make shift road from the district headquarters of Guna. The panchayat village lies in Madhya Pradesh but borders districts of Rajasthan, an Indian state.

The village has a sector sub health centre. Ninty deliveries, took place in this health centre, in June 2007, almost all of them are from this nearby villages. This was not the case a year and half before (before December 4, 2006, the day when this centre was revitalised). Before this date, all deliveries used to happen at home and there were number of maternal deaths in the area, which was revealed by Maternal and Prenatal Death Inquiry and Response or the social audit of maternal deaths in the Bamori block, which includes Fategarh panchayat.

Before December 2006, the centre offered only immunisation services like any other sub health centre in the state. Heath facilities like labour room facility for pregnant women of Fategarh and nearby villages was quite far and accessibility to health services was an issue. This was one of the reasons for maternal deaths in the area. It is here that UNICEF (United Nations Children’s Fund) came in and supported the District administration of Guna, Madhya Pradesh, to help make this centre a round the clock mother and child care service delivery centre. UNICEF not only supported the district by providing them with skilled birth attendants, but also trained them in integrated management of newborn and childhood illness.

The centre, as of now, caters for eleven villages. Niranjana and Kamlsa, auxiliary nurses midwives at the centre feel elated when they see the progress, but they sometimes get exhausted when they have to undertake seven to eight deliveries a day; thanks to the increased awareness and schemes by the state.

The centre also undertakes awareness programmes in remote areas and shares information on various schemes, like Janani Suraksha Yojana, initiated by the state government to promote institutional delivery with the community members. This has helped in creating awareness and demand for the need of the institutional deliveries.

“I felt much protected and secure when I came here for my delivery” says Shravani, a mother of three. Her first two deliveries were at home, but for the third one the village ‘dai’ got her to the sub health centre.

Dr Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh, adds that children and women’ lives can be saved and this can happen with improvement in both access and quality of health services through such interventions. Fategarh model of revitalisation of the sub centre to provide basic health care services, including conducting deliveries, has inspired and has been replicated in six more institutions in Guna.

Fategarh health centre in Guna, MP helps save lives

Anil Gulati

Through UNICEF’s support, this primary healthcare centre has become a round the clock maternal and childcare service delivery centre. The Fategarh model has inspired and has been replicated in six more institutions in Guna.

PRIMARY HEALTH CENTRE, Fategarh village, District Guna, Madhya Pradesh, India: Fategarh is a panchayat village about two hours drive on make shift road from the district headquarters of Guna. The panchayat village lies in Madhya Pradesh but borders districts of Rajasthan, an Indian state.

The village has a sector sub health centre. Ninty deliveries, took place in this health centre, in June 2007, almost all of them are from this nearby villages. This was not the case a year and half before (before December 4, 2006, the day when this centre was revitalised). Before this date, all deliveries used to happen at home and there were number of maternal deaths in the area, which was revealed by Maternal and Prenatal Death Inquiry and Response or the social audit of maternal deaths in the Bamori block, which includes Fategarh panchayat.

Before December 2006, the centre offered only immunisation services like any other sub health centre in the state. Heath facilities like labour room facility for pregnant women of Fategarh and nearby villages was quite far and accessibility to health services was an issue. This was one of the reasons for maternal deaths in the area. It is here that UNICEF (United Nations Children’s Fund) came in and supported the District administration of Guna, Madhya Pradesh, to help make this centre a round the clock mother and child care service delivery centre. UNICEF not only supported the district by providing them with skilled birth attendants, but also trained them in integrated management of newborn and childhood illness.

The centre, as of now, caters for eleven villages. Niranjana and Kamlsa, auxiliary nurses midwives at the centre feel elated when they see the progress, but they sometimes get exhausted when they have to undertake seven to eight deliveries a day; thanks to the increased awareness and schemes by the state.

The centre also undertakes awareness programmes in remote areas and shares information on various schemes, like Janani Suraksha Yojana, initiated by the state government to promote institutional delivery with the community members. This has helped in creating awareness and demand for the need of the institutional deliveries.

“I felt much protected and secure when I came here for my delivery” says Shravani, a mother of three. Her first two deliveries were at home, but for the third one the village ‘dai’ got her to the sub health centre.

Dr Hamid El Bashir, State Representative, UNICEF office for Madhya Pradesh, adds that children and women’ lives can be saved and this can happen with improvement in both access and quality of health services through such interventions. Fategarh model of revitalisation of the sub centre to provide basic health care services, including conducting deliveries, has inspired and has been replicated in six more institutions in Guna.

Sunday, October 14, 2007

Empowering Women

By M V Kamath, The Organiser, Sept 30, 2007

Irrespective of whether a woman is elected President or not, there are certain things that not just a woman President but all political parties should attend to—and it is the rights of women. Not just in India, but all over the world women have been the greatest sufferers. About three quarters of the world’s 20 million refugees are women and their dependents. Women and children account for more than 80 per cent of those living in refugee camps and that is seldom acknowledged. Things are no better, specifically in India.

According to The Indian National Crimes Records Bureau (NCRB) quoted by a distinguished human rights expert, D.R. Kaarthikeyan, there were 9,518 cases of rape in India in 1990 which rose to 9,793 in 1991 and to 15,468 cases in 1999. Similarly, there were 4,836 dowry deaths cases in 1990, which rose to 5,157 in 1991 and to an all-time high of 6,699 in 1999. Cases of torture of women have to be enumerated to be believed. There were 13,450 cases in 1990, as many as 15,949 in 1991 and an unbelievable 43,823 cases in 1999.

In his book on human rights, Mr Kaarthikeyan writes: “Research has shown that for millions of women, their homes are dens of terror and that a huge chunk of violence that is perpetrated against women is committed by their own family members.” Not only that, but such violence cuts across income, class and culture and these incidents are rarely reported and even if they are reported “they are reported when it is too late to change the situation”.

It is frightening to think that every 26 minutes a women is molested, every 34 minutes a rape takes place, every 42 minutes a sexual harassment incident occurs, every 43 minutes a woman is kidnapped and almost every hour a woman is burnt to death over dowry, 25 per cent of rapes involving girls in the age of 16. This is India. The spiral of violence against women is apparently rising “at an alarming rate”—and this is where just not a woman president, not just a government in power, but all political parties irrespective of their ideology must come in, to fight for social reform, for enlightenment of people and for raising our ancient culture to higher levels. Gender violence comes in many forms with which most of us are familiar. They include foeticide, food deprivation, emotional abuse, forced marriage, sati, rape, sexual assault, harassment of all sorts, trafficking, forced sterilisation, torture and finally dowry deaths, the cruellest of all.

There are, of course, legal provisions to fight gender violence but none of these have truly been effective. Jawaharlal Nehru once said: “You can tell the condition of a nation by looking at the status of its women.” On the one hand, India has the world’s largest number of professionally qualified women which may come as a surprise to many to know. India reportedly has more women doctors, surgeons, scientists and professors than even the United States of America. Similarly, India has more working women than any other country in the world and they are notable for their skills whether as surgeons, airline pilots or even bus conductors and menial workers. That should be a legitimate matter of pride.

But then think of this: India has the largest population of non-school going working girls, maternal mortality rates in rural areas are among the world’s highest and of the 15 million baby girls born in India each year, nearly 25 per cent of them do not live to see their 15th birthday.

Compared to baby boys, they get less food, less care and less attention, which is a disgrace to the country. Indians who boast of the panch kanyas, Ahalya, Draupadi, Sita, Tara and Mandodari, and insist that if these are smare nityam, maha pathaka nashanam (the greatest sins are destroyed if they are daily remembered), have no hesitation in resorting to foeticide if the foetus shows that it is that of a girl. What can be more shameful?

In India, female foeticide, sex selective abortion and child prostitution are only too common and few voices are raised against them. Laws are for textbooks, not for application. The Dowry Prohibition Act has been in existence for over 33 years, but how effective has it ever been? Domestic violence is recognised by existing civil law, according to Kaarthikeyan, but only in the context of dissolution of a marriage, and as being conduct amounting to cruelty, and therefore, ground for divorce. Is that all we want? With female foeticide becoming almost routine, we are coming to a stage when young men in some states, especially in the north and west, will have to search for brides elsewhere in the country. In the latest Census, the number of female child births has come down to 93.7 for every hundred male children. The anti-girl child bias has to be fought at the ground level and this is not a party issue: It is a national issue. We need a new set of Raja Ram Mohan Roys to act as social reformers who have the courage to speak out and speak persuasively. Sadly, we don’t have them. We only have cheap politicians for ever dwelling on secularism as their moola mantra which is an easy way to attain political applause.

When did any member of the present UPA government ever speak about these matters? When one realises that women form half of that world’s population—as indeed half of the population in almost any given state—it is shocking to learn that women perform two-third of the world’s work and receive only one-tenth of its income and less than one hundredth of its property. In reality, this is a man’s world. And men are notorious for the ways they treat women—not outsiders—but those in their own homes. In India, the states most notorious for the ill-treatment of women are Rajasthan, Madhya Pradesh and Delhi. Female foeticide is most rampant in Haryana and Punjab. Does anybody care? Trafficking in women and children, according to Kaarthikeyan, is one of the worst and most brazen abuses of human rights. According to him, at least 25,000 children are engaged in prostitution in India’s metropolitan cities, which is a low figure compared to other sources which put the figure as high as 500,000 girl children below the age of 18 years.

These are issues for our political parties lacking vision to give their attention to. But what can a parliament do which reportedly has some 119 MPs with criminal charges against them? What vision can one expect from them? We are not only a wild nation, but additionally we are also a blind nation. Our only national interest is politics, not people and politics, too, of the blindest variety. We speak about the common man, but it would be nice if we occasionally hear about the travails of the ordinary woman who is the lifeline of our society.

Saturday, October 06, 2007

Madhya Pradesh nowhere near reaching key development goals

The authors of the Triple 7 report said the picture in the field of primary education was equally bleak, due to lack of trained teachers and of basic facilities such as drinking water and toilets in the schools.

By S Sharma, IANS - Madhya Pradesh is nowhere near reaching the UN Millennium Development Goals - by the 2015 deadline, if a mid-term evaluation report prepared by voluntary groups is anything to go by.

And this in a state where a world record 3.3 million people across 42 districts took part in a government-sponsored 'Stand Up Against Poverty' campaign in October to achieve the MDGs - reducing poverty, achieving universal primary education, promoting gender equality, reducing child mortality, improving maternal health and ensuring environmental sustainability.

Now voluntary groups in the state have prepared what they call the 'Triple 7 Report' - after a mid-term evaluation of how far the state is from achieving the MDGs.

The report says Madhya Pradesh - where 4.5 million families live below the poverty line - has been found wanting on all fronts.

'Malnutrition is a problem that has always been brushed under the carpet by politicians but the dire conditions in Madhya Pradesh now definitely call for some mandated moves', says Sachin Jain of Vikas Samvad, one of the groups behind the report.

In Madhya Pradesh 82.6 percent of all children under the age of three are anaemic, according to the government's own recent National Family Health Survey - III. The corresponding figure for 1998-99, when NFHS II was carried out, was a low 54 percent.

Sixty percent of all children under the age of three in the state are underweight, 51 percent are stunted and 20 percent are wasted, says the Triple 7 report.

Data collected during the state government's recent growth monitoring drive and Bal Sanjeevni Abhiyaan shows that 80,000 children are suffering from most severe malnutrition and are on the verge of death, the authors of the report say.

According to NFHS III, only 22.4 percent of the children below the age of two have full immunisation coverage.

The Triple 7 report says only 23 percent of the children are registered in Anganwadis -.

In a state where 24 women die in childbirth every day, the maternal mortality rate is 379 per 100,000 live births - third highest in the country.

The infant mortality rate - which counts children who die before the first birthday - stands at 76 per 1,000 live births.

'Though the state has introduced many schemes to help combat maternal and infant deaths, they are not yielding the desired results due to bureaucratic hassles and corruption,' say activists responsible for the Triple 7 report.

The activists refer to a recent report of the Comptroller and Auditor General of India that benefits of the schemes do not reach 52-62 percent of the children and 46-59 percent of the pregnant and lactating mothers.

And it is not as if private healthcare is stepping into the breach. The activists point out that expenditure on health has declined from 5.1 percent of total expenditure in 2000-01 to 3.4 percent in 2004-05.

This is a state where 38 percent of the rural population do not have access to safe drinking water. Madhya Pradesh accounts for 40 percent falciparum malaria cases in the country.

The authors of the Triple 7 report said the picture in the field of primary education was equally bleak, due to lack of trained teachers and of basic facilities such as drinking water and toilets in the schools.

The authorities also had to address issues such as the distance to the nearest school, midday meals and scholarships, the activists added.