MVF’s Intervention on Health.

The focus of the programme is to improve the health of the community especially pregnant women, adolescent girls and children up to the age of 3 by making health a public issue which people demand as their right.
Specifically, the action seeks to decrease maternal and infant mortality, stop child marriages and improve the health and nutrition status of children under-3. It also seeks to prepare local institutions such as the Gram Panchayats, Child Rights Protection Forums, girl youth committees and health committees to take up health issues and strengthen the government health system in order that all women get proper ante-natal care and have institutional and safe deliveries, universal immunisation and prevention of malnourishment for children in the 0-3 age group is ensured, child marriages are prevented and the health of adolescent girls is improved, adolescent girls in the age group of 12 to 18 years are empowered. In addition the health delivery system of the government is strengthened through community participation and ownership in order to improve the community’s access to the health system and processes for systematic review of health programmes at the mandal and district level are established in order to improve the efficiency of the health department.

The following are the activities taken up:

At the gram panchayat level facilitate registration of all births, establish a system for registration of all marriages and identify proposed child marriages and mobilise local groups such as the Child Rights Protection Forum and youth associations to stop such marriages. In addition, follow up with all girl children to ensure that they are retained in schools until they finish class X and not get dragged in to early marriages and organise adolescent girls into youth associations and equip them with skills for self-confidence and to protect their rights.

Equip gram panchayats and local bodies to monitor the health status of women and children, conduct training programmes and exposure visits to members of gram panchayats and local committees and ensure their participation in strengthening of the PHC and the Sub-centres. Facilitate training for Medical Officers, ANMs and all other PHC and APVVP staff at the mandal level on (a) protocols to be established for safe delivery, (b) neo-natal care and (c) emergency obstetric care.

Establish mandal task forces comprising of Mandal President, MRO, MDO, MEO, Medical Officer, ICDS_CDPO, representatives of Child Rights Protection Forum, youth associations, women and gram panchayat sarpanches to regularly review and monitor all components of the programme. Establish processes for review, planning and monitoring at the PHC/APVVP hospital level and the District level for improving the management systems, through providing support by the MVF staff on a day-to-day basis.

Sensitise the health department staff to be responsive to the community, establish linkages and flow of information between the mandal and the district level in order to strengthen the functioning of the PHC/APVVP hospital, make appropriate changes to the job charts of each of the functionaries of the PHC/APVVP hospitals (including field staff such as ANMs and male health workers) to realise their fullest potential as health service providers.

Advocacy by youth groups, women’s groups, gram panchayats, child rights protection forums for changes in the health system to protect women’s health and children’s right to health. Hold rallies, public meetings and cultural programmes to build awareness on child marriages in the entire community

Maintain, follow up and regularly update lists of every pregnant woman in the project area through home visits until they deliver. Establish a link between the pregnant women and the ANM and anganwadi centre for required ante-natal care. Conduct regular meetings with husbands and both the in laws (mother and father in law) of pregnant women to support her for nutrition, rest, access to ante-natal care, institutional delivery, post-natal care etc. Identify high-risk pregnancies and accompany them, in case of referrals.

Maintain and regularly update lists of every child in the 0-3 age-group in the project area. Motivate the families for regular immunisation and contact ANM for administering dosages to all those children who have been left out of the immunisation programme (partially or fully). Monitor the weight of all children in the 0-3 age group, identify those who are malnourished and follow up in co-ordination with the anganwadi centre. Hold meetings with parents on nutrition and growth milestones of children. Identify children with low birth weight, birth deformities, undernourished children, premature babies etc., who need special care and attention such as intensive monitoring of food intake from local sources and educating the entire family to take responsibility for the child’s growth and well-being, train and counsel the parents as well as the neighbourhood to be sensitive to physically challenged children and treat them with dignity, and if necessary link them to appropriate health institutions. Identify anaemic girls and ensure they are given the IFA tablets, in association with the anganwadi worker