In Ajaygarh block of Panna district in Madhya Pradesh, the trend of neonatal deaths is not uncommon. The main reasons behind this sprouting trend are low birth weight (LBW), pre-term deliveries, birth asphyxia and infection or sepsis.Women of the village are not adequately aware of prenatal and newborn care.The socio-economic and cultural norms that exist in the village become a hindrance for women to receive healthcare services available to them.

While proper nutrition, adequate rest and care are necessary for healthy growth of a mother and child, there are various myths that revolve around accessing proper care during pregnancy. One such misconception that exists is if the baby weighs more than the set standard then it becomes difficult for the mother to deliver the child, hence the complicating her condition during childbirth. Such myths do not allow women to receive a healthy and proper diet. The situation remains the same even after childbirth as women are not given adequate diet and expected to resume their household responsibilities. Women are usually deprived of adequate diet and occupied in household chores.

To address the issue, CARE India implemented the New Born Survival (NBS) Project in the Ajaygarh block of Panna district where a community member, Sanjay Kumar Soni is working as ASHA coordinator. In one of his encounters in the remote village of Nardaha, he interacted with Meena Khatik, a pregnant woman from a marginalised community. During his visits, along with another ASHA coordinator, Kamla Kathik, he learned that there were some myths that revolved around the intake of Iron and Folic Acid (IFA)tablets. These tablets were believed to be inducing heat in the body of pregnant women which is harmful to the child and mother.

During the visit, Sanjay and Kamla counselled Meena and her family on the importance of taking a proper diet and adequate amount of rest. The ASHA coordinators also explained why institutional deliveries must be preferred. As a result of their efforts, Meena finally agreed to deliver her baby in a hospital. Meena delivered a baby boy on 27 November 2017, at PHC Dharampur of Ajaygarh. After the delivery, the team realised that the baby weighed just 2.2 kilograms that heightened his risk of survival. Foreseeing the possible negative health outcome of the high-risk baby, the project field staff ensured to follow up regularly and track the improvement in the condition of the baby through ‘Daily Delivery Reporting and Tracking System’. During the first visit, Kamla, the ASHA worker counselled the Meena on Kangaroo Mother Care (KMC). She stressed on providing KMC for at least 1 hour and for as long as possible and its positive effects to improve the weight of the baby.

In her second follow-up visit, Kamla found out that the baby weighed 2.4 kilograms after her intervention. On further interaction with Meena’s family, the ASHA coordinators, Kamla and Sanjay realised that her family was sceptical of these new and innovative ways of childcare that were suggested by them. Sensing the need to counsel her family members, Sanjay advised them to not force her to fulfil her household duties but take care of the child. In the last follow up visit on December 26, 2017, the baby’s condition was found to have improved significantly and he weighed 4.1 kilograms. “It is only due to sustained and supportive house visits by ASHA workers and Field staff of CARE India that I could understand and practice the special KMC method. I am grateful to them as they encouraged my family to support me and my baby’’, said Meena.

This success is a testament to the fact that adequate efforts by service providers and CSOs can break the vicious cycle of prevailing myths and ensure adequate care of pregnant women and improved survival of LBW babies. NBS project of CARE India plays a pivotal role in improving survival outcome of newborn babies and mothers in remote areas of Madhya Pradesh and other parts of the country.

Dr. Sribash Saha and Mohd Zaki Khan