September 25, 2014

Meeting With Dr. T N Seema (Member of Parliament)

Meeting With Dr. T N Seema (Member of Parliament) 

A  team of NAMHHR SC members comprising of Dr. Abhijit Das, CHSJ; Sona Mitra and Priyanka, CBGA; Sandhya Y K from SAHAYOG met Dr. T N Seema, Member of Rajya Sabha and also a member of the Parliamentary Standing Committee on Health and Family Welfare on 10-09-2014 in New Delhi. 

The team gave Dr. Seema the NAMHHR report Maternal  Health and Nutrition in Tribal Areas: Report of the Fact-Finding Mission to Godda, Jharkhand,the CommonHealth Report, Maternal Death and Denial of Maternal Care In Barwani District Madhya Pradesh : Issues and Concerns and other important documents related to the maternal issues in India.

She agreed with the team that since different regions had different realities and requirements, there was a need to have solutions specific to the area, rather than pushing a 'one size fills all' solution. The team raised the issue of the intersectoral nature of maternal health which requires for different Ministries to work in cooperation with each other; for instance, nutrition which forms a core component of maternal health is the responsibility of Minsitry of Women and Child Development while maternal health is the responsibility of the Ministry of Health and Family Welfare.  The discussion also focused on issues related to maternal health bbudgeting. 

A Proud Moment...

Dead Women Talking : Launch of the Report

24th September 2014 was a proud day for the CSOs who work in the field of health. Yesterday when Dead Women Talking : A Civil Society Report on Maternal Deaths in India  released by Dr Syeda Hameed, former member of Planning Commission in New Delhi  fulfilled the aims of a rigorous group's several months works on recording  and analysing the maternal death happened in the Country. The launch was organised in the  India International Centre Annexe, New Delhi.

The report is an outcome of a coordinated civil society effort led by CommonHealth, a national level coalition working on maternal-neonatal health and safe abortion. Twenty one  civil society and community based organizations including NAMHHR compiled stories of 124 maternal deaths occurring over a two year period across 10 states of the country.
The Meeting was cherished with the presence of the eminent panellists like Professor Lakshmi Lingam, Professor and Deputy Director, Tata Institute of Social Sciences, Hyderabad Dr Sridhar Srikantiah, public health specialist and Dr Ritu Priya, Professor, Centre of Social Medicine and Community Health, Jawaharlal Nehru University. The Audience included Leading Public health Activists, Researchers, Civil Society Organisations reporters  and NAMHHR members Dr. Sebanti Gosh, Priya John, Jayashree Velankar and Jashodhara Dasgupta and representatives  from the  leading media. Please find the News article came in Indian Express Pune edition :

Please find the links for the report : 
  1. Dead Women Talking - Report
  2. Executive Summary of the Report
  3. Dead Women Talking - Table

September 17, 2014

Maternal Health and Nutrition in Tribal Areas - Report Launch

Maternal Health and Nutrition in Tribal Areas 
 Report Launch 

Beside the governmental data on Declining  Maternal death Rate and improved maternal health; there are massive gaps when it come to the reality . To find out the reality, a team comprising of Vasavi Kiro (ex member of the Jharkhand Women’s Commission), Dr. Abhijit Das (Member of Advisory Group on Community Action, NRHM) and Jashodhara Dasgupta from  NAMHHR, along with other civil society members undertook a fact finding from 20th to 23rd of November 2013 in Sunder Pahari block, Godda District. The team also tried to explore issues of service provisioning and suggest alternate strategies to improve health and nutrition services in the area  in the tribal areas of Jharkhand.
The FFM team visited three villages selected on the basis of different tribal communities,  varying distance from the block CHC, as well as different accessibility to roads. The team also visited one Community Health Centre (CHC), one First Referral Unit (FRU) and the Godda District Hospital; where the health providers and managers were asked about their assessment of barriers and challenges. 
The Fact-Finding Mission Report was launched in Godda on 1st September 2014 by the D-RCH (former Civil Surgeon) Dr. Pravin Chandra, WHO representative and the Medical Officers in Charge of the Sunderpahari CHC and Mahagama FRU. During the District Dialogue attended by tribal women, Sahiyas and civil society activists of Santhal Parganas, the doctors admitted some continuing challenges like vacancies and lack of skilled staff in the CHC, and the problem of live-saving blood transfusion, which could not be provided in the entire district. The Report was also  shared with the different media in Ranchi and MLA Bandhu Tirkey also joined us and he also did a launch with the media people. 

The profile of the visited area
Godda district is part of the Santhal Parganas division of Jharkhand which is dominated by tribal communities. Sundarpahari is a backward block in Godda.  The block has an entirely rural population, with 79% belonging to the Scheduled Tribe category, and more than half the villages are inhabited by particularly vulnerable tribal groups (PVTGs). Nearly 50% of land in Sundarpahari block is forested and hilly and most habitations are not connected to the few roads that exist. The literacy rate in Sundarpahari is 27%, and AHS 2011-12 data indicates that childbirth at home is 75.2% for district Godda

Summary Findings
  • ·         Giving Birth at home

All the women had given birth at home even though some had complications and near-miss experiences. There was also a maternal death in one of the villages. Yet the women did not consider going to the local health facilities as an option, and had no information about JSY or JSSK. 
  • ·         No Access to Basic Health Facilities

These women did not have access to basic health services such as ANC, and even immunization services for children was unavailable  in the case of PVTG communities.
  • ·         The ANMs did not go to the villages

The ANMs did not go to the villages for either ante-natal care or for home births; the health sub-centres were not easily accessible for many hamlets in the village, and the VHND was not taking place in even half the villages of this block owing to shortages of human resources and transportation issues.
  • ·         No functioning of  blood storage and transfusion facility

In the entire district although a large number of the pregnant women present with high anemia and  comprehensive emergency obstetric care had to be accessed (by those who could afford it) in Bhagalpur Medical College in Bihar. In other blocks where ante-natal care is provided, it is not identifying any danger signs such as anemia, malnutrition or pre-eclampsia.
  • ·         Free supply of grains- traditional Practices were neglected

 The PDS does not incorporate the local grains that are richer in nutrients and instead provides the standard cereals that are given all over the country. The traditional food patterns of the tribal communities which were linked to the forests and the robust practice of mixed organic farming has been disturbed by the introduction of PDS grains. Local practices and resources have been ignored and women have been asked to take iron-tablets during pregnancy instead of promoting consumption of local iron rich foodstuff.
  • ·         No efforts to integrate the tribal health system

Given the geographical situation of Godda district, it is difficult for health services to reach communities located deep in the forests. The tribal communities are seen as ignorant and uneducated, and their practices are looked down upon. The health system has made no efforts to integrate the tribal health system (based on local herbs) and integrate some of the good practices so that the tribal feel less reluctant to use the health facilities.
  • At health facilities in tribal areas 
  • Inter-departmental convergence
  • Re-orientation of community and facility health providers
  • Integration of healthcare with the nutrition services
  • Community Monitoring and Accountability by strengthening the capacity of members of Village Health, Sanitation and Nutritional Committees

The Report of the meeting and Press clippings are attached in this blog post; please find the links below. 

  1. CSO Action Plans
  2. Godda Report Chapter - 5- Hindi Translation
  3. Participant List
  4. Meeting Minutes