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Strengthening Access of Marginalised Communities to Maternal and Child Health Services, Jharkhand

Strengthening Access of Marginalised Communities to Maternal and Child Health Services, Jharkhand

Saranda, the ‘Land of Seven Hundred Hills’ lies at the tri junction of three states- Jharkhand, Odisha and Chhattisgarh and is covered by the dense Sal forest. The region is inhabited by the tribal population (HO tribes) who reside in the deep forest areas, and are highly marginalised due to their inaccessibility. Infant mortality rates in the region are high, with an abysmally low neonatal survival rate. Overall malnutrition rates in the region are high, and health infrastructure is weak.

It was against this background that Phia Foundation in partnership with Society for Reformation and Advancement of Adivasis (ASRA) began implementing a project to strengthen access to maternal and child health services in the region with support from UNICEF. The aim of the project is to strengthen access of basic maternal and child health services health services to excluded communities in 28 villages in three gram panchayats of Manoharpur block of West Singhbhum district.

Since the initiation of the project from 1 August 2016, Phia Foundation and ASRA have implemented community engagement and community mobilisation activities in the area. A key focus of the activities has been to raise awareness among the communities on the different government programmes and schemes (specifically on maternal and child health), and the communities’ entitlements under the programmes/schemes.

UNICEF visit to project sites

On 28 December, 2016, a UNICEF team comprising of Dr. Rahul Kapse, Health Specialist, UNICEF (Jharkhand), and Mr. Anil Kumar, District Consultant, UNICEF visited village Lodo, a project site under Gram Panchayat Chidiya in block Manoharpur in the district. A village level community meeting was organised to facilitate interaction with the community.

During the interactions the community highlighted some key challenges and gaps in accessing health care to the UNICEF team. These gaps were identified during the Phia Foundation and ASRA teams’ engagement and awareness drives with the community, and are listed below.

  • Village Health Sanitation and Nutrition Committees (VHSNC) have not been formed in several villages.
  • No Anganwari worker in more than five villages
  • Sahiyas (community mobilisers) not in place in several villages, which is adversely affecting the uptake of health services and institutional deliveries.
  • There are infrastructural gaps at the Health Sub-Centre(HSC) and Primary Health Centre (PHC) level (shortage of beds, no new born corners, absence of drinking water facilities, and shortfall in human resources).
  • Prevalence of superstitious beliefs and practices, and absence of health seeking behaviour amongst the community.

Chidiya panchayat has been declared open defecation free. Yet nothing seemed to have changed at the ground level as most of the toilets were half constructed and were not used by the community.

Impact of the visit

After the interactions with the community, the UNICEF team realised that the area requires specific attention. The team appreciated the work of Phia through ASRA in the past 5 months for facilitating community engagement on health and nutrition, activating the VHSNC in the village and facilitating establishment of Gram Sabha.

Some of the actions initiated by the team after the interactions with the community are as follows:

  • The team asked to list the gaps in writing, specifically those related with gaps in infrastructure and share with the Deputy Commissioner, West Singhbhum district so that appropriate measures could be taken.
  • UNICEF indicated that they would provide additional IEC resources.
  • UNICEF also agreed to implement a refresher training of Sahiya and Anganwari
  • UNICEF indicated their interest in expanding the work on strengthening maternal and child health services in the district by covering more blocks

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