Abstract
Introduction- Antenatal care is an essential component of health care delivery system in pregnant women.It is the most effective and proven strategy for optimum pregnancy outcome. Large disparities still exist in providing pregnant women with antenatal care and skilled assistance during delivery. The National Family Health Survey(2006) revealed that, only 52 percent of women receive 3 antenatal contacts and 42 percent receive any postnatal care. Largest number of births in the world are reported from India per year (27 millions). Poor women in rural and remote areas are least likely to receive adequate care due to various adversities. Objectives - Improvement of access to maternal and child health (MCH) services to rural underserved populations. Methodology- Multisectoral health and developmental project was implemented in 235 underserved and tribal villages of Ahmednagar district of Maharashtra, India for the period of four years(2006-2009). Two hundred sixty-five trained female health volunteers (FHVs) and TBA‘s received structured training and were equipped with disposable delivery kits(DDKs). The nine rural health centers (RHCs) and five mobile clinics (MCs) were established in the project area. A referal linkage was developed between villages and a tertiary care center. Results- Early ANC registration increased from 52% to 63%, full ANC coverage increased from 51 % to 78%, percentage of institutional deliveries increased from 40% to 74%, percentage of home deliveries attended by TBAs increased from 70% to 91% during the study period. MMR declined from 350 per 100,000 live births/650 in tribal areas to 117 per 100,000 live births/ in tribal areas). IMR declined from 80 per 1000 live births/110 in tribal areas) to 43 per 1000 live births/in tribal areas.
Highlights
Antenatal care is an essential component of health care delivery system in pregnant women.It is the most effective and proven strategy for optimum pregnancy outcome
Monitoring & Evaluation of the Project work was done by through various mechanisms like, a) In-built Monitoring: The Project Director, the Project Coordinator and the Consultants – Woman’s health, Child Health, Nursing Care and Diagnostic services conducted monitoring visits periodically to the Rural Health Centers (RHCs), Mobile Clinics and target villages, target beneficiaries etc. b) Monitoring by Swedish Partners: The expert faculty from Linkoping University, Sweden conducted monitoring and evaluation of the medical services rendered through RHCs and MCs in the project their visit
The services provided by Mobile Clinics of the project were sychronized with the local Public Health (PHC and Sub Centre) Maternal and child health (MCH) clinics of the same village in order to strengthen the overall service delivery to the community (Graph I)
Summary
Antenatal care is an essential component of health care delivery system in pregnant women.It is the most effective and proven strategy for optimum pregnancy outcome. The national Family Health Survey(2006) revealed that,only 52 percent of women receive 3 antenatal contacts and 42 percent receive any postnatal care.Largest number of births in the world are reported from India per year (27 millions).Poor women in rural and remote areas are least likely to receive adequate care due to various adversities. Large disparities still exist in providing pregnant women with antenatal care and skilled assistance during delivery.1The National Family Health Survey (NFHS) Report (2006) revealed that, only 52 percent of women receive 3 antenatal contacts and 42 percent receive any postnatal care in India. Abortion and birth spacing services are not given any attention All these factors have adverse effect on maternal health indicators.2Largest number of births in the world are reported from India per year (27 millions).3More than 60 percent of deliveries still occur at home without skilled birth attendant.
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