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Improving Women’s Access to

Maternal Health Care Services in the state of

Gujarat

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Aim

To evolve community based mechanisms in Navsari district in Gujarat State to improve women’s access to maternal health and promote its replicability in other districts of Gujarat state and at other states and at National level.

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Navsari District at a Glance

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Observations

TBA Mean age of the TBA is 59 years Average number of deliveries (2006-07) -14 40 % were untrained Limited role during antenatal & post natal

period. Only to manage the labour Not aware about their own entitlement and

health service entitlement of pregnant women

Weak linkages between TBAs ANM

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Panchayat

Knowledge about maternal health is limited 47% believes that they do have a responsibility

in the area of health Usually do not make arrangement for

transporting women during emergencies for delivery

Do not monitor the visit of ANM or AWW

Observations

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TBA Training in Vansada Block Total Number of TBAs Trained -

2878 PHCs are Covered

Training of TBA

Core Role and Expanded role as developed by the Dai Association –Gujarat and approved by the DHFW-GOG

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Dai

Training

Transport facilities

Training of ANM/FHW

Improve access to maternal health services

SHG

Panchayat member

Village Health committee

Tra

inin

g

AWW

10

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Experience of DaiTraining

TBAs are committed It is essential to train pairs of TBAs TBA training requires hands on and repetition Presence of ANM/MO/CDHO is essential to

make linkages. TBA Training at PHC helps to develop linkages

with health team

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0.91

48.13

7.76

28.5

91.33

23.37

0

20

40

60

80

100

A B C

Pre Test

Post Test

Grade Pre Test Post TestA 0.91 48.13B 7.76 28.5C 91.33 23.37

Overall Result in Percentage

Pre/Post Training Results

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Action taken by trained Dais(September November 2007)

Action Taken %

Used antiseptic to clean the outer reproductive organs before delivery

36

Used gloves during delivery 42

Discussed the messages related to birth preparedness with family

42

Provided support to organize transport

45

Provided support to get the three ANC done

30