Title: Transforming passive onlookers to agents of change

Body:Every year, tens of thousands of women and babies in India die due to complications of pregnancy and delivery—most of them preventable. Despite the magnitude of the problem, there is widespread lack of awareness and access to maternal and newborn child care medical facilities across the country.

Such was the case in Bharkherva village in Uttar Pradesh, India. The issue of maternal and child health took a backseat to the other problems facing the communityelectricity shortages, delayed monsoons, ruined crops, and poverty. That is, until Mr. Nirbhay Singh, the elected village headman, was approached by Sure Start.

Sure Start—a five-year initiative based at PATH, an international not-for-profit organization supported by the Bill & Melinda Gates Foundation—is working to help mothers and their children to survive and stay healthy in the states of Uttar Pradesh and Maharashtra.

In the numerous villages in Uttar Pradesh where Sure Start works, you will find a twist on the contentious extended family relationships depicted in most Indian television serials. Here, mothers-to-be and mothers-in-law are both part of “mothers’ groups” facilitated by Sure Start. Village women work together with the local health care provider to organize meetings that tackle important topics with entertaining methods—dolls, games, music, and dance are employed to bring about behavioral change. Since January 2008, Sure Start has organized 80,000 group meetings involving approximately 1,200,000 expectant mothers and their mothers-in-law.

Women are not the only ones learning about newborn care. As part of the program, fathers-to-be receive letters from their unborn children. The letters help men understand

the importance of their role in ensuring a safe delivery for their wives and unborn children.

The results are extremely encouraging. Mr. Singh estimates that since the program began in his village in 2008, 70 to 75 percent of adults in the community have become aware ofsafe delivery practices and the vital importance of ensuring access to maternal and child health services.

Sure Start has also been instrumental in working with many of the existent (but often inactive) government-run Village and Health Sanitation Committees and ensuring that members hold regular meetings. This has led to the improvement of facilities at the primary health care level. “No longer do we always need to travel all the way to the big district hospital,” Mr. Singh says proudly.

The essence of Sure Start's endeavor is to transform communities from passive onlookers to agents of change. “I do this in order to pay my debt to the country,” says one community volunteer. “I understand that I can’t do big things, but I can at least bring about tangible change in my neighborhood.”

Sure Start works to educate women in India on maternal and neonatal health. Sure Start, an initiative by PATH, supported by the Bill & Melinda Gates Foundation works to promote safe childbirth practices in India. Facebook: http://www.facebook.com/pages/Sure-Start-Project-by-Path/178629192101Twitter: http://twitter.com/pathsurestart