Pranita gave birth to a healthy baby boy! Read her story.

PATH and our partners in India to reach more than one million women and newborns with essential advice

Relatively simple acts could save babies in the developing world—for example, cutting umbilical cords with sterile blades, using skin-to-skin contact to keep newborns warm, recognizing danger signs that warrant hospital care, and taking advantage of health services when they are available. These things are easy for families to do, if they know about them.

PATH’s Sure Start Project in India aims to help families in crowded urban slums and in rural areas understand the steps they can take to help their babies thrive. The secret ingredient of this successful project comes from the very communities where infant death rates are high.

Countless child deaths

Every year, countless children in India die within a month of birth. Thousands more live but grow up weak or sickly, robbed of the essentials of a healthy childhood.

Myriad economic and social factors contribute to this reality, but one of the biggest is simply lack of knowledge. In the absence of reliable information, people make up their own ideas or fall back on family habit.

For example, in many communities it is bad luck to acknowledge a pregnancy, so few women seek prenatal care. Some women fast during pregnancy in the hopes of having a son. Mothers-in-law may want to bathe newborns right away, which can lead to hypothermia, especially in babies of low birthweight. Many families in the slums wrongly assume that they are too poor to obtain free hospital services, even though they live close to access health care. Few understand the benefits of immediate and exclusive breastfeeding.

Just add community health workers

In PATH’s experience, understanding existing beliefs and traditions is the first step in providing the information people need. That’s why we’re working through local groups and connecting with health workers from the communities we’re trying to reach—poor urban and rural areas where rates of newborn death and illness are high.

We’re training and supervising health workers in the Indian states of Maharashtra and Uttar Pradesh, increasing their knowledge of maternal and child health so they can in turn teach families about the importance of prenatal care and danger signs during pregnancy, birthing, and the postpartum period.
The community health workers circulate in the slums and villages, talk to pregnant women and their families, build trust, and give health advice, returning to check in on the expectant mothers and the babies as they are born.

“It’s important for the community health worker to be a member of the same community as the pregnant mom,” explains Benazir Patil, PhD, our project coordinator in the state of Maharashtra. “She doesn’t require much time to build rapport. And she’s able to reach out, especially in identifying pregnancies. Women have confidence in her. They confide in her several things that they are going through. Because she is one of them, they don’t mind disclosing the pregnancy to her and don’t go by the superstitions.”

Reach mom and you reach baby

Through this program, PATH is changing the lives of families and individuals like Pranita Ingole, a shy girl from the slums of Nanded in Maharashtra. She is very poor, lives with six other family members in two dirt-floored rooms, and plans to deliver her first-born in a hospital, thanks to the health worker’s advice.

“Because of these community health workers coming here, the pregnant ladies are getting a lot of information,” says Pranita. “Especially since it’s my first time, I will go to the government hospital here in Nanded for delivery. I am happy to know what to do to keep myself and my baby healthy.”

PATH and our Sure Start partners will reach 2.5 million women and newborns in India by 2010 with information about pregnancy, childbirth, and available services. The women we reach no longer face motherhood unprepared and alone; their children will have a better chance to thrive.

Focusing on the survival of babies today will strengthen India for the future, notes Dr. Patil. “We often see that weaker babies will grow into individuals who have a lot of illness, and in a country like ours, there is no ready answer to these illnesses; people live and die with these illnesses. So if the foundation is strong, I think a lot of positive things can happen in our country.”

Photo: Satvir Malhotra.