In her first year as nurse midwife at Ithar’s birthing center, Mala Devi Ojha safely delivered 25 babies.
An Indian village learns to take health into its own hands to save lives
Ask the people of the Indian village of Ithar what they’re most proud of and they’re quick to answer: the new birthing center just 15 minutes away.
It’s easy to see why the center is so important. The road to Ithar is buried in grass in some places, littered with broken bricks in others, and barely wide enough for four wheels. Yet this is the road women in labor travel to get to the nearest hospital, over an hour away by car and much longer on the back of a bicycle or in a cart.
“It’s horrible for a pregnant woman to go that long distance,” says Sushila Devi, one of the village health workers commonly called ASHAs. So horrible, in fact, that mothers and newborns have died without getting the medical care the hospital can provide.
To tackle barriers like this, PATH’s Sure Start project helped Ithar form a Village Health and Sanitation Committee consisting of the elected mayor, the ASHAs, and other respected community members. Sure Start has helped to establish or strengthen thousands of these committees in villages that are beyond the reach of the health system. The goal: empowering villagers to take health into their own hands.
In Ithar, one of the committee’s first goals was overcoming the reluctance of villagers to go to the hospital. Distance was not the only factor. “They feared it would cost too much for the doctor, drugs, and transportation,” committee member Parmatma Prasad explains.
The committee contacted vehicle owners and negotiated a lower rate for women in labor. They set up a revolving loan fund to help families facing emergency medical costs. But still, there was the problem of the long and difficult journey.
Try, try again—and succeed
So the committee took a leap. With guidance from their Sure Start supervisor, they sent a letter to the area’s medical officer asking to establish a birthing center in an empty government building located nearby.
“Sure Start taught us how to make things happen.”
There was just one problem. A birthing center needed a nurse midwife who could live onsite and be available around the clock. No midwife was available, the medical officer said.
When a request to the chief medical officer also failed, the committee took an even more courageous step. They traveled to the city to meet with the district magistrate. Impressed by the villagers’ determination, the magistrate put in a call to the chief medical officer. That same day, a nurse midwife was appointed and within two weeks, the birthing center was open.
Champions for women and children
All told, it took a year for Ithar to get its birthing center. “We never lost heart,” says Parmatma.
For Sita Shankar, PATH’s director of Maternal and Child Health and Nutrition in India, it’s remarkable to see men like Parmatma take an active role in the health of women and children. “They are now championing better conditions for pregnant women and babies. They are making sure there is transportation to the health center, that a weighing machine is available for the babies, that vaccines are brought to the village on time.”
And Sure Start has succeeded in empowering communities. “The training that was given to both men and women helped them become better citizens and community members,” Sita says. “Instead of just saying, ‘The government has to come and do this for us,’ people realized that there were things they could do for themselves and their communities.”
Parmatma agrees wholeheartedly. “Sure Start taught us how to make things happen. If you advocate and meet with authorities, then you get services. Now poor communities can have health services closer to home and save the lives of their women and children.”
Photo: PATH/Gabe Bienczycki.