Trained Anganwadi workers reassure communities
By Radhika Srivastava
Parents in Karanjveri feel assured with Kanchana Ben around, especially so after her training, along with 315 others in the state, to supervise children below the age of one. They regularly visit these children and maintain a growth record for each one of them. Describing her primary responsibility, she says, “Our work is to be available, and to give correct advice. If a child has a problem that needs a doctor’s attention, we ask the parents to take the child to the nearest hospital. And if the affliction is minor, we are able to treat them.”
Purushottam and Prerna have been jittery about their child, but Kanchana Ben has been visiting them regularly. She has been observing the baby closely. Since the baby had been crying too often, she made a careful study and came up with a simple solution. “I told the parents there was no problem. The baby was wrapped in two layers of clothing but needed only one. The baby probably felt too warm and cried,” she says. The advice sounded less “medical” than the parents expected, but they followed it. And - it worked. Within minutes, the baby went off to sleep.
In another house in the same village, Kanchana Ben visits with a weighing scale. She weighs a month-old baby and records the weight in her record sheet. She maintains a sheet for every child below the age of one year, under her care in the village.
As part of the Integrated Management of Childhood Diseases (IMNCI) programme jointly run by UNICEF and the government of Gujarat, these field-level workers are working towards reducing the state’s infant mortality rate of 60 per 1,000. The programme’s modus operandi is to provide service at the doorsteps of the community by trained health personnel. IMNCI is a strategy towards addressing known causes of infant illnesses and mortality. It is an approach to assess, classify and manage illnesses as per the symptoms present in a child. The programme also addresses the issues of nutrition and immunisation in children.
This intervention has already made a big difference to the lives of people in Valsad. There are mothers here who have had healthy pregnancies, normal deliveries and beaming, chubby babies. Although many of the mothers are unlettered, they now know more about parenting and how to keep their children healthy and happy than before.
Laxmi, mother of a five-month-old boy said, “Earlier I would have thought it was normal for children to get an upset stomach. And I thought the best way to combat this was by taking the child off breast feed.” She now knows better. “I know that I was wrong. Diarrhoea can be very dangerous for small children and breast milk was the best in all circumstances,” she said.
Bharati Ben and her three-month-old daughter Shivani epitomise the success of the programme. Unlike many others in her neighbourhood, Bharati has had her baby in a hospital. “In the first ten days after the delivery, the nurse visited me thrice. She told me how to breast feed properly and feeding every time the baby demanded.”
Bharati knows she must wash her hands before handling the baby and must breast feed exclusively for the first six months. In-charge of Bharati’s baby, anganwadi worker Sulochana Ben is welcomed wherever she goes. “I feel I have a relationship with Bharati and her baby. The family is very receptive to my advice. The baby developed a rash soon after her birth. I told Bharati not to worry and to apply a soothing lotion. The baby was fine in a couple of days.”
Thanks to the initiative, many serious cases have been detected early and children’s lives have been saved. She spoke of another family that had a pre-term baby born during winter. “On one of my routine visit, I saw the baby was unwell. Her breathing was laboured and noisy. Besides, I could see a depression forming in the centre of her chest every time she inhaled.”
Sulochana then told the baby’s parents that she should immediately be taken to the hospital. “Initially they were not willing to listen to me. They told me the baby needed a hot oil massage and she would be fine. But I insisted and they finally gave in,” she said.