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Community Health Volunteers: Serving mothers and children

© UNICEF/BANA2013-00144/Ahsan Khan
(Left) Alo Rani Pal, a community health volunteer speaks to Shuborna Rani, 6 months pregnant about proper care before childbirth in Palpara, Tangail

By Munima Sultana

Tangail, 4 June 2013: Alo Rani Pal always passes through quite hectic days. Her work begins with the arrival of villagers into her courtyard as the day progresses and she’s hardly free to do her own chores until the last person leaves her home.

The activities of Alo Rani Pal are centred around EPI (Extended Programme for Immunisation) activities. She volunteers to gather all pregnant women, new mothers and under-5 children at her home since she allowed her courtyard to be used as the EPI centre at Pal Para of Bashail sub-district of Tangail district.

Training as a Community Health Volunteer (CHV) has endowed Alo Rani with the capacity to perform all these jobs with efficiency. It has also helped mothers and children during their special needs living close to her neighbourhood.

“Now I understand how important the vaccines are for a pregnant woman and for newborn. I also realise how a small or a prompt decision can avoid many unwanted complications for a mother or a baby and can save their lives,” Alo Rani says.

The middle-aged lady who is popularly known among the villagers as Kaki (aunt), Alo Rani shared story of a seven-day-old boy, whom she saved by taking a prompt decision. She says she did not waste time to send the boy to Tangail General Hospital finding blood in his urine seven days after his birth. “He is now a two-month-old healthy boy.”

Trained community care givers

Like Alo Rani, many middle-aged ladies including midwives were trained up in three sub-district of Tangail district aiming to improve home-based interventions to provide essential maternal and newborn care through a cost-effective approach.

The Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare took the initiative in the low performing sub-districts under the UNICEF-funded project named Tangail Maternal, Neonatal and Child Health Project (TMNCHP).

Alo Rani, Aleya, Johra Begum, Julekha like several other CHVs are providing voluntarily support to the government’s effort after the training. They guide the vulnerable groups at the field level and provide them with proper information and directives.

© UNICEF/BANA2013-00149/Ahsan Khan
Pregnant women learn about newborn care at a courtyard meeting in Sakhipur, Tangail.

Mainul Haque, Programme Manager, ICDDR,B, says, the CHV training tries to provide the volunteers with basic knowledge on pregnancy, delivery and complication to prevent those from getting critical. “As most of the complications during the two stages could be avoidable, the CHVs are actually providing field level support until they reach the institutional health care service providers,” he says.

Under the TMNCHP, CHVs refer patients from field level to the upazila health complex through referral care services when a patient’s condition gets complicated. In cases, they also arrange transport for them in connection with auto-rickshaw drivers from a list that is provided to them under the project.

Increased community acceptance

Villagers in Pal Para during a routine EPI programme in March said they hardly forget their vaccine dates and they know what and when vaccines are necessary.

Alo Rani Paal always keeps them updated. “Kaki keeps us reminding all the time of our vaccines. We think of her first when any emergency strikes,” said Lota Rani Pal, a neigbour of Alo Rani while taking the second injection on her pregnancy.

Her acceptance transcends her own community. Rani Begum said, “Kaki is welcomed everywhere irrespective of religious faiths. This has happened due to her caring nature towards all”

For helping neighbours take timely decisions by providing accurate information, Alo Rani, Aleya, Johra Begum, Julekha and many other CHVs’ social acceptance has increased in their respective localities.

Johra Begum says they can now easily identify the low weight baby, anemic mother, critical situation following water break etc and guide people to take prompt action to prevent deaths and other health complications.

Building close bonds

“Even during their leisure, these women go from door to door to have a chat with the villagers sometimes without any apparent reason. So, they come to know about any development in a family very easily and are able to guide them in a timely manner,”  Rani Begum says.

In the earlier government programmes, health assistants and health workers often could not serve their assigned working areas having at least 4000 people. But the CHVs could easily reach all mothers and children due to smaller coverage area of about 1000 to 2000 people.

It may be too early to assess the success of CHVs, but these ladies are becoming important part of the maternal and newborn care for their easy accessibility within small communities.



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