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Volunteers and helpline join forces to reduce maternal mortality in rural India

© UNICEF video
Asha (right), a community health volunteer, checks in with former ward Reika.

By Anwulika Okafor

NEW YORK, USA, 29 May 2007 – A rigid social structure and gender inequality – which stretches from educational opportunities to health-care access and more – can be a deadly combination for women living in the villages of rural India.

Across the country, millions of impoverished women give birth in inadequate health facilities. Indeed, almost half of Indian women deliver their babies at home, out of reach of emergency medical help. Their social and class standing often make for an environment fraught with risks for many expectant mothers.

There is a clear need for community health volunteers to help solve the medical and logistical problems these women face.

A 24-hour operation

The story of one young Indian mother is proof of the positive effects of such efforts.

Reika, 23, is convinced she would have died had it not been for the assistance of a volunteer named Asha and an obstetric helpline called Janani Suraksha, operating in Rajastan, one of India’s most remote states. Rajastan is among six states with the country’s highest rates of maternal mortality; for every 100,000 births there, 600 women die, mostly from preventable causes.

While Reika was in labour, it was discovered that her baby had shifted to its side. This meant that Reika would need a caesarean and a blood transfusion, neither of which was available at her local hospital. Asha and the helpline found a blood donor and organized transport to better facilities.

© UNICEF video
Staff members at work in the headquarters of the Janani Suraksha obstetric helpline in Rajastan, India.

‘Ready to drive at any time’

“I was having labour pains for a day, and even when I was taken to hospital I felt no one was taking care of me. Without the support of the helpline I wouldn’t be here talking,” says Reika.

Launched just over a year ago, the Janani Suraksha helpline is a 24-hour-a-day operation servicing a population of 100,000. Supported by UNICEF and the Indian Government, the project boasts a team of sympathetic taxi drivers who are available night and day in case of emergency.

“We have to be ready to drive at any time,” says driver Ajay Singh. “Sometimes it’s at night, when there’s a risk of attack by criminal bands on the roads. But we have no choice. We have to bring the women to hospital.”

More than emergency services

The helpline does more that just bring stranded mothers-to-be to adequate health centres. It also provides early registration of pregnant women and antenatal checkups, as well as postnatal care.

Once a call is received, the helpline staff immediately begins to act – not only providing transportation for women, but also negotiating with the health system for the admission and hospital stay of the patient. The effect of this well-rounded programme is showing in the rural villages involved, where ensuring the health of both mother and newborn has now become a community affair.

In Rajastan’s Todpura village, Samosa, 20 years old and six months’ pregnant, sits with friends and shows them her medical chart. She is nervous about the imminent arrival of her first child and is taking no chances. The trip from her village to the nearest medical centre will be made by the most rudimentary of vehicles, a tractor. But that transport, and the medical services she will receive, could save her life and the life of her child.




25 May 2007:
UNICEF correspondent Anwulika Okafor reports on efforts to provide access to quality heath centres for expectant mothers in rural India.
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