Maternal Health: Strengthening maternal, newborn, child health and nutrition (MNCHN) services

Duration: 2012–2015

Location: Mohanpur block, Gaya district, Bihar

Direct beneficiaries of the project are pregnant women, lactating mothers, neonates, infants and children up to the age of 24 months. The project serves 59,010 people in 60 villages and focuses on improving survival, health and nutrition outcomes for children from conception to the age of two.

In all, 38.4% of children under three are stunted (too short for their age), 46% are underweight, and as many as 48% of pregnant women still do not achieve three antenatal visits in pregnancy. Only 23.1% of mothers received iron and folic acid (IFA) for at least 90 days during their last pregnancy. According to a recent Save the Children survey, only 62.4% of women in Mohanpur block undergo childbirth in hospital.

Three convergent approaches are used: strengthening the capacity of frontline workers to deliver and report data on service delivery for key MNCHN interventions; mobilizing community groups and instituting processes to stimulate the block-level health system to improve service-delivery; and advocating with block and district health systems to improve service-delivery and the quality of services.

Case Study

Daulti Devi, Ledhi village, Mohanpur block, Gaya district

Daulti is 35 and lives in the Mushahar tola of Ledhi. Ledhi is a scattered village, surrounded by dense forest and highly affected by naxal activities. Daulti Devi and her husband Girja Manjhi are a scheduled caste couple with five children — three girls and two boys. They are daily-wage farm labourers. Between them they earn about Rs 36,000 a year. Mostly Daulti has to manage her home and care for her children all on her own, as Girja is often engaged in labour work outside the village.
In narrates her story in own words.

‘I was married at 14 and have five children. My first child was born when I was 16. My first four children were born at home. Neither I, nor any of the women in my family, wanted to deliver in hospital. For my fifth pregnancy, Manju didi and Bipin bhaiya counselled me to deliver my baby in hospital. With their support I registered my pregnancy at the nearby anganwadi centre (AWC) during a village Health and Sanitation Day celebration. They made me attend group meetings and I got to learn many important things about nutrition, antenatal care, and immunization. I was completely unaware of these issues before. Manju didi helped me to get all the antenatal services at the village health and sanitation day meetings. I have been able to follow the right feeding practices for my children. They are healthy, growing well, and have had all their ‘tikas’. My son is now 13 months old and is healthy. I will get him fully immunized.

‘My daughter Manisha was severely malnourished. After I took her to the nutrition rehabilitation centre at Gaya, she is better. I do not want any more children, so I have had a tubectomy. Manju didi helped me.’