Providing Essential Health Services and Education

Providing Health Services and Education

Maternal and Child Health  Nutrition  Family Planning  HIV/AIDS  Polio  TB  Malaria

The majority of deaths in children under 6 years of age result from illnesses that are preventable or readily treatable.  Community Health Workers (CHWs) trained in child survival have found that pneumonia, diarrhea, meningitis, malaria, malnutrition and anemia can be recognized early, treated inexpensively, and, with good counseling, prevented at the village level.

In India, pneumonia causes approximately 20% of mortality among children under 5. And pneumonia is more prevalent in rural villages, with the common risk factors for contracting the illness being poverty, malnutrition, low birth weight, and exposure to the burning of solid fuels in the home.

Anemia is widespread in rural populations, particularly among expecting mothers and children. Extra care in identifying nutritional deficiencies and counseling on diet is key to lowering morbidity and mortality.

Community health workers focus on early detection, timely treatment and prevention of common illnesses like pneumonia and anemia.  They depend on strong referral relationships with local government and private clinics, physicians, and hospitals for fast treatment of the villagers in their care.

 

Maternal, Child Health and Nutrition

Rural communities depend on Community Health Workers for guidance on maternal and child health.

Providing prenatal health service

Educating village midwives on nutrition for mothers and infants

India has made great progress since 1990 in lowering the rate of maternal, infant and child mortality.

Despite these successes, the country fell short of the Millennium Development Goal Target for 2015 by a wide margin.  At present, from every 1000 live births in India, there are still 53 deaths of children under 5 years of age, and, when compared to a country like Indonesia (under-5 mortality 29 per 1000 live births), it is clear that a lot of work remains.

 

1990

2013

Maternal mortality per 100,000 live births

560

190

Infant mortality per 1000 live births

88

41

Under-5 mortality per 1000 live births

125

53

The challenge is even greater among the rural poor where maternal and child mortality is significantly higher. Poverty, low birth weight and malnutrition are the greatest risk factors determining the health of mother and child.

CHWs take on a variety of responsibilities – from treating simple illness and providing referral services for serious disease, to delivering counseling and patient home care.  They are important in promoting vaccinations for infants and children as well as institutional births.

Conducting postnatal infant check ups

Providing child health services and education

Family Planning 

In cooperation with local schools, community groups and other NGOs

Trained CHWs organize health education for young women and mothers with small children.

Distributing oral contraceptives and health education

Over the past 25 years, progress has been made in lowering the unmet need for family planning services in India. In 1990, the unmet need was 20%.  In 2010, it was down to 14%. However, in some populations of the rural poor, unmet need has been measured as remaining high as 38%.

The challenges to meeting family planning needs are attributable to poverty, low literacy, lack of knowledge, and lack of access. CHWs focus on education and partnering with programs that provide affordable family planning options for rural families. CHWs are also active in expanding the definition of women’s health to include the broad spectrum of health issues relevant to women, including, but not limited to, maternal, sexual and reproductive health.

HIV/AIDS

Community Health Workers are often the first person consulted in rural villages.

In 2009, it was estimated that 2,400,000 people were living with HIV/AIDS in India. 39% of these patients were women. Over time, the HIV/AIDS epidemic has moved from urban to rural areas and from high-risk populations to the general population. The disease largely affects youth.

The national HIV/AIDS strategy entails integrating programs for prevention, support and treatment, including peer-led interventions by Non-Governmental Organizations and Community Based Organizations. These are linked to general healthcare facilities to ensure that there is access without stigma or discrimination. All are networked to Community Care Centers, Counseling and Testing Centers and anti-retroviral treatment centers located in government hospitals.

These services are being expanded to Primary Health Centers in the rural areas, private sector facilities and mobile clinics.

In many rural areas local trained CHWs and their local NGOs form the majority of the volunteer work force for government HIV/AIDS prevention and treatment initiatives, like our AIDS Awareness Partnership with the local Lions Club, promoting social mobilization and community engagement.

Polio

In rural areas, local NGOs powered by CHWs provide much of the woman- and manpower behind the Pulse Polio Program, and are responsible for the eradication of the disease in India.

Until the early 1990s, India was hyperendemic for polio, with an average of 500 to 1000 children becoming paralyzed by the disease daily. In 2014, the World Health Organization certified India as polio free. This marks one of the greatest achievements in public health.

Transmission was finally interrupted by sustained and extraordinary efforts. Since 2004, annual Pulse Polio vaccination campaigns were conducted 10 times each year, with virtually every child being tracked and vaccinated. The elimination of polio has been dependent on the sincere work of countless health-workers, NGOs, and local volunteers. In rural villages, government polio workers have depended upon local, village-based health workers as the volunteers necessary for this success.

Prior to this effort, however, in some communities the prevalence of post-polio paralysis was as high as 6 per 1000 preschool children. Decades of high polio prevalence have left hundreds of thousands of patients in need of continued help. Families experienced not just the devastating loss of healthy children, but whole communities experienced the disability-associated productivity loss associated with the disease.

Local, community-based NGOs, led in part by our CHWs, have organized wheelchair distribution programs, and organized and assisted in polio reconstruction surgery camps with other NGOs and expert surgeons funded through the private sector.

Tuberculosis

Local trained CHWs are the 1st line of defense against an expanding threat of tuberculosis in the community.

Tuberculosis (TB) remains a major public health problem in India, with the country accounting for 26% of all TB cases reported globally. Approximately 300,000 people die from TB each year in India.

In 1997, the Government of India launched the Revised National Tuberculosis Control Program (RNTCP) to provide free diagnostic and treatment services to benefit the poor and vulnerable groups in Indian society.

This national program, based on the internationally recommended Directly Observed Treatment Short-course strategy, has been shown to increase access to services for TB patients who have low literacy and who are from low-income rural households.

TB mortality and prevalence in the country has decreased compared with 1990 figures, indicating progress towards achieving TB-related targets of the United Nations Millennium Development Goals (MDGs).

Village-based CHWs participant in local program efforts directly, through local NGOs, by providing awareness, detection, and treatment services as well as indirectly by counseling people with symptoms on where to get diagnoses and treatment.

How You Can Support This Work

To implement improvements in a successful model a self-sufficient, self-sustaining program sometimes needs investments that cannot be covered by income from the local economy.  For such advancements, IFFH relies on charitable donations that make it possible for our team to develop new projects utilizing our existing resources and infrastructure.

We want to improve our existing healthcare education programs and need to invest 
in the development of the next phase of our community health projects.  Once investments are made in the development of programs, our goal is always to continue operations on a self-sufficient and self-sustaining basis.

We see opportunities for improving our programs and have the human 
resources and experience to confront old problems with new methods.

Our years of work has produced a strong and reliable network of trained community health workers at the rural village level.  Our success has encouraged us to activate our large network of village based health workers to address the underlying challenges to further improvements in women’s health, children’s health and community health.

You can donate any amount to IFFH.  The organization is a 501(c)(3) nonprofit registered in the United States. Your donations are tax-deductible and much appreciated.