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30-year-old Gayatri Devi is pregnant for the first time after eight years of marriage. Janki Bai Jagat, the senior health worker at the Shiv Tarai subcentre run by Jan Swasthya Sahyog (JSS) in Chhattisgarh, a non-profit, is extra cautious while carrying out the antenatal checkup. Blood pressure, blood sugar and haemoglobin levels were diligently recorded. Whether Gayatri delivers at the government-run hosptial or the JSS-run subcentre depends on the how the pregnancy progresses
Photo by: Vibha Varshney
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The broken building of additional Public Health Centre in the Jalalpur village in Sareela blocks in Hamirpur in Uttar Pradesh. No admission and deliveries can be conducted inside the crumbling building
Photo by: Ankur Paliwal
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Suneeta Pawar waits for her first delivery at a hospital in Rudraprayag district in Uttarakhand, while her Accredited Social Health Activist (ASHA), Sangeeta Pawar who assisted Suneeta, stays to see all’s well. At the age of 22, Suneeta came to the hospital for delivery from Darmola village for its proximity
Photo by: Sayantoni Palchoudhuri
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Sunita Devi, pregnant with her first child at the age of 25, now cares for her step-children. She holds the youngest of her three step-daughters at her village Bhatwadi in Ukhimat block in Uttarakhand. The children lost their mother, who was anaemic, a month after her third delivery
Photo by: Sayantoni Palchoudhuri
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Rajasthan government proactively and aggressively promotes its health schemes. Shown in the picture is a poster of Janani Shishu Suraksha Karyakram (JSSK) which was launched in September 2011. The scheme, which is under the purview of National Rural Health Mission (NRHM), is being dutifully implemented across the state. Under the scheme, the government provides free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth) in government health institutions in both rural and urban areas. One of the motives behind launching the scheme was to promote institutional deliveries. As part of JSSK, women who have delivered normally get food without any charge for three days, while women who deliver through caesarean get to stay for seven days
Photo by: Sayantoni Palchoudhuri
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Anganwadi centres spearhead the immunisation drive in Kota. ASHA workers operate out of these centres. Multi-grained flour (called poshahar) is provided to pregnant women on a weekly basis from these centres
Photo by: Sayantoni Palchoudhuri
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A five month old boy is being given fluids through drip needles to subside excessive diarrhoea inside a small two-bedded ward having tattered mattresses and dirty floor with syringes strewn all over. It is the only ward open for public now in the Malhipur Community Health Centre in Jamunaha block in Shravasti in Uttar Pradesh. The hospital has no sweeper to keep it clean
Photo by: Ankur Paliwal
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It was delivery time for Thukri Bai of Pandripaani village in Chhattisgarh. Her husband called the 108 ambulance on February 3 which brought the mother to be along with her mitanin Sem Kali to the Gaurela block Community Health Centre. Thukri would now stay in the hosptial for a day
Photo by: Vibha Varshney
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Sarita Devi feeds her one-and-a-half month old daughter, whom she delivered in a private vehicle on the way to the hospital, as her four-year-old son, Aditya, plays in the sun. She could deliver safely in the jeep as her Usada village’s midwife in Uttarakhand was with her in the vehicle
Photo by: Sayantoni Palchoudhuri
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The contact numbers of doctors are written at the wall of community health centre in Sareela block in Uttar Pradesh so that people can contact when in need
Photo by: Ankur Paliwal
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Parvati Devi, an Auxillary Nurse Midwives (ANM), is checking a pregnant woman at the additional public health centre in Mamna village in Sareela block in Hamirpur in Uttar Pradesh
Photo by: Ankur Paliwal
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The two story building of community health centre in Malhipur in Jamunaha block in Shravasti district in Uttar Pradesh has separate rooms for doctors of every speciality. But all are locked due to the lack of staff. The Community Health Centre is run by only two general physicians. There is no staff nurse
Photo by: Ankur Paliwal
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Mitanins are the life line of Chhattisgarh. They may or may not be educated but they go through stringent training to deal with all health emergencies. These women are now undergoing 16th level of training at Temri village in Mungeli
Photo by: Vibha Varshney
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Ramesh Srivastava is the driver of this ambulance. Mitanins requring the ambulance service can directly call him on his cell number – 09329561492 in Chhattisgarh. The 24/7 ambulance started functioning in the state a couple of months back. At present, the ambulance is being used for bringing women to the hospital for delivery but it is expensive. The state is trying to strengthen the regular ambulance service to tackle the bulk of delivery cases
Photo by: Vibha Varshney
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Living in Saudi village in Agastmuni block in Uttarakhand, 27-year-old Sangeeta Devi delivered twin boys, out of which only one survived. Sangeeta’s mother, Susheela Devi who is seen holding the underweight baby boy in the picture, blames several referrals from one hospital to the other for the death of the baby
Photo by: Sayantoni Palchoudhuri
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Kota is the most literate district in Rajasthan, and also has the highest rate of female literacy in the state. According to the 2011 census, the overall literacy rate in Kota is 77.48 per cent, while female literacy is 66.2 per cent. Empowered by education, women in Kota know how to take care of themselves during pregnancy and tend to their newborn
Photo by: Sayantoni Palchoudhuri
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Raman Depawat, CMO of Kaithun block, is one of Kota's health stalwarts. “Our success is a direct result of empowering the ASHA workers,” he says. Kota currently has 1,051 ASHA workers, which apart from getting the normal 21-day training are provided with an eight-day training under UNICEF assisted Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme. However, Depawat feels this is not enough, “One-off training is not enough. ASHA workers need to be put through constant refresher courses.”
Photo by: Sayantoni Palchoudhuri
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The warmer (corner right) lying unused in the labour room in community health centre in Sirsia block in Uttar Pradesh because there is no staff to operate it. The new born infants are kept below the 200 watt bulb (seen besides the warmer) to prevent hypothermia
Photo by: Ankur Paliwal
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At Sulochna Paritah’s house in Khera Rasalpur in Kota in Rajasthan, cheerfulness abounds. The 30-year-old is cradling a month-old baby girl. Her other two girls, Harshita and Madhuri, are 12 and six-year old. Even though the husband, who has studied until grade 12 and works as a tailor in Kota, does not earn more than Rs 4,000 a month and Sulochna cannot like her urban counterparts snack on three plates of fruit every day, the income is enough to provide her a diet of milk, dalia and methipalak dal.
The first two children were delivered in Khaitoon hospital, but the family had to incur extra expenses for transport. Not this time though. The Accredited Social Health Activist (ASHA) Sahyogini, Dwarika, paid regular visits to the family during Sulochna’s pregnancy. An ASHA is required to pay seven visits after a pregnancy has been identified and registered with the mother and child tracking system. When Sulochna was due, a private van which is leased by the government was summoned and she was rushed to Community Health Centre. Generally, either a 108 (ambulance) is dispatched by the government or a private van. The hospital pays the van in the latter case
Photo by: Sayantoni Palchoudhuri
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23-year-old Noorjahan lost her nine-month old daughter to an unidentified disease last year. There is no paediatrician at the Community Health Centre in Sirsia block in Uttar Pradesh. The family could also not afford the expensive medicines that general physicians prescribed which needed to be purchased from the private medical stores. Wasim, Noorjahan’s husband earns Rs 70 on good days to feed a family of nine
Photo by: Ankur Paliwal
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Around 20 women had come for tubectomy camp in the community health centre in Kurara block in Hamirpur district in Uttar Pradesh. Such camps are organised once a month in the district. The district health officials attribute good family planning as one of the reasons behind low infant mortality rate in Hamirpur Photo by: Ankur Paliwal 10’- Following the hill tradition, 25-year-old Usha Devi spends 21 days after the delivery in a cowshed with her baby girl in Uttarakhand. Usha’s mother, Sibdea, also seen in the picture, would help her daughter as no one else is allowed near the mother and the child till their isolation period is over
Photo by: Sayantoni Palchoudhuri
Read more: Cradles of hope (Cover Story)
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