Abhay Bang, director of the Society for Education, Action and Research in Community Health (Search), led the pilot project first in Gadchiroli, one of the poorest districts of Maharashtra.
Bang Tuesday told delegates at the fourth Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSH) here that the neonatal morbidity rate in Gadchiroli was nearly 50 percent. The NGO Search therefore decided to develop a low-cost home based model of primary neonatal care by training village women.
"In most homes in the villages, there is generally the mother, grandmother and the dai (traditional midwife) who assists a woman during child birth. We decided to introduce a trained worker to this team to make the process more safe," said Bang.
After a 30-day training course, the health workers were sent to assist women who were delivering their babies at home. The newborn care package, which included checking on the pregnant woman three times during pregnancy, teaching the women in the family about health care, assisting in the delivery and taking care of the baby immediately after birth, was a success. Over a period of eight years (1995-2003), the IMR declined by 70 percent.
"It took us long, because we were still unsure of the process, trying out new methods. Yet, we managed to bring down the IMR from 121 to 30. Also, the fact that we have managed to achieve that national goal is a positive sign. India's overall IMR is 58 and the national goal is 30," Bang said at the conference, which began Oct 29 and will end Oct 31.
To test the project, another pilot project called Ankur was carried out in seven sites in Maharashtra from 2001-2005. "The results were positive. The IMR was reduced by 67 percent," he said. Bang also stressed that the project did not oppose institutional delivery in any way. "Asha, the National Rural Health Mission's (NRHM) project, is encouraging women to go for institutional birth and immunisation for the kids. "But you can't have that overnight. And in all those cases in villages where women still go for delivery at their homes, we want to ensure that both the mother and the baby are safe. This project will support Asha," Bang said.
The Ministry of Family Welfare is now extending this pilot project to five states -- Rajasthan, Uttar Pradesh, Bihar, Orissa and other parts of Maharashtra. The results will be reviewed in 2009. "Scaling up a pilot project is a huge challenge. But hopefully this can be achieved. The important thing is that the policy making environment should be favourable to it," Bang said.
"I am sure that the national goal of reducing the overall IMR to 30 can be achieved in three to five years," he added. Similar projects are also going on in Bangladesh, Nepal, Pakistan, Bolivia and in three countries in Africa.