Our organization, Village Development Society, works on maternal and child health as well as adolescent health. Under this initiative, The Mansi Project provided information on nutrition and immunization for children from zero to five years old and all pregnant women. We also encouraged women to opt for institutional deliveries. Additionally, under this project, we worked with adolescents on health and career counseling.
MANSI 2.0 focuses on strengthening healthcare service delivery at the community level across all two blocks of Haridwar district of Uttarakhand, India. MANSI 2.0 is implemented in close coordination with the district health and family welfare department and women and child development department. The program focuses on improving maternal, child health services, with increased community awareness and improved capacities of health and nutrition workers.
MANSI Objective
- Reduction of preventable death amongst new born and infants.
- Increased number of adolescent girls to adopt healthy practices related to menstrual hygiene, anemia and reproductive health.
- Increased number of community members across Haridwar to adopt healthy practices to early marriage of children, teenage pregnancy and birth spacing.
Healthy Adolescent
Healthy adolescent girls can bear healthy babies thus reducing neonatal mortality. Hence, we constantly strive to reach maximum girls and provide all required support to ensure they are Healthy.
Actions taken in this regard, from the month of March 2023 we have reached a lot of adolescent girls whom we counseled for reproductive health, importance of menstrual hygiene maintenance.
Based on the counseling, we identified many girls who had problem with menstruation:
Dysmenorrhea-Pain full periods
- Irregular periods
- Heavy bleeding (more than8days)
- Amenorrhea-absence of period
- Abnormal periods
Common symptoms of the a fore mentioned problems include
Acne
- Weight gain and trouble losing weight
- Extra hair on the face and body. Often women get thicker, darker facial hair and more hair on the chest, belly, and back
- Thinning hair on the scalp
- Irregular periods
- Fertility problems
Findings
- In the given population lots of girls came up with the problem for irregular periods.
- In a village setting adolescent is unaware of what is going on with her body hormones.
- WithourACHFreachtheystartedopeningupabouttheirproblemwithmenstru action. Accordingly, they wearer ferret the doctors through they received help.
- since menstrual problems and other hormonal issues are a lifestyle disease, the girls are taught the importance of healthy eating and fitness.
• Made the availability of gynecologist easy. Post treatment monitoring should be done regularly as per our pain level. Since it is a long term treatment.
• Holistic approach should be used for treatment which should include weight loss as well as lifestyle changes.
Healthy Mother
Antenatal Care(ANC)
Antenatalcareisessentialforprotectingthehealthofwomenandtheirunbornchildren.Throughthis form of preventive health care, women can learn from skilled health personnel about healthy behaviors during pregnancy, better understand warning signs during pregnancy and childbirth, and receive social, emotional and psychological support at this critical time in their lives. Through antenatal care, pregnant women can also access micronutrient supplementation, treatment for hypertension to prevent eclampsia, as well as immunization against tetanus. Antenatal care canals provide HIVtestingandmedicationstopreventmother-to-childtransmissionofHIV. Objective of ANC are to detect high risk cases and decrease the mortality. Our field workers identify the pregnant population and get the registered in government organization. Our team has identified various high risk pregnancy involving anemia, high blood pressure, little spotting of blood during caring.
Example
We monitored hemoglobin of pregnant female switch not ably increased after our consultation. We also kept a check on healthy weight gain during the pregnancy.
Actions Taken
We reach out to pregnant population and counsel the month following points:
- Early Registration: We focus on early registration to ensure that government authorities are aware of pregnant women in the area and can reach out to provide support during pregnancy.
- 4 ANC Checkups during pregnancy: It is critical that all pregnant women go through regular check- ups and monitoring
- Balanced Diet (Quality and Quantity): From our experience in this region, we know that lot of pregnant women suffer from Anemia and malnutrition and hence it is very important to educate women on the importance of Balanced Diet.
- Institution Delivery: Data collected clearly suggest that still deaths can be significantly reduced through institutional deliveries v/s home deliveries, hence we educate women on important of institution delivery
Breastfeeding Counseling: For weight gain and antibodies development in baby it is important to breastfeed and we counsel women in the region to breastfeed their new born
Findings
We regularly monitor health of all pregnant women and identify any high-risk pregnancies thatneedtobemonitoredcloselyandreferredtorightdoctors/hospitalasneeded.
we identified 652+ such high-risk pregnancies with 244/652 of those high-risk pregnancies being anemic.
Further Steps Required
- Balanced protein energy supplementation.
- Fetal growth monitoring and neonatal size evaluation at all level of care.
- Daily iron and calcium supplements for women during pregnancy
The number of preventable deaths among Newborn and Infants
Our frontline health workers (ACHF) ensure Home Based Care to the woman from the time of conception till two years after delivery, impart knowledge related to antenatal care, diet, exclusive breast feeding, adequate complementary feeding, growth monitoring, vaccinations and family planning. The ACHF will inform and train pregnant/lactating women, caregivers of new bourns/children on critical health issues and its monitoring and management.
Healthy Baby
Low Birth Weight
Low birth weight is a medical classification for a baby who weighs less than 2500gmat birth.
- Prematurity
- Multiple pregnancy
- Poor pregnancy nutrition.
Action taken
- Lactation consultation-is given to the mother and Exclusive breast-feeding advice till 6 months to baby is recommended. Importance of posture main tenancy while feeding.
- Low birth weight babies are unable to suck milk from mothers they are advised to pump the milk and then feed babies.
- Importance of maternal nutritionist directly proportional to fetus weight gain and post pregnancy the milk production. Thus, nutritional advices given to mother
During the period of January to March 2023, there were 263LBW & High risk baby identified and 49% wearer covered
- Regular monitoring of fetuses required through ultrasonography.
- Prevention of LBW is much more needed.
- Management of LBW should have all equipment’s required such as NICU.
- A customized diet plan made according to the geographical area and available resources.
- Balanced protein energy supplementation.
- Fetal growth monitoring and neonatal size evaluation at all level of care.
- Daily iron and calcium supplements for women during pregnancy
- Low birth weight is a condition which arises due to various underlying factors, in rural areas primary being maternal nutrition and then other factors come into play. Exclusive breast feed is the best remedy to overcome this situation. For this maternal nutrition and lactation counseling is must.
Causes for home deliveries
- Lack of medical institutions
- Lack of funds
- Lack of knowledge
- Door to door awareness of people is done through our ACHF for institutional deliveries.
- Regular visit is done in pregnancy.
- Identification of High-risk pregnancies.
- Awareness program needed to change the mind set of people for institutional deliveries
- Distributionofpostersandpamphletsforadvocacyofinstitutionaldeliveries.
- Audiovisual aids should bemused
- Door to door awareness done by ACHF should be more convincing. Influencing bodies of villages should be targeted so that the promote institutional deliveries
- Our front-line workers should be more capacitated.
- People should bemadeawareoftheirrightsbythegovernmentofIndiasothattheycanavailtheserviceswit hour the situation.
- Requirement of more medical institutions.
- According to the data survey in every five families one family goes for home delivery. Thus, more awareness should be spread for institutional delivery.
Care of the mother and then new born after delivery is known new postnatal care.
Objectives:
- To prevent complications of post-partum period.
- To checked equerry of breastfeeding.
- To provide family planning services
- To provide basic health education to mother
- To provide care for rapid restoration of mother to optimum health.