* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Bilal Avan is a clinical epidemiologist by background and is the Scientific Coordinator for the IDEAS project based at the London School of Hygiene and Tropical Medicine. The opinions expressed are his own.
“I didn’t go to the doctor because my mother-in-law has more experience in delivering babies. I wanted to be with someone I knew.” – Mother in Nawab Ganj, Uttar Pradesh, India, 2011.
Buried in the Gangeatic plains of India’s Uttar Pradesh lies the lush, rural village of Nawab Ganj. I had travelled there from dusty, noisy New Delhi to find out why rural women were reluctant to use health centres.
Although a happy place where children curiously examined my camera and grinned for pictures, I didn’t know if their mothers would survive their next birth.
Uttar Pradesh has the highest number of maternal and newborn deaths in India, most of which are preventable with the appropriate care. One woman I spoke to in Nawab Ganj, quoted above, did not visit the local doctor despite difficulties during childbirth.
On this years’ International Women’s Day, we should focus our efforts to improve the health of rural women by increasing their use of health centres.
In spite of many socio-economic and cultural barriers I believe we can help achieve this aim if we work to strengthen the relationship between families and frontline health workers (local community members trained in basic health care).
Within the given resources, the Indian government is working to tackle the situation by introducing frontline workers called ASHAs (Accredited Social Health Activists). ASHAs bring hope to the doorstep of rural families through health education, encouraging them to use health centres for childbirth.
International health projects are also working to maximise the use of India’s limited resources by supporting ASHAs in a wide variety of ways, such as equipping them with mobile phones on which rural women can see illustrations of safe birthing practices.
But do these projects really strengthen the relationship between ASHAs and families so that more mothers and newborn babies survive childbirth as a result?
An exciting new international project called IDEAS (Improved Decisions for Action), led by the London School of Hygiene & Tropical Medicine (LSHTM) and funded by the Bill & Melinda Gates Foundation, is tracking these health projects to find out what works, why and how in terms of strengthening the relationship between frontline workers and families.
Focusing on Uttar Pradesh, Ethiopia and North-Eastern Nigeria, IDEAS will share its results in order to support improved decision-making about maternal and newborn health.
I hope the evidence will guide policy makers on how to make the most of their limited resources and that next time I visit Nawab Ganj, women will tell stories about how they survived birth thanks to their ASHA.
