By Anjali Singh,Womens Feature Service
Accredited Social Health Activist (ASHA) is making a legacy of saving newborn babies from the brink of death in Aligarh District today.
The Comprehensive Child Survival Programme (CCSP), in which the ASHAs of Aligarh are the foot soldiers is an effort in epitomizing a powerful partnership between policy makers, UNICEF India and local communities to preserve the country’s most precious asset: Its children.
One ecstatic young mother shared her life saving experience with the aid of ASHA. Twenty-two-year-old Rekha’s baby girl, who was born pre-maturely at seven months with a birth weight of just over a kilo. Is also fortunate not to have become part of Aligarh’s list of neo-natal deaths. As she suckles her daughter, Rekha knows that she would have lost her child if an Accredited Social Health Activist (ASHA) from her village had not brought her to the Sick and New Born Care Unit in Aligarh town.
The move to use the formidable force of ASHAs began in 17 districts of Uttar Pradesh a year ago. Through the CCSP, backed by the expertise of a reputed institution like the Aligarh Muslim University, the ASHAs of Aligarh have single-handedly managed to address factors contributing to infant mortality in the district. They have ensured almost 70% institutional deliveries here. But that is not all; they have been able to usher in real behavioral change on the ground like by helping to dispel traditional myths with regard to breastfeeding and nutrition.
Generally speaking for human beings, the chances of dying are highest between 0-28 days post birth. In India, the chances of newborns dying are even higher. According to some estimates, the neonatal mortality rate in the country is 36 per 1000 live births. Uttar Pradesh, as one of India’s largest and poorest states, reports an even higher neonatal mortality rate of 48 per 1000 live births.
Health experts are optimistic that the CCSP approach will turn things around. Explains Professor Noor Mohammed, Chairman and Project Co-ordinator of Sociology and Social Work Department that the focus was to build the capacity of the ASHA to provide the required services to new mothers and their infants.
The CCSP programme involved building a network of care givers. Prior to this module, only 13% of the 900 ASHAs in the six blocks in the district were performing home visits for newborns and only seven per cent were following the prescribed schedule. This has now risen to 92% and 81%, respectively. There are a total of 2,200 ASHAs in entire district of Aligarh.
According to Professor Mohammed, there has also been a significant change in traditional attitudes. Before newborns were kept hungry for three days as it was believed that mother’s milk was bad for babies. Instead they were given ‘khada’ (a local decoction made from honey, jaggery, ‘ghee’ and ‘ajwain’). ASHAs have managed to change this practice completely by counseling the families of young mothers. This has led to a 50% rise in breastfeeding within the first hour of birth.
The CCSP programme has now run for a year. It was launched in 17 districts of Uttar Pradesh in its first phase but because it has had such encouraging outcomes, the state government plans to implement it across all 71 districts. In addition, the supportive supervision model evolved in Aligarh is being replicated in all the CCSP districts.
The sense of service and zeal of the ASHAs is admirable. A single ASHA addresses the maternal and child health needs of a population of 1,000.They receive for a paltry performance-based incentive that comes to approximately Rs 3,000 (US$1=Rs 44.3) per month. They certainly have the eternal gratitude of young mothers in Aligrah district now delighting in their little bundles of hope.
