India & Bangladesh
Improving maternal, newborn and child health in low-income countries: 2008-2013
With consortium partners Centre for International Health and Development (CIHD), Diabetic Association of Bangladesh (BADAS) and ekjut , we have received a 5-year grant from the Big Lottery Fund to mobilise communities to address their maternal, newborn and child health challenges and strengthen healthcare to improve timely use of better quality services.
To read more about the strategic maternal and newborn health programme WCF and partners are implementing in India and Bangladesh please click here
India accounts for 20% of maternal deaths worldwide, 21% of all child deaths, and 25% of all neonatal deaths. Access to skilled attendance at delivery attendance at birth has increased to around 47%. Jharkhand and Orissa are two of the poorest states in eastern India. About 40% of their total combined population lives below the poverty line. The average life expectancy among women in both states is about 60 years, and an estimated 63% are illiterate. Neonatal mortality rate (NMR) per 1000 livebirths is 49 in Jharkhand and 45 in Orissa, and maternal mortality ratio per 100,000 livebirths is 371 and 358, respectively. These are disproportionately higher than India’s national estimates of 39 per 1000 for NMR and 301 per 100 000 for maternal mortality ratio.
In India, Ekjut, which means “coming together for a cause”, is now working with 519 women’s groups, and has achieved tremendous results. In collaboration with University College London’s Centre for International Health and Development, Ekjut recently published groundbreaking research findings in The Lancet, which demonstrated that community mobilisation through participatory women’s groups can dramatically improve birth outcomes in poor rural communities in eastern India. The key results were a 45% reduction in the newborn mortality rate and a 57% reduction in moderate maternal depression.
Ekjut has also been involved in setting up Village Health Committees across eight districts in Jharkhand and Orissa. The Village Health Committees promote decentralised decision-making, monitoring and planning for health. They analyse key health and nutrition issues in the community, raise awareness amongst villagers of health services and entitlements, and provide feedback to relevant government officials to ensure that community health issues are addressed. However, many of these Village Health Committees function poorly, and Ekjut is working to improve them as an important contribution to strengthening health services overall.
Since 2002, Women and Children First has worked with the Diabetic Association of Bangladesh’s , Perinatal Care Project (PCP) to address maternal and newborn health problems in the districts of Bogra, Faridpur and Moulavibazar. The work on improving health care for mothers and babies was carried out through women’s groups. In 2008-09, a total of 648 new groups were set up to address maternal and newborn health; another 162 groups, which were established in 2002, continue to meet and have extended their discussions to include women’s and under fives’ health.
Building on the lessons we have learned during the course of this work, we placed increased emphasis on encouraging newly married and pregnant women to join the groups and on increasing the density of women’s group coverage across the three districts. The project team has also been engaged in strengthening the health system by mapping health facilities and communicating with local health care providers to help improve both the quality of care and access to services.
CIHD is leading on rigorous programme monitoring and evaluation. Women and Children First is leading on policy, advocacy and communications to establish and strengthen dialogue with governments and policy makers. Our goal is to increase commitment within these spheres of influence to address maternal, newborn and child health in both programme countries at the district, state and national levels, across Asia and internationally.
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