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Through the support of Wipro Cares (Wipro Foundation), ECS has been implementing a community health initiative covering 12 villages covering a population of 15000, under the Noksen and its adjacent block in Tuensang district since June 2015. The project’s key objective is to develop and deliver a comprehensive primary health care program especially focussing on children, adolescent girls, and women.
The project area covers one Primary Health Center and three Sub Centers that provide coverage to the 12 target villages and adjacent areas. 4 villages fall under the hard-to-reach area with paramount issues and problems for delivery of health care services through the health units, particularly with regards to access to delivery services among pregnant women and health services for children.
The approach was to build strong community responses to health care whereby, from the onset of the project, conscious efforts were made to involve the community in the implementation process. The main focus is to access maternal services during and after pregnancy and to improve maternal health outcome in the villages.
Over the last 6 years, the project has witnessed a major involvement of the community and behaviour change in mothers regularly accessing services from the health centres, and also the immunization of the children by the parents has shown a marked increase. The Village Health Committee, the core of the project, has shown greater interest and involvement in Phase II (2018-2021). A lot of efforts were made on building their capacity and even the church leaders have begun to take healthcare more seriously. Dialoguing with the village stakeholders has been the core activity initiated in this phase. Mothers are actively accessing services and demanding nurses to come for vaccination.
The development of delivery point at Ngoungchung sub-center covers 6 villages from the project area and another 3 villages. Due to the proximity of the sub-centre and availability of nurses, many couples have started to opt for institutional delivery. And In fact, the mothers now prefer the delivery point to the District Hospital in Tuensang town since the expenses incurred is higher in the latter case. Since transportation is a particular challenge in the area which results in many home deliveries, ambulance services have also been provided at Ngoungchung sub-centre through the project. This has been helpful not only for ANC and hospital deliveries but has helped dozens of general patients by reaching them to larger health centres to seek medical help at the right time.
NOTABLE ACHIEVEMENTS IN PHASE II
All pregnant women within the project areas are tracked and provided with ANC services (Rural Tuensang- 18.7% DLHS 2012-13), along with counseling and nutrition training. Through these interventions, there is now a shift in the mindset of many women, and the rate of institutional delivery has risen to 64% compared to the baseline data of rural Tuensang: 7.5% (DLHS 2012-13) PNC services focus a lot on the newborn baby’s health and immunization. The immunization picture is much improved with 100% of children from the 12 villages getting enrolled in the immunization program (Baseline: Children receiving full immunization 35.7% (DLHS 2012-13).
There is Improved hygiene and cleanliness in the community and Mothers have started demanding for the Nurses and the Doctors to be in the station which was not seen during the initial period of the project.
Mothers club members are taking up responsibility in encouraging, promoting service utilization, behaviour change, and removing stigma in the community towards deliveries, menstrual hygiene, immunization, etc.
During the Covid-19 lockdown period, the ECS team along with the frontline functionaries have been working non-stop to provide services to the community. Awareness on Covid 19 and delivery of essential nutrition and ANC services continued for pregnant mothers in all ECS focused villages including those that come within the Wipro Cares project. The CareMother kit was used by village health workers to provide services to women and children.
In PHASE III, we plan to strengthen the Noksen PHC, the only primary health centre in Noksen block, which is currently functioning with many limitations. We will also continue to work towards strengthening the existing delivery points and bringing more resources from the state health department and continue community mobilization efforts. We are also in discussions with the district hospital to ensure vaccines are brought on time to the health centres in order to ensure no child misses a dose.