Govt. Community Health Programs
Pushparajgarh Health and Nutrition Initiative (PHNI)
Anuppur is one of the peripheral districts of MP, bordering Chhattisgarh and a lot of the sickest patients coming to JSS arrive from here. According to the 2011 census, 47.9 percent of the population belongs to the Scheduled Tribes category. It has 4 blocks. Pushprajgarh is the largest Block with 268 villages. Estimated population in 2018 was 2.3 lakhs, with 96.3 percent rural population. It mostly has a tribal population, with very limited means of income. It is divided into 8 sectors in terms of health administration. Karpa and Tithi-Jaithari Sectors are most backward in terms of road, water, electricity, and communication. Health facilities and outcomes are extremely poor in these two sectors. Number of home deliveries are very high. Both these sectors also have high infant and maternal mortality (many of these deaths are not even recorded).
Our goal in this area is to improve the quality of primary healthcare in 12 subcenters, 1 CHC and 1 PHC in this area with special focus on maternal and newborn care. We believe that when both infrastructure and quality of care available to people improve, it will in turn improve the number of Institutional Deliveries in this area, and also help reduce Maternal and Newborn mortality and morbidity. With that in mind, we came up with the following focus areas for improving primary healthcare services through facility strengthening; strengthening community processes; improving access and ambulance services in 2 sectors; making Pushprajgarh CHC Cesarean Section active.
It was important for us to consider the 4 components so that we build a connection or say a chain of healthcare from grassroots to facility level. Through the process of strengthening community processes we could work with ASHAs, intervene in VHND (Village and Health Nutrition Day), see and advocate for the challenges that they face. For facility strengthening, we make an effort to work with local administration and make the facilities capable enough to provide services for minor ailments, treatment for seasonal diseases like malaria, scabies, diarrhea, conduct deliveries and bring health services closer to people. Through this we have also been able to work closely with ANMs, understand their challenges and work hand in hand to some extent. Improving access and ambulance services in these 2 sectors further brings health services closer to people. Another area of work includes making the Caesarean Section services active at CHCs for instance, so that it is possible for the whole block to avail this facility on time and indirectly reduce maternal mortality and infant mortality.
With availability of sufficient HR and slow improvement in supply of essential drugs we have seen an increase in patient load and improvement in care over the years. Presence of ANM mentors in the facility and recent availability of 2nd ANM has made it possible for a health staff to be in the sub center 24×7. Intervention in community processes and advocacy with district administration for availability of ambulance when required has improved delivery load and care in sub health centers. When we had started work in 2018 only 3 sub centers were functioning as delivery points. Today out of 12, 6 sub health centers are functioning as delivery points, and 4 other sub centers are fully functional with their infrastructure remarkably improved.
The nutrition initiative in Pushparajgarh is focused on the under-3 child. Creches have been started in these remote tribal hamlets. More information on these can be found here Phulwari.