The Safe Motherhood initiative aims at developing a feasible, affordable, acceptable and replicable model, utilizing by and large the existing health infrastructure through the primary health care approach. The high maternal mortality and morbidity are expected to be reduced in a reasonably short period of time through his approach and model. The current Safe Motherhood project is an extension of the earlier Women’s Leadership Project taken up in the same area and population which helped women to organize themselves to constitute Mahila Mandals (Women’s Clubs) to look after their own health and improve their status in the society by getting empowered through knowledge and by acquiring skills for taking up income generation activities. This was the beginning of Community participation in health care activities particularly focused on women and children.
Area and Population Covered
The Safe Motherhood project covers two Primary Health Centers, Adle BK and Khadkala of Zilla Parishad, Pune, having a population of little over 60,000 (1991 census) spread over 60 villages of Mawal Thesis of Pune District. There are at present 17 sub–centers. The villages are located not only in the plain area which are accessible but also are tucked up in between the Sahyadri range of hills which are relatively less accessible. Although the area is rain fed, there is acute shortage of drinking water during summer in some of the villages. The socio–economic status of the people is generally of the middle and lower order.
To achieve improvement in reproductive health of women, particularly pregnant women, towards achieving safe motherhood through a package of services covering health care, economic development and income generation by women; adopting the primary health care approach with community participation and use of appropriate technology as the two major thrusts.
Apart from fully utilizing the existing health infrastructure of Zilla Parishad (District democratic institution of government of Maharashtra) intersectoral co–operation and networking of non–governmental agencies and private agencies involved in health and developmental activities have been Raison De’tre of the project.
Each village has at lest one Mahila Mandal. There are in all 74 Mahila Mandals already established in the area out of whom 62 are already registered with the Charity Commissioner and have received Rs.1,000/– as grant for initiating community activities.
A limited research staff consisting of a Social Scientist as the Project leader assisted by two Medical Social Workers located at headquarters Pune, Community Welfare Workers (CWWs), in all 16 in number, and 2 Field Supervisors (FSs), are the grass root level workers working for the project. The CWWs and FSs are locally recruited staff with limited education (up to 10–12 years of schooling) who receive stipend (honorarium) of Rs.500/– and Rs. 700/– respectively. They received extensive training initially and have been getting orientation training on various activities taken up from time to time. The CWWs and FSs are the back bone of the project and they are the interface between the community and the health care organization. They are as facilitators.
Developmental activities Promoting
- Primary and adult education
- Non–formal education activities
- Free legal aid centers
- Organization of group effort like “Shramadan” (voluntary labor) towards construction of public wells, approach road, cleaning of wells/ponds etc.
- Raising kitchen gardens by individual families.
- Raising medicinal plants
- Putting up smokeless “Chullahs” (domestic stoves)
- Avoiding early marriage.
Income Generation Activities and Saving Schemes
- Stitching hospital linen
- Detergents and phenyl
- Stuffed toys
- Candles, scents and other items used during festivals
- Carpet weaving
- Envelope making
- Putting up smokeless chullahs.
- Preparing fruit juices, squash, jam, jelly and pickles.
- Preparing decorative articles for home
- Mushroom cultivation
- Poultry farming
- Taking small catering contracts
- Postal savings scheme
- Sanjay Gandhi Niradhar Yojana
- Rojgar Yojana
- Self–help groups
- Government schemes like DWCRA, TRYCEM, etc.
- Home Nursing.
- Balwadi Teachers’ Training.
- DAI’s Training.
- Beautician Training
- Training in growing medicinal plants.
Thus the project aims at achieving safe motherhood by adopting Primary Health Care approach involving the community by empowering women through imparting necessary knowledge and also women’s rights by creating awareness for social welfare, training, and encouraging in income generation and savings activities.