Community – An integral aspect of radically improved MCH

Interviewing a woman surrounded by neighbors and children.

‘…Ghar main bahun ke hotein saas kam karegi to log kya bolegein.’ (‘…What will the community say if in-spite of a daughter-in-law (DIL) the mother-in-law (MIL) does the household work’)

The concerns for a mother are not around what the family members would say but what the community at large would say. This was a common phenomenon observed in and reported by most of the family and community members on field in Bihar. Concerns like what the community would say, what would they think, how would they react, etc. determine the conduct of the people in their daily lives. Thus unlike in urban areas the community stands as the primary/fundamental social unit and not the family. It is the community that acts as the rural equivalent of the ‘family’ in cities. This is something that the healthcare system has never accounted for. Rather than leveraging on the capabilities and capacities of the community it has rather completely isolated it from the system. The interaction that the healthcare system has, through the frontline workers, is only limited to the women in question (pregnant woman or mother) and at times her immediate family, It never targets the other key players in her larger eco-system, acting ignorant to the fact that adoption and continuation of any practices happen at a community level and not at a family level. Similarly perceptions and attitudes around any practice or information are formed at the level of the community, scope and ambit of which is much bigger than what the healthcare system currently functions in.

The Bihar Innovation Lab contests that the future of public health lies in empowering the individual, the family and the community to ensure the health and wellness of the mother and the child.

So how can there be a larger participation of the community that can contribute to radically improving lives of mothers and children? Our able researchers and designers have been pondering over this for a while, and the following are some of the basic designs that we have come up with so far.

-       ‘Community Health Dashboards’ that are maintained by households, self-help groups and panchayats. These dashboards are a new platform through which the community itself keeps track of the health of pregnant women, mothers and children in the village as well as rates and audits the health service provided by the government healthcare system to the village.

-       ‘Mother’s Voice’, an audio-blog that allows mothers to anonymously post grievances and feedback on service provided to them, through their mobile phones. This blog is accessed by community member / representatives as to provide validation and also act as a pressure point for the healthcare system to act upon grievances.

-       ‘Community Transport Facilities’ wherein every community has dedicated transportation services managed by community so that dependence on ambulance services decreases and timely arrangement can be made.

-       ‘Nutrition Security’, by developing local agriculture supply chain and community ‘nutrition kitchen’ entrepreneurial models to ensure routine availability of high nutrition food for mothers with anaemia, malnutrition, inadequate lactation, etc.

-       ‘Community Bare-foot Mobilisers’, which will consist of village elders, members of the SHGs, and other influencers who can leverage their social influence in the community to ensure the health of pregnant women, mothers and children.






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