TF has now developed a holistic programme for the care of mothers and infants called ‘Jatan’ which is implemented since 2017. This programme is based on a structured format for home visits. The VHWs are given incentives for carrying out quality home visits.
Beginning with the focus on basic community based health care of pregnant women and under-five children;TF has evolved a unique programme for community based health care of mothers and children, called ‘Jatan’. ‘Jatan’ means ‘Nurture’ in Gujarati.
Physical aspects of health care of mothers and children remain important for reducing the maternal and infant mortality rates. These include very well established interventions as shown below –
- For mothers –
- Early identification of pregnancy
- Regular antenatal check up
- Provision of Iron folic and calcium tablets
- Tetanus vaccination
- Identification of risk factors and appropriate management of high risk pregnancy
- Ensuring institutional deliveries (now much easier because of government schemes)
- For infants –
- Essential Newborn Care
- Breast feeding and complementary feeding
- Treatment of common illnesses
The TF VHWs, through their home visits, are constantly striving to improve these aspects of Maternal and Child Health care. This hard work at grass root level is reflected in significant improvement in maternal, neonatal and infant mortality rates in TF villages.
In 2015 – 16 (NFHS – 4) NMR &IMR in Rural Gujarat were 28.4 & 38.8. MMR in Gujarat – reported in NITI document for period 2011 – 13 was 1.12.
However, to further improve the situation, following aspects of maternal and child health care also needs to be taken care of.
- During antenatal period
- Adequate preparation for birth (delivery)
- Adequate preparation for breast feeding
- Adequate preparation for Kangaroo Mother Care
- Mental health of mothers (During pregnancy and after delivery)
- After delivery
- Adequate postnatal care of mothers including mental health
- Kangaroo Mother Care for Low Birth Weight newborns
- Improving feeding practices – both breast feeding and complementary feeding
- Development of the infant
Mental health of the mothers is now considered very important and it is well established that mothers with depression not only have more frequent physical problems but their infants have more frequent illnesses and their care (like immunizations, treatment of illnesses) and development are also affected.
Moreover, home based care of mothers and children is as important as institutional care. Improvement in home based care practices needs constant efforts in a systematic way.