Impact Analysis

Method

In Save-A-Mother project, it would be possible to assess the results, both as quantitative data and as quality of life achieved.

The quantitative data will include: number of trained health activists, number of mothers registered, number of their prenatal visits, medicines supplied, immunization status and deaths due to pregnancy and delivery. Infant deaths will also be recorded.

Number of deaths per 100,000 live births will be part of the demographic profile of the district drawn by governmental census every decade. But we will conduct sample surveys to gather the preliminary results every year. The real impact will be obvious only in two to five years.

Program impact as of March 26, 2009 :

We have been working in 15 blocks comprising of about 150 villages. We conducted our first impact analysis in 10 blocks after working there for 6 to 12 months. Unacceptable maternal and infant mortality is prevalent.

Even though the survey was not done with scientific precision, yet the result of our work is encouraging and often has exceeded our expectation. We propose to conduct more precise surveys annually and show further improvement on the data below. We have a declared ‘zero tolerance’ for any maternal and infant death.

Qualitative Impact:

• Awareness on health-care and health issues has risen within the community
• SHG members have internalized the seven best practices on health-care
• Improved health seeking behavior among the community
• There is higher awareness, among women, of Government schemes such as the Janani Suraksha Yojana run under the National Rural Health Mission (NRHM)
• Increased synergy with community and health functionaries: Self Help Group meetings have emerged as one-window convergence platforms at which communication on health issues and information on health-care can be disseminated by government or village functionaries
• Increased community support to Auxiliary Midwives and Anganwadi workers in disease surveillance and referrals
• The convergence approach has brought a sense of responsibility among government functionaries and provided them an opportunity to work more effectively
• Improved recording of health statistics.
• Increased participatory involvement.

Quantitative data & impact of the program May 08 to 24 Nov 09

no	Name of block	Number of pregnant women linked to institutions (CHC, PHC, ANM sub center) by swasthya sakhi	Number of deliveries
			Total	M	F	ND	MD	I	NI
1	Amti	240	160	90	67	3	2	110	50
2	Shahgarh	450	210	110	97	3		170	40
3	Musafir khana	225	130	80	44	6		103	27
4	Gauri ganj	155	11`0	64	40	6		100	10
5	Sangrampur	165	120	65	50	5		103	17
6	Bhadar	107	50	30	20	0		40	10
7	Bhetua	223	163	105	55	3	3	143	20
8	Bhadiya	155	110	57	50	3		83	27
9	jagatpur	339						285
10	Gaura	78	39	29	15			36	3
11	Rahi	122	48	14	18	16	4	33	8
12	Jamo	135	87	50	37			47	40
13	Bahadur pur	91	48	23	19	6		37	11
14	Unchahar	105	50	27	21	2		42	7
15	Salon	55	23	13	8	2		10	7
16	Dalmau	16	3	1	2	0		3
17	Jagdish pur	120	75	40	30	5	1	70	05
18	Baldirai	110	60	35	25	0	0	40	20
19	Dubeypur	53	00	00	00	00	00	00	00
20	Rohinya	6	1	1				1
21	Amava	120	52	28	22	2		34	18
22	Singhpur	33	11	6	4	1		4	7
Total		3103	1550	868	624	63	10	1494	327

no	Name of block	Number of pregnant women linked to institutions (CHC, PHC, ANM sub center) by swasthya sakhi	Number of women got benefit of JSS	Total number of CLA meetings which ANM, ASHA, and AWWs attended	Number of families started good cleaning habits (hand wash, bathing, etc)	No of people adopted family planning
1	Amti	240	110	19	1050	58
2	Shahgarh	450	170	34	1560	37
3	Musafir khana	225	103	17	780	15
4	Gauri ganj	155	100	18	712	62
5	Sangrampur	165	103	20	435	14
6	Bhadar	107	40	20	480	22
7	Bhetua	223	143	29	560	32
8	Bhadiya	155	83	25	680	16
9	jagatpur	339	285	59	3611	275
10	Gaura	78	36	7	1242	7
11	Rahi	122	33	22	1210	23
12	Jamo	135	47	25	535	27
13	Bahadur pur	91	37	21	130	7
14	Unchahar	105	42	18	690	22
15	Salon	55	10	12	40	6
16	Dalmau	16	3	6	50	2
17	Jagdish pur	120	70	20	301	16
18	Baldirai	110	40	28	283	14
19	Dubeypur	53	00	00	16	00
20	Rohinya	6	1	1	20	1
21	Amava	120	34	7	130	7
22	Singhpur	33	4	6	60	10
Total		3103	1494	414	14575	673

SS: Swasthya Sakhi, M: Male, F: Female, D: Died, I: Institutionalised, NI: Non-Institutionalised; JSS: Janani Suraksha Yojna, PHC:Primary Health Centre, CHC: Community Health Centre

* Note: D occurred due to delay in registration, delay in reaching the hospital, delivery in house, etc, and these are the learnings and examples which are being shared by Swasthya Sakhis with the community to show the disastrous effect of these mistakes.

Abbreviation used
M:   Male
F:    Female
ND:  Neonatal death within one month of delivery.
MD: Maternal death
I:     Institution delivery (hospitals)
NI:   Non institutional delivery (house)

ID and MD were due to:

• Delay in registration with public health
• Poor antenatal care.
• Delay in reaching the hospital.
• Delivery at home.

Positive Impact in 22 blocks since the program started in 2008:

• Registration of pregnancies with public health institutions has increased.
• Good cleaning practices have increased.
• Adoption of family planning is increasing.
• The impact is not limited to maternal health but extends to health literacy. Over 14575 families reported hand washing compared to 3103 pregnancies.

How does this data help the program?

• Health activists use the adverse outcomes to illustrate to the community the disastrous effects of the mistakes.
• The data will form the base line. To see the impact. we will compare this data to new data after next 18 months and after next 1500 live births

Conclusion:

• This death rate is unacceptable. We aim for ZERO maternal and neonatal mortality.

Note: This data will need improvement in collection, collation and comparison.