1. Improving Women’s Access to Maternal Health Care Services in the state of Gujarat

2. Aim
To evolve community based mechanisms in Navsari district in Gujarat State to improve women’s access to maternal health and promote its replicability in other districts of Gujarat state and at other states and at National level.

4. Navsari District at a Glance

6. Observations TBA Mean age of the TBA is 59 years
Average number of deliveries ( ) -14
40 % were untrained
Limited role during antenatal & post natal period. Only to manage the labour
Not aware about their own entitlement and health service entitlement of pregnant women
Weak linkages between TBAs ANM

7. Observations Panchayat Knowledge about maternal health is limited
47% believes that they do have a responsibility in the area of health
Usually do not make arrangement for transporting women during emergencies for delivery
Do not monitor the visit of ANM or AWW

8. Training of TBA 8 PHCs are Covered TBA Training in Vansada Block
Total Number of TBAs Trained -287
8 PHCs are Covered
Core Role and Expanded role as developed by the Dai Association –Gujarat and approved by the DHFW-GOG

9. Improve access to maternal health services
Dai
Training
Transport facilities
Training of ANM/FHW
Improve access to maternal health services
SHG
Panchayat member
Village Health committee
AWW

11. Experience of DaiTraining
TBAs are committed
It is essential to train pairs of TBAs
TBA training requires hands on and repetition
Presence of ANM/MO/CDHO is essential to make linkages.
TBA Training at PHC helps to develop linkages with health team

12. Pre/Post Training Results

13. Action taken by trained Dais (September November 2007)%
Used antiseptic to clean the outer reproductive organs before delivery 36
Used gloves during delivery 42
Discussed the messages related to birth preparedness with family
Provided support to organize transport 45
Provided support to get the three ANC done 30