Cultural barriers and low awareness have led to many women not seeking early ante-natal care (ANC) services in Surgana, a remote tribal block populated predominantly by the Kokna tribe in the Nashik district of Maharashtra. Home deliveries are not uncommon here, which have been leading to high-risk pregnancies and associated complications.
Under the Government of India’s Aspiration Blocks Programme (ABP), WHO India national and field teams are supporting the district and block health departments take focused action to improve early ANC registrations for safe and respectful childbirth.
Community mobilisation has been prioritized in Surgana block, with health workers and ASHAs (community health volunteers) conducting door-to-door campaigns to share information about the importance of early ANC registration and check-ups with women and their families. “I was hesitant to register initially, but ASHA didi (sister) convinced me that check-ups from the start of my pregnancy will benefit me and my baby. All tests and services are free, including a free consultation from a doctor,” said Ms Sarita, who is pregnant with her first child.
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Umbarthan Primary Health Centre organized a Village Health and Nutrition Day on National Immunization Day for polio at Zilha Parishad School Raghatvir to ensure the community received comprehensive health services during a single visit (Photo: Dhanashri Deore / © WHO India)
Surgana block administration amplified focused interventions through existing programmes, including Pradhan Mantri Matritva Suraksha Abhiyan that provides free comprehensive antenatal care services to all pregnant women on the 9th of every month, and the Government of Maharashtra-run Manav Vikas Camps for maternal and child health organized every month at Primary Health Centres.
Field teams from WHO India also assisted in the development of block action plans for improving planning for Village Health Nutrition Days in remote and hard-to-reach areas. Pregnant women who registered for ANC in the first trimester received nutritional support and health workers conducted regular follow-ups.
These concerted efforts have led to a steady increase in ANC registrations in the first trimester of pregnancy in Surgana block, with 99% of pregnant women registering in their first trimester in 2024. This has led to improved mother and child health, higher institutional deliveries, reduced pregnancy related complications, and fewer maternal and child deaths. Maternal mortality declined from 138/100 000 live births in 2021 to 111/100 000 in 2024, while infant mortality reduced from 12/1000 live births in 2021 to 6/1000 in 2024.
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WHO national and field teams discuss record-keeping with Community Health Officer Dr Bhagyashree Gawli at Ayushman Arogya Mandir Pratapgad in Surgana block
To strengthen noncommunicable diseases (NCD) services in the district, WHO has also been supporting capacity building, team-based care, patient-centric services, supportive supervision, review meetings, logistic management, and use of data for planning since 2022.
Under the ABP indicators, WHO teams have been supporting the development of Block Development Strategy, capacity building of the health workforce, onsite support of NCD days and screening camps, and forecasting of drugs and logistics for uninterrupted services. WHO assisted in improving the quality of NCD screening services for several government initiatives, Mata Surakshit Ghar Surakshit (safe mother, safe household); Tarunaiche Vaibhav Maharashtrache (youth health), Mahaarogya Shibir (health fair), and Sampoornata Abhiyan for fully screening the target population in a block. Till 31 December 2024, 8480 persons with hypertension and 3451 persons with diabetes have been diagnosed and being provided treatment.