According to WHO
“Half the world’s people currently live in rural and remote areas. The problem is that most health workers live and work in cities. This imbalance is common to almost all countries and poses a major challenge to the nationwide provision of health services. Its impact, however, is most severe in low income countries.”
My last two blogs gave a glimpse of my work in community toll free helpline projects and for every helpline or health service needs the supportive health facility. This blog describes my experience of two health centers in a primary health service run by ARTH-My pulse NGO located in interior rural areas of southern Rajasthan, northern India. These health centers are dedicated to serve Tribal population where trained nurse-midwives are providing skilled maternal and newborn care round the clock daily where an urban trained Doctor with influential and privileged background never willingly go to fit or visit distant rural healthcare facilities.These patients needs a healthcare facility with greater accessibility and affordability.
The nurse-midwives independently detect and manage complications and decide when to refer women to the nearest hospital. For emergency care or if they need help or professional advice in complicated cases there is facility of telephonic consultation with Doctor. It’s a quite an achievement with their commitment to provide quality healthcare with exceptionally low Price of Medicines and Maternal Services.
Professionally trained midwives are an important human resource and an effective solution for rendering maternal health care, especially in underserved primary care settings. A functioning referral system and back-up hospital care are vital components of successful maternity care programme. However, referral to an urban hospital may not be possible or might be subject to delays because of distance, costs and the family’s apprehensions about the woman being referred and marginalized groups continue to lag behind in access to essential maternal health services. After providing first-level emergency care, the intervention attempted to reduce all three delays in accessing referral services. This was achieved by counseling the family early about the need for referral. Several unwilling families were reassured when told that a staff member would accompany them and facilitate hospital admission.
The nurse-midwives independently detect and manage complications and decide whether to refer women to the nearest hospital for emergency obstetric care, in telephonic consultation with a doctor, when required. This describes an active referral system which allowed for rapid access to emergency obstetric care for women, especially those from the poorer, socially disadvantaged communities of the area. Midwives recruited to health centers had either undergone an 18-month auxiliary nurse-midwife certificate course or a three-year general nursing and midwifery diploma.
By this service we can conclude that trained nurse-midwives can significantly improve access to skilled maternal and neonatal care in rural areas, and manage maternal complications with and without the need for referral to higher healthcare facilities. These centers are in distant villages where professionally trained doctors never wish to visit then how can we have the emergency maternal healthcare facilities in those remotely located areas.
I had a opportunity to visit those health centers and amazed by their enthusiasm, indelible effort to provide easy, accessible, affordable healthcare. Could you imagine the cost of delivery??? It’s only maximum 8-9 USD charged per delivery. Amazed?? Yes it’s true. The commitment, grit and effort invested by the staffed Nurses at the health centers deserves best possible applaud and appreciation.