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Breaking down barriers to healthcare

I went to India recently to present the findings of the Nutrition Barometer report at a side meeting at the World Economic Forum held in Gurgaon, just outside of Delhi.

After the meeting, I flew to Ranchi which is the capital of Jharkhand state in the eastern part of the country. The state is rich in natural resources and mineral reserves, and economic activity is visible everywhere.  The hustle and bustle however belies the state of health and nutrition in Jharkhand.

Dismal indicators

Health outcomes in Jharkhand are some of the worst in India, which to begin with, has some most of the most dismal health indicators in the world.    Half of  Jharkahand’s children below five years are stunted and nearly 60 percent are underweight according to the Demographic and Health Survey 2005-06.

Less than half of children get the measles vaccine and only 40% receive DPT3 immunisation. Sadly, the country hasn’t had any recent nationally-representative health survey so it is difficult to tell  how these indicators have changed in the recent years.

While in Ranchi,I went to a village to see the monthly village health and nutrition day which is a government programme.  Once a month, health workers are supposed to mobilise women and children in the anganwadi centre so they can receive basic health services.  These include antenatal visits, vaccines, vitamin A supplementation and weighing and recording of children’s weight.

Transport essential

The health worker informed us that six children were scheduled for vaccination that day. I saw two mothers come with their children and the health worker gave polio and DTP vaccines to one of the babies.  On the way out of the anganwadi centre, I noticed a sign with a telephone number in it.

I was told that the sign asks health workers to call the ambulance when a women is about to give birth.  Transport is one of the barriers women face when seeking healthcare and this service helped bring them to a facility when they most need it.

Lifeline in Jharkhand: sign asks health workers to call the ambulance when a women is about to give birth

One thing is obviously working in the case of the village health and nutrition day–the regularity and predictability of service in a location accessible to the village.  People are are more likely to seek healthcare when they do not have to travel far to a facility, know that it will be open when they get there and that they will actually get the service that they need.

It is no use to travel far only to find out that the centre is closed or you cannot get the service that you need because the health worker is absent or did not have the medicines required.

Breaking down the barriers to seeking healthcare is one way to improve health and nutrition.  This should be done most especially in poor and remote areas where households are least likely to seek healthcare for many reasons.  Having reliable service free at the point of use at their doorstep is a good way to reach the poorest and most vulnerable.

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