‘CHETNA@40-Nurturing Dreams, Empowering Destinies,’  chronicles four decades of transformative work in women's health and community empowerment across India

When Julkiben, a dai or a traditional birth attendant (TBA), received a call from a pregnant woman, she immediately swung into action. First, she dialled 108, the number of the state government emergency ambulance. After she reached the pregnant woman's house, she cut a clean cloth into pieces to be used at the hospital and kept an empty lota (water container) ready to fetch and store water. But when the woman's labour pains increased and it became impossible for her to climb down the hillock to reach the ambulance, Julkiben summoned young men from the neighbourhood to make a sling from a bed sheet and carry the pregnant women to the ambulance. They had barely reached the hospital labour room when the woman delivered. Julkiben's presence of mind and timely action helped to save the lives of mother and child.

It was not just TBAs like Julkiben but women, their families and community members in 60 villages in Vansada and Chikhali, two tribal blocks of Gujarat's Navsari district, who learnt that maternal deaths could be prevented by accessing the public health system's maternal healthcare services. In fact, the  three-year initiative in these two blocks by the Centre for Health Education Training Nutrition and Adolescents (CHETNA), the Ahmedabad-based not for profit working to empower women, adolescents and children, led to remarkable changes. There was an increase in institutional deliveries from 58% to 82% in Vansada block. More importantly, of the 776 deliveries that took place during the last phase of the intervention, not a single maternal death was registered in the area.

 How was this achieved? What was done differently that brought about behavioural change?  Could this success be replicated in other districts with poor health indicators for women?

Answers to all these questions and more have been given in the recently published coffee table book to mark their milestone of turning forty. Titled 'CHETNA@40-Nurturing Dreams, Empowering Destinies', the book chronicles the organization's four decades of collective efforts, its distinctive approaches and the impact made by its innovative communication strategies that transformed countless lives and communities in 78 districts, 124 blocks and 439 villages in seven states.

One of the biggest reasons behind its ability to make a difference has been its focus on incorporating a gender lens to all its work, says Pallavi Patel, co-founder and Director, CHETNA. Being the country's first all-women health initiative helped make CHETNA a trendsetter in women's health, nutrition and gender. It's pioneering approaches and impactful communications material gave it an edge over others. The popularity of their resources can be gauged by the fact that in 2022-2023 alone, over 2,77,981 copies of CHETNA's materials were sought by various government and NGOs based in 11 states.

The book unpacks their hands on, people-centred strategies to tackle not just the challenges in dealing with child birth complications in remote tribal areas with minimal health facilities in Rajasthan and Gujarat, but widespread nutritional anaemia in Gujarat, Rajasthan and MP. It also reveals how CHETNA fostered a change in behaviour in getting 70 schools certified tobacco free in Ahmedabad as well as in mindsets especially in Mehsana, Gujarat, one of the districts with the worst child sex ratio (CSR) in the eighties and nineties. The deeply entrenched son preference psyche and practice of placing the blame on the woman when a girl was born was addressed through saas-bahu meetings, engaging with caste panchayat leaders and innovative dal-chawal games to explain the  role of the X and Y chromosomes in determining the sex of the child.

At the centre of these efforts has been CHETNA's ability to be adaptable, flexible and, creative. Besides out of the box thinking, health messages have been tweaked according to local needs, traditions and practices. Their innovative anaemia kit has undergone several adaptations as has their unique and highly popular cloth aprons with several flaps that are worn by male and female trainers to show the reproductive organs in the two sexes. Songs, games and animation films have been created to share knowledge on child care, nutrition, puberty, menstruation, adolescent health, anaemia and contraception.

The book details how CHETNA, which works under the symbiotic umbrella of the Nehru Foundation for Development set up in 1966 by the eminent scientist Vikram Sarabhai, strategically used their scientific and inventive health communications to make a lasting impact. Whether it has been to break the silence on menstruation, or creating an enabling environment for girls,  CHETNA has shown that the dream it began with 40 years ago, of making women the mistress of their own destinies, was not an impossible one.

(The writer is a journalist writing on development and gender. The views are expressed are personal