An assessment of maternal and child health services and challenges of frontline health professionals during Covid-19 in Ganjam has been undertaken by the Youth for Social Development (YSD).
The purpose of the assessment was to assess the functioning of maternal and child health services during the lockdown due to Covid-19 and to observe how citizens accessed maternal and child health services, and identifying the gaps in health delivery systems and challenges faced by the frontline workers.
The YSD covered a sample size of 105 which included multiple stakeholders such as pregnant women (42), lactating women (34), and service providers such as ANM workers (5), ASHA workers (14), and AWW workers (10). Participants were selected through a systematic sampling method which included 10 per cent samples of AWC beneficiaries.
32 per cent of the pregnant women were told to revisit the health facility for check-ups during the lockdown period, while 68 per cent of them were told not to visit at all. Pregnant women mostly went for scanning, vital testing and major check-ups during lockdown.
Similarly, an overwhelming 71 per cent of them had to buy the necessary medicines from private pharmacy stores, while the remaining 19 per cent could not even afford to buy the medicines prescribed by the doctor. The study also found that, 44 per cent of the pregnant women included in the study had no idea about the type of medicines and their usage.
Some participants mentioned using tablets for iron and folic acid and vitamin deficiencies, along with medication for other purposes. A large number of pregnant women who visited public health facilities had to incur additional expenses to purchase medicines from private pharmacies or for visiting private hospitals and clinics.
Quite a large percentage (74) of the women, however, noted the presence of hand washing facilities; followed by 22.5 per cent of women could not find any hand wash facilities in the health centers which is a big concern. Similarly, 77 per cent of women reported that, they maintained the necessary physical distance during their visit and most of them wore masks during their visit to healthcare centre. 48 per cent of the surveyed women believed that the health centers were disinfected on a daily basis.
Approximately three-fourths of the participants had seen display posters and guidelines on Covid-19. 45 per cent of women were aware of screening facilities at the district hospital while 48 per cent were not aware of the presence or the lack of testing facilities at PHCs and CHCs.
The survey further found that, the CHCs and PHCs were not well equipped and were functioning without necessary screening facilities. Mamata Divas (VHND) events were an overwhelming as 86 per cent of participants responded that they were aware of the events being organized in the village. In contrast, the remaining 14 per cent did not.
More significantly, 77 per cent of the lactating mothers visited the health centre for delivery. While remaining 23 per cent of participants attended the health centre for necessary childcare services for their newborn. 65 per cent of the participants visited health centers during the lockdown period, where 95 per cent from the visiting mothers found the centers to be open and functioning while 11 respondents did not visit any health facility in this period.
91 per cent of the children from participating mothers had been vaccinated. 54 per cent of the participants could obtain the necessary medication from the Government Niramaya stores, while 32 per cent of women were forced to buy drugs from private pharmacy stores.
Four of the seven participants paid approximately between Rs 200 and Rs 500. Only one participant had to pay between Rs 2,000 abd Rs 3,000. Out of the 29 respondents, only 14 ASHA and 4 ANM workers were assigned duties at temporary medical centres (TMCs) for treatment of Covid-19 patients.
At the same time, all the AWW workers had been designated for door to door listing of migrants, health monitoring, list of home quarantine migrants, and thermal scanning. 35.5 per cent positive/suspected cases were not taken immediate action at the TMCs, which is a severe concern.
Only 69 per cent of the frontline workers were using masks and PPE kits while performing their duties. Only 38 per cent of those frontline workers received masks from the government while the rest had to manage it from different NGOs involved in the field. However, the most concerning aspect was the fact that 31 per cent of the frontline workers were still performing their duties without even necessary protective measures such as masks.
Only 59 per cent of the frontline workers had undergone the mandatory training programme. As observed in figure 12, 86 per cent of ASHA workers, 60 per cent of ANM workers, and only 30 per cent of AWW workers had the opportunity to avail the training. 41 per cent of the people were not maintaining any social distancing at the health centres during the lockdown period, while 28 per cent of the visiting patients were not wearing masks. only 28 per cent of the frontline workers mentioned that their health centres were regularly disinfected.
Only 28 per cent of the frontline workers mentioned having posters and guideline displays on their health centres. While 75 per cent of the participants expressed no fear while working on the frontline, only 13 per cent of the workers were apprehensive and expressed their concerns of contracting the virus themselves while performing their duties. 17 per cent of the workers mentioned that the corresponding VHND events in their locations were held at the sub-centres.