The Infant Mortality Rate in AP, at 66 per 1000 babies born, is the highest in South India. The incidence of birth rates below 2500 grams (MICS 2000, UNICEF India), at 75 out of 1000 in rural AP, is similarly high. These figures have remained stagnant since 1990.

A two-pronged strategy is aimed at reducing infant mortality and low birth weight: we retrain traditional health workers and introduce a proper nutritional programme for pregnant mothers.

With the help of the MLL hospital in Madanpalle, dai-s or traditional health worker and community health workers are being retrained to spot possible complications during pregnancy, birth and the post natal periods.

Each dai is given a kit containing, blades, threads, cotton, spirit and antiseptic powder for use during delivery to ensure standards of hygiene.

Antenatal care is aimed at raising birth weight and monitoring the health of pregnant women: Under the programme, every pregnant woman is fully investigated (including ultrasound), immunized and given nutritional supplements (iron & calcium). They would also be advised on whether a domiciliary or hospital delivery is preferred. All women who have delivered will also make three post partum visits. In the 3 years since its inception we have seen the average birth weight creep up from 1.8 kg to a healthier 2.3 kg, just short of the desired 2.5 kg.

The cost of a domiciliary delivery works out to be Rs. 700 and a hospital delivery Rs. 3000. Patients pay 1/3 to 1/2 of the costs incurred. The remainder is paid by the Health Centre as a subsidy.

Two agencies are involved in this programme, namely, Indians for India and MMKCMT.

For further information contact Dr. Kamakshi: kamakshi@rishivalley.org