Pregnancy Care

Standard Practices Improve Credibility of Grass-Root Level Pregnancy Care

Written by Pritee

Since 2015, several NGOs have used our CareMother pregnancy care solution in rural areas of Aurangabad and Ahmednagar districts, urban slums in Govandi/M-East ward in Mumbai, and tribal areas in Nandurbar and Palghar.

In September 2019, officers from the Central Health Ministry visited our Program site at ‘Lambkana Primary Health Centre (PHC)’ in Aurangabad, collaborating with Savitribai Phule Mahila Ekatma Samaj Mandal (SAFU), an NGO working with Hedgewar Rugnayala.

The review by Ministry officers was very motivating for our team! They were amazed by the standard practices followed by our health workers (ASHAs) to take care of pregnant women.

We are happy to share some of these practices:

1. The health worker registers a pregnant woman within the first 12 weeks of pregnancy.

2. At the time of registration, she performs her first prenatal check-up.

3. She updates new pregnancy registrations to the ANM (Auxiliary Nurse Midwife) daily.

4. She mandatorily uses gloves during every ANC check-up.

5. She opens the CareMother portable screening kit and begins by checking the mother’s weight on a digital weighing scale. She ensures that the scale is on a flat surface and the mother is standing still and looking straight.

6. Point-of-care random blood-sugar and hemoglobin tests: This involves a finger-tip prick. She uses the standard sterilized lancet for a safe and secure prick, wipes out the initial blood flow, and uses a drop of blood, first for hemoglobin, and then for the blood-sugar test. Both tests give results in 10-12 seconds.

7. Temperature: We have provided a digital thermometer in the kit. After completing the test, the health worker uses a sanitizer-wipe to clean the thermometer. 

8. Blood pressure: She asks the mother to rest on a chair for 5-10 minutes and breathe slowly. She uses a digital BP monitor and ties the cuff on the mother’s left arm.

9. Fetal Heart Rate: The kit includes a fetal doppler device that detects the baby’s heartbeat. She performs this test after the 22nd week of pregnancy. We have trained health workers to detect the baby’s heart position on the mother’s abdomen.

10. Urine test: She asks the mother to provide the urine sample mid-stream and provides a sterilized container for the same. The kit includes a urine strip necessary for measuring protein (for hypertension) and sugar (for diabetes).

11. While performing these tests one by one, health workers put the data into the CareMother app, and counsel mothers on the next steps for any high-risk conditions.

12. As per high-risk status, the application’s decision-support guides the health worker to either conduct more follow-up visits, or refer the mother to the ANM’s care, or to the PHC, or a higher center.

These practices have tremendously improved health workers’ credibility and acceptance of the intervention among families of pregnant women.

About the author

Pritee