A quarter of all maternal and newborn deaths in the world occur in India—an estimated 78,000 mothers die giving birth in the country every year, and a million babies die within their first month of life. Many of these deaths can be prevented with the most basic of care and precautions, the lack of which is a widespread and pressing issue. Yet, in a country where a large proportion of the population is fighting for the basics of survival—food, water, a place to live—the health of mothers and their newborns often takes a backseat. To tackle this problem and raise awareness about the issue, a project called Sure Start—an initiative based at PATH, an international not-for-profit organization supported by the Bill & Melinda Gates Foundation—is working to help mothers and their children to survive and stay healthy. One of the ways Sure Start does this is by creating a new awareness of positive maternal and neonatal behaviors through a network of community-initiated mothers groups in rural communities in Uttar Pradesh and settlements of marginalized people in Maharashtra, two states with among the lowest maternal and newborn health indicators. By mobilizing village block- and district-level government, non-governmental, and community organizations, the project also reduces barriers to accessing lifesaving maternal and newborn (MNH) health services. Sure Start’s initiatives also include building networks of community health workers to assist birth attendants and visit mothers within the first few days of birth, training workers to recognize danger signals during pregnancy and delivery, and developing saving programs to help cover the cost of newborn and maternal complications and referrals. A number of extraordinary individuals are working together to help Sure Start make a difference. People like Ms. Shamshad Sheikh who holds a day job as a social worker. She is also a member of one of 30 Monitoring of Maternal and Newborn Health Services committees in Pune, Maharashtra. Ms. Sheikh and her fellow committee members had a difficult time when they began work. “We faced a lot of problems,” she says. “People used to think that the health of mothers and newborns wasn’t any of our business.” But the committee made it their business—on every level. First, they approached doctors and nurses at local hospitals and health care facilities, explaining the Sure Start mission. This has helped bridge the gap between health care practitioners and the community. At the same time, the committees are helping to create community identity. Community perceptions toward the project also slowly changed. The team vividly remembers the story of one pregnant woman. “We kept asking her to go for an antenatal checkup,” Ms. Sheikh says, “but she was averse to the idea.” Step by step, the committee members chipped away at the mother-to-be’s resistance. Finally, she went to a nearby health center. “The doctors found her to be in dire need of medical attention and blood transfusions, which they administered,” says Ms. Sheikh. “They narrowly saved her life and the life of her unborn child.” Ms. Sheikh is one of India’s many unsung heroes. Through timely and effective Sure Start interventions, these individuals are saving lives and bringing about tangible change from village to village, city to city, and life to life.
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