Grassroots work to promote maternal health in tribal areas: Seba Jagat

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Many times we wonder how grassroots level organisations work, what activities they carry out! In this second part of the series “Illustrations from the Indigenous Communities”, we shall find out about some tribal communities  of Odisha (and learn to speak the Panga language!) as well as how Seba Jagat, a community based organisation that I am placed with as an AIF Clinton Fellow, is working to promote maternal and child health in Kalahandi district.

Tribal Communities in Odisha

As per the Odisha Economic Survey, Odisha is home to 62 scheduled tribes (many are still not listed); 8 out of 30 districts of Odisha have more than 50% tribal population and 6 districts have 25%-50% tribal presence. In terms of distribution of tribal communities, Odisha (9.2%) comes third after Madhya Pradesh (14.7 %) and Maharashtra (10.1%). Within Odisha, the tribal people constitute 22% of the state population and 9.19% of India’s total population. Some of the major tribes found in Odisha are:

Gonds

Santhal

Oraon

Munda

Khond

Kol

There are 13 Particularly Vulnerable Tribal Groups (PVTGs) having less than 1000 persons in Odisha, the highest for any Indian state. Some of them are Mankidia, Birhor, Paudi Bhuiyan, Juang, Chuktia Bhunjia, Dongria-Khond and Khadias. The people face challenges similar to the indigenous communities across India such as inadequate access to social welfare services related to education, health, livelihoods generation and so on. One of the major social concerns is high infant and mortality rate. According to the National Family Health Survey 2015-16 (NFHS-4), Odisha recorded an infant mortality rate of 48 per 1,000 live births.

Cultural Overview of Tribal Communities Served by Seba Jagat

Seba Jagat is the implementing partner of UNICEF’s Sampurna Barta in 44 Gram Panchayats, 753 villages, 621 Gaon Kalyan Samiti, at 36 Sub-Centres in M. Rampur and Lanjigarh Blocks of Kalahandi, to promote the maternal and infant health in a holistic manner by working with key stakeholders. The population in one village varies from 50 to 200 households. The family members range between 4 and 5. Notably, in the plains one family usually has 2 to 4 children. In contrast, the families from hilly regions (locally called the ghaat areas) have 10-12 children each. The varying literacy rate, awareness of family planning, social customs among people cause this stark difference. Seba Jagat engages with many tribes, such as Panga, Desiya, Kotiya, Kondha and Gond.

Odisha is a culturally rich state. The diverse tribal communities have their own unique cultural practices and art forms. Ghumra dance and Dhap dance are famous in Kalahandi. Now the tribal women wear saree but earlier they wore two towel-like clothes on upper and lower parts of body. Some wear 25 rings in their ears in everyday life. All the tribal languages are not only different from one another but also distinct from Odia, the official language of Odisha. Jagyanseni Bhoi ji from Seba Jagat learnt the Panga language while engaging with the Panga people. It is similar to the Dravidian languages, such as Telugu and Tamil. She has shared some phrases to get one started with this language:

How Seba Jagat Promotes Infant and Maternal Health?

Under the Sampurna Barta programme, Seba Jagat actively works with multiple stakeholders including women and adolescent girls, frontline health workers, community mobilizers and influencers, Gram Panchayat Extension Officers, members of the Integrated Child Development Scheme (ICDS) as well as the district administration. After Odisha reported its first case of COVID-19 on 15 March, 2020, Seba Jagat continued to provide essential services to pregnant women in spite of the lockdown restrictions.

Village Health Sanitation and Nutrition Day (VHSND)

Every Tuesday and Friday, the Village Health Sanitation and Nutrition Day (VHSND) is organised at the village Anganwadi centres, wherein Seba Jagat also participates and supports to ensure the quality of services. They generate awareness, distribute iron-folic acid and dry ration to expecting mothers from tribal communities. Here the Auxiliary Nurse Midwife (ANM), Anganwadi worker (AWW), Helper and Accredited Social Health Activists (ASHAs) measure the weight, haemoglobin and sugar levels of the pregnant woman. These indicators help to evaluate the health of women and to foresee any risks.

To encourage the women to consume a balanced diet, nutritious green vegetables are demonstrated and Take Home Ration (THR) is provided so that they can right away start taking extra care of their health.

Members of Seba Jagat conduct home visits to follow up with women whether they are having nutritious food and consuming the iron tablets or not. They also break misconceptions regarding the medicines and institutional delivery.

If someone does not turn up for the meetings, the volunteers from Seba Jagat rush to inform the ‘influential person’ in that village who encourages the family to attend the camp. The people trust this person and follow his / her advises.

Mamta Meetings

The ‘Mamta meetings’ (motherhood meetings) are held for pregnant ladies in villages by Seba Jagat members, ASHAs and AWWs. They make the women aware of government schemes like Janani Surakya Yojana (JSY), Janani Shisu Surakshya Karyakram (JSSK).  They register them to avail their entitlements under these schemes, such as direct cash transfers up to Rs. 6000 in 4 tranches to their bank account and, free treatment to mothers and infants at public health centres respectively.

The volunteers note how many pregnant ladies are in a village, check whether they are registered and have bank accounts. Those who have no bank account, Seba Jagat helps them in opening it. The volunteers assist pregnant women who are about to go in labour and live in isolated areas, to get admitted to the Maa Gruha or ‘Maternity Waiting Homes’ set up by the Government of Odisha.

Capacity Building of ASHAs and AWWs

Seba Jagat regularly conducts training sessions of the health workers including 265 ASHAs and 394 AWWs under Sampurna Barta. As part of the program, they meet the people, facilitate forum meetings or Jaati Sabha among the Scheduled Tribe and Scheduled Caste. Here they discuss family planning, above 18 age of marriage, prioritize institutional delivery, prohibition of dowry and so on. Seba Jagat trains adolescent girls to volunteer. In batches of 20 to 40, the girls discuss issues of child marriage, Covid-19, reproductive health and so on. These future change-makers accompany the Seba Jagat staff during home visits and counselling session. Involving them is the best way to sustain such behavioural change among women to take care of their reproductive health, and also influence the rest of the society.

For sustainable change to take place, persistent efforts need to be undertaken. Community based organisations such as Seba Jagat are trying to bring about positive social change through collaboration with individuals, communities, government and international organisations.

In the next and final part of these series, we shall meet a group of individuals from the community who has been impacted by the work of Seba Jagat.

References:

National Family Health Survey 2015-16 (NFHS-4): District Fact Sheet, Kalahandi, Odisha. Ministry of Health and Family Welfare Government of India, http://rchiips.org/nfhs/FCTS/OR/OR_FactSheet_395_Kalahandi.pdf.

Odisha Economic Survey 2019-20. Planning and Convergence Department, Directorate of Economics and Statistics, Government of Odisha, Feb. 2020, https://pc.odisha.gov.in/sites/default/files/2020-03/Economic_Survey_2019-20.pdf.

*A previous version of this article was originally published on February 05, 2021, by the American India Foundation: https://aif.org/grassroots-work-to-promote-maternal-health-in-tribal-areas-seba-jagat/

Author Bio:

Anushri is serving as an American India Foundation (AIF) Clinton Fellow with Seba Jagat in Kalahandi, Odisha. For her fellowship project, she is developing a case study to reduce the impact of COVID-19 on the community by identifying innovative practices and traditional health related practices, documenting processes, analyzing qualitative and quantitative data, and measuring indicators. Anushri is a passionate development professional who has completed her double Masters in Social Work and Political Science from the University of Delhi. She is excited to serve as an AIF Clinton Fellow with Seba Jagat in one of the most underdeveloped districts of India – Kalahandi, Odisha. For her fellowship project, she will be engaging in project management of their ongoing effort to reduce the impact of COVID-19 on the community and in the implementation of the Sampurna and rural sanitation programme aiming to reduce infant mortality rate and maternal mortality rate in the area. Anushri has interned at the United Nations Development Programme’s (UNDP) Plastic Waste Management Programme where she worked on the Financial Inclusion of the waste picker community. During the COVID-19 lockdown, she registered domestic workers in the Public Distribution System to receive rations guaranteed by the government. She also made video-stories for Delhi-based and Rajasthan-based Community based Organisations to generate awareness about their work and to raise resources to continue their work. As an AIF Clinton Fellow, she will be venturing into a once-in-a-lifetime opportunity of working at a place with immense scope to learn and bring about change. She hopes to be an asset to her host organization and achieve their objectives through dedicated efforts. She envisions building skills in project planning, implementation, and monitoring and evaluation by the completion of her fellowship.

AIF’s William J. Clinton Fellowship for Service in India is a fully funded, interdisciplinary, experiential learning program that places young professionals in service with communities in India for ten months. In partnership with local NGOs, Fellows learn about inclusive leadership in poverty reduction through collaboration and capacity building.