“Delivery Van” and “Bike Ambulance” in Kandhamal
Kandhamal district in Odisha lies in the high altitude zone with inter spreading inaccessible terrain of hilly ranges and narrow valley tracts. Almost 66 percent of the land area of the district is covered with dense forests and towering mountains comprising of 12 rural tribal blocks. The problem here has been the fact that as tribals dwell in the scattered remote pockets in the hilly terrains and dense forests, number of welfare schemes in general and those relating to health in particular do not reach them.
However, things have changed in the last two years on the health front. As an “ASPIRATIONAL DISTRICT” of the country, both the state and central governments have coordinated to make health services available for general patients, particularly for pregnant women and the new born.
Earlier the tribal childbirths were usually conducted by untrained “Dhais” in the village and the pregnant women hardly went to a local hospital for delivery. Traditional healing systems were given more importance over institutional systems, leading to several deaths. Childbirths were usually conducted by untrained ‘dhais’ in the villages, as community norms treat childbirth as part of a natural process, not requiring much external intervention.
But now, the district administration, to encourage Institutional Deliveries in hospitals, has introduced Delivery Vans, touted as the first-of-its-kind initiative, in the state. To bring the community on board, the district doubled its efforts for increasing the demand and supply-side interventions.
The district administration, to encourage “Institutional Deliveries” in hospitals and other facilities, has introduced Delivery Vans, touted as the first-of-its-kind initiative, in the State. As the district is having the highest number of difficult villages (914) and as there is less number of 102 Ambulance Vehicle, the District Administration took an innovative step like Delivery Van & and Bike Ambulances.
Considering the instances of delivery on the roadside and under the tree in some hard to reach areas of Phiringia Block, an innovative “Delivery Van” has been designed. The vehicle is equipped with all necessary instrument & equipment required for normal delivery, water facility, delivery table etc. Two trained Staff Nurses, attendants along with essential drugs and consumables are stocked in the van to provide required care to the mother for safe delivery of the child in emergency situations.
On the supply side, all delivery points have been made functional. Five (5) Bike Ambulances and 11 Janani Auto vehicles were deployed in outreach pockets where there were more incidents of high home delivery. Seven (7) Maternity Waiting Homes (MWHs) were also established that have significantly contributed to the Institutional Deliveries. Apart from the ‘108’ and ‘102’ Ambulance service, all existing vehicles including Government Ambulances, “Arogya Plus” vehicles, MHU & MHT vehicles were also engaged to transport pregnant women to the Government health facilities.
On the demand side, awareness generation activities were undertaken to improve the intake of the services provided. The Bike & Auto Ambulances along with the Delivery Vans in Kandhamal have improved the last mile connectivity for pregnant mothers. As a result, the rate of Institutional Deliveries in Kandhamal is now the highest in the State at 97% & maternal deaths have reduced by 65%.
It may be noted that the Aspirational Districts Programme (ADP) was launched by Prime Minister Narendra Modi in January 2018 with the vision that renewed focus and incisive interventions in the most backward districts of India are imperative to achieve inclusive and holistic growth. Anchored by NITI Aayog, the programme rests on the three pillars of Convergence (of Central and State Schemes), Collaboration (between Centre, State, District and Citizens) and Competition (among the districts through NITI Aayog’s Champions of Change dashboard), with the underlying spirit of the mass movement. Health and Nutrition, Education, Agriculture and Water Resources, Financial Inclusion and Skill Development, and Basic Infrastructure are the programme’s core areas of focus measured through 49 key performance indicators. Districts are aspiring to first catch up with the best in their State, and subsequently aspire to become one of the best in the country, by competing with, and learning from others in the spirit of competitive and cooperative federalism.