Reproductive health is defined as the ability of a woman to live through the reproductive years and beyond with reproductive choice, dignity and successful childbearing, and to be free of gynecological disease and risk. Reproductive choice is a concept that allows a woman to exert control of her reproductive process and dignity refers to the social and psychological wellbeing woman derives from the process of reproduction. A woman’s health is not only a state of physical being, but it is an expression of the many roles she performs as a wife, mother, care-giver and wage earner, as well as her interaction with the social, cultural and economic world which influences her daily life.
Our innovation is to bring high quality reproductive health care services to these underserved and impoverished slums and rural villages using our state of the art diagnostic mobile health center. Health care services are provided at the doorstep by dedicated and highly skilled staff . The van is staffed with 2 doctors, 1 midwife, 6 nurses, 3 educational specialists, 2 pharmacist and support staff. All service delivery sites are fully equipped to perform pelvic exams, draw labs, conduct screenings, and dispense medicines. We follow a schedule and visit each village alternate weeks which lets us visit each village two times per month. We see patients from 10:00 until 4pm. The patients know that we are visiting their village because we have a consistent schedule and also utilize ASHA workers to convey the message of our arrival. Once the ambulance is parked, patients arrive. We see approximately 40 to 80 patients in one day. As we register the patients we take a complete health, pregnancy and family history and check vital signs. Then the doctors and nurses see the patients. We have the latest diagnostic equipment including fetal heart monitor, rapid tests for pregnancy, blood glucose, hemoglobin, UA, blood type, Rh, syphilis, HIV, malaria, Hepatitis B and Hepatitis C. These rapid tests allow our doctors to diagnose and subsequently treat on the spot. We give the patient enough medicines to last 2 weeks or until we return.
Quality and affordable reproductive health services are non-existent in our communities leading to poor health outcomes. Lack of health awareness leads to poor health outcomes and health education is practically nill within the communities we serve. There are many misconceptions concerning reproductive health and it is often seen as a taboo topic. The confluence of lack of services and misconceptions/lack of awareness in these communities leave the population vulnerable to greater morbidity and mortality from preventable causes, particularly in regards to reproductive health. In India, 1 woman is dying every 2 hours from unsafe abortions, even though India has one of the most liberal MTP laws. Unsafe abortions continue to outweigh safe abortions. Within our communities many women seek unsafe methods of abortion due to lack of access and lack of education, putting their lives and health at risk. RTI’s are rampant causing PID and in some cases infertility. RTI’s causing PID are seen in adolescents- even before they are sexually active and are seen in the majority of women after they deliver or undergo an abortion.
Birth Control/ Family Planning
Reproductive Tract Infection
Pelvic Inflammatory Disease
Dysfunctional Uterine Bleeding
Urinary Tract Infection
Care for menstruation related abnormalities such as dysmenorrhoea; reproductive tract infections & sexually transmitted infections , pelvic inflammatory disease and polycystic ovary disease
Maternal and Infant Health
Pregnancy testing, antenatal care including tetanus toxoid injections and vitamin supplementation, counseling, post-natal care visits and counseling (including post-natal home visits, general clinic for mothers and children and family planning
Oral Pills, Emergency pills, IUD, condoms, referral for sterilization, counseling and education services
Services for Men
Treatment and counseling for sexually transmitted infections, reproductive tract infections, and family planning
Pap smears, hemoglobin, blood sugar, urine tests, HIV, gonorrhea, chlamydia, HBV, HCV, blood group, malaria, pregnancy
Medications are dispensed per the doctor’s orders. Enough medicines are given to last 2 weeks. The latest most effective medicines are used.
Reproductive Cancer Services
Pap smear test, counseling and referrals as well as screening for breast cancer
For children, adolescents and women for ACUTE CARE needs such as infections, fevers, injuries
HIV Related Services
HIV testing, pre and post-test counseling, prevention counseling and referral for treatment.
For women who suffer from chronic diseases such as diabetes, hypertension, osteoarthritis, hypothyroidism and gastritis
The table shows the number of patients seen in each quarter of 2013 for reproductive health issues. Approximately 90% of all total patients in 2013 were seen exclusively for reproductive health issues. .
One patient said, “While I was pregnant, I started having abnormal vaginal discharge. I went to my doctor and was told that it was due to hormones, and after I give birth it would cease. After delivery, I started having pelvic pain and the discharge became heavy and smelly. I went to Rekha Clinic for a check up and found out that I had a reproductive tract infection. I learned about the abnormal vaginal discharge symptoms that shouldn’t be ignored. From the Bella Health classes, I learnt that one shouldn’t take health for granted. If someone has symptoms or if they are worried, they should take timely treatment before the problem increases.” .
Reshma came to our Rekha Clinic in Selaqui, complaining of severe lower abdominal pain, backache, and a frequent fevers. “I have visited many doctors and have been taking medicine for the past four years. But instead of improving, my health was deteriorating. I couldn’t do any more household chores. After I was told about Rekha Clinic, I got myself checked and was diagnosed with Pelvic Inflammatory Disease. During my pelvic exam, an infected Copper T was found. I was shocked when I was told about the care which must be taken after IUD insertion. I hadn’t been counseled about the signs not to ignore. Now, I can see so much improvement in my health. Besides quality treatment, counseling is also provided to every patient. The class on birth control has helped me in adopting a new contraceptive method.” .