To achieve the full life-saving potential that ANC promises, a minimum of four visits will be provided which include: Identification and management of obstetric complications, such as preeclampsia, tetanus toxoid immunization, identification and management of infections including HIV, syphilis and other sexually transmitted infections, counselling to promote institutionalized delivery with a skilled delivery person, deworming, treatment of anaemia, supplementation, IFA distribution, promotion of exclusive breast feeding, and the need for post natal visits. Labor, delivery, emergencies and ultrasounds will be referred to the hospital.
The most dangerous time for the mother and baby is within the first 24 hours of delivery. 50% of child deaths occur in the first 28 days and this is when, due to cultural norms, women and their babies rarely leave the house. PNC visits will be conducted at the home by a registered nurse. The PNC will incorporate preventive care practices and routine assessments to identify and manage or refer complications for both the mother and baby including: vital signs, feeding habits, and for the mother, signs or symptoms of infection, etc.
Health Education & Health Camps:
Health education is our passion at Bella Health. Health education empowers our participants by giving them the knowledge necessary for adopting healthy behaviors. Health education betters lives, families and entire communities. Bella Health provides health education through classes for adults and children, through our Adolescent Reproductive Health Program, through our health camps and screenings, and through our School Age Project. Health Education classes are provided to all patients who access our health care services. We encourage patients to return for health classes even when they are feeling better. Health education sets Bella health apart from other organizations. We hope this education will sustain the health of the community! The education we impart on them, will stay with them, encourage them to adopt healthy behavior, take a proactive approach to their health and have an intergenerational impact making families healthier. When we “exit “ we hope people will be empowered with the tools and resources to adopt a healthy life and be better able to advocate for their health and the health of their families.
Yakuban, from the village Markham Grant in Dehradun, said, “I was ignorant about the important biological functions of the female body. Things like the menstrual cycle and what is vaginal discharge and proper hygiene management during these days. After attending the class on menstrual hygiene, I feel empowered to make the right decisions about my health. I have become aware about the various sensitive health issues which are left ignored in our family”.
Health Education for Females
Bella Healthcare provides education to women and children who present themselves for health care services. The majority of patients who receive treatment also complete a health education class. Many women return to take health education classes, after their treatment is over, to learn more. Participants are awarded a gift and certificate when they complete 6, 12, or 18 classes. Our health educators have their Masters in Social work and are trained at Bella Health to conduct health education classes. Depending on the sensitivity of the topic, classes are taught by male or female educators.
Classes are supplemented with videos, posters, handouts to make it interesting, interactive and relevant. The number of classes that the participants attend is also tracked to ensure that the participants of 6/12/18 classes receive the awards/ certificates. To measure the effectiveness of the education we ask the participants pre-/post-test questions. We ask the participants the “pre” questions before the class to measure their baseline information and then ask the “post” questions after the class to ensure that the objectives of the class were met. This allows our team to evaluate the effectiveness of the education and endorse a more participatory learning environment. We also track the number of classes the participants attend. After the participants attend 6 classes they receive a certificate and present from Bella Health.
India has higher maternal mortality and morbidity rates than many neighbouring countries, even though its economy is booming. But this development has not equally benefited all parts of India, and in some places health indictors are actually regressing. The government has the policies in place to provide maternal health, but they are not implemented effectively. The government has failed when it comes to providing adequate health care facilities, trained medical staff, safe sterilization services, essential medicines, and an effective and timely facility referral system. Uttarakhand has some of the worst health indicators for maternal and child mortality rates in India. Antenatal care (ANC) and prenatal care (PNC) visits are essential to decreasing maternal and child mortality rates because they lead to early treatment and prevention of mother/child deaths. The WHO suggests that a minimum of 4 ANC visits and 3PNC visits are required for women going through pregnancy.
The Problem: Low health awareness leads to poor health outcomes. One study found that 200 million women in India have NO understanding of menstrual hygiene and the associated healthcare. 88% of menstruating women do NOT have access to sanitary napkins and use alternatives such as cloth, dried leaves, ash, hay or plastic. And the incidence of Reproductive tract infections is 70% more common in women who use unhygienic materials during menstruation. If we invest for improved menstrual hygiene education, it will enable the millions of girls to have healthier and more dignified lives.
|Month||Class 1, Weeks 1 and 2||Class 2, Weeks 3 and 4|
|March||Environmental Health||Educating Girl Child|
|April||Smoking||Educating Girl Child|
|June||Unsafe Abortions||Birth Control|
|October||Unsafe Abortions||Vaginal Discharge, Menstrual Hygiene|
|November||Nutrition||Girl Child Education|
Bella Healthcare conducts ‘Monthly Health Camps’ in various villages/slums to provide health promotion and education to large numbers of people. In 2013, Bella Health provided over 80 Health Camps among the target population, reaching nearly 8,000 participants. Health camps are tailored to educate families, with special emphasis on reaching head of the households. Since men are often responsible for allocating family resources for healthcare, food, education, medical treatment, hygienic supplies, and family planning, it is crucial to include and educate them on health topics. Classes are held in evenings and Sundays, when men are readily available.
|Name||Locations||No. of participants /Topic|
|Doon hospitals (Govt. Hospital)||Dehradun||1029 participants on various topics.|
|Norell Company||Selaqui, Dehradun||2000 participants on anemia, nutrition, vaginal discharge, STI/RTI, stress anagement.|
|Drikung Kagyu Nunnery||Shastradhara Road, Dehradun||488 participants on Menstrual cycle/ hygiene, anaemia, nutrition, cancer and more.|
|Slums: Kath Bangla , Bhagat Singh, Deep Nagar||Dehradun||750 classes on various Reproductive health topics including: MC, MH, Abnormal Discharge , Birth Control , STI/RTI, HIV/AIDS|
|Astitva , collaborating NGO||Dehradun||95 classes on nutrition, personal hygiene and environmental health|