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NEWS |
| 24 Dec 2010 |
 JICA TQM Consultant invited as Guest Speaker for the Seminar on Bio Medical Waste Management in Gwalior (24th December 2010) .. .....Details |
| 16 Dec 2010 |
 The Common Review Mission visits Damoh district (16th - 22nd December 2010) .. .....Details |
| 6 Dec 2010 |
 National Dissemination Seminar of JICA MP RH Project held at NIHFW, New Delhi .. .....Details |
| 19 Nov 2010 |
 JICA Consultants oriented the Data Officers of DoHFW on use of GIS .. .....Details |
| 13 Nov 2010 |
 JICA team invited for the Partners Forum on Womens and Childrens Health, New Delhi .. .....Details |
| 19 Oct 2010 |
 JICA TQM Consultant invited to present a paper at the Asian Network for Quality Congress Delhi 2010 .. .....Details |
| 12 Oct 2010 |
 Dr. Kiran Ambwani, Deputy Commissioner (FP), MoHFW, GoI, visits Tikamgarh for the District level planning for MCH centres of Sagar division .. .....Details |
| 9 Sept 2010 |
 Dissemination Seminar held to share the findings of the Terminal Evaluation Mission .. .....Details |
| 8 Sept 2010 |
 Joint Review Meeting of JICA Project held on 8th September 2010 .. .....Details |
| 30 August 2010 |
 JICA TQM Consultant presented a poster at the Global Maternal Health Conference .. .....Details |
| 17 August 2010 |
 Madhya Pradesh becomes the first State to start the Public Health Management course at State owned Health Institute (SIHMC), Gwalior .. .....Details |
| 14 June 2010 |
 JICA TQM Consultant invited to present paper at Lal Bahadur Shastri National Academy of Administration, Mussoorie .. .....Details |
| 15 June 2010 |
 Chief Representative, JICA India Office visited Project site .. .....Details |
| 24 May 2010 |
 JICA Consultant nominated by DoHFW, GOMP, for Training of Master Trainers on BEmONC at New Delhi .. .....Details |
| Abbreviations |
COUNTERPARTS |
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| Ministry of Health & Family Welfare |
| Department of Health & Family Welfare |
Bundelkhand Encyclopedia
ETHNOGRAPHICAL ACCOUNT OF REPRODUCTIVE HEALTH PRACTICES IN BUNDELKHAND
This is a brief ethnographical account of the prevailing socio-cultural
practices during the ante natal, intra natal and post natal period. It
highlights the findings collected during the course of JICA Project field
work.
Age at Marriage
The age at marriage varies from 14 to 18 years. There are some villages
where the age of marriage has gone up to 18 years and above. This is mainly
because of the increased awareness regarding the legal age of marriage.
Age at First Conception
Since no family planning methods are used, the age at first
conception is at times as early as 15 years. The range is in between 15- 19
years.
1) ANTE NATAL PERIOD
Detecting Pregnancy
There is no formal tracking of the date of Last menstrual period. The usual
practice is to keep track of the time the hair was last washed. The track is
usually kept with reference to some festival or cropping pattern or Hindi
calendar months.
Disclosing Pregnancy
Pregnancy is disclosed to peer group first, then the sister in laws, friends
and co sisters. There is no formal disclosure to the family members per se.
Many a times they come to know because of the symptoms like nausea and other
times when the pregnancy is visible physically.
Nutrition during Pregnancy
In most of the places, the nutritional intake reduces since they don’t feel
like eating. They eat only “what the child wants”. In some villages, the
women were reported to be eating mud during pregnancy. No special nutritious
foods are taken.
Rest during Pregnancy
The women work till the last hour of pregnancy. Even if they do get tired,
the fear of mothers in law forces them to keep working. There is no notion
of rest. In villages like Kutpura, in Tendukheda block of Damoh district,
the pregnant ladies have to carry water for long distances (as much as 4
kms.).
Approaching the AWW and ANM
The women approach the AWW for the immunization of TT. The AWW in turn tells
the ANM. However, they are not aware of the time when they should be
availing the TT shots. Some were reported to approach the AWW as early as
4th month. Most of the women still prefer that the ANM comes to their house
to give the TT shots. The families do not have to spend any amount for this
service and the community is well aware that this is a free service
available from the Government.
It should be noted that this is the first formal (public) disclosure of the
fact that the woman is pregnant and the registration of
pregnancy happens at this stage. The usual trend is to approach the health
workers for the first time around 5-6th month. However, this range varies
from place to place and is dependent on the functional efficiency of the
ANM.
ANC services for community undertaking seasonal migration
Women who go out for seasonal migration come for availing the TT
shots as late as 8th month onwards. They usually don’t inform the ANM about
their pregnancy and come in the last stages to their home villages. In such
cases, the ANM is unable to give any ANC services to the woman.
Consumption of IFA tablets
Although the ANM and AWW give them IFA tablets, very few women were
reported to consume the tablets, Most of them don’t consume it because they
feel nausea or stomach upset problems after having IFA.
Seeking ANC check up
There is no practice of seeking ANC check up even once. Mostly the ANC check
up is confined to taking TT shots. Medical help is sought either from the
ANM or any private practitioner only in case of untimely pains or problems
during pregnancy. However, women who come to know of the schemes have
started availing the facility for ANC check up because the provision of the
scheme makes it mandatory to have minimum 3 ANC check ups.
2) INTRA NATAL PERIOD
Place of Delivery
Most of the deliveries take place at home. The trend of institutional
deliveries has recently been started due to the JSY. The well off families
seek the services of the private practitioners. In cases of complications,
the nearest Medical Colleges are approached.
Conducting the Delivery
As soon as the labor pains start, the Sayani (old and wise) women from the
household and neighboring houses gather in a room. The room is usually one
of the lesser used rooms. No preparation of the room is done before the
delivery. Around five such women help in conducting the delivery. The woman
sits in a squatting position on the floor, one woman sits on a cot in front
of her, two others press from the back and one or two others stay for
assistance. These women help the mother to deliver. The woman is asked to
bear down (exerting pressure around the anal area to push the baby out) even
before the cervix is fully dilated. In case the delivery goes on without
hindrance and there are no complications, the Dai is called for at this
stage and her role starts now.
In case of complicated labor or difficulty in delivering, pressure is put on
the abdomen, pressing it from above downwards, believing that with the
pressure the baby will be out. The buttocks are also given an upward push,
pressing against the foetal part, assuming that this would help the baby to
come out. In case of misproportion of the baby size and birth canal, the
presenting part of the baby is caught and given a pull resulting into tear
of the birth canal and profuse bleeding. In severe cases, the tear is so
grave that the anal canal is also torn. The profuse bleeding is allowed to
happen. The tear is not tended to and the traditional practice of using pads
of old and dirty cloth to soak the blood leads to infection of the wound.
This results in first the local infection and then spreads to the
Reproductive tract. Only in such grave conditions, when the situations are
out of control of the local women, is the help of ANM/LHV sought.
3) POST NATAL CARE
Care of newborn and mother by the Dai
The Dai is the main person responsible for the care of the newborn and the
mother. The freshly delivered child is laid on a Soopa (a tray made of cane)
and no one touches the child till the Dai comes. The Dai washes her hands
with hot water and cuts the cord of the child with a fresh blade supplied by
the family. A one rupee coin is kept at the base to cut the cord. This coin
is not sterilized. A new thread is then tied on the navel of the child. A
hole is dug in the room in which the cord and placenta remains are dumped
and a simmering cow dung cake is put on the placenta. The placenta burns for
4-5 days. In communities having higher awareness and education level, these
remains are disposed off outside the house. The child is then given a hot
water bath and covered with an old cloth and kept near the mother. The fluid
and other remains are cleaned by the Dai. The mother is also cleaned,
specially the lower areas. The mother and child are then given Dhooni
(fumes) of materials like Neem (Azadiracta indica) and Ajwain. The room is
also cleaned by the Dai. The mother is then given a massage by the Dai. The
mother is then given a cup of hot tea. The child is fed with cow or goat
milk with a cotton wick.
Rituals observed in the Post Natal period
On the second day, the Dai does all the cleaning
and the mother is given traditional sweet (Ladoo and gur). The child is
massaged from the second day onward. A tradition called Charua is observed
wherein 7 married women offer prayers to the earthen pot filled with water.
This water is then boiled and given to the mother.
This practice continues till the pollution period finishes
(Sootak uthana). The Pandit declares when the pollution period, which lasts
for 4-5 days after delivery, is over. The Barethan (woman
from the washer community) is called to wash clothes and the Khwasan (woman
from the barber community) to cut the nails is also called. Thereafter the
room is besmeared with mud and cow dung.
Once the pollution period is over, the mother is allowed to breast feed the
child and is also served full meal.
On the tenth day, another ritual called Galta is observed
and the mother goes to the well to offer prayers (Kuan poojan). Her parents
and other immediate family members bring gifts for the groom’s family
members. A party is thrown to celebrate the coming of the new born. The
celebrations are more pronounced and vibrant in case of a boy child. It is
assumed that the mother will assume her daily chores from this day onwards.