A Study on

Experiences of Mothers and Service providers under JSY/ NRHM

AtSaikawt & Henglep TD Blocks

In Churachandpur Dist. Manipur

Researc

h Team

T. Zamngam

Dawnga

Khiangte

Mis. V

ahcha

Ms. Cheenny

(Zougam Institute for Community Resource Development – Manipur)

Authors

Peter Z

. Hangm

i

T.Zam

ngam

Background/Context(Socio-geo-politico)

C C Pur

Henglep

Saikawt

Henglep : Rural, Remote & Mountainous Saikawt : Small town close to district head quarter.

Background Geographical boundaries

Saikawt (Block A)& Henglep (Block B) in Churachandpur Dist, Manipur

Time boundaries Mothers who delivered during the last six months

preceding this study (Jan–June, 08) Stakeholders

Women :Saikawt 20, Henglep – 20 ASHA : Saikawt – 10, Henglep – 3 ANM : 1 each Doctor : 1 each DFWO, DMO, VA for secondary Data

Looking at the two blocksSaikawt PHC Henglep PHC

Joyous ride From Henglep to

Dist. Hqtr.

No labour room in both PHC

Research Objectives

Awareness level of mothers about JSY Health Service providers view about

JSY. Factors that determine women

choosing Home Delivery (H.D) Suggestions for improving the

implementation of JSY.

Methods: Sampling From Each TD Block

Random selection of vulnerable villages 10 each

1 ID & 1 HD each from each village selected 13 ASHAs randomly from the selected villages One ANM from Sub-centre Doctor each from the two PHC

Methods of data collection (Tools used) Indepth interview to Mothers (for Primary Data) Survey from ASHA, ANM & Doctors, DMO, DFWO,

Statistics Office (for Secondary Data) FGD (Mothers & ASHA for Primary Data)

From CHSJ: Short time period, Limited Finance

resource, Little guideline on the subject

From Authority concern: Less cooperation from concerned

authority. DMO.DFWO and State H&FWO.

Limitations

Results/FindingsSNo. Questions BLOCKA(n = 20) B(n = 20)

1 Registerd by ASHA. 100% 0%

2 Inst.identified before del. 85% 40%

3 Pvt. transportation availed 100% 0%

4 Receive TA 0% 0%

5 Receive full ANC from Govt. inst. 100% 0%From pvt. Inst. 0% 95%

6 ASHA visited 95% 0%

7 ANM visited 90% 0

8 TT and Iron Tablets. From govt. inst. 100% 0%

From private 0% 100%

Maternal Care

Block A – Saikawt PHC

Block B – Henglep PHC

SN Questions BLOCK

A n = 20

B n = 20

1 Know about JSY and its benefits. 90% 45%

2 Source (ASHA) 100% 5%

3 Do you get any JSY benefit? 10% 0%

4 Amount in Rupees (700) 10% 0

5 Service charged (Providers) 0% 5% pvt.

6 Service charge to Village Dai. 0 65%

7 Have JSY Card. 0% 0%

8 Home delivery 20% 65%

9 Institutional delivery 80% 35%

Awareness & Benefits of JSY Scheme

Why did not deliver at govt. facility?

Sl.Reasons

BLOCKA

n = 20B

n = 20

1 Couldn’t afford facility* 50% 60%

2 No JSY benefit even if in inst.

65% 5%

3 Distance Location (02 – 100 kms)

60% 80%

4 Concept of interference to staffs.

5% 25%

* No medicine supply in govt. institutions.

Q.No. Questions ASHAn = 13

1 What is your age? 20 – 29 years 38%

30 and older 62%

2 When were you appointed/elected as ASHA? 2006 20072008

54%38%8%

What was the process? (All names are proposed by village chief)

Appointed by village chief, no election.

54%

Elected among many nominees

46%

Selection of ASHA

Q.No Questions ASHAn = 13

1 Have undergone trainings. 100%

2 Times of training undergone (2 full days each time)

(Training medium in Manipuri, not understood by Many ASHAs.)

1 time 23%

2 times 16%Above 3 times 62%

3 TA/DA during your training days. 100%

Trainings

ASHAn = 13

SN Questions

1 Participate in Pulse Polio program. 92%2 Give Health Education in village. 31%3 Organize VH Day 0%

4 Counsel pregnant women 100%

5 Accompany women 38%

6 Have VHSC in your village. 77%

7 Attend the VHSC meeting 77%

8 Get help from ANM. 100%

9 Women get TT Iron tablets. 100%

Roles and Responsibilities

ASHAn = 13

Q.No Questions

1 Village received Untied Fund. 85%

2 Receive incentives/compensation under JSY Scheme.

0%

4 The women you registered getting JSY payment.

8%

How many women? 3 Amount

Normal 2 Rs. 700

CS case 1 Rs. 700

Incentives/Compensation

Unheard Voices

Mothers : “Poorly treated in govt. hospital. No medicine supplies, expensive. No JSY Benefit as told”.

ASHAs & ANM : “Mothers don’t trust us any more. Only 3 out of all 40 women received money”.

Doctors: “Funds disbursed only at district H/Q. Women are waiting their turn, serial number published in local newspapers. So we are helpless”.

Conclusions

Implementation of JSY Block “A” avails a better facility of the scheme. Block “B” far and remote, mountanous area,

inaccessible to the scheme. However, JSY incentives/compensation has not

been given neither in town nor remote areas. Thus, No improvement in institutional delivery

according to the findings.

Most serious challenge to inst. Del. in both blocks Poor treatment by staffs in govt. facility Lack of prompt payment of JSY payments.

Recomendations

Comment: To Improve fund flow system district level, state level

and national level. To provide more systematic transportation referral To strength Private Public partnership system (PPP)

One big Suggestion : To introduce SOCIAL SERVICE DEPARTMENT in

medical institutions nation wide. Social workers should be

Licentiate by govt. Fully recognized and supported by Human Rights

Commission of the country