May 14, 2013.
Well the last month here has been really busy with getting the maternal health project up and running. It’s a long and slow process of course but hopefully every step is part way to improving the well-being of a group of extremely marginalised people. The aim of this initiative is twofold: to raise awareness in the village of available maternal health services and also to bring about positive changes to harmful behavioral patterns while fitting in with cultural ideals. In order to do this we first of all need to know what services women know about, what they are and are not using and what behavioral patterns they are following…… And so began the long process of knowledge seeking.
It must have been three months ago now that I started working with Ash and Ed on preparing a survey that would answer important questions to do with pregnancy, childbirth and early childhood care. The survey was prepared in English and then translated into Hindi. Once this was done I had to prepare some of the female members of the Hunar Ghar staff along with some volunteers on how to carry out the survey.
Survey team orientation and training of staff and local volunteers at Hunar Ghar
This was quite a challenge for various reasons: Mainly I had not done anything like this before and nor had the women; and then there was the troublesome old language barrier! Luckily Deepak was on hand for the training sessions and I could not have done it without him. We prepared a two day training plan and informed the women of times and whereabouts. We were a bit late starting on the first day as some of the volunteers didn’t turn up so Deepak had to go and find them! The first day of training went well. It was mostly an information session on things such as ASHA/ anganwadi services, Government schemes, Iron Folic Acid (IFA) tablets, supplementary nutrition and immunisations. We had sourced information leaflets and videos which helped to get a discussion going on the subjects. The women seemed really interested and everybody enjoyed the day. The second day focused on how to carry out the survey and the technicalities of filling in the form. Unfortunately it didn’t go quite as well as I’d hoped and it was clear by the end of the day that the women were not entirely ready to go out in the field.
We had planned a pilot training session in another village close by so we went ahead with that two days later. The women worked in pairs making sure that one of the team members was fluent in the local language. Each team interviewed just two households and then I took the forms to assess them as by the quality control guidelines that I had set. There were a few problems occurring and so it was decided that we would have another days training session before going ahead with the main survey.
The next training session was focused on the technicalities of form filling. We had planned different exercises that helped the women to identify the problems that they were having in terms of form filling. They worked well together, asking lots of questions and were obviously keen to understand how to make a good job of the survey. I was pleased with the response to the session as I could see that the women were gaining confidence, interested and understood the importance of going out and getting real results. Without this it would be pointless going and carrying out the survey.
Survey team in action in Bakhel
We began the main survey the following day starting with just four houses per team. Again I took the forms to be assessed so that I could give the women feedback the next day. Unfortunately Deepak had to leave unexpectedly this day which was quite a setback for me. I was worried that I would not be able to organise everything on my own and that I would not be able to communicate properly with the teams. The women were great though and understood the difficulties that it would cause me. They made a real effort to speak slowly and be patient with my slow stuttering Hindi! We were out in the field for 9 days and interviewed 280 households. It wasn’t easy in the heat especially with the areas that are so spread out. The water in my bottle was warming up at a rapid rate…it’s amazing what you will drink when you have a thirst on though! The interviewers continued to have certain problems with the form which we did our best to address as they occurred. Also, some women were not too happy about answering the questions. Pregnancy and women’s bodies are rarely talked about and so understanding and encouragement was often needed. I have to say that I felt truly privileged to be able to go into people’s houses and gain an understanding of the real issues and problems for women in relation to their reproductive health. I will go in to more detail about this in my next blog when I will discuss the findings of the survey.
For now I will continue work on analysing the data that we came back with. I am now stuck in front of the computer for a while. I’d much rather be out in the village but the analysis is crucial in terms of deciding how we will move forward on the issue of improving the health and well-being of mother and child. Until next time…..
The full Maternal Health Survey team