ARTH has been working in rural-tribal areas since 1997, with a major focus on maternal, neonatal and child health (MNCH). It has since expanded to other areas like, sexual and reproductive health, malnutrion among children and health of older persons.
ARTH has used a basic midwifery care model to attend 17,193 deliveries at 2 of its 3 health centres, each located in Udaipur and Rajsamand districts. These health centres, one at Iswal and another at Lakhmawato ka Guda, provide 24×7 delivery services. Nurse-midwives live on campus and are therefore available round the clock – including on festivals/holidays and long weekends. Additionally, clinic attendants and Skilled Health Assistants (SHAs) are also present at the health centres as part of the staff. All nurse-midwives are provided with training to provide safe maternal and neonatal health care services in interior areas without requiring continuous presence of a doctor. However, gynaecologist doctors visit the centres twice a week to provide outpatient services and a doctor is always available for telephonic consultation in case of a complication.
The following services are provided by the team at ARTH’s health centres:
- Maternal and neonatal care including ANC, delivery, post-delivery mother and newborn care and postpartum care
- Reversible contraception
- Pregnancy confirmation and counselling
- Primary care for adults and children
Upon visiting, the doctor provides the following services:
- Safe, legal abortion in the first trimester
- Management of reproductive tract infections, infertility and other gynaecological disorders
All deliveries are monitored and conducted as per WHO norms. Nurse-midwives also keep a close watch for complications, and if needed initiate emergency treatment to stabilise the patient, and/or refer the patient to the District Hospital in Udaipur. Meanwhile a doctor is informed of all complications telephonically. The patient’s family is provided with all details in case of a referral. Nurses help them arrange for a vehicle if needed. ARTH’s helpline worker receives the family upon arrival at the District Hospital and supports them with admission and receiving care. Additionally, the nurses provide a detailed referral note, which has been appreciated by the District Hospital.
Nurse-midwives have managed cases like primi with breech presentation, shoulder dystocia, severe anaemia, APH, pre-eclampsia, PPH, etc. Since inception of its health centres, more than 50 nurse-midwives have worked with ARTH, many of whom have gone on to work in government hospitals.