*Y.C.* Dayako Sagar (Ocean of Mercy) Maternal Health Program
ECTA wants mothers to have better options. ECTA's goal is to provide access to ante-natal care, post-partum care, a trained and equipped birth attendant and the materials necessary for a safe and hygienic birth to every mother in the region of service. With the help of the Village Health Workers (VHW) all pregnant women will be visited in their homes monthly to receive information about nutrition, the development of their fetus, hygiene, and warning signs to look out for during pregnancy. These monthly services will also provide proper screening and care for the mother. In their 8th month each mother will receive a home birth kit. This is to ensure that the mother will at least have the needed materials for a hygienic birth if she chooses to stay at home for her delivery, does not have time to reach a healthcare facility, or is not able/does not wish to call the VHW. Each birth kit will include clothes for the baby at the time of birth, receiving blanket, sterile cord clamps, a sterile razor for cutting the cord, soap to wash hands, medication to stop hemorrhages, and an instruction sheet to guide the woman through the birth. Instructions are written in Nepali with illustrations for the illiterate woman.
The VHW sells the kits for the cost of the materials enclosed plus a moderate mark up to provide income for the VHW. The receiving blanket and clothes for the newborn will be subsidized by ECTA. VHW’s are trained by ECTA to oversee births in a hygienic and compassionate manner, to identify signs and symptoms which warn of potentially life threatening conditions, and given the confidence to transport these women in their time of need. They are equipped with proper instruments and training necessary to prevent a maximum number of mother-child mortalities. Mothers will also receive post-partum visits so that potential complications, such as infections, can be identified before they become serious.
There will be four levels of potential care made available to every mother:
Level 1: Basic birth kit for an unattended home delivery
Level 2: An assisted home birth attended by a trained and equipped VHW.
Level 3: Treatment given by a healthcare professional inside the ambulance or at the Kaffer clinic.
Level 4: Emergency transport in the Naya Jeevan Ambulance to a hospital with surgical facilities.
This initiative will give women who decide to deliver at home a healthier birth and provide access to specialized care for those who desire help at the time of delivery. Another important aspect of the initiative is the development of community based health care. The Dayako Sagar Maternal Health Program was created cooperatively with members of the village community in order to create local ownership and sustainability.
About You
Section 1: About You
First Name
Amanda
Last Name
Phillips
Organization
ECTA- International
Country
India, WB
Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?
Yes
Section 2: About Your Organization
Organization Name
ECTA-International
Organization Website
Organization Phone
303-335-0206
Organization Address
3889 Beasley Drive, Erie, CO 80516
Organization Country
United States, CO
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Your idea
Name Your Project
*Y.C.* Dayako Sagar (Ocean of Mercy) Maternal Health Program
Country your work focuses on
India, WB
Describe Your Idea
ECTA wants mothers to have better options. ECTA's goal is to provide access to ante-natal care, post-partum care, a trained and equipped birth attendant and the materials necessary for a safe and hygienic birth to every mother in the region of service. With the help of the Village Health Workers (VHW) all pregnant women will be visited in their homes monthly to receive information about nutrition, the development of their fetus, hygiene, and warning signs to look out for during pregnancy. These monthly services will also provide proper screening and care for the mother. In their 8th month each mother will receive a home birth kit. This is to ensure that the mother will at least have the needed materials for a hygienic birth if she chooses to stay at home for her delivery, does not have time to reach a healthcare facility, or is not able/does not wish to call the VHW. Each birth kit will include clothes for the baby at the time of birth, receiving blanket, sterile cord clamps, a sterile razor for cutting the cord, soap to wash hands, medication to stop hemorrhages, and an instruction sheet to guide the woman through the birth. Instructions are written in Nepali with illustrations for the illiterate woman.
The VHW sells the kits for the cost of the materials enclosed plus a moderate mark up to provide income for the VHW. The receiving blanket and clothes for the newborn will be subsidized by ECTA. VHW’s are trained by ECTA to oversee births in a hygienic and compassionate manner, to identify signs and symptoms which warn of potentially life threatening conditions, and given the confidence to transport these women in their time of need. They are equipped with proper instruments and training necessary to prevent a maximum number of mother-child mortalities. Mothers will also receive post-partum visits so that potential complications, such as infections, can be identified before they become serious.
There will be four levels of potential care made available to every mother:
Level 1: Basic birth kit for an unattended home delivery
Level 2: An assisted home birth attended by a trained and equipped VHW.
Level 3: Treatment given by a healthcare professional inside the ambulance or at the Kaffer clinic.
Level 4: Emergency transport in the Naya Jeevan Ambulance to a hospital with surgical facilities.
This initiative will give women who decide to deliver at home a healthier birth and provide access to specialized care for those who desire help at the time of delivery. Another important aspect of the initiative is the development of community based health care. The Dayako Sagar Maternal Health Program was created cooperatively with members of the village community in order to create local ownership and sustainability.
Innovation
What makes your idea unique?
The Dayako Sagar Maternal Health Program was created cooperatively with members of the village community in order to create local ownership and sustainability. The unique aspects of this initiative are:
Holistic health care: ECTA has created a framework that utilizes other communal health-based initiatives which work to ensure the long-term health of mothers, children, and families in the region. Village Health Workers (VHWs) are trained to assist in home deliveries, provide pre and post natal care, educate on preventative health, and provide emergency assistance.
Empowerment: Many women in this area are afraid to have children because of the abuse they will face in the local hospitals or because they risk death in childbirth if they decided to deliver on their own. These women lack education and resources and are often dependent on men to make choices for them. With the Dayako Sagar Maternal Health Program women are empowered with knowledge and alternative options in order to make their own decision. If a woman decides to have a traditional home-birth a VHW will offer home-birth kits, proper training, and follow-up care. Women can also decide to have an assisted birth with a VHW.
Sustainability: VHWs are trained and given access to logistics and support necessary to ensure that their efforts to impact maternal health last longer than ECTA’s presence.
Communal Engagement: This initiative was created with the voices of the community. Village members were active in assessing their needs and sharing stories in order to develop a program that would work within their culture and community. VHWs are members of the community who have been trained to serve making this program sustainable in the long term without outside assistance.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
Twenty Village Health Workers have been trained and equipped to work with mothers and families compassionately and with professional care as they go through the prenatal, birthing, and postpartum process.
Hundreds of pregnancies have been overseen by ECTA Staff and/or VHWs, and even more have been assisted through home-birth kits and education.
Systems and processes have been set in place through partnerships with Indian NGO’s which provide for the continued training and maintenance of the maternal and infant health programs.
Hundreds of home birth kits have been distributed.
Damaging cultural norms have been challenged and impacted. Women have been empowered and equipped to make decisions regarding their health and the health of their children. Families have been educated in how they can be a part of the birthing process. Children and women have often been cast as of lower importance due to the high mortality rate. With this initiative they are now valued more highly and their health needs are regarded as important to the community.
Problem
Women in these remote villages of India lack an infrastructure, government or otherwise, that ensures their well being and that of their child. Cultural norms promote the marginalization of women and children. With a lack of education and support, women are often dependent on men to make their decisions about health care which often promote women as “second class citizens.” Women in the villages are afraid to use the local hospital because mothers are beaten in labor by the nurses, placed in soiled beds, forced to use bathrooms with sewage on the floors, and are made to leave without an overnight stay or post-natal education after birth. The local hospital is not a great option for receiving care, yet child birth at home can be just as dangerous. Many women die in child birth due to a lack of proper training, unsanitary equipment, or lack of pre and post natal care.
Actions
ECTA has created a holistic health program for the villages beginning with a health education program for children in schools to teach general sanitation and preventative health measures. Along with this program, Village Health Workers are trained to the level of EMT in order to assist with medical needs of the community. The VHWs learn business skills in order to create a sustainable micro enterprise. A small clinic has been built for the local villages.
The VHWs are also trained to educate women on health issues, monitor pregnancy, and assist in home deliveries. In the case that a woman does not want to have an assisted birth, VHWs have home delivery birth kits.
Another aspect of the program is the emergency services. ECTA has partnered with other Indian NGOs to provide continued health care for villagers and an ambulatory service.
Results
This program has resulted in an increased knowledge about health issues among the local populace. The increase of knowledge has led to a shift in cultural norms for women. Women in these villages are being empowered to make decisions about their own health care. More women are having healthy births with health worker assistance, birth kits, and proper education. The decrease in the maternal and infant mortality rates is also due to follow up care and sanitation. These preventative measures reduce the risk of infections.
Another result of this program is the community development. We have now trained 20 Village Health Workers who can serve in their communities to assist with births and also meet a host of other health needs. The VHWs have a sustainable micro-enterprise that will meet the needs of their family while still supplying affordable care to the village. This program is fully sustainable in one village and we hope to see sustainability in another village soon.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
-Continued financial support
-Expanded financial support to cover $20,000 needed to start program in neighboring villages
-$18,000 for an ambulance
-Continued in-kind support (supplies for birth kits, etc)
-Continued partnership with Indian NGO’s
-Healthy relationship with community
-Medical volunteers to train village health workers (Three to four volunteers that can commit to six month period)
-Sustained international awareness of Indian maternal health issues
What would prevent your project from being a success?
-Inadequate training for health workers
-Poor relationship with community
-Lack of funding
-Lack of international awareness for maternal health issues
How many people will your project serve annually?
More than 10,000
What is the average monthly household income in your target community, in US Dollars?
Less than $50
Does your project seek to have an impact on public policy?
Sustainability
What stage is your project in?
Operating for 1‐5 years
Is your organization a
Non‐profit/NGO/citizen sector organization
Is your initiative connected to an established organization?
Yes
If yes, provide organization name.
ECTA-International
How long has this organization been operating?
1‐5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have a non-monetary partnerships with NGOs?
Yes
Does your organization have a non-monetary partnerships with businesses?
Does your organization have a non-monetary partnerships with government?
Please tell us more about how these partnerships are critical to the success of your innovation.
Our partnership with Hayden Hall gives us access to an established curriculum and support organization continually seeking to improve and expand upon its vocational medical training program. By working together, we have melded community and organization into a symbiotic whole which addresses the holistic needs of the community through a respected and nationally recognized support structure. This ensures that long after ECTA is gone, there will be a continued method by which health workers can be trained.
Our partnership with CDMU gives us and all associated health workers access to a local logistics support system which provides low-cost, quality medical equipment and medicines. In working with CDMU, all village health workers, even after ECTA turns over all operations to the local populace, will have continued access to this supply line thus enabling them to successfully operate as sustainable village enterprises.
What are the three most important actions needed to grow your initiative or organization?
The most urgent action focuses upon expanding current vocational training for Village Health Workers, increasing their numbers, and maintaining a presence aimed at nurturing the sustainability of their micro-village enterprises. This is to be undertaken utilizing existing training methods, as well as engaging in a 'train the trainer' mentorship program, wherein existing village health workers could effectively mentor other local volunteers who would wish to start their own village health practices.
The second most urgent need is currently a mobile clinic, to be operated by a volunteer base of village health workers and ECTA personnel which will enable more efficient access to urgent care for all health concerns. Currently, many villagers face a three to six day journey to get to the nearest medical care. By providing a mobile alternative, their time to care could be cut to a fraction of what it currently is, saving countless lives and setting in place a sustainable operation which could be expanded upon in the future.
The third most urgent need is for an expanded medical care facility in or near Kaffer to provide additional levels of care to would be patients. Currently, ECTA is exploring the purchase of unused hotels in the area to transform into hospitals staffed by volunteer Indian doctors, VHW's and ECTA personnel. This would provide a compassionate, safe and effective alternative to traveling to the nearest hospital, which often provides an inadequate level of care.
The Story
What was the defining moment that you led to this innovation?
I first considered becoming a midwife after learning that the majority of families in the Indian village had either a mother or baby which had died in child birth. We traveled back to the USA for the birth of our first son. It was a joy to hold Asher for the first time but our thoughts drifted back to India. We suddenly realized that if we were Indian villagers with no access to medical care that I and our firstborn son would be dead. We both resolved to dedicate our lives to finding and being the solution.
Then, in the delivery room of a poor village is where I learned what it really was like to be an Indian woman, to see my worst nightmare come alive. I was 14 weeks pregnant with my second child and having a miscarriage. I had tried bed rest to no avail and had to be carried on a stretcher to the nearest PHC, which was 3 hours away. I had lost a lot of blood, and my husband couldn’t get an IV in my already collapsed veins. The men of the village had to carry me in the dark on a rainy night. The doctor was asleep, the instruments were not sterilized, and no one took any of my vitals. If it weren’t for my medic husband, I would have died hours earlier.
I had seen D & C’s done before working in the government hospital. I told my husband, “I know exactly what is about to happen to me and it is my worst nightmare come true. I have seen how rough they are, how bad the women scream. You know I was reading today before this all happened that compassion means ‘to truly suffer with.’” This is how it all began.
Tell us about the social innovator behind this idea.
Amanda Phillips lives in Kaffer India along with her husband and their two amazing boys, Asher and Shepherd. She is a North American Registry of Midwives (NARM) Certified Professional Midwife, from the National College of Midwifery, and she has a B.S. in Science from CCU. Amanda has a heart to help the women in her neighborhood view giving birth as an opportunity for life instead of a chance for death. Assisting in births is perhaps the greatest thing in the world for her.
In 2003, Amanda and her husband sold their belongings and gave all that they had to start community development work in India. She has dedicated her life to empowering women and service to the vulnerable. Amanda values building community and listening to the voices of the marginalized, which can been seen in her life and work. Her two favorite pastimes are crocheting and teaching maternal/child nutrition.
How did you first hear about Changemakers?
Email from Changemakers
If through another, please provide the name of the organization or company
nomination for this competition
 | 108 weeks agoAmanda Phillips said: Thank you for all of your support and encouragement! about this Competition Entry. - read more > |
| 108 weeks agoSarah Lawton said: Amanda has an awesome mission and a huge heart for the Nepali women she works with. Just hearing the stories of her work is life ... about this Competition Entry. - read more > |
| 112 weeks agoAmanda Phillips said: The indepth answer can be found at http://ecta-international.org/endindx.php?wnext=three. Currently we are training VHWs that were ... about this Competition Entry. - read more > |
| 112 weeks agoBre Booren said: I love that you built this program through the community and really found what works with the culture. That is the key to having a ... about this Competition Entry. - read more > |
| 117 weeks agoAmanda Phillips said: Thanks for your question! We actually focus on education by training the Village Health Workers. They in turn visit women before birth ... about this Competition Entry. - read more > |
| 117 weeks agoSarah King said: You mentioned the fear many women have because of their lack of education and resources. How will you overcome this barrier? How will ... about this Competition Entry. - read more > |
| 117 weeks agoAmanda Phillips updated this Competition Entry. |
| 121 weeks agoAmanda Phillips submitted this idea. |
