We believe that maternal and child health are directly linked to the well-being of the community. Our health-centric community improvement initiatives focus on the dynamic relationship between health, socioeconomic conditions, and environmental resources. We take a holistic approach to healthcare by investing in nutrition, sanitation, clean water, education, and livelihood initiatives. These activities are a proven form of preventive care and contribute to lower infant and maternal mortality rates.
Sustainable Well Being Initiative
The 4 core components of the Sustainable Well-Being Initiative are:
- Preventive Health
- Environment
- Livelihood
- Awareness, empowerment, and engagement
Preventive care is an approach to healthcare that focuses on maintaining wellness and good health rather than treating illnesses when they occur. Preventive care is not only the most cost-effective approach to healthcare, but it is also designed to prevent or delay illnesses and diseases, which in turn increases life expectancy. Preventive measures decrease disease incidence and reduce the strain on limited healthcare resources.
Treating even one child with a serious condition incurs significant expenses. Limited health care resources are then diverted from multiple other children who could benefit with less expense. Thus, our goal is to prevent illnesses from becoming serious through education, awareness, and preventive measures. Taking a preventive care approach to healthcare enables us to efficiently use resources and maximize the number of children we are able to help.
The Challenge
- In India, illiteracy, poverty, and lack of awareness and access to healthcare resources contribute to the under utilization of healthcare services for routine infant, child, and maternal wellness checks.
- Limited healthcare resources, lack of adequate staff, medications and functioning equipment limit the number of people that can be treated in a timely and effective manner.
Solution
Ekam’s goal is to maximize the number of lives saved or treated, with a cost-effective and lasting approach to bring a change in the entire community’s health and wellbeing. Multiple interventions are done by Ekam towards this goal.
Trained Ekam staff:
- Conduct health screening camps
- Coordinate outreach campaigns to spread awareness about the importance of antenatal care and mobilize mothers to seek it
- Increase awareness about the importance of immunizations
- Sanitize labor rooms
- Conduct Microbial surveillance to prevent infections
- Organize Nutrition education camps
- Train community health workers
- Teach the community about topics such as maternal and child health, general health, and government health resources such as emergency medical response support, insurance schemes, and free health programs
- Reach children at a young age by conducting school training, promoting volunteerism through drives, and establishing youth clubs.
Impact stories from the field:
Preventive Care: Before established programs in one community, a pregnant woman came to the hospital right as she was going into labor. Throughout her pregnancy, she did not receive prenatal care or attend wellness checkups so she never knew that she had heart disease. During childbirth, her heart could not sustain the strain and both her and the baby passed away. The doctors tried to save them but were unable to. If she had proper prenatal care, her condition could have been diagnosed and appropriate precautions would have been taken to save the mother and the baby. Ekam works in the community so that no mother or child loses their life to preventable causes.
Emergency Resources: A pregnant woman collapsed in a village and someone in the crowd who had previously attended Ekam’s workshop on healthcare resources shouted, “Call 108 for an ambulance”. The ambulance arrived and took her to safety in a timely manner. In many remote villages, information about emergency resources is not common knowledge. Ekam helps to save lives by working at the grassroot level to educate people about the healthcare resources available to them.
Screening Programs: Ekam conducts health screening programs in government schools to identify children who may need medical treatment. For example, sometimes children with heart conditions may have few or no symptoms and their condition can go un-diagnosed until it is too late. Through ’s screening programs, the organization identified 120 kids with heart conditions. then helped the parents to navigate healthcare resources, government insurance schemes, and paperwork. All the children received care using government funds earmarked for this purpose at no cost to the parents.
Youth Volunteer Program: About 40% of newborn deaths and 50% of maternal deaths occur on the day of birth. Ekam trains youth volunteers in villages to check up on newborn babies and educate mothers on how to properly care for them. One 10th grade volunteer trained by Ekam did a routine examination of a newborn baby and referred the baby to a nurse because she believed that the baby had neonatal diabetes. This is a very rare condition that even Dr. Sai, a pediatrician herself, had never seen. Ekam immediately arranged for the baby to be transferred to a higher-level facility and tested. The baby indeed had neonatal diabetes at birth. This condition may be more common than we think, but many babies go un-diagnosed and die without proper treatment. Remarkably, with training from , a volunteer in 10th grade was able to check for and identify common and uncommon medical conditions ultimately saving lives in her village. ’s network and structure ensure that every child has access to appropriate healthcare resources.
Vaccination: Often in rural areas, superstitions and myths about vaccines dissuade many people from receiving them in a timely manner or at all. For example, when Pulse Polio–an initiative to give polio vaccinations across India within a two-day span–happened, many well-meaning but ill-informed mothers hid their babies from vaccination officers. In collaboration with UNICEF, Ekam works to improve vaccine compliance, especially among those who missed vaccinations due to COVID-19. Ekam trains local village volunteers to educate the community about important health topics using strategies like role-playing, puppet shows, and other formats that are easy to understand so that villagers become more open to health measures such as vaccines.
Environment: Attaining a healthy environment is central to improving quality of life and life expectancy. Our approach focuses on the environmental factors that decrease the likelihood of illness and death.
The Challenge
- Malnutrition is the cause of 69% of the deaths in children below the age of 5 yrs in India (UNICEF Survey, 2019)
- Around 27% of the children are underweight (low weight for the age) 17% of the children are wasted (low weight for height) and 32% are stunted (low height for age)
- Annually 1.5 million children in India die from diarrhea and other waterborne illness
- Only 44% of households have access to tap water and only 32% have access to treated tap water
- India has a huge waste management problem with trash choking its ecosystem and posing a health hazard
Solution
- Conduct community outreach events that cover topics such as sanitation, first aid, nutrition, handwashing, menstrual hygiene, toilet practices, and food choices
- Spreading awareness of waste management, collection methods, and treatment of disposal of waste
- Creating kitchen and herb gardens.
Impact stories from the field
Maternal health has a direct impact on newborn well being. Malnourished women often give birth to babies with a low birth weight (LBW). A single bout of diarrhea can cause LBW babies to suffer acute malnutrition. Therefore, it is very important that families have access to clean water, energy-dense nutritious food, and proper sanitation.
Ekam detected a high incidence of iron deficiency anemia in pregnant women during prenatal visits at Chengalpattu Medical College. The Ekam staff then worked to develop a program to fight malnutrition using education and awareness camps to teach women how to grow their own vegetables. Ekam also provided land, seeds, and other resources. Once the community became aware of the value of good food and gained access to nutritious food, iron deficiency anemia levels declined.
Livelihood
Improving the economic well-being of individuals has a direct effect on the health of the community. Parents with greater economic opportunities are able to provide nutritious food, a safe environment, and medical care for their children. These factors contribute to the physical and emotional well-being of children as they grow and develop. Ekam helps to create livelihood opportunities that focus on sustainability, building up local communities, and promoting healthy living.
The Challenge
- The majority of the population in rural areas lives on subsistence wages
- Farmer welfare is linked to food and nutritional security
- Diseases are more likely to affect people from lower socioeconomic backgrounds
Solution
- Educate communities on organic farming and other livelihood opportunities
- Train farmers in organic farming techniques
- Create marketplaces and improve accessibility to natural farm produce
- Train rural healthcare workers and increase employment opportunities in healthcare
- Utilize local skilled labor to create solutions to healthcare challenges
Impact stories from the field
Mothers were having a difficult time holding their babies for a long time without support. In collaboration with local women, Ekam staff designed a simple cotton baby sling to be sewn and distributed. The sling provides a solution to mothers with low birth weight infants. With the sling, the babies receive prolonged skin-to-skin contact and frequent breastfeeding. This project provides work to local seamstresses while solving a local healthcare issue.
Awareness, Empowerment and Engagement
In some communities, inappropriate antenatal and neonatal care increases infant mortality rates. Improper care often stems from ill-informed cultural beliefs and traditions or a lack of knowledge about proper infant care. For example in some communities, people apply ghee (clarified butter) to the umbilical cord, discard colostrum, breastfeed late, skip immunizations, do not wash their hands prior to contact with newborns, and do not maintain proper diets. To combat these issues, Ekam works in the community to conduct behavioral change workshops. Rural healthcare workers also continue to follow up with communities after workshops to see how they are implementing learnings. Given the current circumstances surrounding the COVID-19 pandemic, Ekam has also conducted virtual workshops and created educational videos with an emoji cartoon called Lakshmi who provides helpful information about pediatric and maternal health.
The Challenge
- Cultural beliefs and traditions in different communities influence care practices
- Certain practices, health myths, and superstitions have no scientific basis and can be deleterious to the health of babies, children, and mothers
Solution
Ekam empowers local communities with knowledge and encourages them to take ownership of local health issues. Ekam’s team of social workers work at the district level to:
- Conduct behavioral interventions for the community, which focus on questioning current belief systems about gender norms, social issues, and individual health prioritization.
- Give marginalized members of society a platform to raise issues affecting them.
- Promoting early detection and management of diseases through teaching communities about pediatric and maternal health.
- Provide manuals, training curriculum, and other awareness-building materials created by technical experts from various healthcare fields.
- Integrate Panchayat, Block, Taluq, District, and State level governments to form health committees and strengthen the linkages between government hospitals and the community.
Impact stories from the field
Ekam provided pregnant mothers with anemia with supplementary iron pills during antenatal visits. However, during follow-up visits, rural healthcare nurses found that the women were throwing away the pills instead of taking them. On further inquiry, staff members realized that there was a misconception in the community that the pills affected the babies and caused them to have dark-skinned complexions.
Following these events, Ekam conducted awareness camps to address this issue and educated the women about iron deficiency. Ekam works to identify the root cause of a problem and address it through local volunteers who are a part of the community and are accepted more easily by the patients than outsiders. Ekam uses effective strategies such as role playing, puppetry, theater, etc. to make the rural population understand important concepts and bring change.
By employing its expertise in behavioral change management, Ekam creates a framework to support community monitoring and subsequent reforms. Ekam also uses information collected from community outreach programs to understand the requirements and scope of evolving independent community-led bodies which help lead to community health reforms. Ekam thus helps the Government in reform and make policy changes to help the communities. Ekam gives community members a voice in healthcare decision-making.
