Facility and Community- Based Services for Rural Remote Tribal Communities by Medical School with Concepts of Social Accountability

Abstract

The Melghat region of Maharashtra has high maternal, perinatal, infant, and child morbidity and mortality compared to the rest of Maharashtra, India. Kasturba Health Society, Sevagram which runs Mahatma Gandhi Institute of Medical Sciences, took the initiative to change the scenario. After struggle for almost a year with government, change took root beginning January 1, 2012 with help from a philanthropist. With guidance, the support of MGIMS of KHS, Sewagram, the team offered 24-7 service including Caesarean sections, minor and major gynecological procedures, and cataract surgeries performed regularly and surgical cases, all by camp approach. While trying to do whatever we could, many difficulties came and solutions were found with the realization that community-based services, community motivation, mobilization, and behavior changes were essential. Steps were taken. Nurse midwives provide community-based antenatal services with advocacy of intranatal, postnatal, neonatal and child care, started with 52 villages served by four nurse midwives that grew to seven nurse midwives serving 140 villages within 10-85 kilometers from the health facility created. There are monthly meetings for monitoring, feedback advice, and planning. General diagnostic therapeutic camps have been become an annual event. In March 2012, the facility served 226 patients; in February 2013, there were 1036 patients; in February 2014, 1107 patients; in February 2015, 1883 patients; in February 2016, 2197 patients; and in 2017, 268 differently abled patients were provided with supports and aids including hearing aids, crutches, calipers, and surgeries for Cleft lip and Cleft Palate. In 2018/2019, there were a total of three monthly camps with 2,665 beneficiaries. A medical institute as backbone can do a lot for communities in rural, remote regions by sending health providers in rotation and taking care of health providers everyday life needs until the time there are a sufficient number of providers who take interest in the health of rural remote communities.