Discardation of First Breast Milk, Pre-lacteal Feeding of Neo-nants & Exclusive Breast Feeding of Infants among Recently Delivered Women of Uttar Pradesh, India | Chapter 08 | Emerging Trends in Disease and Health Research Vol. 1

 Since 2005, the major goal of ASHAs has been to visit the homes of newborns, with the Comprehensive Child Survival Program in Uttar Pradesh (UP) being the first programme run through ASHAs in 2008. Since then, ASHAs have been tracking all deliveries and newborn babies as part of their work in all of the NHM's primary health-care programmes in UP [1,2]. ASHAs' role and work are triangulated here with the reactions of mothers of newborns and babies. Since 2011, evaluation studies on the performance of ASHAs have been conducted, as ASHAs had worked in the field for a minimum of 5 years. The National Rural Health Mission was established in April 2005, but states took one to two years to hire ASHAs and put in place procedures from the state to the village level [2]. Recently Delivered Women provide detailed input on their infants' Exclusive Breast Feeding (EBF) practises as part of the newborn and infant care programme. In addition, as part of the district-level newborn care programme, a complete feedback on pre-lacteal feeding of their newborns is collected from newly delivered women.

Currently, 1.50,000 ASHAs have been taught in UP on all eight training modules recommended by NHSRC, GOI, for a total of 23 days of training each ASHA [3].

Through the replies of mothers of newborns and infants on newborn care, the current study explores some of the critical variables on home-based newborn care activities, such as the optimal practise of EBF of newborns and infants. The ideal practise of EBF in newborns and babies is a crucial facilitator of breastfeeding practises in child health programmes. The current paper examines the role of ASHAs in home-based newborn care and child care programmes by looking at mothers' EBF responses and the fluids they provided their infants the day before the survey. The moms were chosen as respondents because they were chosen from a list of mothers who were present with their ASHAs at the time of the survey.

The current study also looks at some of the most important characteristics in home-based newborn care activities, such as the poor practise of pre-lacteal feeding of newborns and mothers' reactions to newborn care. A major impediment to breastfeeding is the practise of pre-lacteal feeding of newborns in child health programmes. The current paper examines the role of ASHAs in the Home Based Newborn Care programme by examining women' responses to pre-lacteals and milk discarding before nursing their children. The moms were chosen as respondents because they were chosen from a list of mothers who were present with their ASHAs at the time of the survey.

 

Many surveys do not contain data on the type of pre-lacteal feeding of newborns as a barrier component of child health and neonatal programmes, therefore the study's relevance assumes significance. Furthermore, many studies/surveys do not collect response specifics from women on these possibilities on pre-lacteals where their types are discussed. Many surveys do not collect replies that collect actual activities on pre-lacteal feeding and milk disposal before breastfeeding. Such data collection indirectly assesses ASHAs' work and approach, including ASHAs' and mothers' awareness of programmes connected to Early Initiation of Breastfeeding (EIBF), which is not the subject of extremely large-scale health surveys. Similarly, many sociological studies or surveys do not cover such responses to these two barriers on EIBF-related newborn care activities through the work of ASHAs in currently implemented programmes. When the response is asked directly from the horse's mouth, as in the current article, the poll gains more valence.

The study's importance grows as data on EBF in actual months and the type of fluid other than breast milk supplied to newborns and babies in the first 6 months of life, which operate as a barrier component of child health and newborn programmes, are not included in many surveys. Furthermore, many studies/surveys do not collect answer specifics from mothers on the types/contents of fluids addressed in this article. Such data collection indirectly evaluates ASHAs' work and approach, including ASHA and mother awareness of programmes connected to Exclusive Breastfeeding (EBF), which are not the subject of large-scale health surveys.

Similarly, many socioeconomic studies do not include answers to impediments to EBF-related newborn and infant care through the work of ASHAs in currently implemented programmes. When the response is asked directly from the horse's mouth, such as in the current article, the surveys receive greater valency.

A total of four districts in Uttar Pradesh were chosen for the study, and data from mothers in those districts was collected. A pre-tested systematic and in-depth interview schedule was used with close-ended questions. These in-depth interview questions elicited descriptive information from mothers. The moms provided the quantitative data, and a total of 500 people took part in the study.

The findings revealed that the majority of RDWs in Banda, Barabanki, and Saharanpur districts, as well as roughly 94 percent in Gonda, had given their baby milk other than breast milk as a pre-lacteal feed. The discarding of milk before breastfeeding the kid was the next barrier as an action. About 10% of RDWs in Banda, over 5% in Barabanki, and less than 5% in the other two districts said they dumped the initial milk from their breast before putting the newborn to the breast for the first time.

 

The majority of RDWs in all four areas exclusively breastfed their child for the first six months, which is the recommended practise. This response's descriptive statistics table clearly reveals that the mean is 6 months. Furthermore, nearly half of all RDWs in Banda, one-third of all RDWs in Barabanki, nearly half of all RDWs in Gonda, and more than one-fourth of RDWs in Saharanpur said they had given their child something other than breast milk the day before the survey, contradicting their first EBF response in months and defeating the purpose of EBF.

The last component of RDW responses focused on the type of fluid provided to the kid the day before or the night before the survey, excluding breastfeeding. The most common choice among RDWs in the four districts surveyed was any animal milk.
 
Author(S) Details

Tridibesh Tripathy
Homoeopathic & Public Health Expert, Subject Expert, Master of Public Health (Community Medicine) Program, Lucknow University, Lucknow, India.

Shankar Das
School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, IIHMR, Delhi, India.

D. R. Sahu
Department of Sociology, Lucknow University, India. and Department of Sociology, Ravenshaw University, Cuttack, Odisha, Secretary, Indian Sociological Society, New Delhi, India.

Anjali Tripathy
Water Aid, UP Office, Lucknow, India.

Rakesh Dwivedi
Centre for Advanced Studies in Social Work, Department of Social Work, Lucknow University, Lucknow, India.

Mohini Gautam
Centre for Advanced Studies in Social Work, Department of Social Work, Lucknow University, Lucknow, India.

Sovesh Chandra Tripathy
Proponent of Homoeopathy and Public Health, Employee, IB River Valley Coal Fields, Coal India Limited, Jharsuguda, Odisha, India.

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Capacity Building of ASHA at the Monthly Meeting Platforms IN PHC and CHC in Uttar Pradesh, India | Chapter 9 | Selected Topics in Humanities and Social Sciences Vol. 2

 Introduction: Women community health workers have been identified as a key strategy for addressing the emerging shortage of health workers in developing countries. The ASHAs are established by the state as part of the Government of India's National Rural Health Mission to provide health care at the grassroots level. Capacity-building initiatives and the empowerment of local women are critical for the effective delivery of health care to a large portion of the rural population. The current study investigates some of the critical variables of capacity building initiatives at monthly meeting platforms at CHC/PHC in the state of Uttar Pradesh. Research methodology: A total of four districts in Uttar Pradesh were purposefully chosen for the study, and data collection was carried out in the villages of the respective districts using a pre-tested structured interview schedule that included both closed-ended and open-ended questions. In addition, in-depth interviews with ASHAs were conducted, and a total of 250 respondents took part in the study. The monthly meetings at various PHCs in their respective districts were attended and benefited by a large majority (90 percent) of the ASHAs. The total duration of these meetings varied from 2-3 hours in each district, with the main agenda items being a review of daily work, training, and problem solving. Various other topics, such as cord care and new-born care, were also covered in the meetings; however, certain topics, such as interpersonal skills, gender, and equity, were not adequately addressed. Due to inaccessibility, Banda District in the Bundelkhand region reported difficulty and low attendance at meetings. Travel difficulties and frequent rescheduling of meetings The Health Education Officers were primarily in charge of facilitating these meetings in the four districts. The ASHAs cited the benefits of these meetings as increasing their confidence while working in the community, and the inputs also increased the required level of knowledge on various health issues. Simultaneously, they reported that their counseling skills and the quality of their home visits had improved. Conclusions: The process of ASHA capacity building in monthly meeting platforms could be viewed as an important strategy in developing the community health workforce. These meetings and training platforms are used to maximize their motivation, confidence, work skills, and the quality and quantity of their home visits. Meetings are more effective when topics such as regular guidance, work-related problem solving, record keeping, and activity documentation are discussed frequently.

Author(s) Details

Dr. Tridibesh Tripathy
Lucknow University, Lucknow, UP, India

Prof. Shankar Das
School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.

Anjali Tripathy
Water Aid, UP Office, Lucknow, India.

Dr. Rakesh Dwivedi
Centre for Advanced Studies in Social Work, Lucknow University, India.

Dr. Mohini Gautam
Centre for Advanced Studies in Social Work, Lucknow University, India.
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