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Rapid Assessment of Yashoda in Orissa

  • Deepak Yadav
  • Agency : Yashoda, ASHA, Programme Staff, Community, Counseling, Inter-linkage
  • Objective : To assess the role of the Yashoda within following parameters:
    • Creating a comfortable environment for the pregnant women  and recently delivered mothers   
    • Counseling for initiation of breastfeeding within one hour and stay at health facility for 48 hours. Present as a support to the pregnant women during delivery 
    •   Ensuring immunization of the newborns  
    •   Identifying danger signs in mothers and newborns and their referral  
    •   To understand the linkage of Yashoda with ASHA

  • Background : With an inspiration from Yashoda in the Mahabharata, Norway India Partnership Initiative (NIPI), launched “Yashoda Scheme” in order to enable India to attain the Millennium Development Goal 4. NIPI's objective through this approach is to provide up-front, catalytic and strategic support to improve child health and related maternal health service delivery quality and access.
    Yashoda's main roles include providing congenial environment to the mother, newborn and mother care, post delivery care, counseling and motivation to the mothers. Yashoda serves as a complementary support to both clinical staff and woman at the facility.

  • Methodology : To evaluate the effectiveness of Yashodas the study objectives were broadly divided into four crosscutting components of Maternal and Neonatal care viz. Service component, Counseling component, Support component and Reduction of Workload of ASHA.
    The study was carried out in 16 districts of Orissa with a sample of 404 respondents (81 ASHAs, 162 beneficiaries, 81 Yashodas and 80 health care providers) for functional role analysis of Yashodas. A total of 24 respondents were selected for finding qualitative and outcome related findings for the same. The study methodology consisted of a progressive mix of qualitative and quantitative data collection. For quantitative component of study the respondent groups were Yashodas, recently delivered mother (beneficiaries), service providers and ASHAs. For qualitative part the respondents identified were district and block child health managers and key community members (AWW, PRI leader, VHSC member).

  • Findings : Socio-demographic profile of Yashoda: In order to analyse the socio-cultural determinants of Yashoda's work, a basic profile was prepared. According to which majority of Yashodas belonged to general category with a minor representation from SC, ST & OBC. At the time of the study, It was found that most of the Yashodas were in the age group of 25–35 years and so were the newly recruited ones. Marital status query reflected that almost all of the Yashodas were married some were divorced/widowed also. With regard to the distance travelled by a Yashoda from her home to the facility, an average distance of 1.5 Kms. was found.

  • Recommendations : The study findings show that thourgh Yashodas were providing services along the lines of their designated roles & responsibilities to a large extent yet an effective capacity building framework to deliver quality services is required to achieve long term goals of maternal & newborn health care.

Counseling for initiation of breastfeeding within one hour and stay at health facility for 48 hours. Present as a support to the pregnant women during delivery