Role of ASHA in improvement of maternal health status in northern India: an urban rural comparison
Background: In spite of extensive network of health care facilities areas of concern in the state of Punjab are alarming rate of children suffering from anemia, high prevalence of anemia among women, particularly pregnant ones, low consumption of IFA tablets and poor post natal care, proportion of children exclusively breastfed is very low, delay in initiation of breastfeeding and use of supplementary foods. To combat this NRHM was launched and ASHA is the most important link between the community and health care. Objectives: to evaluate the role of ASHA workers in rural areas of district Faridkot using the maternal health indicators by making urban rural comparison. Methods: A house to house survey was conducted in selected urban and rural areas of Malwa region of Punjab to select the cohorts of pregnant females. These pregnant females were registered and followed till 42 days after delivery. All the information regarding ante natal, natal and post natal care of the pregnant female was recorded on the self-structured and pretested questionnaire and an urban rural comparison was made to evaluate the role of ASHA. Results: Out of 2841 pregnant women of urban area, 900 (31.7%) had an abortion whereas out of 5088 of pregnant women of rural area 1063 (20.9%) ended in an abortion. The females whose pregnancy ended in an abortion were not included in the study. Therefore, 1941 and 4025 pregnant women formed the sample for the analysis to avoid bias. 92.6% of pregnant women living in urban area had an institutional delivery and 7.4% delivered at home. The pregnant women of urban had a higher still birth rate (40.8 per 1000 live births) than pregnant women of rural (11.1 per 1000 live births). Sex ratio of the newborns was also more skewed in urban (866 females per 1000 males) than rural area (995 females per 1000 males). Conclusion: This can be concluded from the present study that the maternal and child health services delivery definitely improves after inception of ASHA worker in rural community.