Field Story Details

SHOUAHRDO Health Care Volunteers: providing support where it is needed most
December 1, 2009
Meet Assia Begum, she is the Local Healthcare Volunteer for Chaklerk 9 No. Ward Village in Charklerk Union, Shuborbanocha Upazilla, a remote rural area of Noakhali, Bangladesh. Her role
is to hold regular meetings in the community on issues related to health and welfare such as hygiene and sanitation, maternal and childhood health and nutrition and monitoring, family planning,
and access to available healthcare services.

This is a significant job in a country where maternal health suffers as a result of poor nutrition of mothers, the use of unskilled birth attendants during labour, poor or non-existent antenatal and postnatal care, and poor sanitation practices1.

As part of CARE Bangladesh’s SHOUHARDO program Assia, and many other women like her, receive training and support giving her the tools she needs to provide healthcare to the poor and extreme women and children in her area. Maternal and child health is a specific focus for the SHOUHARDO program, and Mother and Child Health and Nutrition (MCHN) Groups, run by local health volunteers, are an important part of addressing some of the issues which lie at the heart of poor maternal and child health outcomes.

On the day we visited Assia at work, we saw first hand the positive impacts she is having on people’s livelihoods. During our discussion with the MCHN Group, the mothers told us that since Assia has started coming to the village, there is less diarrhea, the babies are healthier, and chest infections are not as common. As part of the MCHN program, mother and child nutrition is now being monitored through the use of SHOUHARDO health cards, and malnutrition rates for newborn babies has improved.

Assia also explained how she encourages and often accompanies women to see local health service providers when they are having more serious health problems than she can manage, “I go with the women, sometimes they are scared, and they trust me. I cannot fix everything”. These are all big changes for people who traditionally relied on village superstition and untrained medical knowledge to treat all health issues, no matter how serious. Assia’s work also involves educating people about the
importance of sanitation, “In this village 167 households now have sanitation facilities, and the remaining 25 households will have these facilities by the end of the year,” she says. This has been achieved with the support from the local Union Parishad Chairman, Md. Khairul Alam Selim, who has agreed to provide funding for the remaining 25 houses that still need latrines.

There is no doubt that the work Assia is doing results in direct improvements in the livelihoods of the people with whom she works, and her hard work is paying off. However, there is still room for improvement if sustainable changes in the health and well being of program participants is to be
fully realised. 1

Some of the areas which need improving in this village include the method for weighing mothers and babies as part of the health and growth monitoring process. Currently there are no set guidelines for confirming the accuracy of the scales, and people are only weighed once, which often results in inaccurate weight recordings, particularly of children. This is especially important when monitoring the growth of babies, as 100 grams can mean the difference between a healthy or malnourished child. During our visit, the CARE team found inconsistencies on some children’s health care cards, and there was some confusion about dates, as well as gaps in the monitoring of their weight. Also, the birth rate of the village was quite high, despite Assia’s education about family planning, which puts a significant strain on the limited resources of both individual families and the community as a whole.

To address these issues CARE Bangladesh is working with the local partner NGO Sagorica Samaj Unnayan Sangtha (SSUS) to increase the monitoring, training and support Assia needs to improve the integral services she provides in her union. This is critical as the SHOUHARDO program draws to a close in September 2009. Ensuring Assia, and the people she provides healthcare and nutrition support to, can continue improving their health and livelihoods is one way in which the SHOUHARDO program can achieve its goal of strengthening households ability to respond to development pportunities.

By Lyrian Fleming, Regional Communications Assistant

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