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Friday, September 17, 2021

Hit by Covid: Delivery, immunisation, nutrition

From institutional deliveries to ante-natal care, immunisation to Anganwadi schemes, the Covid-19 pandemic has hit all crucial healthcare services.

Written by Tabassum Barnagarwala | Jalgaon |
Updated: June 8, 2020 11:10:47 am
Jalgaon, Immunisation, Nutrition Asrabari village locals say no health worker has since the lockdown began. Express Photo: Tabassum Barnagarwala

In Jalgaon’s Kanchan Nagar, Anjali Birade (20) cradles her month-old son, Ronak, born on the bed she is sitting on. On May 5, at 1.30 am she developed labour pain. “The civil hospital here has been converted into a Covid-19 facility. Private nursing homes nearby were also shut,” her husband Chandrakant Birade said. With nowhere to go, they woke up an elderly woman in the neighbourhood around 4 am to deliver the baby.

A month since Ronak’s birth, no immunisation shot has been administered to the child against infections like hepatitis, measles, and polio. From institutional deliveries to ante-natal care, immunisation to Anganwadi schemes, the Covid-19 pandemic has hit all crucial healthcare services.

The effects have rippled in tribal stretches as well. Forty km from Jalgaon, Asrabari village near Satpura range has not been visited by any Anganwadi workers or Accredited Social Health Activists (ASHAs) since March. The village, housing Tadvis and Pawaras tribes, has not reported any Covid-19 case but the lockdown has hit services for pregnant women.

Aged 17, Sangeeta Ramsar is six-month pregnant with her first child. “I have not gone to a primary health centre, and no one came here to check me,” she said. She has to walk 7 km to reach the nearest village where public transport was available until March. Since the lockdown, even that transport is lost.

Her neighbour Reshma Bodya delivered her fifth son a fortnight ago in a hut. “Yahan koi gadi nahi hai. Shehar band pada hai virus ke karan. Hospital kaise jaye (There is no vehicle here. The city is shut due to coronavirus. How do we go to hospital),” said Khedya Patil, a tribal woman.

Jalgaon, Immunisation, Nutrition Anjali Birade with her month old baby in Jalgaon, he is yet to get any immunisation shot. Express Photo: Tabassum Barnagarwala

District health officer Dr DS Potode said since Asrabari is a tribal area, the institutional delivery rate is already low there. “In nearby villages, we have a facility for delivery at the primary health centre,” he said.

According to MLA Girish Mahajan, Jalgaon civil hospital was performing 1,000 childbirths in a month. “Since it became a Covid-19 facility, there have been zero deliveries there. Another private hospital, Godavari, has been converted into a civil hospital, but it has performed only 200 deliveries. Every other health service has been affected since the civil hospital has been converted,” Mahajan said.

In Parola taluka, Mangrul primary health centre has 148 pregnant women registered since March after lockdown, of them 37 are first-time pregnancies, all eligible for Pradhan Mantri Matru Vandana Yojana (PMMVY), a scheme under which Rs 5,000 is given to a woman for her first delivery. Nurse Ankita Aadhav said since the pandemic began, data entry procedures have come to a standstill. “We have not been able to link bank accounts and Aadhaar. None of these women has received the first installment of Rs 2,000,” she said.

As per government norms, immunisation activity, ante-natal check-ups are prohibited in containment and buffer zones where Covid-19 positive cases are diagnosed to prevent the risk of transmission. “We have allowed these health services outside containment zones. So, services may be slightly affected in containment areas,” said Dr Archana Patil, additional director in Directorate of Health Services. “But we are managing to meet targets for immunisation and deliveries,” she added.

Anup Kumar Yadav, director of National Health Mission, admitted the health services were hit in March and April as resources were diverted to address the Covid-19 pandemic. “The state government kept rural hospitals, primary health centres and sub-centres free from Covid-19 activities to focus on other services to solve these issues,” he said. But in several districts ASHAs have been engaged in Covid-19 survey of migrants, affecting mother and child care services. “Our focus is to find migrants, who travelled from outside, and quarantine them. After that if there is time, I focus on immunisation and ante-natal care,” said ASHA worker Swati Patil in Mangrul village.

Jalgaon, Immunisation, Nutrition Sangeeta Ramsar, six month pregnant, has not undergone a single ANC checkup. Express Photo: Tabassum Barnagarwala

Maharashtra performs 80,000-90,000 deliveries in government sector per month. State officials said corporations like Pune, Mumbai, Thane, Jalgaon, and Malegaon that have been hit by Covid-19 are facing problems with routine health services.

Pregnant and lactating women are also not able to avail Bharat Ratna APJ Abdul Kalam Amrut Yojna in parts of state. In Akkalkuan, Dhadgaon, and Toranmal areas of Nandurbar, Anganwadis are shut and pregnant women are getting no ration, a review meeting held in the first week of June found. Food for children aged up to six years has also been affected. In May, Nandurbar district data found that 15,402 children were screened at Akkalkuan, known for a high malnourishment rate, and 2.3 per cent were found severely underweight and 12.6 per cent moderately underweight.

In Jalgaon, no such screening of children for malnourishment has been carried out for the last three months, when such an exercise must be undertaken at least once a month.

Anganwadi worker Seema Patil said, “We can’t do house-to-house visits to weigh children, as there is Covid-19 scare. There is also a problem of ration. We had asked for ration for 65 children, for nine children no ration came.”

Health secretary, Dr Pradeep Vyas, admitted that the pandemic had hit other services. “We are working on normalising routine services,” he said. Indra Mallo, who heads Integrated Child Development Services, which monitors Anganwadis, was unavailable for comment.

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