ARMMAN: Kilkari & Mobile Academy for India’s frontline health workers

In India, a woman dies in childbirth every twenty minutes. Two children under 5 years old die every minute while 4 of 10 children do not realize their full potential due to chronic under-nutrition/stunting. Poor health awareness among women and a faltering primary health system leads to poor management of high-risk conditions, resulting in preventable mortality and morbidity.

Current health policy, backed by evidence, focuses on institutionalizing delivery, with a 54% increase in hospital-based deliveries from 1992-93 to 2015-16. However, only 51.2% of women had 4 antenatal visits. Even with uptake of care, overworked health workers overlook counselling. Urban India has a virtually non-existent government primary care system and tertiary hospitals/private clinics are approached for first-contact care. In rural India, limited training (23 days) of community health workers (ASHAs) creates gaps in skills and motivation. ASHAs also prioritize incentive-linked activities that exclude counselling.

Providing critical health information to women during pregnancy and infancy creates awareness of complications and risks and develops agency to seek and demand timely healthcare. Regular training of community health workers (ASHAs) creates an efficient primary health care system with early detection and better management of high-risk pregnancies and infancies.