Today is clinic day. The Karagahawela Maternal and Child Health Clinic is packed with mothers and children, a few grandmothers and even some fathers who have accompanied them. Some mothers are carrying infants in their arms, others in their bellies. Grandmothers fuss over their grandchildren whilst fathers wait patiently outside with their bikes. One year ago, mothers from this village and the surrounding villages had to travel nearly 10km to access a clinic.
"The clinic was held once a month. But the journey to the clinic was challenging for mothers and children," says Sakunthala Dharshani, 24, mother of a three-year old, "Only a few buses plied on that route and they were often over-crowded. It was impossible to board the bus with the children. If we hired a three-wheeler it cost a lot of money. Generally, mothers opted to miss clinic."
However, unknown to them the prevalence of underweight and anaemia began to increase among mothers and children in the area.
"Lack of awareness on health and nutrition appeared to be the main reason for this," says Dr S M S Bandara, Medical Officer of Health for Bibile "last year (2015),16.1% of children under 5 were found to be underweight and 70% of them were suffering from anaemia."
"Mothers in this area have a misconception that they must spend a lot of money to provide protein-rich food and were unaware of the locally available nutritious food," he says, "They were also addicted to instant food items."
Thus, during the joint annual planning session of World Vision, a clinic at a closer location was identified as the biggest need by the community and by all partners including the Medical Officer of Health.
The chief priest of the Buddhist Temple donated the land to build the clinic, World Vision provided support for construction and equipment and the MOH Office monitored the construction. Within four months, the
well-equipped Karagahawela Maternal and Child Health Clinic was handed over to the community. The Clinic is open every week and is managed by the midwives while the doctor visits once a month. It is easily accessible and benefits communities in five Grama Niladhari Divisions (local administrative units). Currently 431 children under 5 and 55 pregnant women benefit from it.
“We no longer have to travel far for checkups or treatment,” says Chathurangani, 22, mother of a three-year-old, “and every mother is now eager to attend their clinic sessions and get vaccinations for their children on time.”
In order to further improve their knowledge and promote behavior change regarding nutrition, World Vision also introduced the PD (Positive Deviance) Hearth Programme for mothers. PD Hearth Programme engages mothers with children whose nutrition level is low, providing them knowledge on health and nutrition and awareness on locally available nutritious food. Mothers learn different ways of preparing them through a 12-day training programme. Identified leader mothers continue to conduct PD Hearth sessions for new mothers in the community.
"At first I had no clue about nutrition and didn’t even know my child was underweight," says Chandani, 27, a leader mother, "but since the Programme and the changes I experienced in my child, I literally hunt down mothers with children who are underweight and coax them to attend the Programme. I also follow up on them until the children reach the required weight."
The Divisional Secretary and the Medical Officer of Health in Bibile have forged a tripartite, multi-stakeholder force with World Vision to address the nutrition issues of children in the area. According to Dr.Bandara, this programme is receiving national attention as a means to tackle malnutrition. The Presidential Secretariat has commended this and has requested that it be replicated in other places as well.