Ekjut is a community- based NGO. Currently working in Jharkhand and Odisha, their main focus has been on empowering rural communities by facilitating participatory learning and action for reducing newborn mortality. The interventions initiated by Ekjut have contributed to the empowerment of the communities and have resulted in considerable decrease in the new born mortality and maternal deaths, especially in areas which lack access to health services and with difficult geographical terrain.
The innovations Ekjut has introduced in public health have proven to be sustainable and impactful on the quality of people's lives. This has led to their expansion to other Indian states such as Bihar, West Bengal and Madhya Pradesh. We acknowledge their contributions to public health in India, and honor them as a Public Health Champion.The press releases issued on the subject can be accessed at:http://searo.who.int/india/mediacentre/releases/2015/whd_2015/en/ http://searo.who.int/india/mediacentre/releases/2015/public_health_champions/en/
Ekjut has been awarded a grant by the ESRC-DFID Joint Scheme for Research on International Development for a project entitled "Socio-economic inequalities and the MDGs: building evidence to support equitable improvement in maternal and newborn health in Asia & Africa". The project will be lead by Dr. Tanja AJ Houweling, from the UCL Centre for International Health & Development, and will involve collaboration with six research sites in Malawi, India, Nepal and Bangladesh.
Progress towards the Millennium Development Goals (MDGs) has been highly uneven. Poor and otherwise disadvantaged groups lag behind their more fortunate compatriots for most MDGs. To make things worse, effective interventions are known, but rarely reach those who need them most. Unfortunately, little is known about how to effectively reach poor and otherwise disadvantaged groups, and how to address socio-economic inequalities in mortality.
This project aims to fill these gaps by generating evidence on (1) how socio-economic inequalities translate into inequalities in maternal and newborn mortality within countries, (2) how to address the exclusion of poor and otherwise disadvantaged groups from efforts to achieve the MDGs, and (3) how to reduce socio-economic inequalities in maternal and newborn mortality.
Data will be obtained from six surveillance sites, in India, Nepal, Bangladesh and Malawi, where a combined population of over 2 million is prospectively followed-up. Information on birth outcomes, socio-economic position, health care use and home care practices will be used to describe and explain mortality inequalities. Data from randomized controlled trials of participatory women's group interventions in these sites will be used to evaluate the differential reach of these interventions across socio- economic groups and the impact of these interventions on socio-economic inequalities in mortality.
The three year project will actively engage with and learn from stakeholders, drawing on their experiential evidence regarding what works to ensure an equitable improvement in newborn and maternal health.
For more information on this project, visit the project website: http://equinam.global-health-inequalities.info/ Or contact Dr. P.K.Tripathy (email@example.com) or Dr. Tanja AJ Houweling (firstname.lastname@example.org).
Chakradharpur (West Singbhum): Kusnopur is a hamlet in the area and it is a transformed place. As are some other villages in this mineral-rich district. Indkata, Dengsorgi and Landupoda are also in the grip of a quiet — and happy — revolution. Fewer newborn babies are dying. How has this happened?
Through an extraordinary training project for local tribal women. Prasanta Tripathy runs the NGO Ekjut, which facilitated the training. He says "there is a 45% reduction in neonatal mortality rate as well as a change in behaviour and practices related to child-rearing. Besides, there is a 57% reduction in postnatal depression."
TRIBAL TRIUMPH: Volunteers at an awareness camp
It's been a hard slog — for the NGO and its volunteers, and the tribal women. Aantri Koda, 28, of Balundi village, was one of the early trainees. She recounts how hard it was: "When I joined the NGO for training, my husband asked me to concentrate on household chores rather than become a neta. However, my sister in-law persuaded him to let me join, citing her own suffering during pregnancy due to inadequate knowledge."
There was resistance from village elders too. Mother-of-two Kulsum Sundi, 33, recalls the gram pradhan opposing volunteers who wanted to assist her when she was pregnant. "He said that they are polluting the culture of our village by carrying semi-naked pictures of pregnant women." Nitima Lamay of Ekjut says lack of awareness caused the initial resistance. "Gradually, the senior members of the village realized our good intentions and started co-operating with us." Tripathy says the training stresses " participation, learning and action – the three steps of the 'knowledge circle'." He adds that "these are the key ingredients that go into the making of an empowered mother and healthy baby."
The NGO started working with roughly 20 women in three villages around Chakradharpur six years ago. By now, it has 20,000 trained women, spread across more than a thousand villages in nine districts of Jharkhand and Orissa. Sumitra Gagrai, Ekjut group coordinator, says the core of the revolution was the community spirit unleashed, when trained female volunteers fanned out across remote villages "to hold meeting with adolescent girls and married women and encourage them to find practical solutions related to preserving good health during the pre and post pregnancy period."
It was a success and recently praised as such by 'The Lancet', the authoritative British medical journal.
Ranchi, March 10: In a model that can well be replicated by other
states in future, intervention of women groups in two districts of
Jharkhand — West Singhbhum and Seraikela-Kharsawan — and in
Orissa's Keonjhar, has shown a fall in neonatal infant mortality rate
and post-natal moderate depression among new mothers.
While the neonatal infant mortality rate, which stood at 60 per 1000
in these districts before intervention began in 2005, fell by 45 per cent
to bring the figure to around 33 out of 1000 deliveries in three years,
post-natal moderate depression fell by as much as 75 per cent.
Occurrence of post-natal moderate depression among new mothers
was 12 per cent in these districts before intervention started. In 2008,
the same was brought down to 3 per cent.
Ekjut head Prasant Tripathi in Ranchi on Tuesday. Picture by Hardeep
"The credit goes to the women, who under the guidance of Ekjut, successfully brought down neonatal infant mortality rate and moderate depression rate of mothers in the three districts," said Prashant Tripathi, head of Ekjut, an NGO.
Ekjut, along with Pradan and Centre for International Health and Development (University College of London), identified the three districts to improve the health of newborns and new mothers in 2005. They helped 250 women's groups in 400 villages of these districts make positive intervention in health care, especially during and after childbirth.
Tripathi said the 250 groups, comprising over 5,000 women, monitored 4,692 births in the three districts between 2005 and 2008. The average neonatal mortality rate in Jharkhand is 49 per 1000, while in Orissa it is 45 per 1,000 live births.
In India, over 2.1 million children die annually before reaching their fifth birthday. The majority of these deaths occur during the neonatal period — the first 28 days after birth. While around 4 million children die within the first 28 days across the world, in India the figure is around one million.
Women's support groups operating in rural India have achieved dramatic success by significantly improving neonatal survival rates, a new study has revealed.
These community groups provide a cost-effective intervention along
with benefits such as reducing significantly maternal depression and
improving decision-making amongst poor women. Annually, an
estimated four million children across the world die within the first
month of their lives.
A previous study carried out in Nepal in 2004 suggested that participatory women's groups could achieve a significant impact on neonatal health in poorer countries, far more than one-to-one contact with a health worker. In order to find out if these findings could be applied in other countries, the researchers repeated the exercise in Jharkhand and Orissa. Neonatal mortality rates in the two regions are 49 and 45 per 1,000 live births respectively, much higher than India's national estimates of 39 per 1,000. By comparison, in Britain the figures are four per 1,000.
(Source: THE HINDU, January 30, 2016)
(Source: THE TIMES OF INDIA, January 26, 2016) http://timesofindia.indiatimes.com/city/ranchi/Centre-adopts-state-model-to-bring- down-crib-deaths/articleshow/50727031.cms
(Source: The Telegraph, January 25, 2016) https://epaper.telegraphindia.com/details/166106-4418453.html
Ekjut, a community-based NGO working in Odisha besides Jharkhand, is among six organizations/individuals to be awarded by WHO India as public health champions, on April 1, 2015. (Source: THE TIMES OF INDIA, April 4, 2015) http://timesofindia.indiatimes.com/city/bhubaneswar/NGO-in-state-among-6-WHO- awardees/articleshow/46802738.cms
Chief Minister of Odisha launches Shakti Vaarta.. (source : The Telegraph, May 1, 2013) https://www.telegraphindia.com/1130501/jsp/odisha/story_16846819.jsp#.UYCbMErmTIU
Targeted intervention, through participatory approach, by a non- governmental organization focusing on infant and maternal mortality,has helped in reducing mortality rate in Jharkhand and Odisha by up to 70%... (source: The Times of India, March 26, 2013) https://www.theguardian.com/global-development/2010/sep/24/child-mortality-cut- india-ekjut
The women come one by one. Some bring blankets and some little brown sacks to sit on. They spread the blankets and the sacks neatly in front of the house.. (Source: THE HUFFINGTON POST, UNITED KINGDOM, 21 May, 2012) http://www.thehindu.com/opinion/op-ed/Lessons-from-the-Ekjut-way/article159260 75.ece
Congratulations to the team behind the Ekjut Trial in Jharkhand and Orissa, which has been awarded Trial of the Year by the Society for Clinical Trials. (Source: Wellcome Trust wordpress, April 11, 2011) http://www.indiatogether.org/comm-health
The trial of Ekjut, an organization working on reproductive and child healthcare, has earned global recognition for its work in underdeveloped areas of Jharkhand and Orissa (Source: THE TIMES OF INDIA, March 30, 2011) http://timesofindia.indiatimes.com/city/ranchi/Global-recognition-for-child-healthcare/ articleshow/7829417.cms?referral=PM
Tamarind seeds and picture charts are just one example of these. Other methods include using visual cards, dummy dolls,storytelling, role play, street theatre, dancing and singing - and a lot of talking in between. (Source: Guardian Developement Network, September 24, 2010) https://www.theguardian.com/global-development/2010/sep/24/child-mortality-cut- india-ekjut
From Jharkhand, tales of change that spell new promise for women and children (Source: THE HINDU, September 15, 2010) http://www.thehindu.com/opinion/op-ed/Lessons-from-the-Ekjut-way/article15926075. ece
A pilot project in community-based monitoring under the National Rural Health Mission in three districts of Jharkhand provides encouraging results. Freny Manecksha reports. http://www.indiatogether.org/comm-health
Ekjut, an NGO, started working with roughly 20 women in three villages around Chakradharpur, India six years ago. By now, it has 20,000 trained women, spread across more than a thousand villages. (Source: Times of India, Posted: March 29, 2010) Read the Full Story
Women's community groups have had a dramatic effect on reducing neonatal mortality rates in some of the poorest areas of India, according to a study published today in the 'Lancet'. https://wellcome.ac.uk/press-release/womens-support-groups-improve-neonatal- survival-rates
It's a success story that has dramatically curbed one of India's worst healthcare challenges — abysmally low neonatal survival rate. (Source: The Times of India, Posted: March09 2010) http://timesofindia.indiatimes.com/india/Orissa-Jharkhand-cut-neonatal-mortality/ articleshow/5661120.cms
Power of words of the co-ordinator of Ekjut facilitated the women to think through issues and implement solutions on their own about the various good care practices. This resulted in a reduced neonatal mortality in the participating villages by 45 per cent in the past two years. (Source: The Telegraph, Posted: March 08, 2010) Read the Full Story
Women, under the guidance of Ekjut, successfully brought down neonatal infant mortality rate and moderate depression rate of mothers in two districts of Jharkhand and one district of Orissa (Source: The Telegraph, Posted: March 11, 2010) Read the Full Story
In underserved areas of Jharkhand and Orissa where neonatal mortality is extremely high, a group of women got together to help save lives of both the newborns and their mothers. And they do this through a participartory learning and action cycle. (Source: The Telegraph, Posted: March 20, 2010) Read the Full Story
Local women, who are non health care professionals, under the guidance of Ekjut, worked through a 'community action cycle which significantly affected neonatal mortality and maternal depression in intervention areas. (Source: Deccan Herald, Posted: March 25, 2010) Read the Full Story
21-year-old to advocate rural development policy in hometown. (Source: The Telegraph, Posted: March 08, 2007) https://www.telegraphindia.com/1070308/asp/ranchi/story_7485512.asp
New Delhi, March 8: The furore in Parliament hasn't stirred Sumitra Gagrai yet but she has reason to celebrate women's empowerment on another battlefield — saving the lives of babies.
The 28-year-old mother of two girls is the co-ordinator of a self-help
programme for women that has dramatically reduced mortality among
babies below one year of age across dozens of villages in Jharkhand
The programme, led by a non-government and academic consortium, has reduced neonatal mortality in the participating villages by 45 per cent in the past two years. Instead of improving access to doctors or medicines, the programme merely used local women to talk to self- help groups about maternal and newborn care regularly in village meetings."These women have shown us the power of words in saving newborn lives," said Prashant Tripathy, secretary of the non-government Ekjut which conducted the programme in collaboration with institutions in the UK.
Research suggested that the reduced neonatal mortality in these villages did not result from more visits to health centres or consultations with health workers but was because of improved levels of hygiene and newborn care practices.
"There was a move away from harmful practices such as giving birth in unclean environments and delaying breast-feeding," said Anthony Costello, professor at the Institute of Child Health, London, and a member of the team whose findings appear today in the journal The Lancet.
Village women selected as "facilitators" — and supported by Gagrai —
visited some 190 villages in West Singhbhum and Keonjhar and talked
about the merits of breast-feeding, wrapping the newborn snugly and
boiling a blade to cut the placenta.
"We first ask the self-help groups whether we can join them, then begin by telling stories — real stories — about how someone lost a baby," Gagrai told The Telegraph. "After that, we ask them to think about what might have gone wrong
Gagrai, who lives in West Singhbhum's Narangabeda village and is a member of Jharkhand's indigenous people called Ho, spends up to 10 days a month riding her scooter to neighbouring villages to promote good care practices.
Even women who do not attend the self-help meetings learn through
their peers. "It is crucial that the women were allowed to think
through issues and implement solutions on their own, rather than us
telling them what to do," said Ekjut's Nirmala Nair.
Jharkhand's neonatal mortality rate of 49 per 1,000 livebirths and Orissa's figure of 45 are far higher than India's national neonatal mortality estimate of 39. The new study suggests that women's groups could be an alternative to health-worker led actions.
The researchers also observed improvements in the mental well-being of the women in the self-help groups. Tripathy said preliminary data also suggests that the poorest and marginalised among women were also benefiting from the village meetings.
"We believe this is a model for other poor states that lack adequate health services," Tripathy said. "Sometimes, one-to-one communication (between health worker and a mother) doesn't seem to work — in such situations, the women's groups will be an alternative method of getting across health messages."
In underserved areas of Jharkhand and Orissa where neonatal mortality is extremely high, a group of women got together to help save lives of both the newborns and their mothers. And they do this through a participartory learning and action cycle. http://www.youtube.com/watch?v=fF-ebpLWNm8
Between 2005 and 2008, a team of researchers led by Anthony
Costello, University College London, and Dr Prasanta Tripathy, from the
Indian voluntary organisation Ekjut, assessed how women's groups
affected neonatal mortality and maternal depression in intervention
areas as compared to areas where no participatory groups were set up.
The groups were evaluated using a cluster-randomised controlled trial.
The groups were facilitated by women recruited in the local area,
non-healthcare professionals who were mostly married, with some
schooling, and a respected member of the community. The number of
women taking part in the groups increased from one in six women
(17 per cent) of childbearing age in the first year to over a half (55 per
cent) in the third year.
The women worked through a 'community action cycle' consisting of four stages: identifying the problems linked to pregnancy, childbirth and care of newborns; developing strategies to tackle these problems, such as improving hygiene, raising emergency funds and producing their own birthing kits; working with local community leaders, teachers, politicians and others to implement these strategies, and; evaluating their success.
Dr Nirmala Nair, Ekjut, said: "It was crucial that the women were allowed to think through the issues and implement their own strategies to tackle them, rather than us telling them what to do. We believe that a trained facilitator who supports informed peer learning is more effective for lasting behaviour change than a traditional instructor/learner approach."
The results of the interventions were remarkable: by the second and third years of the trial, the neonatal mortality rate in the areas where the participatory women's groups existed had dipped by 45 per cent. These areas also saw a 57 per cent fall in moderate depression amongst mothers by the third year of the trial.
Costello said: "What we were seeing was a change in behaviour towards better hygiene practices and improved care for newborns". "There was a move away from harmful practices such as giving birth in unclean environments and delaying breastfeeding. We saw significant improvements in areas such as basic hygiene by birth attendants, clean cord care and women responding earlier to care needs."
Dr Audrey Prost, UCL, said: "Many of the women in these groups would have been relatively young, living in arranged marriages with only their mother-in-law or a very limited network of friends for support". "If you've been to a group and a problem arises, you've got a ready-made network that you can go to for help and support." The researchers estimate that the additional cost on introducing support to these groups per newborn life saved was around $910. Whether Central or state government, non-governmental organisations, or a combination of the two would pay for supporting these groups is still a question.