"We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology" — Carl Sagan



Birth Village http://www.birthvillage.in/ south India's first natural birthing centre has created a local NGO - Birth for Change (BfC) - providing a variety of services to the women and girls living in the slum colonies of Kochi. BfC contacted Network for Information and Digital Access (NIDA), for assistance with a pilot project specifically addressing maternal health problems in this community.

This study was designed as a participatory impact assessment, testing the results of a programme of health education interventions, based upon specific questions relating to birthing practices, menstruation, diet, drugs and alcohol use. It used a selective interview process with a randomised survey and, finally, attempted to use a simple randomised case control for the effect of different types of maternal health interventions. These included inducements in the form of healthy food and dietary supplements as well as group education sessions in a pop up health clinic within the Udaya slum. 10% of the women in the two slum populations were interviewed.

The pilot project was carried out during 2017 as a partnership between Birth for Change (BfC) and NIDA. BfC provided the educational interventions and monitored their impact. The work is co-funded by Hardie Wren Development Initiatives (HWDI).



A final report has been written by Amy Davies of Birth for Change. Initially 100 girls and women chosen at random were interviewed with their responses entered into a survey designed specifically for health literacy. Then, BfC set up a pop up clinic in the Udaya slum called “Tejus”, the Malayalam word for light and offered six well advertised clinics on different aspects of maternal health and nutrition (including alcohol and drug use). It also offered one-on-one appointments with the nurses and midwives of Birth Village.
Some of the most interesting findings related to the increasing importance of education to the family budget and the use and expense of private medicine. In addition, the diet was found to be quite varied and there were very low rates of smoking and alcohol intake. Another positive finding was the high incidence of breastfeeding.
However, the survey uncovered a real lack of education around menstruation and the continuing inacceptability of this subject, even between mothers and their daughters. In addition, these women are given very little information about any aspect of maternal health at both local private and Government hospitals which is resulting in a high incidence of Caesarean sections (32%) and miscarriage (28%). There was a clear correlation between literacy and family income with the type of hospital visited (private or Government run) and the incidence of non vaginal births.
The final part of this pilot project - a second round of interviews to assess the effectiveness of the educational clinics - did not take place due to local difficulties within the slums. BfC will be focusing in the future, on providing information about menstruation, contraception, pregnancy and birth practices which are where education is most lacking.



HWDI presented the results of Phases 1 and 2 of the Maternal Health Pilot Study in Kochi at the September 2017 meeting of the European Conference on Information Literacy (ECIL) during a special session on Science Literacy
(http://ecil2017.ilconf.org/). In addition this project featured in a presentation given by Dr. Allison Wren to the Women Leaders in Science, technology and Engineering meeting, held in Kuwait in October (http://wlste.org/WomenConference).

Maternal Health Survey 2017