KCR Kits & Financial Scheme success result of joint efforts

Mahabubnagar: Introduction of KCR Kits and financial assistance to pregnant women to go for institutional deliveries in government hospitals has led to increased trust among the people on public healthcare system. However, well-coordinated efforts of Asha workers, anganwadi teachers and ANMs is a must to reach a large number of beneficiaries.

Right from the moment a woman gets pregnant, the State government ensures the services of Asha worker, anganwadi teacher and an ANM. Asha worker and ANM hold the responsibility of getting the pregnant woman checked twice within the first five months of pregnancy and the anganwadi teacher is responsible for providing nutritional food and other supplements to the pregnant woman. Each of these three individuals maintain records and registers to enter the date of pregnancy and other health related details of the woman.

During the entire process, Asha worker and ANM are supposed to be in regular touch with the pregnant woman. During delivery and till six months after pregnancy the health workers are supposed to take care of the healthcare needs of the mother and child.

After the State government introduced Rs 12,000 (Rs 13,000 if it is a girl child) financial assistance and KCR Kits with toiletry and other items needed by mother and child, the responsibility of reaching out to the beneficiaries of these incentives has been put on ANM.

If the first two health checkups of pregnant woman are not done within the first 5 months, then the beneficiary loses Rs 3,000 which would have otherwise been deposited in the beneficiary’s bank account. Similarly, if there is any discrepancy in name, Aadhaar card number or even minor errors, the financial incentives can’t make it to the bank account of the beneficiary.

Most important is the entry in registers and constant follow-ups, which is missing in the present system which has been there for more than three decades now.

For example, according to a reliable source, about 30 per cent of beneficiaries are not getting the financial incentives and KCR Kits in Mahabubnagar Government Hospital and it is certainly not the fault of the hospital.

The problem lies with ANM and Asha workers in many areas, who fail to register pregnant women. The present anganwadi book registers and online registers reveal different data, because they are either not updated regularly, or the names of many beneficiaries fail to make it to the registers. Under many anganwadi centres, the names of women who may have delivered a baby two years ago, may still be registered as pregnant women.

From the moment a pregnant woman enters a government hospital, there are three entries in the hospital. However, when it comes to receiving these incentives, data entered by the ANM are taken into consideration. If either a bank account number is missing or if there is a discrepancy in the name given, for whatever reason, the beneficiary becomes devoid of any financial assistance or even a KCR Kit.

In case of HIV+ women, it becomes even more important for Asha and ANM to ensure the first two check-ups are done in time and the pregnant is put through medication to prevent the baby from acquiring the virus. But this kind of dedication is missing in rural areas due to which babies born to HIV patients are dying either during or after birth.

Unlike corporate hospitals, beds in government hospitals in rural areas are not numbered. A patient is assigned to a ward but not to a bed. This has only increased the difficulty for hospital staff to effectively address data discrepancy issues and acts as a wall between a health worker and patient. This prevents the overall personal service goal envisaged by the State government.

The hospital administration thinks the issue has to be handled at the anganwadi-Asha-ANM level, as it is not possible for hospitals to have a new department to handle scheme-related data and to rectify errors in the previous records.

Though a new monitoring system for anganwadi centres is on the anvil, unless entries are updated and followed up effectively by the ground-level health workers, the State government’s great exercise to strengthen public healthcare system may not achieve the desired results, say experts.

Most importantly, many genuine beneficiaries continue to be devoid of the highly innovative schemes the State government has launched for the welfare of women and children.