Mother’s Kit

Keeping Mother and Child Healthier

Introduction:
The Ministry of Health (MoH), Government of West Bengal, acknowledges the importance of investing
in the Health of Women and Children as a way of addressing its Development Goals in West Bengal. MoH is
committed to ensuring that every Mother gets access to the basic Services for her and her Child.

This commitment notwithstanding, MoH faces the challenge of delivering the above services
amid acute shortages of Resources. In such circumstances, while addressing the wider scope of health
and Nutritional problems, MoH often finds it necessary to prioritize Health and Nutritional interventions
by focusing on the essential and realistically achievable services and/ or Support .

This commitment notwithstanding, MoH faces the challenge of delivering the above services
amid acute shortages of Resources. In such circumstances, while addressing the wider scope of health
and Nutritional problems, MoH often finds it necessary to prioritize Health and Nutritional interventions
by focusing on the essential and realistically achievable services and/ or Support .

Consequently, in the effort to reduce child mortality and improve the Nutritional Status of both Mother and Child,
we are proposing the MoH to devise an essential Kit (the Mothers’ Kit) as an urgent and cost-effective
measure to ensure that Child Health a n d H y g i e n i c c o n d i t i o n is maintained. The Mothers’ Kit consists
of basic supplies that are required to maintain Child Health i.e. Sterile Cotton, Plastic Sheets, Oil, Soap,
Cream, Towel, etc.

The ministry will be glad to note that what will start as a small initiative in a few districts will result in
replicated and the kit will be accessible in all the districts of West Bengal. In line with its commitment to
make the Mothers’ Kit accessible to the most vulnerable, MoH can provide it Free of charge to the mothers
through the Medical Stores and working with Health Sector Development Partners. It is also gratifying to
note that the kit will support humanitarian responses throughout the state.
Background
Mothers’ Kit, a clean and healthier Mother and Child care kit, can be launched in West Bengal in t h e F Y
2019-20 with support from Ministry of Women and Child Development and funding from the State Government in an
effort by the MoH to reduce on illness a n d N u t r i t i o n a l d e f i c i e n c y and deaths of mothers associated
with poor hygiene and nutrition after delivery.

The initiative can be started much in 2019 as a joint WHO/ MoH venture. Many other Partners can come to
support this initiative later and these can include USAID, UNICEF, Red Cross Society (RCS), MoH (Central), etc.

This is an easily affordable Delivery Kit consisting of – Plastic Sheet, Sterile Gloves, Razor Blades, Cord
Ligature, Cotton, Sanitary Pads, Tetracycline and Soap. The initial kit had a Needle and Syringe but later this
was removed to avoid dangerous community misuse.

The term Health Care Kit is used throughout the Proposal, but the whole concept of Hygiene and Nutrition is
emphasised.. All the Districts can participate to some extent in this intervention with minimal support. However
MoH, West Bengal can now made availability of Mothers’ Kit a government priority.
At the launch of the kit, our estimate is that State wide, about 60
percent of Mothers can be covered at their home in the First three
years. Reasons for the low utilization of health services include the
perceived poor quality of antenatal and delivery services at the health
facilities, and poor attitudes of health workers stemming from the lack Factors
of basic supplies at the health centres and hospitals and poor
remuneration.
behind
Quite often, mothers are required to buy the basic necessities such as
the high
dettol, antiseptic crème, cotton, cleaning accessories, towels and
cotton wool and soap. The absence of these items after delivery
Demand of
increases chances of infection to all the parties involved after child Mothers’ Kit
birth – Nothers and New-borns.

Owing to the prevalent poverty in most communities and more

especially the interior areas of West Bengal, cost sharing in form of
paying for some of the items needed after child birth poses a
serious deterrent to seeking post-natal health services. Many mothers
who are too poor to afford anything will simply stay away from health
services when told to buy items such as cotton wool. Those that try
to beat the odds will turn up with the bare minimum requirements,
some too unhygienic to be used. It was for example common for the
Mothers to turn up for health services with improvised torn plastic
sheets.
Health Workers, working under acute shortages of even basic supplies are often perceived by
Mothers as rude who in turn get discouraged to seek child health services in formal health
units. Consequently, the above scenarios simply promote the “do it at home” practice
among mothers.

The above drawbacks are compounded further by the higher illiteracy rates especially in the
rural areas. In almost all districts, it is evident that more literate women seek Nutritional Health
Services than those that are illiterate. Consequently, hospitals and health centres in towns and
Semi urban areas tend to register higher number for health services than those in typical rural
communities where literacy is lower
 To respond to the above challenges, we a r e proposing to the
MoH and Ministry of Women and Child Development, to devise the Mothers
Kit with a view of making the basic requirements for Child Health
accessible to all mothers especially in Rural Areas. The overall
objective of this modest initiative is to contribute on the reduction of
morbidity and mortality (illness and deaths) through clean and safe

Mothers’ services after delivery.

Kit The objectives of the Mothres’ Kit initiative were:

initiative: • To provide information to Women, Men and Communities

on the importance of Health and Hygienic Environment.
Vision and • To provide Mothers’ Kits to all Women who h a s delivered
baby;
objectives • To build capacity amongst community leaders to be able to
mobilize on Health and hygiene.
• To establish a monitoring and evaluation system for
implementing the Mothers’ Kit initiative and monitor the
impact.
 district.

Strategies and Support:

To achieve the above objectives, Mothers’ Kit pilot project in North and South 24 Parganas districts w i l l
b e relied on a four-point implementation strategy to deliver results. These were:

• Provision of support to Cottage Industrial Production of Mothers’ Kits locally;

• Establishment of appropriate, affordable and sustainable Production System.
• Support establishment of an affordable and sustainable logistics system.
• Provision of support for advocacy and IEC materials

As the implementation w i l l get underway, we w i l l identify and introduce the idea of the Mothers’
Kit to the Funding Agencies including the Government and development organizations, NGOs in India/ Bengal concerned
with well- being and general development of people in t h e S t a t e .
Move to action: Distributing the
Mothers’ Kit
The mode of kit distribution will vary with the funding and participating partners involved in
the initiative. Consequently, the content of the kit w i l l also be varied with partners and their
perception of the vulnerability of the Target Population. Government funded and subsidized
kits will be purchased and distributed in North and South 24 Parganas district free of
Cost. While some other partners such as UNICEF, USAID, UNFPA and CSR funds of the Corporates
can also be provided to support to other Districts.

Even though, the plan is to cost-share the kit with the mothers, but t h e Government
should opt for a free service. There are some suggestions that the kits should be given
free only to the most -needy expectant mothers, and sold to others. This w i l l however
pose some challenges: Firstly, it is not possible to arrive at any clear-cut criteria on how to
determine the most needy mothers state wide. Secondly, even the most needy would still be
asked to part with some payments for the kits by some devious Health Workers.

Given the challenges above, the Government should decide to provide the kit free. The MoH
should take up the procurement and distribution of the kits to the districts and even integrated
them into the essential Drug Distribution System. Under this system, the District Admin will
Purchase the kits and in turn Supply to the health centres of the respective Districts. Supply to
health units will be replenished after returning the accountability-tracking sheets that will
indicate how the previous provisions were utilized. Distribution to the District or Block Health
Centres will be conditioned on training and response practices. This will be well documented in
a l l th e districts where the logistics system was specifically targeted for improvement.

In addition to MoH distribution, other partners can be involved in the distribution of the kit. NGOs
can be the significant Partners, which will be able to tap into the internal corporate community
and external donors to boost the Mothers’ Kit initiative. Bank, Corporates can all contribute to
the NGOs to internally fund the kit.

Maama Kit
12
District Health Visitor - Lira

Our team will visit the Rural Areas and identify Mothers, verify and sensitize them about the kit
on the day of distribution. While the Health Workers can attend the sensitization, but they will
not keep the kits. The kits will be given directly to the beneficiaries – the mothers. During the
sensitization they will encourage the Mothers to attend postnatal clinics.

Some corporate bodies can a l s o physically get involved in distributing kits in the
communities. Staffs for example can travel to the camps in North and South 24 Paraganas to
deliver the kits to the needy mothers as part of the Sorporate Social Investment.

As expected, sometimes the kits will not be enough to cover all would be beneficiaries. In
such circumstances, the distribution criteria c a n put emphasis on the most vulnerable or
needy Mothers.
 Outcomes of Mothers’ Kit utilization

Outcomes can be looked at two levels: (1) improved Hygeinic Service Delivery; and (2) improved
utilization of the kit and related services by the Mothers.

Overall, all health s e r v i c e providers and partners w i l l agree that the gains expected of
Mothers’ Kit initiative will largely be achieved. Demand for the kit across the districts will
be high – an indicator of both perceived benefit of the kit by the mothers, and increase in the
utilization of the health services.
IMPACT: Health service delivery
In face of acute shortages in post-natal chid health related services, health officers feel the kit will
become handy for child health after deliveries. There is a general agreement that the kit will become an
effective solution for Child and Mothers’ health, after child deliveries. As a result, rates of health related
diseases of mothers will be in some places can be eliminated or reduced drastically.

Similarly, in the areas of implementation, women will have after the launch of the kit stop complaining of
health and hygiene related issues, after delivery at health centres, an indication that infections will be
reduced. In this regard, the kit will go a long way in ensuring clean and safe baby to the benefit of
all parties involved – mothers, newborns and health service providers.

Besides serving as an infection control measure, the Kit will also improve the relationship between
health workers and their Patients. Previously the mothers perceived the Health Workers as rude, an aspect
blamed on the later’s negative attitude stemming from an overstretched Health System where service
delivery falls short of patient expectations.

1
IMPACT: Improved service utilization
The outcomes of Health Service Utilization will be assessed at two levels; (1) Child Care at health
centres, and (2) PNC attendance. There will be no case of Resentment or Refusal of the kit by Mothers.

The kit w i l l provide answers to the shortages of child care facilities. We only pray that supply
is enough and sustainable. Mothers’ Kit w i l l give the mothers a sense of ownership in service
delivery.”

As a consequence, the kit will increase the appreciation of the importance of PNC services. All the
implemented districts will report increase in PNC attendance after the provision of the kit starts.
Initially, the provision of the kit might be conditioned on PNC attendance as an incentive to increase
service utilization. The promise of a free kit will lure Mothers to attend PNCs at the health units. The
fear of lack or user cost of kit items might make some mothers stay away from PNCs can be averted.

A good number of health centres will report increases in child health care improvement, after the
distribution of the kit starts.
IMPACT: Kit will enhance Humanitarian Response
The initial outcome of the Mothers’ Kit will inspire other Partners to help Poor and Vulnerable
communities replicate the initiative. The initiative will accelerate humanitarian responses to help
mitigate the suffering of vulnerable people.

Onc e w e g e t e x t e r n a l f u n d f o r t h e P r o j e c t , the externally funded Kit will h a v e

additional items such as baby panties, nappies, baby sheets, safety pins, and two pullovers, three bars
of washing soap, baby lotion, powder and a large mosquito net for both the Mother and Newborn.
 Like any other health initiative, Mothers’ Kit will have some challenges to
Challenges learn from in addition to the successes seen above. The health workers major

remain fear w i l l be sustainability of supply. Supply of the kit may

sometimes be intermittent and HWs might often run short of stock, this
will threaten the gains made so far.

In addition to sustainability, both HW and beneficiaries will continue to raise

issues with the size of the kit. Some mothers feel the plastic sheeting is too
small and should be increased in size. While the HW will feel the numbers
of pairs of surgical gloves in the kit should be increased.
Conclusion
To this end, it is gratifying to note that the MoH, in an effort to
consolidate the e x p e c t e d gains from Mothers’ Kit, might decide to
incorporate it under the Essential Medicine List elaborated in the Health
Sector Strategic Plan.