Norway India health cooperation in Rajasthan

Norway and India have a long standing cooperation to promote maternal and child health through the Norway India Partnership initiative (NIPI). The end of lock down (due to the pandemic) gave an opportunity for the Embassy to visit one of the NIPI project sites in Rajasthan. They were impressed with the results achieved.

Home based care and counselling for mothers seemed to have made a good impact in Alwar district. The district hospital has equipped doctors and nurses to identify new born children with growth challenges and treat them in an emergency manner. The Sick and New Born Care Units with its state-of-the-art infrastructure in Alwar and Jaipur children hospitals, impressed the delegation. Meetings with top government officials from the health sector, showed that the health indicators have improved. According to the report released by the Registrar General of India on 14 March 2022, the Maternal Mortality Rate in Rajasthan has improved to 141 in 2017-19 from 164 in 2016-18.

The delegation consisting of Deputy Chief of Mission Martine Bottheim,  Counsellor Marit Strand and Adviser Suresh Mathevan, met the ASHA (Accredited Social Health Activists) workers in Chikkani village in Alwar district. The ASHA workers provide home based care and counsels mothers on health, nutrition, well being and development of children. The delegation was shown the Mamtha chart, a chart to monitor health of children.

The delegation interacted with Dr. Om Prakash Meena, Chief Medical Officer of Alwar district. Dr Meena emphasized the importance of adapting processes and use new types of interventions, including digitally based at the district level. 

With NIPIs support, an Emergency Triage Assessment and Treatment (ETAT) centre has been set up in the Children’s Hospital in Alwar. The ETAT has equipped doctors and nurses with knowledge and skills to identify and triaging children coming to the hospital. According to NIPI staff, around 1000 children have been treated at the centre. 

The visit to the Sick and New Born Care Unit (SNCU) was quite heartening. SNCU is a concept introduced by NIPI in Phase I. SNCUs provide specialised, facility based care to small and sick new born (less than 28 days), to improve the chances of their survival. The delegation saw the functioning of the SNCU unit in the Alwar hospital and interacted with the doctors.

Human Milk Bank is an innovation that has been set up with NOREC and NIPI support with the aim of promoting exclusive breast feeding and availability of breast milk through the milk bank to sick new born children. The delegation noted that Human Milk Bank at the hospital can store about 2000 ml of milk in proper sanitary conditions.

The concept of Yashodas, a facility level worker, was introduced under NIPI. The Yashodas support mothers after institutional delivery by introducing key practices and behaviours related to new born care. The discussion with the Yashodas revealed that they encourage mothers to stay for 7-10 days in hospital after a C-section and at least for 48 hours after a normal delivery.

The delegation met Ashutosh Penderker Secretary, Medical and Health, Government of Rajasthan, who thanked the delegation for the support extended by NIPI to the state for 13 years. He stated that in general, the health indicators of Rajasthan have improved. The meeting with Mr. Jitendra Soni, Joint Secretary and Mission Director, National Health Mission of Rajasthan was interesting as well, as he recalled the useful exchange visits of Indian and Norwegian nurses.

The delegation visited the human milk bank and the new and critical new born care services in the JK Lone Hospital in Jaipur, which seemed to have very good infrastructure with 1000 beds for children.

The delegation also took the opportunity to visit the WHO surveillance centre in Alwar and met with the state head Dr. Rakesh Vishwakarma. Dr Vishwakarma explained how WHO works jointly with government regarding the surveillance work. WHO supports the digitilisation work and building of a geomapped database. WHO is active in the quality assurance for the data, and uses a technical and neutral approach to encourage pro-active reporting of outbreaks.

NIPI is implemented through the NIPI-CURE office, that coordinates closely with the Ministry of Health and Family Welfare. NIPI focuses on evidence based innovative interventions to help support reducing child and maternal mortality in five states of Bihar, Odisha, Jammu and Kashmir, Madhya Pradesh and Rajasthan. The NIPI program in India has had a total support through the embassy of over NOK 600 million.