Increasing institutional delivery in Salempur in Uttar Pradesh

Women frontline workers influence increased uptake of institutional delivery services among a village community.


Salempur is a small agricultural village of 1,434 people located in Khairabad block in Sitapur District, one of the 25 High Priority Districts (HPDs) in Uttar Pradesh. Much of the Salempur’s population belongs to the scheduled caste community. Many members of the village have small landholdings on which they rely heavily for the production of grain for their livelihood.


Salempur is located very near to Madhwapur Sub-Centre, which has generally served as the RMNCH+A delivery point for the village. Despite the relative proximity of this sub-centre to Salempur, the uptake of institutional delivery services amongst the community has generally been significantly low. Local service providers and public health workers have attributed this low demand for care to a lack of awareness about the availability of services amongst Salempur residents, as well as the need for strengthening the quality of maternal health services.


Since mid-2014, the UP TSU has been supporting the Government of Uttar Pradesh to implement regular meetings for Anganwadi Workers (AWWs), Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) at the sub-centre level. Known as “AAA Forums”, these meetings provide a platform for the “AAA” frontline workers to convene regularly, share their concerns, experiences, and coordinate their outreach activities accordingly. In Khairabad block, UP TSU’s CRPs have assisted in facilitating these meetings, and FLWs responsible for outreach in Salempur have participated in the forums.


During a recent AAA meeting in Khairabad block, the attending ANM reviewed the progress of local villages in routine immunization coverage, antenatal care (ANC) and institutional delivery. The participating frontline workers discussed the geographic areas where the uptake of these services were low, and where it was high.


Through this discussion, the FLWs noted that the village of Salempur had significantly low uptake of institutional delivery services. The 8 participating ASHAs and 10 AWWs jointly decided to visit Salempur and raise awareness amongst the residing families. With the support of a CRP, the ASHAs and AWWs organized a visit to the village, divided themselves in to teams, and began conducting house-to-house visits. During these visits, ASHAs and AWWs interacted with families to explain the benefits of institutional delivery and shared information about various government schemes, such as Janani Suraksha Yojana.


Under the strategic leadership of the CRP, the frontline workers conducted 3-4 additional follow-up visits to Salempur, and contacted local influencers as well as the village Pradhan. A larger meeting was called within the village, with attendance from the Pradhan as well.


Ultimately, the outreach efforts of the CRP and FLWs resulted in an increased knowledge and understanding of the advantages of institutional delivery amongst residents of Salempur. The village has seen a resulting rise in the number of residents visiting the sub-centre facility for services. Today, Salempur is the village with the highest uptake of institutional delivery services in the entire sub centre