The project focuses on strengthening maternal and child health care at the Community Health Center in Dumri, an existing health facility run by the government of Jharkhand. It has been able to enable Comprehensive Emergency Obstetric and New born Care services.
K.J. Somaiya Institute of Management Studies and Research
It is a project on strengthening the First Referral Unit at Community Health Center. It was initiated in April, 2017 in a tripartite Public Private Partnership between Jharkhand Rural Health Mission Society, State Government of Jharkhand, J M Financial Foundation and Deepak Foundation.
J M Financial was interested to work in areas that were the least focused on when it came to CSR activity. Moreover, the Dumri block was one of the worst performing blocks in Jharkhand on maternal and child health care services with a score of 0.29. So, on being approached by Deepak Foundation, a visit was organised and undertaken in Dumri and the nearby areas and the final selection was made on the basis of the target population and what the company could do to bring about a change in the respective areas.
The authorities involved in the monitoring and evaluation of the project at different stages are-
Jharkhand Rural Health Mission Society, State Government of Jharkhand
J M Financial
Up to two years prior to the commencement of the program, the Maternal Mortality Rate (MMR) in India was at 174 for every 1, 00,000 live births, and 6, 59,000 neonates were declared dead within 0 – 27 days of their birth2. About 830 women die from pregnancy or childbirth-related complications around the world every day. Of these, 99% occur in low-resource countries. Around 15% of all pregnant women develop life-threatening complications that call for skilled obstetric interventions3. It has been observed that there are three main factors that affect the outcome of pregnancy-related emergencies, defined by the length of three kinds of delays- Delay in deciding to seek health care, Delay in identifying and transportation to a health facility and Delay in receiving adequate and appropriate care upon reaching health facility.
The said three factors are interwoven. While the first two delays are issues of access, dependent on the patient, her family, and safe and reliable transport, the third delay is connected to services available at the health facility. Although any intervention program must try and address all three delays, the United Nations Population Fund (UNFPA) stresses on development and provision of Emergency Obstetric Care (EmOC) services by prioritizing the third delay first, since facilitating access in the absence of well-staffed, well-equipped and quality services is redundant.
Availability of referral services and timely management of complications are critical for effective management of maternal and neonatal morbidities and mortalities. Despite efforts by the Govt. of India to strengthen EmOC services across all its First Referral Units (FRUs), assessments of their functioning have indicated that these units have not become fully operational and overall satisfaction level among patients is approximately 50%. This can be improved further by improving delivery of services.
The state of Jharkhand is one of the high focus states under the Empowered Action Group (EAG) and holds a very low record for institutional delivery rates. Despite intensive efforts by the state government, Jharkhand still struggles with 53.4% deliveries taking place at home, with only 27.4% being assisted by a Skilled Birth Attendant (SBA), 23.6% deliveries in government facilities and a Maternal Mortality Ratio of 2456. The Dumri block of Giridih district of Jharkhand is one of the worst performing blocks in Jharkhand on maternal and child health indicators with an overall score of 0.29.
While the above given problem statement zeroes in on the indicators that we targeted to intervene in, it was through a match of needs and resource availability, where JM Financial’s ethos for CSR was found to be in line with the requirement at the grassroots.
Delay in deciding to seek health care – The project has been successful in influencing the patients’ and their families’ decisions in ensuring that they afford good quality healthcare at a public health facility. Over the past 27 months, the patient numbers seeking OPD treatments has risen from 649 to 1,375 (as of June 2019).
Delay in identifying and transportation to a health facility – While the project could not undertake the larger state responsibility of creating good quality roads and infrastructure, it ensured reaching out to the farthest villages through an ambulance, so as to avoid emergency cases from remaining un-treated. Through relentless follow-up, it also got the FRU to receive an ambulance from the state, thereby increasing its outreach and paving the way for sustainability.
Delay in receiving adequate and appropriate care upon reaching health facility – Whether it is a postmidnight accident on the national highway or a postpartum complication from Poraiyya Panchayat, the FRU and its team has ensured timely diagnosis, treatment and care to the patients. Babies that were being birthed in homes or expensive medical facilities, now receive care at the FRU – 2,415 deliveries till June 2019, and counting.
The CSR Committee of JM Financial group of Companies, have unanimously chosen and followed a strategy committed to integrated rural transformation through long-term grassroots CSR projects, undertaken by JM Financial Foundation (JMFF) – a philanthropic arm of the JM Financial group of Companies, in partnership with local non-profit organizations. Through the said project, we have been able to reach out intensively, to the most unreached rural regions inhabited by tribal communities in Jharkhand. Our project is designed to make a deep, focused and sustainable impact through changes to the existing Government machinery, thereby impacting community beneficiaries’ knowledge, attitudes and practices, with regards maternal health and health seeking behaviour.
This is JM Financial’s first ever nomination submitted with an intention to get this project thoroughly assessed, so that, any outcome – positive or otherwise, can be showcased as an unprejudiced supporting testimonial, to the Government, in order to continue or scale up the project, which gets concluded technically in 2020. FICCI being a credible federation, can make an immense difference to showcase the project achievements and success.
Societal and environmental benefits:
The project had set out to mitigate three critical and inter-linked delays in the form of:
1.Delay in deciding to seek health care
2. Delay in identifying and transportation to a health facility
3. Delay in receiving adequate and appropriate care upon reaching health facility
Puja Dave, Director and Head CSR
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Mumbai, Maharashtra, IN
Business Website: https://www.jmfl.com
Year Founded: 1973
Number of Employees: 1001 to 5000
One of India’s leading financial services groups, J M Financial provides a variety of businesses to financial institutions that cover the diverse areas of investment banking, mortgage lending, distressed credit and asset management. The company has consciously developed strategies for a wider geographical client base who can get a rich experience. In their collaboration with international corporate houses, they are driven to ensure excellence for their customers. The institution goes further by supporting causes related to education, health care, skill development, disaster relief, entrepreneurship promotion and animal welfare.