Anantnag : Lal Jan, an ASHA worker in Hapatnard Gogaldar village in Anantnag district has helped out at least 500 deliveries since she was appointed in the health department. In 2005, Lal Jan (45) was appointed to the health department as an ASHA worker before her appointment. She has helped out at least 250 deliveries at their homes. Lal Jan's mother Zaina Begam was also doing this job and has helped out at least 700 deliveries at their homes in normal delivery when there were no health facilities in their area
Speaking to the reporter, Lal Jan said, "I have learnt from my mother, my mother was very known in the area for helping pregnant ladies in home delivery." Her mother died 30 years ago. Lal Jan, has experience in deliveries for the last 30 years, she goes from house to house raising awareness about family planning.
In 2007, Lal Jan got an appreciation award from the office of block medical officer Bijbehara for her motivation to a number of beneficiaries for family planning and female sterilization during the year 2007- 2008 and 2009, her performance character and conduct remained satisfactory for the said period, she said.
According to her, in the Hapatnard area and nearby villages, at least 300 women have done sterilization and taken procedures after their birth of the 3rd, and 4th child some among them have 6th, and 7th child. The Hapatnard village which is located on the foothills of Khovripora block is about 35 km from the District headquarters in Anantnag.
In 2008, a PHC was established in the village which was functional in 2018. Before the functionality of the PHC, the patients of the area either were visiting sub-district hospitals or MCCH hospitals Anantnag. The PHC of the Hapatnard village is catering to about seven thousand people in eight villages which are around the hospital. The hospital lacks basic facilities including X-ray and diagnostic testing facilities forcing patients to visit the seer Sub District Hospital or MCCH Hospital Anantnag.
Due to the non-availability of a gynaecologist, pregnancy care has also been hit badly and women in the area face severe hardships. According to official data in Anantnag District, more women, than men were opting for sterilization in Anantnag District, official data provided by the Chief Medical officer of Anantnag reveals that from 2019 to date 1369 women were operated upon for various permanent birth control methods, including laparoscopic sterilization and mini-laparotomy, while only one man opted for permanent sterilization in the period.
Same in the spontaneous miscarriages in District Anantnag at least 3144 cases were reported since 2019 to date, data reveals. However the only maternity and child care hospital in Anantnag district which caters to the entire south Kashmir as well as Chenab and Pir Panjal Valley of Kashmir region has also provided data to this reporter which their data reveals that 913 women were operated on for permanent birth control methods in hospital, through laparoscopic sterilization and mini-laparotomy since 2019 to till date,
The hospital is presently housed in an old, worn and unsafe building in the congested Sherbagh locality of the old town in the Anantnag district. The 40-bedded hospital gets an average of 40,000 patients in the Out-Patient Department (OPD) and about 7000 indoor patients every month.
According to official sources, the ratio will be high in South Kashmir as most of the patients prefered to do Sterilisation and miscarriages in private hospitals. Dr Nawaz, HOD Gynecology in MCCH hospital Anantnag while talking to the reporter said that Female sterilization is the most preferred family planning choice here in south Kashmir's Anantnag district.
The department witnesses hundreds of women undergoing sterilization procedures for permanent birth control each year. Misconceptions and lack of awareness is the main factor in the urban as well as rural population for poor uptake of family planning services in the Anantnag district. Other responsible factors include cultural and religious beliefs. Men generally don't undergo vasectomy for sterilization because they believe that it affects their manhood, he added.
Anaemia is another problem in the country. According to a study conducted by the Department of Obstetrics and Gynecology GMC Anantnag, almost 83 per cent of pregnant and lactating women in South Kashmir were anaemic due to poor nutrition.
Anaemia can lead to multiple complications during pregnancy, labour and the postpartum period, which include fetal growth restriction, abruption of the placenta, cardiac failure, and even death of mother and baby, Nawaz says. Women don't take the recommended iron and folic acid supplementation in adolescence and pregnancy. Short birth intervals and multiparity further add to the problem.
ASHA workers and primary care physicians should be involved in rural areas to address the issue. Focus on adolescent health, preconception care and counselling, good nutrition, education and awareness can bring down the problem significantly, he added. Another issue that is under-addressed in this part of the world is the emotional and mental well-being of pregnant women. Poor social support, bad pregnancy experiences and outcomes in the past are one of the few responsible reasons.
There are a number of women in south Kashmir in hospitals who suffer from mental health issues during their pregnancies, especially those expecting moms who had a negative experience in the past, such as a miscarriage.
This further adds to the burden of mental disease as women don't tend to seek help. Good social support and timely intervention can mitigate the problem, he said.