Haryana Launches Pentavalent Vaccine In The State Immunization Program, to Counter Pneumonia and Meningitis

                                    Becomes the first state in north India to take this initiative

Chandigarh, December 19, 2012: The Department of Health, Government of Haryana will soon be launching the pentavalent vaccine in all 21 districts of the state. After the successful launch in Tamil Nadu and Kerala in 2011, pentavalent vaccine will be rolled out in Haryana, which provides protection against five life-threatening diseases -Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib (Haemophilus influenza type b). Hib is the primary cause for childhood pneumonia and meningitis.

“Approximately ­­­­­­­­­­­­­5.5 lac children will be covered during the current year­­­­­­­­­­. This will not only prevent morbidity associated with pneumonia and meningitis but also avert thousands of deaths due to these diseases annually. The vaccine will be available free-of-cost at all public health institutions and through the State Routine Immunization program,” said Mrs. Navraj Sandhu, Principal Secretary, Health and Medical Education, Government of Haryana.

During the media partnership workshop organized today, Dr. Rakesh Gupta, Mission Director, National Rural Health Mission (NRHM), added, “ the launch of the pentavalent vaccine will help in reducing the number of shots a child receives from 9 to 3. It will also provide logistical conveniences since five vaccines are stored in a single vial and a lot of space will be freed up for storage and transportation. A single auto-disable syringe will be used instead of three per child, thereby substantially reducing the plastic and sharp waste”.

“Children below the age of five years are more vulnerable to diseases and conditions that contribute to fatal consequences leading to increased child mortality. Vaccination is one of the most significant medical interventions preventing such serious diseases. Most diseases contributing to under-five mortality are now preventable using currently available vaccination against them”, said Dr. Satish Gupta, Health Specialist (Immunization), UNICEF.

Welcoming this initiative, Dr. Naveen Gupta, General Secretary, Indian Academy of Pediatrics (IAP), Haryana, and private practitioner said, “The introduction of pentavalent vaccination, which was available in the private sector till date, will now be available free-of-cost for all newborn children in the state. Over the last few years, I have seen steady reduction of pneumonia cases after introduction of the pentavalent vaccine in the private sector”

“We congratulate the Government of Haryana on taking this progressive initiative and including the vaccine in it’s immunization program. The vaccine will now be accessible to all sections of the society, especially those most in need”, added Dr. Pradeep Haldar, Deputy Commissioner, Immunization, Government of India.

The workshop was facilitated by officials and experts from the Government of Haryana, UNICEF, WHO, IAP and Global Health Strategies.  The interactive session was attended by representatives from the regional- national print and electronic media, health department officials and health professionals.

About Pentavalent Vaccine

The pentavalent vaccine aims at providing protection against the five life threatening diseases - Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib (Haemophilus influenza type b).  The DPT (Diphtheria, Pertussis, Tetanus) and Hepatitis B are already part of the national routine immunization programme. Protection against Hib is a new addition. Together, the combination is called pentavalent.

Haemophilus influenza typeB (Hib) is a bacterium that causes severe pneumonia, meningitis and other life-threatening conditions in children less than five years of age. Hib not only endangers a child’s life but also can leave the child with long-term neurological problems such as deafness, brain damage, co-ordination related problems and epilepsy.

 About Pneumonia in India

Pneumonia is one of the largest killers among young children aged one month to five years of age. Of the estimated 1.7 million childhood deaths, pneumonia contributes to nearly 390,000 deaths (20%) per year¹. Pneumonia is caused by bacterial and viral organisms. Appropriate vaccination, exclusive breast-feeding until six months of age, timely identification and treatment are key strategies to reduce mortality and morbidity due to pneumonia.

The National Technical Advisory Group on Immunization in 2009 had recommended that Hib vaccine reduces the high child mortality due to Hib meningitis and pneumonia.

Promoting Appropriate Management of Diarrhea: A Systematic Review of Literature for Advocacy and Action: UNICEF-PHFI Series on Newborn and Child Health, India

Childhood diarrhea is a significant public health problem in India; the point (two-weeks) prevalence is 9-20%. Diarrhea accounts for 14% of the total deaths in under-five children in India. Infants aged 6-24 months are at the highest risk of diarrhea. There is a lack of robust nation-wide data on etiology; rotavirus and diarrheogenic E.coli are the most common organisms identified. The review was conducted to identify, synthesize and summarize current evidence to guide scaling up of management of diarrhea among under-five children in India, and identify existing knowledge gaps.The review reaffirms the high burden of childhood diarrhea and deaths due to it in India and the role of ORS and Zinc in preventing deaths, and hand washing and breast-feeding in preventing its occurrence.

This review summarizes current evidence on childhood diarrhea and provides evidence to inform child health programs in India.

Systematic Review- Promoting Appropriate Management of Diarrhea

Joint Press Release: Thursday June 14 World Unites to Accelerate Progress in Ending Preventable Child Deaths

Washington, D.C. – Today over 80 governments and a multitude of partners from the private sector, civil society,and faith-based organizations gather at the Child Survival Call to Action – a high-level forum convened by the governments of Ethiopia, India and the United States, in collaboration with UNICEF, to launch a sustained, global effort to save children’s lives. 

Over the past 40 years, new vaccines, improved health care practices, investments in education, and the dedication of governments, civil society and other partners have contributed to reducing the number of child deaths by more than 50 per cent. 

Still, millions of children – most of them in Sub-Saharan Africa and South Asia – die every year from largely preventable causes before reaching their fifth birthdays. In 2010, this translated to 57 children dying for every 1,000 live births. 

The Call to Action challenges the world to reduce child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. Reaching this historic target will save an additional 45 million children’s lives by 2035, bringing the world closer to the ultimate goal of ending preventable child deaths.

Modelling shows that this goal can be reached by greater effort across five key areas:

1. Geography: Increasing efforts in the 24 countries that account for 80 percent of under-five deaths occur
2. High Burden Populations: Focusing country health systems on scaling-up access for underserved populations, to include rural and low income groups
3. High Impact Solutions: Addressing the five causes that account for nearly 60 per cent of child deaths: pneumonia, diarrhea, malaria, pre-term births and intrapartum (around the time of childbirth)
4. Education for Women and Girls: Investing beyond health programs to include educating girls, empowering women, and promoting inclusive economic growth
5. Mutual Accountability: Unifying around a shared goal and using common metrics to track progress

At the Call to Action, governments and partners are being asked to pledge their support for A Promise Renewed , a commitment to work together on sharpening national plans for child survival, monitoring results, and focusing greater attention on the most disadvantaged and vulnerable children.

“We have the tools, the treatments, and the technology to save millions of lives every year, and there is no excuse not to use them,” said UNICEF Executive Director Anthony Lake. “To renew our promise to the world’s children, we have to focus on the leading causes of child mortality like diarrhea, pneumonia and malaria, scaling up coverage of high-impact, low-cost treatments, sparking greater innovation, and spurring greater political will to reach the hardest to reach children. The grand goal of preventing child deaths must be our common cause.” 

”India is honored to co-convene this global call to action. The opportunity is timely, and we have to seize it. Though there has been a steady decline in child mortality rates in India over the past 10 years, there is no place for complacency,” said Ghulam Nabi Azad , India’s Minister of Health and Family Welfare. “Reducing neonatal, infant and child mortality remains the topmost goal of India’s National Rural Health Mission. With India’s experiences in child survival interventions, and the magnitude of scale of programming, the country is well positioned to work towards furthering collaboration in implementation of Child Survival Initiatives in the Asia-Pacific region,” he added.

“In the world, there are no two countries that are the same. Therefore each of us needs to define our own roadmap to achieve this laudable goal. In Ethiopia, we have halved under-5 mortality rates from 166 to 88 per 1,000 live births just in the last decade,” said Dr. Tedros Adhanom Ghebreyesus, Ethiopia’s Minister of Health. “What we can promise the world and our children now is that Ethiopia will try our best, as we have done in the past, to bring the rate down to fewer than 20 deaths per 1000 live births by 2035. We will then be able to look back and say that we have done justice for our children, and we have written an important piece in human history,” he added.

USAID Administrator Rajiv Shah said: “Development can be full of problems we have few ways to solve. Helping a child reach their 5th birthday is not one of them. It is not a question of whether the world can end preventable child deaths; it is question of whether we will.”

###

The two days of events will be Livestreamed at: http://www.apromiserenewed.org

Twitter hashtag: #Promise4Children

B-roll and events of the day will be recorded, packaged, and delivered on:
http://weshare.unicef.org/pickup?key=S788e1517-36e8-4ed9-8a56-01a92fc5fa3d

Updates and photos will be posted on the Facebook page at: www.facebook.com/APromiseRenewed

For further information or requests, please contact:

Peter Smerdon, UNICEF New York, Tel.             + 1212 303 7984      , Mobile             +1 917 213 5188       psmerdon@unicef.org
Sarah Crowe, Spokesperson for the Executive Director,             1 212 326 7206       scrowe@unicef.org

India
Caroline den Dulk, Chief, Communication & Advocacy, UNICEF, India Country Office. Mob # 9818106093, email: cdendulk@unicef.org

Geetanjali Master, Communication Specialist, UNICEF, India Country Office. Mob # 9818105861, email gmaster@unicef.org

Global leaders to chart course towards the end of preventable child deaths

WASHINGTON, D.C. – The governments of the United States, India and Ethiopia will in collaboration with UNICEF convene the Child Survival Call to Action in Washington D.C. 14-15 June 2012.

The Call to Action brings together 700 leaders and global experts to launch a sustained effort to save children's lives. The untold story of child survival is that the global community now has the combined knowledge, innovations, technical know-how and affordable tools to end preventable child deaths. Evidence shows that it is possible to decrease under-five mortality rates in developing countries to levels approaching those in wealthier countries, and to reduce disparities between the poorest and wealthiest children within nations.

The Call to Action challenges the world to reduce child mortality to below 20 child deaths or fewer per 1,000 live births in every country by 2035.  Reaching this historic target will have saved an estimated, additional 45 million children’s lives between 2010 and 2035, bringing the world closer to the ultimate goal of ending preventable child deaths. 

The Call to Action forum will launch Committing to Child Survival: A Promise Renewed, a pledge to accelerate declines in maternal and child mortality.Through national action and international cooperation, governments and partners renew the world’s commitment to give every last child the best possible start in life.

The press conference is ahead of two days of discussions on 14-15 June at the Child Survival: Call to Action. On 14 June, there will also be a special announcement by actor, director and founder of the Eastern Congo Initiative Ben Affleck.

WHEN: Wednesday, 13 June, 2:15 pm EDT telephone press conference.

WHO: Speakers include Tedros Adhanom Ghebreyesus, Minister of Health, Government of Ethiopia; Anuradha Gupta, Permanent Secretary, Minister of Health and Family Welfare, Government of India; Anthony Lake, UNICEF Executive Director; and Rajiv Shah, Administrator, US Agency for International Development.

Child Survival: Call to Action Conference AgendaThursday and Friday, 14-15 June 9:00 am—5:00 pm EDT.

WHERE: Georgetown University, Washington, D.C.

The two days of events will be Livestreamed at: http://www.apromiserenewed.org

Background:Ten years after the UN General Assembly passed the landmark resolution on A World Fit for Children, A Promise Renewed aims to build on the global success in reducing preventable child deaths and renew political will to get the job done. By pledging support for A Promise Renewed, partners vow to redouble efforts to achieve Millennium Development Goals 4 and 5 by 2015 and to reduce child mortality in all countries, achieving 20 or fewer under-five deaths per 1,000 live births by 2035, with a focus on reaching the most disadvantaged and hardest-to-reach children in every country.

Editors’ panel highlights importance of immunization in media at IGNOU-UNICEF Health Editors meet

IGNOU and UNICEF Health Editors' meet on April 26
at Hotel Royal Plaza, New Delhi

Veteran journalists Mr. Vinod Mehta and Sir William 
Mark Tully chaired the valedictory session.

April 26, 2012: A high level group of editors from Delhi and Madhya Pradesh came together for a brainstorming session, today, to mark the Global Immunization Week as a part of the Indira Gandhi National Open University (IGNOU) and UNICEF partnership on immunization initiated last year.

Setting the context, Dr. Ajay Khera, Deputy Commissioner, Ministry of Health and Family Welfare, New Delhi informed that the Government of India has declared Year 2012 -13 as the year of Intensification of Routine Immunization.

Focusing on the fact that out of  26 million children born every year in India, one-third do not complete their immunization, national editors discussed  the crucial role that media  can play for tackling this issue.

Sir Mark Tully, veteran journalist said, “Undue emphasis is laid on curative medicine rather than preventive measures and that is why I entirely support the immunization campaign. For spreading awareness traditional media like radio can still be very effective to reach remote areas of the country”.

Emphasizing on the need for health communication to be simple, icon of Indian journalism, Mr. Vinod Mehta said, “Health issues are often communicated in a complex manner. Stories have to be simple in order to communicate effectively. Strategies like celebrity endorsements as seen in the case of the polio program, can make a huge difference.”

Mr. Palash Surjan, Editor, Deshbandhu, Madhya Pradesh pointed out that MP has one of the lowest immunization rates - 42% against the national average of 60%. The need to build capacities of grassroots journalists and sensitize the large number of women Panchayati Raj Institution members was emphasized by him.”

Caroline Den Dulk, Chief of Advocacy and Communication, UNICEF, said, “Today’s discussion highlights the need for large-scale partnerships, bridging information gaps and building trust at all levels in order to prevent millions of under five children dying from Vaccine Preventable Diseases.”

Citing the example of Right to Education, Mr. Saunand from IGNOU and Mr. S.K Singh, Executive Editor, Zee News proposed the concept of “Right to Immunization” for ensuring an equitable approach for IRI. This would call for all stakeholders including media to join forces.

Ms. Nidhi Kulpati, NDTV India highlighted the need for media to focus on the frontline workers  who are crucial for delivering health services in remote areas Mr. R.K Singh, Editor Navbharat Times and Mr. P. Somvanshi, Resident Editor, Hindustan pointed out that in areas where both media penetration and immunization coverage is low, innovative means of communication such as mobile phones should be used. Voicing the critical role played by Urdu media, Mr. Alamgir, News Editor, UNI highlighted the critical role of Urdu media in reaching out to minorities and marginalized communities. Ms Sanchita Sharma, Health Editor Hindustan Times pointed out that negative news or controversies can be turned into huge opportunities and highlight critical survival issues.

Stressing on the need for two-way flow of information between the media and health authorities, Kounteya Sinha, Health Editor, Times of India said,  “We are interested in doing good stories. Immunization is a major problem area for the country and we are only too eager to help provided there is complete transparency.”

“Compared with the national media the state and district media has extensive reach and it is important to engage specifically with these grassroot level journalists. Branding with local connect should be created around the concept of Routine Immunization,’” said Mr. Q. W Naqwi, Aaj Tak.

Mr. N.K. Singh, senior media editor from Madhya Pradesh also emphasized the need for branding and making RI a social programme where diverse groups of civil society members are engaged. 

Dr. Henri van den Hombergh, Chief Health, UNICEF added, “Routine immunization can become routine if there is popular demand and awareness for it and the role of media therefore is absolutely crucial”.

Developmental journalists who have contributed some of the best immunization stories since the launch of the partnership were recognized and awarded during the function. The awardees included Mr. Kounteya Sinha, Health Editor, Times of India, Mr. Nitin Yadav, Senior Sub- Editor, Amar Ujala, Mr. Santosh Singh, Senior Correspondent, Prabhat Khabar, Mr. M.A. Alamgir, Chief Sub Editor, UNI Urdu, Ms. Shefali Chaturvedi, Senior Manager- Programming- Radio Dhammal24. Media professionals from Madhya Pradesh who received the certificates are Mr. Sundip Pouranik, Principal Correspondent IANS, Mr. Raju Kumar, Principal Correspondent, The Sunday Indian, Ms. Ruby Sarkar, Special Correspondent, Deshbandhu, Ms.Ankita Mishra, Asst. Editor, LN Star, Mr. Rakesh Malviya, Freelance journalist, Rohit Shrivastava, Senior Reporter, Dainik Bhaskar and Mr. Pankaj Shukla, City Bureau Head, Navdunia.

Caroline den Dulk,Chief, Advocacy & Partnerships, Tel: +91-98-1810-6093      

E-mail:cdendulk@unicef.org                             

Geetanjali Master, Communication Specialist, Tel: +91-9818105861,

E-mail: gmaster@unicef.org                   

Sonia Sarkar, Communication Officer, Tel : +91-9810170289

E-mail : ssarkar@unicef.org

Anil Gulati, Communciation Specialist, Tel : + 097-052 538802

Email : agulati@unicef.org

S. Saunand, IGNOU. Tel: + 81 30 35 8629

E-mail: ssaunand@ignou.ac.in

UNICEF-IGNOU discuss immunisation project with health editors

  April 26,2012- IGNOU-UNICEF Health's Editor meet
 in progress at Royal Plaza Hotel, New Delhi

Source : The Sunday Indian, Pratham  Dwivedi | New Delhi, April 26, 2012 21:14


Indira Gandhi National Open University (IGNOU) and United Nations International Children's Emergency Fund (UNICEF) discussed their partnership project on Routine Immunisation as a part of Global Immunisation week, with health editors of national and state media here on Thursday.

Speaking during the meet, Public Health Expert & Deputy Commissioner of Ministry of Heath and Family Welfare department, Dr. Ajay Khera said full immunisation coverage in India is 61%, which is over 90% in some of our neighbour countries. “Major reason behind abysmal immunisation coverage is the information gap. It could even be understanding phobia of adverse events after immunisation which should be addressed. If we can fill these gaps we will be able to make a major change.”

While giving his presentation on National Immunisation Program in India, he said, “We give vaccines against seven vaccines preventable diseases, but some of the countries are giving vaccines against as much as 20 vaccine preventable diseases.”

“To intensify immunisation the government has declared year 2012, the year of intensification for immunisation,” he added.

Dr. Henri van den Hmobergh, Chief of Health, UNICEF said, “One of the most important part of routine immunisation is to follow a routine and we need media to help continue that routine, if demand side is strong, supply side will also be strong and media should be the voice of the demand side.”

The editors present in the meet raised issues related to immunisation and suggested several ways to improve routine immunisation and fill the information gap. Chief Editor of IANS Tarun Basu raised the issues of information gap and regulation of health reporting and suggested ways such as new media, sms, citizen journalism to reach out to people.

Radio can be an effective and cheap medium to disseminate information suggested Mark Tully, Former Bureau chief of BBC India. He also referred to BBC World Service Trusts' leprosy elimination campaign and said that rotary can do good work for the Routine Immunisation campaign.

The role of soap operas, importance of health workers, direct communication, branding of the campaign, building trust among the people, focusing on the target group, Improving delivery system, involvement of women, making social and religious connect and long term planning to reach out to people were some of the other points raised by the panelists present in the meeting.

IGNOU and UNICEF also recognised the journalists associated with them, for their contribution and awarded certificates of recognition to them. Raju Kumar, principle correspondent from The Sunday Indian was one of the journalists who received the award.

'टीका लगाना था इसलिए नहीं गई खेत"

Article contributed by Mr. Pankaj Shukla, City Bureau Head, Navdunia, Bhopal, Madhya Pradesh

ग्रामीणों पर मनोवैज्ञानिक प्रभाव 

बालाघाट। मगरदर्रा की आँगनवाड़ी में अपनी तीन माह की बेटी को टीका लगवाने लाई कौशल्या अनुसूचित जाति वर्ग है। गरीब परिवार की बहू कौशल्या कमाई के लिए खेत पर काम करने जाती है। इनदिनों ध्ाान की कटाई का काम चल रहा है करीब सौ रूपए रोज कमाने वाली कौशल्या अपने टोले की एक और महिला के साथ टीका लगवाने आई। उनसे जब पूछा गया कि काम पर क्यों नहीं गईं तो वे कहती हैं कि बच्ची को टीका लगवाना ज्यादा जरूरी है। टीका लगवाना जरूरी है यह किसने कहाँ, पूछने पर वे आँगनवाड़ी सहायिका की ओर इशारा कर देती हैं।

केवल कौशल्या ही क्यों, रोशन पंचायत की समनापुर आँगनवाड़ी में मिली सितकूर टोला की उमा भी कहती है कि उसे आँगनवाड़ी कार्यकर्ता बुलाने आई थी और वह अपने टोले की एक गर्भवती महिला के साथ बच्ची को टीका लगवाने आई है। टीका क्यों जरूरी है? जवाब मिला-बच्ची बीमार नहीं होगी। टीका लगाने के बाद भी तो वह उदास और बीमार हो जाती है, पूछने पर उमा कहती है वो तो दो दिन में ठीक भी हो जाएगी। यह जवाब सुखद आश्चर्य से भर देता है। यह जवाब उस जिले कर अनपढ़ महिलाओं के हैं जहाँ नक्सली प्रशासन के लिए चुनौती बने हुए हैं। महिलाएँ सौ रूपए का घाटा सह कर बच्चों को टीका लगवाने लाती हैं। प्रशासन को तो केवल उन तक सूचना पहुँचाना पड़ती है कि किस दिन टीका लगेगा। 

एएनएम सुनीता मैथ्यू बताती है कि ग्रामीण ज्यादा सवाल नहीं करते। उन्हें बुला लिया जाता है तो वे आ जाते हैं। लालबर्रा की एएनएम उर्मिला पटले कहती हैं कि हम लोगों को पहले ही बता देते हैं कि टीका लगाने के बाद बच्चे को बुखार आ सकता है। बच्चा सुस्त होता है तो इसका मतलब है कि दवाई असर कर रही है। अगर ज्यादा बुखार आ जाए तो तुरंत डॉक्टर को दिखाना चाहिए। स्वास्थ्य कार्यकर्ता केके यादव कहतेे हैं कि बच्चा बीमार होता है तो लोग लेकर तुरंत आ जाते हैं। कुपोषण पर वे जिला मुख्यालय में पोषण पुनर्वास केन्द्र (एनआरसी) में भी भर्ती करते हैं। श्री यादव का कहा एनआरसी में भ्रमण के दौरान सच लगा। यहाँ 19 बच्चों को पोषण के लिए भर्ती करवाया गया था। ग्रामीणों की जागरूकता ही परिणाम था कि तुमड़ीटोला की आँगनवाड़ी में दोपहर तीन बजे तक लक्ष्य के सभी बच्चों को टीके लग चुके थे। केवल एक गर्भवती महिला का आना शेष था और सभी उसका इंतजार कर रहे थे। नहीं आई तो? इस पर आँगनवाड़ी सहायिका ने कहा कि वह तीसरी बार बुलाने जाएगी। जब कोई इतना पीछे पड़ जाए तो टीका लगवाने आना तो पड़ेगा। 

मगरदर्रा के सरपंच श्यामसिंह चौहान कहते हैं कि बालाघाट मंे लोग जागरूक हैं। वे अपनी बच्चियों को कम से कम आठवीं तक तो पढ़ाते ही हैं। कई लोग आगे पढ़ने के लिए बेटियों को बाहर भी भेजते हैं। इस बार गाँव में दसवीं तक स्कूल खुलवाने की कोशिश हो रही है ताकि सभी बच्चियाँ दसवीं तक पढ़ सकें। टीकाकरण के लिए पंचायत कुछ करती हैं, पूछने पर वे कहते हैं कि जरूरत पड़ने पर हम जोर दे कर ग्रामीण से टीके लगवाने का कहते हैं। वैसे वे मानते हैं कि जननी सुरक्षा योजना के कारण लोगों में संस्थागत प्रसव का रूझान बढ़ा और खाना मिलने के कारण लोग बच्चों को आँगनवाड़ी में भेजते हैं। न भेजेंगे तो खिलाएँगे कहाँ से? यहाँ जागरूकता का एक और उदाहरण देखने को मिला। ग्रामीण अपने देशी इलाज पर भरोसा करते हैं तो अस्पताल जाने से भी परहेज नहीं करते। वे ओझा के पास भी जाते हैं और इलाज करवाने डॉक्टर के पास भी आते हैं। वे दोनों की बात मानते हैं। उनका उद्देश्य बच्चे का ठीक होना है। 

एएनएम ममता सर्राटे कहती हैं कि जिले में आशा कार्यकर्ताओं की कमी है। छत्तीसगढ़ से लगे हिस्से में लोगों की भाषा समझने में दिक्कत होती है। अगर इन क्षेत्रों में भी आशा कार्यकर्ताओं की भर्ती हो जाए तो टीकाकरण की दर और बढ़ सकती है। वे सुझाव देती है कि ग्रामीण टीवी कार्यक्रमों से प्रभावित होते हैं तो क्यों न कोई विज्ञापन बना कर टोलो में दिखाया जाए ताकि ज्यादा से ज्यादा लोग जागरूक हों। आशा कार्यकर्ता सुरसता सलीम और चन्द्रप्रभा कहती हैं कि उनकी माली हालत ठीक नहीं है। एक संस्थागत प्रसव पर 150 रूपए मिलते हैं। इसलिए वे हमेशा खोज में रहती हैं कि गर्भवती महिला की जानकारी उन्हें ही मिले। बाद में वे टीके लगवाने का काम भी करती हैं। हालांकि कई बार इन्हें पैसा मिलने में वक्त लग जाता है लेकिन वे ये काम नहीं छोड़ती। वे टोलों में होने वाली शादियों और काम के लिए यहाँ से जाने वाले लोगों का हिसाब भी रखती है ताकि हर शुभ सूचना उनके पास रहे। 

सीएमओ डॉ एसएल साहू कहते हैं कि दिक्कतें यहाँ भी हैं। कई लोग काम नहीं करते। समय पर नहीं आते लेकिन निगरानी तंत्र को मजबूत बना कर रखा गया है। जो नहीं है उसका काम कोई और संभाल लेता है। समय-समय पर महिला एवं बाल विकास विभाग तथा स्वास्थ्य विभाग की संयुक्त बैठक होती है। अत: दोनों विभागों में समन्वय की समस्या नहीं होती। जिले में चिकित्सकों की कमी है लेकिन महिला स्वास्थ्य कार्यकर्ता पर्याप्त है। 2015 आँगनवाड़ी कार्यकर्ताओं और सहायिकाओं के साथ 1144 आशा मिल कर बढ़िया नेटवर्क बना लेती है। ग्रामीणों और मैदानी अमले की यही जागरूकता बालाघाट की ताकत है