Home visits are a central component of MYCHI. Calcutta Kids health workers conduct monthly home visits for pregnant women, postpartum women, children, and as follow up to manage medical cases.
Home visits also serve as a confidential means for women to talk with the health workers about personal problems they are facing, sometimes having to do with their pregnancy or child and sometimes completely unrelated. These visits give women an opportunity to ask questions they may not want to bring up in the larger setting of community meetings. The health workers provide assurance to women that someone is watching out for them and for their children.
Home visits have transformed our health workers into well-respected members of the community- wisdom figures- that the people of Fakir Bagan turn to in times of need. One CK health worker explains, “The monthly home visits allow us to develop a close relationship not only with the mother and child, but the whole family. We gain recognition within the family and then the family is more likely to allow the women to access Calcutta Kids services. It also allows us to observe the living and family situation and how it changes over time.”
Pregnancy Home Visits
Senior health workers (called Area-In-Charges) are responsible for pregnancy home visits. Every month, they counsel pregnant women individually about important antenatal practices such as routine ANC with a skilled health practitioner, taking micronutrient supplements, increased daytime rest and food intake, decreased physical labor, and watching for pregnancy danger signs. They explain the major, and largely unspoken, changes which occur in a woman’s body during her pregnancy and about the life that is developing inside her. They share information on what to expect during labor and delivery, and possible complications that can occur. The family is also advised to put aside a small amount of money each week for costs associated with her delivery. Finally, pregnant women are given critical information on breastfeeding, lactation, and care for a newborn child—lessons that will be used immediately after delivery. The home visits are an important element in the Pregnancy Care Program to ensure that women are wholly prepared for the birth of their child.
We now have two excellent portable flip charts that are culturally appropriate pictures accompanying the messages to help our health workers in the counseling of families about best practices and the early detection of problems, antepartum and postpartum.
Child Home Visits
Calcutta Kids health workers conduct monthly home visits for children 0-3 years old enrolled in the Child Health Initiative. The main objectives of the visits are to monitor child health, nutrition, and growth and to counsel the mother on optimal infant and child care. The child home visits fulfill, in large part, the ‘Promotion’ aspect of GMP. Health workers look at the child’s growth chart and the measurements from the last GMP. They ask the mother to share her understanding of her child’s growth status and counsel her accordingly. (Read More- GMP). Counseling topics include breastfeeding, complimentary feeding, the importance of immunizations, common childhood illnesses including diarrhea and respiratory infections, preventive care, and proper hygiene.
Postnatal Home Visits
Calcutta Kids health workers conduct two postnatal care (PNC) home visits with new mothers and their newborn babies. The first home visit occurs 24 hours after the mother returns home with her baby (or as soon as CK is notified that she has returned home). The second home visit occurs 7-10 days after the first visit. During the visits, the health worker collects delivery information (birth weight), monitors the health of mother and newborn, and ensures that the baby is breastfeeding properly. The mother is counseled on breastfeeding, postpartum care, and newborn care.
Medical Case Management
The Medical Case Management Home Visit is a follow up visit with women and children who have received medical treatment at the weekly health camp.Home visits are carried out within 3 days of the patient’s checkup. In each case, the health worker talks with the family about the illness that occurred, the recovery process, the importance of finishing the medicine prescribed (to avoid antibiotic resistance), and ways to avoid such an illness in the future. If the patient is not recovering, the health worker recommends follow-up treatment and facilitates as needed.