It was around 2 am in the middle of the night, when the phone rang. An anxious voice was heard on the line, “My daughter-in-law is having labor pains and the ambulance number is unreachable. There is no private car available during lockdown. What should we do?” he pleaded. A reassuring voice responded, “Please do not worry. The ambulance will reach you within a few minutes. And if we are not able to contact the ambulance, we will send a personal car to your home to take the lady to the hospital.”
20 minutes later, the ambulance reached the location and took the pregnant woman to the hospital. She safely delivered and is now back home with her baby.
The reassuring voice that took that late night call was that of Dr. Mahendra Janardan Kolhe, Program Officer for Maternal, Newborn and Child Health at Jhpiego, posted in Bikaner. With support from the Children’s Investment Fund Foundation and in partnership with the Government of Rajasthan, Jhpiego has been providing technical assistance to strengthen the quality of care being given during and immediately after childbirth at public health facilities through the government’s flagship quality improvement initiative, called Dakshata, meaning adroitness. Jhpiego was the lead technical partner in conceptualizing and rolling out this flagship quality initiative and continues to provide support to the Rajasthan government in its implementation.
With the spread of COVID-19, Dr. Kolhe and his close government counterpart, Dr. Ashutosh Upadhyay– a Dakhsta mentor1, were finding it increasingly difficult to visit facilities regularly for their supervisory visits. So, the district team, in consultation with Dr. B. L Meena, Chief Medical Health Officer (CMHO) and Dr. Ramesh Gupta, the District Reproductive and Child Health Officer (RCHO), came up with an innovative solution – that of teleconsultations. Four doctors would be part of this panel, including Dr. Ramesh Gupta (RCHO), Dr. Kolhe (Jhpiego) and Dr. Upadhyay (Dakshata mentor), that would provide assistance and consultation to pregnant women on phone. In early April 2020, the district administration released notices in the newspapers, informing the general public about this panel and gave the mobile numbers of the panel members, who could be called at any time for pregnancy related emergencies.
Since then, the panel is receiving many calls and being able to help many pregnant women and their families every day, with many of these calls coming from remote or severe lockdown areas of Bikaner.
“From our homes, we are attending these calls, and we provide consultations. If we need to send medicines, we do that. If we need to organize an ambulance, we help with that too. We call the hospital prior to their arrival, to inform the team about the arrival of a pregnant lady from such and such area,” says Dr. Kolhe.
The CMHO has called this team the “backstage heroes”, who despite being home, are being able to help the community during this pandemic in ensuring that essential services, like assistance to pregnant women, are not compromised.
The Bikaner teleconsultation innovation has worked so well that it is now being taken up by other districts in Rajasthan, like Barmer, Jaisalmer, Sirohi and Jodhpur. For Jodhpur and Barmer, our Jhpiego Dakshata Program Officer, Dr. Ashwini Kumar, is part of the teleconsultation panel.
Not just this, Jhpiego Dakshata is proud to be assisting the state of Rajasthan in multiple ways in its COVID-19 response. Through online sessions, Daskhata’s training is helping health workers across cadres get a good understanding of COVID-19, its signs and symptoms, modes of transmission and preventive measures. Very importantly, the training is assisting participants to understand the steps to prepare their facilities for COVID-19 positive cases, provide specific care for pregnant and breastfeeding women during the pandemic, understand steps to triage patients, infection prevention, and the importance of instituting measures to ensure continuity of quality maternal and newborn health care services. So far, Jhpiego, through its Dakshata program, has provided this training to close to 300 doctors, nurses and auxiliary nurse midwives from district hospitals, community health centers and primary health centers in Rajasthan.
Dr. Kolhe feels great satisfaction about doing his part during this challenging time. He speaks of the thank you calls he has been receiving, including one from the family that had called at 2 am, “When the family of someone we are able to help calls back to thank us and appreciate the timely help they received during these tense times, it gives us a real corona warrior kind of satisfaction, and motivates us to soldier on and do our bit in this global war against this elusive enemy.”