Haldwani, India—Nineteen-year-old Kavita arrived at the Haldwani Women’s Hospital carrying her nine-month-old in her arms. Worried and fatigued, the young mother was looking for Chandra Bisht, the family planning counselor at the hospital in Uttarakhand State in northern India. “The moment I helped her sit, tears started rolling down her cheeks,” recalls Chandra. Kavita was pregnant again and her husband, the family’s sole wage earner, was still jobless after many months.
As a family planning counselor at a government-run hospital, Chandra has seen many such cases—of women becoming mothers too early and having repeat pregnancies, as well as those who are unaware of the health risks for both mother and baby that are associated with closely spaced pregnancies. “The need to counsel them on the benefits of postpartum family planning (PPFP), or family planning after birth, is very high,” says Chandra.
After calming Kavita, Chandra offered to meet with her and her husband to discuss the various family planning methods they could adopt following the birth of their second child. This would give Kavita control over her own fertility and time to heal and focus on her family. The couple decided to use the postpartum intrauterine contraceptive device (PPIUCD), a safe and long-acting (up to 10 years) family planning method that can be inserted immediately after delivery. A reversible option, the PPIUCD can be removed when the couple is ready to have another child.
“I assured her that if she faced any problems, I would be there to help,” recalls Chandra.
Chandra is among 26 family planning counselors who have been trained in India through the U.S. Agency for International Development’s flagship Maternal and Child Health Integrated Program (MCHIP), which is led by Jhpiego. MCHIP works to strengthen PPFP in India, where annually, more than 55,000 women die due to childbirth complications and more than 1 million children die before they reach their first birthday. Although initially hired by MCHIP, Chandra and the other counselors are now employed through India’s National Rural Health Mission—a true example of MCHIP’s commitment to develop a sustainable work force.
In less than two years working as a counselor at the Haldwani Women’s Hospital, Chandra has become the face of PPFP at the facility—affable and informed, passionate about the importance of healthy pregnancy spacing in saving lives. She is proof positive of the impact that good counseling can have on a couple’s decision to adopt family planning services at a health care institution. Haldwani Women’s Hospital caters to a large population, with women coming from many of the surrounding mountainous areas. Chandra seizes every opportunity to talk to them, be it during their prenatal care visits to the hospital or during early labor. She also talks to the husbands or family members who accompany the women. Since Chandra began counseling families, the number of women accepting PPIUCDs in a month has shot up from an average of 29 to as many as 81.
Strengthening PPFP services is a major priority for the Government of India, and in this program, counselors play an increasingly vital role. Anuradha Gupta, Additional Secretary and Mission Director of the National Rural Health Mission, recently observed: “Effective counseling is a means which empowers clients to seek what is best for them and to exercise their rights to good quality maternal, newborn, child health and FP [family planning] services.”
Chandra’s ability to listen and talk to women and their families in their local language is a big reason for her success. Her dedication and commitment to her work have won Chandra the respect of all the health care providers and paramedical staff at the facility.
Chandra recognizes the importance of providing clients with accurate information and treating them with respect and care. “If a client gets followed up well, she will talk about her positive experience to her family and friends,” Chandra says. “Such feedback will increase the demand for PPFP, including PPIUCD, as these women would listen to a satisfied client more than us.”