Dr Bharatkumar Mahale, Gynecologist and Medical Officer at Jawhar Sub District Hospital in Palghar, is trying to tackle malnutrition by enabling woman to ensure proper spacing between two pregnancies.
He has done the highest number of Postpartum Intrauterine Contraceptive Device (PPIUCD) procedures, one of the family planning tools which save women for the next 10 years from unwanted pregnancy. He has performed it on 721 women at his sub-district hospital in 2016-17. The State Health department is going to felicitate him on the occasion of World Population day on July 11 for his special achievement.
“Palghar is a tribal area with poor literacy rates. Tools like using contraceptive, condoms are not very popular here. I have seen many women, who could not avail of any family planning method and so got pregnant immediately after their previous pregnancy. These people don’t accept the idea of abortion and if a woman gets pregnant after having given birth to a child, they accept it,” said Dr Mahale.
While explaining about the reason and the relation between spacing in two deliveries and nutrition status of a child, he said, “If women could not ensure proper spacing between two pregnancies, it directly affects the child’s nutrition status in a negative way. PPIUCD offers an option to ensure proper spacing between two deliveries and proper nutrition to the child.”
He and his team focus on counseling the patient whenever they come for the check up during the pregnancy period. “Do you want to go through all this ordeal of delivering a child immediately after this delivery? If not then do this PPIUCD.” This is how Dr Mahale convinces women.
“There are many women who tell us not to reveal the fact that they have undergone PPIUCD procedure to their in-laws and husbands. It then remains a secret between my staff and the woman,” he added.
There are many misconceptions among women in this area about PPIUCD. Women think that the inserted part will come out while they are working on the field. But, the doctor has created a special network of Public Health Centers (PHC), ASHA and Anganwadi workers to ensure that their doubts are cleared and they visit the hospital after every six months for the follow ups.
The hospital has 100 beds which cater to the population of around four lakhs. This is the second year that the hospital is performing PPIUCD procedure. Last year around 375 women could avail of the facility. “It is important to raise awareness. There are three villages from where maximum women have undergone PPIUCD procedure because some women from those villages informed others about the benefits that it provides,” added Dr Mahale.
According to government statistics the number of death of kids in Palghar is 512, 485 and 600 for the year 2013-14, 2014-15 and 2015-16 respectively. In April, May and June this year, 2,822 children were found under the category of Moderate Acute Malnutrition (MAM) and 1,206 children who were found under the category of Severe Acute Malnutrition (SAM) in Palghar. While Dr Mahale to prevent malnutrition, he says there are many who are yet to be tapped for these kinds of family planning intervention which would ensure spacing between two pregnancies and thereby will help in maintaining good nutrition for a child.
“There are around 2,000 deliveries that happen in our hospital every year. That means there are still 1,300 women who did not accept methods like PPIUCD. We cannot force it, but still convincing these women to go for such options is our challenge,” he said.
Jamsar PHC in Jawhar Taluka caters to population of around 25,000. It procures around 100 contraceptive pills and around 5,000 condoms. Ashwini Bhoir, ASHA worker from the PHC, said, “Only one woman in a month would come and ask for contraceptive pill and only 500 condoms are demanded at the center annually. In such a case, PPIUCD is the best option in this area where people are not bold enough to use either pill or condom.”
Archana Patil, Additional Director of the State Family Welfare Bureau, State Health Department, Pune, which monitors all these programs of family planning in Maharashtra said, “There are many interventions for tackling malnutrition and family planning is one them. Others should get inspiration from such doctors to tackle the issue of malnutrition.”