Working Together to Improve Health: ANMs Redefine their Role in the Community intentions, there is no way I can cover all the houses in our areas on a regular basis,” says Bobde.

The CLICS program has been a boon for ANMs like her as it provides the forum of Bal Suraksha Diwas (BSD), held once monthly in a village, to deliver comprehensive services to mothers and their children. Till the program was initiated in the area, she struggled with the sole burden of caring for the community’s women and children. Today the Anganwadi worker, and the CLICS MJ Bobde loves helping people doot work together with her on the occasion of BSD, and the delivery of services is more Her shy smile and reticent manner are effective. “I feel so supported by the CLICS project. Before it started I had to do everything alone,” says Bobde gratefully. ANMs like her also participate in other campaigns that fall under the CLICS umbrella in the form of village celebrations such as Suraksha Aaichi aani Balachi Mohim (Safe Mother and Child

misleading, for M.J Bobde is at the forefront of efforts to improve the health status of her community. Every single person in the village of Kamthi knows her! Her keenness to help her clients and to provide social service has made her a popular and sought after Auxiliary Nurse Midwife (ANM) in the Anji PHC area. This has much to do with her love for her profession, which began when she was a little girl. “I would watch nurses dispensing medicine and want to do the same,” she says.

Campaign); Mulgi Wachawa Mohim (Save the girl child campaign); Kishori Melawa

(Adolescent Girls Fair), Parenting Workshops; and Sasu Aani Sunn Melawa (In Laws Mela).

ANMs have been part of the public health system for several years now, and have a huge load to bear: At the ratio of one ANM per 5000 people, it is difficult for Bobde or any of her colleagues to perform their jobs effectively. Under the mandate of RCH-II, ANMs are to follow a fixed day schedule to cater to the health needs of mothers and children. But the sheer effort of traveling from house to house stands in the way of service delivery. “Despite my best Nilima Tatekar displays her latest award


Another ANM in Anji PHC who feels grateful to the CLICS project for transforming her role from that of overburdened health worker to being an effective part of a health system is Nilima Tatekar. She is also the winner of several awards for her contributions to family planning, Pulse Polio and leprosy campaigns, and healthy baby contests. Apart from her job as an ANM, she is the secretary of the Lions Club and also publishes regular articles on women and children’s health for the newspapers. Despite her boundless energy, Nilima admits to feeling skeptical when she first heard about the CLICS program. “ I got worried when people from Sewagram came here and started the program as I already had too much to do and thought CLICS would make it worse.” She thinks the CLICS programme has been effective in mobilizing the community to work together because

personal benefits from the project: the CLICS program has improved their status in the community as well as their own feelings of selfesteem. While Nilima feels that the project has fuelled “a desire and passion to improve things,” Tatekar says her mission is finally being accomplished. “Today I feel I am doing a proper service to the community.”

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Community Led Initiatives for Child Survival (CLICS)

“everyone’s mission is the same - improving health.”

Dr. Sushila Nayar School of Public Health Incorporating Department of Community Medicine Mahatma Gandhi Institute of Medical Sciences Sewagram - 442 102 Wardha District Maharashtra (India) E-mail:

Undoubtedly the CLICS project has been successful in creating a synergy between its own resources and those of the government, and thus realizing common objectives. Pooling together of the skills of different health workers in the village along with the community has resulted in better health systems and delivery. Both ANMs feel that the CLICS project has brought about several positive changes in the lives of women and children in the community. Early registration of pregnancies, improved breast feeding

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practices and an increase in immunization are some of the indictors of this change. Aside from the health benefits, Nilima and Bobde also feel they have derived numerous


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