This follows a visit of Ethiopian health officials to Shodhgram last November, according to the Ethiopian Regional Health Bureau. Ethiopia had sent a team of health officials, including their National Health Director, for a five-day training. The visit triggered the launch of a Community Case Management programme to treat pneumonia in children with the help of Health Extension Workers (HEWs) and women trained to administer primary treatment at home.

The community health initiatives in tribal areas by the NGO set up by Dr Abhay Bang and Dr Rani Bang in 1985, have brought a change in the lives of the tribals. Empowerment of tribal women to give primary treatment for pneumonia, diarrhoea and malaria in children and training them in neonatal care was an important facet of the change, bringing down neonatal mortality by 70 percent in 39 villages between 1995 and 2003. The effort has been hailed by Time, Lancet and Forbes. Lancet included the model in its special issue on its best reports in 180 years. The Journal of Perinatology (US) brought out a special issue on it.

Bangladesh, Pakistan and Nepal, too, have started working on the model after training experts at Shodhgram. “Ethiopia is a major contributor to neonatal and child deaths. Like in rural Gadchiroli, pneumonia is a major reason, apart from malaria, diarrhoea and malaria,” says Dr Abhay Bang, who visited Ethiopia four years ago. “Also, Ethiopia faces overall backwardness and superstition among its population,” he adds.

Only 55 per cent of children born in Ethiopia survive. It has a child mortality (below 5 years) of 109, the infant mortality (below one year) being 69 and neonatal mortality (below 1 month) being 41 per thousand births, according to UNICEF statistics. “In the past, their government was reluctant to allow local women, even trained HEWs, to use antibiotics to treat pneumonia in children. Politicians had to be convinced for the change.”

In a letter to Bang, UNICEF Health Section Head in Addis Ababa, Dr Luwei Pearson says, “What convinced people here was intervention and results on the ground...”

The initiative has been recognised by the Planning Commission, which has recommended it in the 11th Plan. In the new guidelines on maternal and newborn health issued by the Ministry of Health and Family Welfare, the thrust is on making deliveries safe by providing skilled attendants for births and emergency obstetrical care when needed. Over 1.1 million newborns die every year in India contributing to two-thirds of infant mortality. The guidelines propose to ensure newborn survival by training Accredited Social Health Activists for home-based newborn care in villages and access to hospital when needed.