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Saving Mothers’ Lives in India

Meet Poonam Devi.

She is 20 years old and lives in Bhagwantpura village in northern India, away from her childhood home and family.

I was married when I was 17,” says Poonam. “Now I live with my husband’s family. He works and lives in Delhi.”

Poonam is pregnant. It’s her first pregnancy, and she needs strong support. In 2013, nearly 50,000 women in India died from complications during pregnancy and childbirth. More women died in Poonam’s state of Uttar Pradesh than anywhere else in India.

With help from our Matrika project, she’s getting the care she needs.

Meet Alka Pal.


She is part of the government of India’s powerful cadre of public health volunteers. She is an Accredited Social Health Activist or ASHA, dedicated to supporting rural, underserved women like Poonam in their homes and communities.

I love serving others,” says Alka. “I am very proud that with my support, people can become healthier.”

ASHA means “hope.” That’s exactly what Alka gives to Poonam and others like her.

“Alka supports me,” says Poonam. “She teaches me how to take care of myself, about nutrition and my pregnancy. Before, I didn’t drink milk or eat vegetables during my pregnancy. Now I do. I take iron pills because Alka said they would improve my health and give me energy.”

Alka serves approximately 1,000 people.

To do her job well, she needs support of her own. That’s where Pathfinder International comes in. We build upon the government’s program, training ASHAs like Alka to counsel women on safe pregnancy and delivery.

Meet Vivek, Pathfinder’s community coordinator.


He regularly accompanies ASHAs on their home visits, providing real-time, on-the-job support and supervision. Alka calls him “bhaiya.” It means brother.

“He taught me how to follow my clients through the process, to ask the right questions, and make sure they get the care they need,” explains Alka. “Especially for women with very poor health. He gives me suggestions for how I can give better care to the pregnant ladies who depend on me.”

Alka and Vivek use a Pathfinder tool—a birth preparedness calendar—to help Poonam plan for a safe delivery in a health facility with a skilled provider and attend her scheduled antenatal care visits, too. Nearly 70% of mothers here do not attend the recommended number.

Women like Poonam face extreme barriers to getting the care they need. At a nearby rural clinic, it’s difficult to get a blood test or get her blood pressure or urine checked—the provider she needs to see is only available one day each month.

Poonam could get the care she needs at a higher-level government center, but it is 22 kilometers away from her home—close to five hours on foot.

The government of India is committed to reducing maternal and infant mortality. But it requires an unprecedented partnership between public and private health systems.

So Pathfinder International, World Health Partners, and the state government joined together with support from Merck for Mothers to help make it happen.

For the first time, through our project, public sector ASHAs are accompanying clients to nearby private health providers where they can access antenatal care.

This new linkage is important.

Alka and Poonam walk together to attend Poonam’s antenatal visit, her third at the nearby Sky Health Center, a rural private provider part of a large social franchise network delivering antenatal care services to pregnant women for the first time.

Here, Poonam is screened for things like acute anemia and high blood pressure, which will help her provider identify risks as early as possible. Any women identified as high risk are referred to a higher-level facility to get the specialized care they need.

Through a free telemedicine consultation, Poonam confers with a highly trained doctor in Delhi in real time. At every point, her ASHA is beside her, learning how best to support Poonam in her pregnancy.


“When women see an obstetrician from Delhi talking to them, they feel many things,” says Alka. “A little anxious, thinking, ‘how is this happening?’ But they are also curious and excited.”

With this groundbreaking collaboration between public and private providers, Poonam and others like her can feel more confident about childbirth. She has an entire network supporting her: her ASHA, her community coordinator, and her health care providers.

Whether Poonam chooses to deliver her baby at a private or public health facility, she knows that thanks to the Matrika project, she has options. She knows she will receive quality maternal care.

The results are clear: 66 private and 189 public health facilities are now stronger and linked to expand women’s access to life-saving care. Nearly 1,000 ASHAs have been trained to guide women and families safely through pregnancy and childbirth. And nearly 200 health care providers have been trained to deliver quality antenatal care and ensure safe delivery.

The future is looking brighter for India’s most underserved women and their families.

Quality maternal health care is the right of every woman.

Our mission is to make sure every woman gets it.

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