260924 Innovative river boat outreach delivery of maternal and child health services in Brahmaputra river islands: Akha-Boat of Hope

Wednesday, October 31, 2012

Jina Dcruz, MSW , Health Promotion and Behaviour Sciences, University of Texas School of Public Health, Houston, TX
Gabriel Forrey, MPH , Health care Administration, US Navy, 29 Palms, CA
Nino Gvetadze, MA , Disaster reduction, UNICEF, Tbilisi, Georgia
Ruchirang Goswami , Marine Institute of Memorial University of Newfoundland, St. John's, NF, Canada
Purpose: In India, river-dependent populations, living on the islands of Brahmaputra, are geographically isolated and annual floods exacerbate their vulnerability. Government interventions are limited, which limits community health and education resources available in the islands. ‘Akha: Boat of Hope', an innovative medical boat outreach initiative offers regular specialized health care to islanders with the aid of skilled medical professionals. This study aims to assess the relevance of an innovative community based mobile outreach interventions in limited resource environment. Data: Data was collected from 72 households, comprising 512 individuals from 4 out of 14 Brahmaputra river islands using systematic random sampling in 2008. Methods: Demographic and health and Knowledge, Attitude and Practice (KAP) Surveys, Semi structured Interviews, and Focus group discussions were used. Descriptive statistics and qualitative analysis was employed using SPSS 14.0 and Atlas.ti. Results: 87% of the islanders use Akha boat as sole source of healthcare during floods and 92% during dry season. 71% of mothers sought antenatal care from Akha boat and 63% received free health check ups. Akha intervention was positively correlated with increase in exclusive breastfeeding (p<0.005) and iron folate consumption (p<0.001). 100% children aged 12-23 months were fully immunized through Akha. Accredited Social Health activist (ASHA) and community health workers selected from the community is instrumental in Akhas success. Recommendations: The model of community based Akha boat intervention and the Public Private Partnership (PPP) between nonprofit, government of India and funding agency can be used to model successful health service delivery in disaster prone areas.

Learning Areas:
Diversity and culture
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
To describe an innovative community based river boat intervention strategy which delivers primary healthcare overcoming barriers of geographical isolation and natural disasters in the ultra-poor riverislands of Brahmputra. Assess key differentiating characteristics of the mobile outreach intervention operating in a limited resource environment. Evaluate the contribution of context focused mobile outreach in improving maternal and child health delivery and outcomes.

Keywords: International MCH, Community Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was a key member of the four member team which conducted data collection of this project. I contributed to designing the study, carried out data analyses and articulated the results as well as implications of the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5016.0: Poster Session: Innovations in International Health 1