The Indian government has undertaken various initiatives to enhance mother health over the last 15 years, particularly by offering financial advantages to boost institutional childbirth and expand public health facilities. As a result, the share of institutional delivery has increased significantly yet unevenly among geographical areas and socioeconomic categories. Tribal people constitute 8.6% of India's population. There is a vast difference between the health outcomes of India’s tribal population vis-à-vis its non-tribal population. The percentage of institutional births in tribal (indigenous) populations is particularly low. The existence of these discrepancies suggests that a new strategy is needed to address the Tribal community's maternal health issues.

Piramal Swasthya aims to support government initiatives by identifying and filling the gaps. The organisation's efforts are on reducing the maternal and newborn mortality rate. Asara, an initiative of Piramal Swasthya, has aligned its mission towards maternal mortality and infant mortality. Through its 'ASARA' initiative, Piramal Swasthya has been providing health care services to the tribal belt of Vishakhapatnam (Vizag). In Hindi, the word 'ASARA' means 'support,' which perfectly encapsulates the program's goal of assisting the tribal people in obtaining improved health results.

(ASARA Health Care Team on duty)

Piramal Swasthya, a health care wing of Piramal Foundation which is one of India's largest non-profit organisations specialising in basic public health care, with an emphasis on increasing maternal, child, and adolescent health and lowering noncommunicable illnesses (Diabetes Mellitus, Hypertension, Oral, Breast and Cervical Cancers). Piramal Swasthya uses creative solutions to bridge the last mile gap in primary healthcare service delivery, from enhancing the existing healthcare system to pushing for improvements.

The Asara initiative, which began in 2011, provides a primary health care system. Secondary and tertiary healthcare gets distributed to government and other private hospitals. In the fifth year of operation, the programme was a success, with institutional deliveries increasing by 50% and no cases of maternal death. The Asara team provides high-quality, sustainable healthcare to India's rural and tribal areas, where it is most needed. Their hardworking grassroots team collaborates with the government to reach out to more people and create healthier communities. Consistency and planning programmes at regular periods are crucial to the program's efficacy. Piramal Swasthya's team, backed by qualified healthcare staff, create seamless processes and dives in hands-on to manage treatment until it's completed, guiding each patient and meeting their requirements.

(ASARA Service on duty to help Tribal Community)

Case Study of beneficiary Kusum Kumari

Kusum Kumari belongs to the Tribal Community of G. Madugula Mandal, Palamamidi village. G. Madugula Mandal has been added to the programme in April 2018 This Mandal has 381 habitations and a high prevalence of malaria, which has a negative impact on pregnant women. Women in this Mandal have a poor literacy rate, resulting in a lack of information about health and dietary concerns. The ASARA programme has provided health and nutritional services to a total population of 27,224 people in 163 habitations. For both the Tribal community and the ASARA team operating in the G. Madugula Mandal, May 10th was an important day. The ASARA team received a call from Kusum Kumari's husband, who was pregnant requesting to take her to the PHC for delivery. The team arrived in the area with an ambulance in 30 minutes to take her to the nearest PHC. However, they encountered a big hurdle at the village's gate, where locals had set up a checkpoint to prevent strangers and vehicles from entering owing to rigorous COVID pandemic regulations. Determined to assist Kusum, the ASARA program's ANM (Prema Lalitha) and driver travelled to the village on foot, mobilising a few people along the way who assisted the team in bringing Kusum to the ambulance. Her labour progressed to the last stage after a three-kilometers walk to the ambulance. Seeing the scenario, Prema quickly arranged for the baby to be delivered in an ambulance while adhering to all COVID guidelines. Kusum gave birth to a healthy son and was transported to the G. Madugula PHC for post-natal treatment. Through their perseverance in the face of adversity, the ASARA team captured the hearts of government leaders. Their efforts were also lauded by the media. The manual's project officer praised the ASARA team's efforts and prompt responsiveness in such difficult circumstances. He pledged to continue to work with the ASARA team in the future.

(Team Asara supporting the beneficiary)

The initiative began in 140 habitations a decade ago and has now expanded to 950 habitations over seven mandals in the Vishakhapatnam district. Increased institutional deliveries and minimising maternal mortality in challenging communities were the goals of the project. All pregnant women living within those communities get prenatal, postnatal, and nutritional care as part of the programme.

Union Minister of Health and Family Welfare, and Union Minister of Tribal Affairs, launched a program named Anamaya, the Tribal Health Collaborative. The Collaborative is a multi-stakeholder project of the Ministry of Tribal Affairs, which is supported by the Piramal Foundation. It would bring together the efforts of numerous government departments and organisations in order to improve the health and nutrition of India's tribal communities. The aim of the mission is to help improve the health and nutrition of India's most marginalized people. It took all the organisations more than a year to come together with a wide range of skills and expertise, bringing them together for the shared goal of improving tribe health.

Some Health Care practices by Piramal Swasthya are being advocated by NITI Aayog to be adopted as part of healthcare service delivery plans under the aspirational district’s transformation project. Piramal Swasthya's high-impact platform received the 'Inclusive Health Access Award' from USAID. The ASARA project will now be expanded to include Chintapalle, Paderu, and other mandals in Vizag. It will also address nutrition and related stuff.