The current article of Uttar Pradesh (UP) is about the ASHAs who are the daughters-in-law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the Empowered Action Group (EAG) states. UP is one such Empowered Action Group (EAG) state. The current study explores the actual responses of Recently Delivered Women (RDW) on their postnatal visits that are linked to safe MCH practices. From the catchment area of each ASHA, two RDWs were selected who had a child in the age group of 3 to 6 months during the survey. The response profiles of the RDWs on these visits are reflected upon to give a picture that represents the entire state of UP.

The relevance of the study assumes significance as detailed data on the modalities of postnatal visits of their recent delivery are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to these visits with a dual approach i.e. timing of the visit in days & about the designation of the person who did the visit. The current study is basically regarding the summary of this two-fold approach for each of the three postnatal visits.

When post-natal visits are done poorly both in quantity & quality, it does impact the Maternal Mortality Rate & Ratio (MMR) & there by influencing the Neonatal Mortality Rates (NMR) in India and especially in UP through the emergence of unsafe Maternal & Neonatal practices in the postdelivery stage. The current MM Rate of UP is 20.1 & MM Ratio is 216 where as it is 122 in India (SRS, 2019). The SRS report also mentions that the Life Time Risk (LTR) of a woman in pregnancy is 0.7% which is the highest in the nation (SRS, 2019). This means it is very risky to give birth in UP in comparison to other regions in the country (SRS, 2019). Similarly, the current NMR in India is 23 per 1000 livebirths (UNIGME, 2018). As NMR data is not available separately for states, the national level data also hold good for the states and that’s how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that include effective and timely post-natal visits to RDWs in making their post-natal stage safe. This is the area of post-natal visit detailing that the current study throws out in relation to home visits after delivery.

A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions.  The current article deals with six close ended questions with options, two for each of the three visits. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study.

Among the districts related to this article, the results showed that 93% in Gonda district and 97% in Banda district and all the RDWs in the other 2 districts replied that their first postnatal visit was after the first day of delivery. All the RDWs in Saharanpur, 98% in Barabanki, 95% in Gonda and 94% in Banda replied that ASHA had done the first postnatal checkup. Regarding second post-natal visit, what was more striking here was that 36% in Barabanki district did not receive any checkup, 26% in Gonda district and 20% in Banda district did not receive second postnatal visit/checkup. None of the RDWs of Saharanpur replied that they did not receive second postnatal checkup. It was also found that the ASHAs in Barabanki district and Banda district did not prioritize to focus on the second postnatal visit for all the RDWs.

Regarding the third postnatal visit, it emerged that those RDWs who did not receive second postnatal visit also missed out on the third postnatal visit. Further, it was also seen that the ASHAs of Barabanki and Gonda districts demonstrated poor performance for the third postnatal visit of RDWs.