Traditional Birth Traditional Birth Attendant (DAI)Attendant (DAI)

Issues and ConcernIssues and Concern

Presented by Dr. Ajay KharePresented by Dr. Ajay Khare

Who are TheyWho are They

Traditional- Family basedTraditional- Family basedOld Women / Family Member Old Women / Family Member

( Tribes)( Tribes)Trained for 30 daysTrained for 30 daysMostly Schedule Cast, Some Tribes or Mostly Schedule Cast, Some Tribes or

MuslimsMuslims

Their workTheir work

Care During PregnancyCare During Pregnancy Identification of Danger SignIdentification of Danger SignAssisting LabourAssisting LabourCare of New BornCare of New BornPost Natal Care/ Follow upPost Natal Care/ Follow upDisposing placentaDisposing placentaMassage Women / New BornMassage Women / New Born

Their RemunerationTheir Remuneration

From Govt.- started from Rs 2 to From Govt.- started from Rs 2 to now Rs 50now Rs 50House Hold- Rs 50- 100 House Hold- Rs 50- 100 5- 10 Kg Cereals5- 10 Kg Cereals SariSari Some times Rs 500- Some times Rs 500-

10001000• • JSY- Rs 600 - 350/ DeliveryJSY- Rs 600 - 350/ Delivery Birth Assistant – Rs 50Birth Assistant – Rs 50

Deficiencies / DifficultiesDeficiencies / Difficulties

Mostly old, Illiterate, Poor Women, SCMostly old, Illiterate, Poor Women, SC Work is considered dirty / untouchableWork is considered dirty / untouchable Training was given very old timeTraining was given very old time Unable t access new information/ Unable t access new information/

KnowledgeKnowledge Mostly put pressure during deliveryMostly put pressure during delivery Bath New Born even premature babyBath New Born even premature baby Retraining requiredRetraining required

But deep rooted culturally and But deep rooted culturally and sociallysocially

Some FactsSome Facts

Available in most of the villagesAvailable in most of the villages Villages 52049 Dais 52995 Villages without Dai Villages 52049 Dais 52995 Villages without Dai

10261026 Dais Training started in 1973Dais Training started in 1973 Training ComponentTraining Component 1. Care of pregnant women1. Care of pregnant women 2. Normal labour2. Normal labour 3.Asepsis3.Asepsis 4.Breast feeding4.Breast feeding 5.Weighing new born5.Weighing new born 6.Vaccination6.Vaccination 7.Referral 7.Referral

IssuesIssues

Some Dais became ASHASome Dais became ASHASome are Anganwadi assistant and Some are Anganwadi assistant and

competing with ASHA for JSYcompeting with ASHA for JSYAfter Institutional delivery child and After Institutional delivery child and

mother unattendedmother unattendedDeliveries on the wayDeliveries on the wayVillagers still have faith in DaisVillagers still have faith in DaisSome times waited dais for two days Some times waited dais for two days

for cutting umbilical cordfor cutting umbilical cord

Some CasesSome Cases

Mangaliya Bai 55Yrs- Village MarkadhanaMangaliya Bai 55Yrs- Village MarkadhanaIlliterate, traditional dai, tribal Illiterate, traditional dai, tribal

village trained for 3 days, get only village trained for 3 days, get only coconut or Sari, considered religious coconut or Sari, considered religious work, ASHA not available, Working as work, ASHA not available, Working as motivator for JSY motivator for JSY

Bhuriaya Bai 70 Yrs - Village HarsdiwariBhuriaya Bai 70 Yrs - Village HarsdiwariTrained 6-7 years back, Selected as Trained 6-7 years back, Selected as

ASHA but JSY cases are taken by ASHA but JSY cases are taken by Anganwadi workerAnganwadi worker

Some CasesSome Cases

Ganiya Bai 70 Yrs - Village BijoriGaniya Bai 70 Yrs - Village Bijori

Familial work, received Rs 300, Familial work, received Rs 300, Cereals and Sari / DeliveryCereals and Sari / Delivery

She has conducted many difficult deliveryShe has conducted many difficult delivery

After ASHA all income stoppedAfter ASHA all income stopped

Katto Bai 50 Yrs- ChhindiKatto Bai 50 Yrs- Chhindi

Trained Dai, Very Popular, ASHA is Trained Dai, Very Popular, ASHA is not getting JSY casesnot getting JSY cases

Some CasesSome Cases

Naziran Bee- ChhindiNaziran Bee- ChhindiTaken Fatwa for Dai work, Taken Fatwa for Dai work,

Trained, Earlier Govt. paid 50Rs / Trained, Earlier Govt. paid 50Rs / Delivery and from family Delivery and from family Rs 400 – 500, ASHA is not getting Rs 400 – 500, ASHA is not getting JSY casesJSY cases

Some Dais are conducting deliveries in Some Dais are conducting deliveries in PHC and CHC alsoPHC and CHC also