Woman in orange and white head scarf holds book featuring illustration of mother and child.

A health worker talks to women at a Sure Start mothers’ group meeting. Photo: PATH/Gabe Bienczycki.

This week, more than 200 people met in New Delhi to celebrate the results of PATH’s Sure Start project, a seven-year effort to improve the health of families. Since its start in 2005, the unprecedented, community-based project has reached nearly 25 million people in India.

Since its start in 2005, SureStart, the unprecedented, community-based project has reached nearly 25 million people—about 2 percent of India’s billion-plus population—with services aimed at making childbirth safer and babies healthier.

Sure Start’s results showed improvements in health behaviors and increases in the use of health services. Communities that hosted Sure Start projects, for example, saw large increases in the percentage of women receiving prenatal care, the number giving birth in hospitals, and the number adopting recommended breastfeeding practices.

The heart of a project: health workers

In rural areas, volunteers known as accredited social health activists, or ASHAs, were at the heart of Sure Start. Mentored by Sure Start staff, thousands of ASHAs learned how to teach their communities about healthy practices for pregnancy, childbirth, and baby care. They ran meetings of mothers’ groups, which provided a forum for women to receive information and support, and made home visits. Gently but persistently, ASHAs changed age-old traditions, myths, and superstitions that endanger mothers and newborns.

A safe birth, a healthy child

At the New Delhi meeting, a mother named Lakshmi spoke about what Sure Start had meant for her and her family. She said she had previously given birth to three children at home, and all had suffered medical problems.

With Sure Start in place, an ASHA taught her about healthy behaviors during pregnancy, arranged for prenatal care, and encouraged her to deliver the baby at a government hospital. The ASHA even helped her find transportation to the hospital, where Lakshmi gave birth to a healthy baby by caesarean section. Standing in front of the packed conference room, Lakshmi held her infant—her personal proof of the project’s success.

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