HEALTHY MOTHER & CHILD

Foundation of a Strong Nation

Gandhiji prophesized that education and effective healthcare services to all at local levels is the key for the upliftment of a country to a progressive nation. India is a nation of over 1.3 billion people and the majority of its population is young. Therefore, reproductive health is of prime importance for the country.

Gandhiji's devotion to women began with his devotion to his mother and Kasturba, most particularly to women as mother. Motherhood became increasingly his model for liberation of India.

“Whether a healthy mother is responsible for a healthy child or whether a healthy child makes a healthy mother? To say one is more important than the other is an understatement.”

“A happy working of the human machine depends upon the harmonious activity of the various component parts.”

– M.K. Gandhi

In keeping with the quotes of our revered leader, the National Institute for Research in Reproductive Health (NIRRH) has been working towards a holistic approach in Maternal and Child Health. Towards this, a women-centric lifestyle approach is being employed by addressing reproductive health challenges of adolescents, reproductive tract infections by improving menstrual hygiene, preventing unsafe abortions, preventing maternal mortality and morbidity, improving nutrition status of mothers and children, providing genetic testing services and counselling to the affected couples, etc.

It is the only institute in the country dedicated to addressing the various issues of reproductive health in accordance with the nation's needs and priorities. It is one of the premier institutes of the Indian Council of Medical Research (ICMR), established as a family planning unit in 1954. During its inception the focus was on population stabilization towards building a healthy nation. Several emerging contraceptives like NET-EN, vaginal rings, oral pills, injectables were evaluated for their safety, efficacy and acceptability for induction into the National Family Welfare Programme. The Experimental Animal Facility at the Institute was used for the preclinical testing of contraceptives. Over the years, there was a felt need to address the issues of infertility in women, as women had to bear the burden of family bearing and rearing. Harsha, India's first scientifically documented test tube baby, was a fruit of efforts in this direction.

Mahatma Gandhi opening a Free Maternity Home and Dispensary, organized by the Welfare Centre by the members of Rotary Club Poona, at Khadakvasala village, Poona, November 15, 1945.

The Institute for Research in Reproduction (IRR) was inaugurated on February 21, 1970 by Hon’ble Union Health Minister, Dr. K.K. Shah (top-left), in presence of Dr. P.N. Wahi, DG ICMR and Dr. Shanta S. Rao, Officer-in-Charge (top-right). The Institute in 1970 as IRR (below-left) and in 2018 as NIRRH (below-right).

Through the years, the Institute has seen enormous expansion, both in terms of infrastructure and research. NIRRH has an impressive mandate, be it Research, Collaboration, Training, Products, Policies and Programs, or as a research nucleus. The World Health Organization has recognized the Institute as a Collaborative Centre for Research in Reproductive Health, as well as a Centre of Excellence for imparting training in diagnosis and management of infertility. A dedicated team of around 40 scientists is the pillar of strength of this institution. These scientists with their diverse academic background and training form the backbone of the basic, clinical, operational and socio-behavioral research conducted in this Institute and continue to strengthen the activities of the Institute.

HEALTHY MOTHER – HEALTHY BABY

“Our parents who bring us into this world do not, as a rule, cultivate self-control. Their habits and their way of living influence the children to a certain extent. The mother's food during pregnancy is bound to affect the child.”

– M.K. Gandhi

Institute’s success stories: Baby Harsha, conceived through IVF (left); and Technology Day Award to Dr. M.I. Khatkhatey (extreme right) by Ministry of Science and Technology on May 8, 2001 by Hon. Vice President of India, Shri Krishan Kant for transfer of urine-based fertility kits developed at the Institute to industry.

The well-being of mothers, infants, and children is an important public health goal, which determines the health of the next generation. NIRRH is involved in improving the health and nutritional status of vulnerable segments of the population by implementing a multicomponent health and nutrition education intervention. Providing iron supplementation to under-five children, demonstration of preparing nutritious delicacies using locally available food, and health education are the main activities undertaken. ICMR has initiated a major programme in three states in partnership with Indian Council of Agricultural Research (ICAR), M.S. Swaminathan Research Foundation (MSSRF), and Biotechnology Industry Research Assistance Council (BIRAC, DBT) to develop a district-level model to address undernutrition and hidden hunger. Palghar, a tribal district in Maharashtra, is one of the study sites and the work here is being coordinated by NIRRH.

Gandhiji's vision for people to adopt a healthier lifestyle and his teachings on healthy eating and exercise for a better standard of living are propagated through our community outreach programmes via family welfare clinics set up in semi-urban areas. Community awareness and motivation is a key for disease prevention and for a swasth (healthy) India. Through the clinics, lectures and talks on the importance of eating healthy, regular exercise, cleanliness and routine health examinations for a healthy life are also disseminated. Regular yoga camps are organized in the community to inculcate yoga in the day-to-day routine.

PREVENTING UNSAFE ABORTIONS

Thirteen per cent of maternal deaths in developing countries are attributed to unsafe abortions. Women who survive unsafe abortions are likely to suffer long-term reproductive morbidity. The Institute embarked upon research programmes to identify reasons for seeking abortions and unsafe abortions and has also played an important role in developing non-invasive, medical methods of pregnancy termination. These research endeavours at the Institute have contributed to the Drug Controller's approval to use RU 486 and misoprostol combination for first trimester abortion in the country.

“To call women the weaker sex is a libel; it is man's injustice to woman.”

– M.K. Gandhi

Gandhiji's message almost eight decades ago at the All India Women's Conference on December 23, 1936 was: “When woman, whom we call abala, becomes sabala, all those who are helpless will become powerful.” In keeping with his ideologies on female power, NIRRH also worked towards empowering women tolerating domestic violence, with choices in family planning.

DIAGNOSIS OF GENETIC DISEASES

The Genetic Research Laboratory at the Institute has been involved in detecting chromosomal abnormalities and inborn errors of metabolism. It also offers counselling and prenatal diagnosis to couples harbouring defective genes.

Intervention activity to improve nutritional status and health held at a village in Dahanu. Lectures were given to women and lactating mothers on diet, supplementary nutrition, and rest (Top-Left). Demonstration of low-cost nutrition recipes from locally available foods to pregnant women and mothers of under-fives by nutrition experts (Top-Right). Yoga camps organized by the institute (Below-Left) and clinical examination of under-5 children at Kokner village in Palghar district (Right). Ectodermal dysplasia Progeria Cutis

Children with genetic disorders examined at the Genetic Clinic of the Institute.

PREVENTION OF REPRODUCTIVE TRACT INFECTIONS AND PROMOTING MENSTRUAL HYGIENE

Reproductive Tract Infections (RTIs) including Sexually Transmitted Infections (STIs) are also causes of morbidity and mortality in affected individuals. The Institute is actively pursuing several research programmes addressing basic, clinical and operational aspects of RTIs/STIs including HIV. NIRRH was involved in the development of the National Guidelines on prevention, management and control of RTIs/STIs and preparation of the training material. The training modules are being used for training in the NACP-3 and RCH-2 programmes under the National Health Mission (NHM). In addition, the Institute has also contributed in the development of Operational Guidelines for programme managers on prevention and control of RTIs/STIs. Vigorous efforts are also being made to create awareness about RTIs and STIs and their impact on reproductive and general health among rural and tribal women. Linkages have been strengthened between HIV (ICTC/PPTCT) and family planning services for the prevention of unwanted pregnancies among women living with HIV/AIDS.

The risk of infection (including sexually transmitted infection) is higher than normal during menstruation. Menstrual health hygiene is therefore an area that cannot be ignored. The Institute has been advocating use of washable menstrual pads which, apart from being hygienic and reusable, are economical and environment-friendly, unlike the commercially available disposable sanitary napkins, wherein disposal is an environmental hazard.

In the interest of safeguarding our environment and preventing its hazardous effects on health, the National Centre for Preclinical Reproductive and Genetic Toxicology at NIRRH has been studying the impact of endocrine disruptors on reproductive health and evaluating several promising drugs for their safety.

Inauguration of Adolescent Friendly Health Clinics ‘Maitri’

Doctoral students of the Institute with his Excellency President of India, Dr. APJ Abdul Kalam, September 12, 2005 on the eve of inauguration of the Global Forum for Health Research.

ADOLESCENT HEALTH

Adolescents constitute about one-fifth of India's population and represent a huge opportunity that can transform the social and economic fortunes of the country. However they are also the most vulnerable population to physical and sexual abuse as is obvious from the daily news reported. This vulnerability stems from their naivety and lack of proper information on reproductive and sexual health. Keeping this unmet need in mind, Adolescent Friendly Health Clinics (AFHCs) named ‘Maitri’ were established which covered adolescent and youth population falling in the age group of 10–24 years. IEC material in the form of posters were developed at NIRRH and submitted to Government of Maharashtra. These were adapted and made available on a large scale in the state.

Mahatma Gandhi playing with Nandini, niece of Pyarelal Nayyar (not in picture) at Sevagram Ashram, Wardha, August 1944.

Following Gandhiji's ideals for a Shreshtha Bharat, NIRRH takes pride as one of the leading institutes for building the next generation of researchers through its PhD programme, and shaping students and faculty all over the country for scientific excellence by way of workshops, training courses and conferences.

Research done at the Institute has translated into ‘Swadeshi’ or ‘Make in India’ products. Kits for urine-based fertility assessment, kits for detection of Chlamydia trachomatis, sperm quality and Fertility Assessment Tests were developed and are some of the indigenous achievements of the institute. We aspire to continue our walk into the future on the Gandhian ideology towards a ‘Swachh, Swasth and Shreshtha Bharat’ where the reproductive needs of all its citizens can be met.

Mahatma Gandhi and Kasturba Gandhi talking to girls of Mahila Ashram (Wardha), on the occasion of Rantia Jayanti (Spinning Wheel Anniversary) in front of Mahatma Gandhi's hut at Sevagram Ashram, Wardha, 1940.

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