The Born Healthy: Addressing Maternal Infections to Improve Newborn Outcomes in India

www.jhpiego.org/india29, Okhla Phase – III, New Delhi – 110020, India. Tel: (91) 11-49575100

Jhpiego’s MNH programs in India started from 2012

Working in private and public sector healthcare institutions across states in India13

India

Donors

Supporting quality improvement in close to 2600 facilities

Ensuring high quality care

during the most critical period— the intra and immediate postpartum period

updated: April 2018

The Jhpiego Difference

Systems

Institutions

Providers

This is done through

To ensure sustainable impact at every level of the healthcare system

Strong partnerships

Programming approach adaptable to specific needs

Innovations in processes and tools

360 degree strategy in quality improvement

Focus on transfer of learning

Ÿ as well as targeted nutritional supplementation during pregnancy

Ÿ an evidence-based ANC model with a special focus on the identification and management of maternal infections

Ÿ a model of improved antenatal care called group antenatal careŸ and technology in the form of Point-of-Care (PoC) tests to make testing and

treatment of key high risk maternal conditions efficient, cost-effective and readily available

Ÿ a pan-country scalability through informing the ANC guidelines for the country

Ÿ provision of quality ANC services for pregnant women

To devise

To test

To achieve

Improving Quality of Maternal and

Newborn Health (MNH) in India

Evidence Based - Life Saving Practices for Safe Childbirth

What are we up against?

A large mortality burden:

Ÿ 15% of global maternal deaths 1occur in India . Every 12 minutes a

woman dies due to complications 2related to pregnancy and childbirth

Ÿ India is the largest contributor to neonatal deaths in the world. Every 50 seconds a neonate dies in India. Nearly 700,000 babies do not make it to their 5th week of birth

Where do most of these deaths occur?

Ÿ Up to half of maternal and neonatal deaths occur during the intrapartum period or on the day of

3birth

Can these deaths be prevented? Ÿ A large proportion of these deaths

are preventable by adherence to simple, evidence based care practices

Ÿ Decrease in maternal and neonatal mortality is not commensurate with the increase in institutional births, reflecting sub-optimal quality of care at facilities

Sub-optimal Quality:

What are the opportunities?Ÿ Women are at healthcare facilities during this critical intrapartum and immediate

postpartum period

Ÿ Ensuring quality of childbirth care is a strategic priority for the Government of IndiaŸ Focusing on specific time around childbirth may be an efficient strategy

The Dakshata Initiative

Drawing heavily from the learnings of Jhpiego's quality improvement initiatives —the Safe Childbirth Checklist (SCC) program in Rajasthan and the standards based quality improvement program in Maharashtra--- the Government of India in 2015 launched---

Ÿ To strengthen quality of care during and immediately after childbirth through competent, skilled and confident providers

Ÿ Trained more than 1,400 trainers and mentors. More than 4,000 structured mentoring visits conducted by these trained mentors

Ÿ Continuing to provide technical support at national, state and district levels through advocacy, support in trainings, onsite mentoring

Ÿ More than 13,000 healthcare providers trained (Doctors and Staff Nurses)

Ÿ Currently working in more than 180 districts (scaled-up from 7 to 12 states as requested by respective state governments)

Jhpiego's MSD for Mothers supported program for the private sector, recently transitioned from

Leveraging Private Enterprise to Improve

Maternal Newborn Health and Family Planning in India

Sustaining Quality Assurance

Accreditation for Maternal Healthcare in

India’s Private Sector

Ÿ Presented a scalable model for quality improvement of maternity services in the private sector

Ÿ Piloted concept of developing a commercially viable quality management model involving NABH entry level certification: 3 facilities certified

Ÿ Improved adherence to high impact practices in the 140 target facilities in Uttar Pradesh and Jharkhand

Ÿ 129 facilities have been certified by FOGSI for Manyata

Ÿ Manyata is currently being implemented in 295 facilities across Uttar Pradesh, Maharashtra and Jharkhand

Ÿ Jhpiego proposes to develop and validate a viable and investable business model for quality assurance mechanism and continue laying the groundwork for sustainable quality improvement

Ÿ Quality management program 'Manyata' launched in partnership with FOGSI and NABH in January 2017

Ÿ Resource availability

Ÿ Focused and customized training

Ÿ Improved monitoring and accountability

Ÿ strategy for transfer of learning

SCC has been used to define the framework

of action

GoI’s strategic initiative

Jhpiego is GoI's lead technical

partner

Phase 2

Phase 1

FOGSI- Federation of Obstetric and Gynaecological Societies of IndiaNABH- National Accreditation Board for Hospitals & Healthcare Providers

DAKSHATA

*Data till March 2018

2Levels and Trends in Child Mortality - Report 2017

1Trends in Maternal Mortality: 1990 to 2015 report

3WHO Maternal Mortality Factsheet. http://www.who.int/mediacentre/factsheets/fs348/en/