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Maternal and Newborn Health

Promoting maternal health and safe deliveries for women in vulnerable settlements


Mumbai (Kalyan, Thane, Vasai, Virar, Mira Road, Bhayandar, Ulhas Nagar, Bhiwandi), Pune

The Problem


In India, more than 289,000 women die from pregnancy and childbirth-related complications each year. Nearly all of these deaths are preventable with adequate prenatal care and education.

of women in urban Maharashtra accessed full antenatal care

infant mortality rate in urban Maharashtra

State-run primary health care centres, maternity homes and tertiary hospitals offer maternal health services, but often experience capacity constraints. These constraints affect delivery of critical health services to vulnerable pregnant women and newborns. Many target beneficiaries in urban informal settlements are unaware these services exist, and also demonstrate limited understanding of best practices that can enhance the wellbeing of mothers and newborns.

Source: National Health Family Survey 4 (NHFS 4) 2015-16

How can we better equip families, communities and government health systems to ensure safe pregnancies and healthy newborns?

Our Work


We believe that strengthening delivery of public health services and raising community awareness of these services can improve health outcomes among pregnant women and their newborns.

Establishing and facilitating a maternity referral network


We have partnered with seven municipal corporations in and around Mumbai to strengthen maternal and newborn referral processes. The referral system works to improve coordination and documentation across various municipal health facilities. These improvements aim to reduce the load on overburdened health facilities and ensure that high risk pregnancies receive timely, critical care.

Strengthening primary care


In urban India, health posts are local clinics that provide free primary health services to communities. We work with health post staff to develop effective processes, track efficiency, and facilitate community awareness building.

Forming community health committees for informed action


We facilitate the formation of voluntary women’s groups that can address community health needs and promote healthy practices, particularly for maternal and newborn health. These groups’ presence within the community enables them to reach more women, specifically in emergencies. We build their capacity to enable them to serve as an effective resource pool for their community.

Reach


156

public health facilities strengthened
to deliver quality health services
(until 2017)

52,000+

high-risk pregnant women assisted
to deliver safely through SNEHA-initiated referral networks (2012-2017)

1,481

public Health Post staff trained in
maternal and newborn care (2012-2016)

1,568

govt. outreach workers trained to
address maternal and neonatal
health in their communities (2012-16)

Impact



30%

increase in women registering
in first trimester for antenatal checkups
(2013-2016)

96%

of antenatal care clinics
functional in intervention areas (2013-2016)

133

Health Committee groups formed
across seven municipal corporations
(until 2017)

80%

appropriateness of maternity referrals, thereby reducing burden on tertiary institutions
(2013-2016)

Notes from the field:
Referrals for a safe delivery


Women in our communities are often hesitant to deliver babies in hospitals due to misconceptions and lack of awareness around hospital services. By facilitating hospital visits and referrals, we try to ensure that each woman is aware of the benefits of hospital deliveries.

Twenty-four year old Seema* was easily convinced and proactive about opting for an institutional delivery. She had enrolled herself at the health post for antenatal care, even before she met a SNEHA Community Organiser. During a routine visit, the CO found that Seema was preparing for a home delivery. Seema had misplaced her antenatal card and test reports, and was worried about going to the hospital without them.

Seema was encouraged to go to the hospital, despite not having the documents. On admission, doctors found that there were complications due to the position of the baby. The hospital assisted her with an ambulance and rushed her to a tertiary hospital.

Seema underwent a Cesarean section, a procedure she would not have had access to in a home delivery, or even at a maternity home.

*Name changed

Scaling Our Model


Our partnerships help us scale our models and exchange best practiceswith other organizations in maternal and newborn health.

Learn more about how we work.


We documented our maternal referral system to three other municipalities near Mumbai through a grant from WHO in 2013. The system now covers a total of 7 municipalities across the Mumbai metropolitan region resulting in more optimal utilisation of health facilities.


In 2017, child rights organisation Save the Children (STC) adopted our referral model for safe pregnancies and uptake of primary care throughout the Pune Municipal Corporation. We provided technical support and capacity building in order to support the STC team in strengthening delivery of health services at municipal health facilities. We worked with STC to customise clinical protocols, and facilitated workshops with public and private health system workers towards the adoption of best practices.

Partners


Kalyan- Dombivali Municipal Corporation

Thane Municipal Corporation

Vasai Virar Municipal Corporation

Municipal Corporation of Greater Mumbai

Mira-Bhayandar Municipal Corporation

Bhiwandi Nizampur Municipal Corporation

Ulhas Nagar Municipal Corporation

CIPLA Foundation

F

Family Welfare Bureau

Directorate of Health Service (DHS) Maharashtra

Philips

Redbrick