Improving the Quality of Maternal Care in a Public-Private Network of Providers in Rural Uttar Pradesh, India

Session: What is the Local Private Health Sector and Can it Offer Quality Maternal Health Care?

Presenter: Mahesh Srinivas, Pathfinder International

Background: Pathfinder International and World Health Partners (WHP) have created a high quality health service network in Uttar Pradesh (UP), India, where an estimated 15,000 women die every year due to maternal causes. The network applies innovative and proven approaches to improve the quality and accessibility of maternal health and family planning services in both the public and private sectors for poor rural communities. The project, funded by Merck Sharp and Dohme Corp., includes a network of 190 public and 59 private facilities, plus 385 private and 1000 public community health workers. Health providers were trained on various aspects of quality maternal health care with a focus on prevention and management of post-partum hemorrhage.

Methodology: The project has initiated quality improvement (QI) visits in public and private facilities, building on various trainings to support sustained change in skills and clinical practices. For the first time in UP, public sector doctors along with team members from Pathfinder and WHP are engaged in on-site assessment of quality of service provision in both sectors. This Mobile Technical Support Unit (MTSU) has adapted tools for different levels of care, and incorporates a combination of methods including knowledge and skills assessment, direct observation and non-judgmental, supportive feedback.

Results: Data is beginning to show positive results and is expected to produce hard evidence within the next two quarters. Through knowledge and skills enhancement, and improved response by the health system to address infrastructural gaps, the visits are resulting in improved practices around delivery and postnatal care.

Conclusion: QI visits are a feasible way to improve maternal health outcomes even in the most remote, poor areas. The strategy can effectively address capacity gaps of health personnel engaged in primary care, both public and private, and add significantly to the ability of health personnel working in very low resource areas.