Strengthening Maternal and Neonatal Healthcare Services

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Strengthening Maternal and Neonatal Healthcare Services

Issue

As part of the Millennium Development Goals (MDGs) target, India is expected to reduce neonatal and maternal mortality by 2015. However, despite having a large network of public health care services, Mumbai with a population of about 12.4 million, suffers from widespread problems of inadequate and inequitable health care. Information on maternal and child health indicators among slum-dwellers reveal that their health is 2-3 times worse than what the average urban statistics indicate. Unplanned deliveries, delayed registration, delays in reaching facilities and deliveries by untrained personnel all contribute to injuries and loss of life during birth.

Project

With the goal to integrate the maternal and neonatal health agenda into the service mainframe of primary level health care institutions, the Society for Nutrition, Education and Health Action (SNEHA) aims to strengthen public health posts in Mumbai. The Narotam Sekhsaria Foundation supports SNEHA in to achieve its goals.

Specific Objectives of the Project:

To build the capacities of the Community Health Volunteers (CHVs) to focus sufficiently on maternal health in their outreach work
To increase the uptake of antenatal services offered at health posts by improving maternal heath outreach by the CHVs
To enable women in unreached slum pockets to access services at the health posts through community engagement

The health post infrastructure has all the human resources and basic medical infrastructure to establish community outreach and provide health services at their doorstep. It is in the context of achieving these objectives that SNEHA has joined the MCGM to set up Antenatal Postnatal and Neonatal (APN) clinics at the health posts. This has served to reduce overcrowding at the maternity homes and paved the way for better care. This has resulted in a reduction of delayed registration from 23 to 8 per cent and increase in early registration from 49 to 63 per cent. 2579 neonates have been brought in for neonatal care and easily accessible services were created for the vulnerable populations in the slum communities. As part of this project, SNEHA set up antenatal clinics at 30 health posts in the vulnerable and high infant mortality wards. The project facilitated the establishment of a referral system across the city. This has facilitated linking of all the levels of the hospital for improved access and quality of services for mothers and newborns.

About the Organisation

The Society for Nutrition, Education and Health Action (SNEHA) is a voluntary, secular, non-profit organisation that addresses the special needs of women and children living in the slums of Mumbai to improve their health. Their maternal and child health programme vision is based on the principles of working with existent systems to simultaneously improve both the supply and demand side of health care — to affect change in women and children’s health.

Impact

Ensuring that women access these services, it requires their involvement in the process. Community engagement at the grass-root level is key to breaking the access barriers and to encourage active participation in seeking early and appropriate care. Therefore, SNEHA created and implemented a plan of community engagement using appreciative enquiry.