FOGSI in association with Jhpiego and MSD for Mothers introduce 16 standard parameters to reduce Maternal Mortality Rate.
 

With an intention of providing quality healthcare to new mothers and newborns, FOGSI (Federation of Obstetric and Gynaecological Societies of India), has teamed up with MSD for Mothers, MacArthur Foundation and Jhpiego (an affiliate of Johns Hopkins University), and has launched 'Manyata' - a nationwide initiative to improve the quality of maternal and neonatal care in private sector in India. The launch was flagged off by Ms. Pankaja Munde, Minister of Rural Development, Women and Child Welfare in the presence of Dr.Rishma Pai, President FOGSI and Ms. Shilpa Shetty, Bollywood actor and celebrity.

 As a continuum to the journey of FOGSI's Vision 2022 and with the mantra of 'Women's Health is Nation's Wealth', a set of 16 parameters have been introduced as the standard practice which constitutes the minimal essential care every woman must receive during her delivery. Any hospital that gets enrolled in this initiative will be assessed, and the concerned healthcare provider will be trained on the 16 parameters, reassessed post training and on scoring over 85%, the hospital will be certified with the 'Manyata Seal of Quality' and shall officially be considered as a healthcare facility that provides quality maternal care.

Throwing further light on the initiative, Dr. Hema Divakar, the national convener for Manyata, and FOGSI Ambassador to FIGO, said "Manyata is not just a promise to expecting mothers for quality care, it is a reality. It is FOGSI's approval recognizing those who consistently deliver quality care during pregnancy and childbirth knowing that better, safer and respectful care will reach mothers. FOGSI's clarion call through Manyata is to engage as many providers as we possibly can so that no mother dies giving life. It is a direction to our community of doctors that we must do whatever we can because she matters. We must remember never to forget moms even if she forgets about her own well-being. We must empower her. The time is right. The time is now."

"Manyata aims to first upskill all centers to the required standards, and eventually through public private partnerships, and optimal utilization of technology, digital media for reinforcement of the training, and continuous monitoring supervision. The reforms and universality in the care and coverage ensured by Manyata will ensure more people from all sections of the society will be benefitted. By expanding to all states in the country, it can be guaranteed that anywhere a woman delivers, the entire medical team at her disposal is geared up to assist her to deliver safely," added Dr. Hema.

With maternal mortality rate declining at a rate slower than expected, and 60% of population seeking care from private sector, providing a universal and standardized maternal and neonatal care becomes crucial. It is also optimally not viable to focus only through individual programmes, Govt.initiatives, and medical institutes, as the reach will only be around 40%, compared to the reach an initiative like Manyata can bring.The launch also saw various officials from the national government, civil society, doctors, development agencies and academics take an active interest in the initiative. The Manyata logo and the website were officially unveiled during the event. A short public awareness film, 'Don't Forget Moms', was also shown in a bid to encourage private facilities to join the quality bandwagon.

 

Fact Sheet Statistical progression of Manyata initiatives - pilot project (2013 - Present)

 The project was piloted in 2013 under the name of 'Helping Mothers Survive' and two standard parameters.

 With diligent training and focus, the project succeeded in rising the adherence to protocol of the enrolled hospitals from 4% to 93%.

 Shortly after, the two parameters grew to 16, and the project was expanded to 11 cities across UP and Jharkhand on 150 private hospitals. These 150 hospitals had a base score of 18 - 30% at the beginning.

On completion of the project all 150 hospitals scored between 85 - 98% on adhering to the 16 parameters as a standard practice.

 

Further initiatives of Manyata (Present - Future)

Now, in Phase 2 the initiative has expanded to Maharashtra, and by 2018 aims to enroll 500 hospitals for training and upskilling. More standard parameters will also be added based on the research findings from the training already conducted.

200 centers from Maharashtra are enrolled into the programme and their teams were trained similarly. Out of these, in the last six months few hospitals have already crossed the benchmark - from 30% they have progressed to 85-90% and they will soon be accredited by FOGSI.

Phase 3 will focus on expanding to Karnataka, and private hospitals of all States in India. The focus is to first cover 5000 hospitals, and then proceed further from there.

Training on soft skills, confidentiality, the dignity of women, safe delivery, safe sex, how to take care of the baby, contraceptive advice, how to conduct the delivery, how to manage complications are some of the components included in the training. All these training are no theory all simulation based, so the experiential learnings will stay with them for a longer time.

16 parameters to Quality Maternal Care

1. Screen for clinical conditions for complications like HIV, Anaemia, etc.

2. Prepare for safe care during delivery

3. Assess all pregnant woman at admission

4. Conduct PV examination, follow infection prevention practices and record findings

5. Ensure respectful and supportive care

6. Monitor the progress of Labour

7. Assist pregnant woman to have safe and clean birth

8. Assess and perform immediate new born care

9. Perform Active Management of Third Stage Labour and examine the placenta thoroughly

10. Identify and manage postpartum Hemorrhage

11. Identify and manage severe pre-eclampsia/Eclampsia

12. Perform new born resuscitation if baby does not cry  immediately

13. Ensure care of newborn with small size at birth

14. Adhere to universal infection prevention protocols

15. Offer postpartum care package to the mother and baby at  discharge

16. Review clinical practices related to C-section at regular intervals