Venkatesh Srinivasan, MPH, PhD, Integrated Population and Development Projects, United Nations Population Fund, C-312, Ground Floor Triveni (SFS), Sheikh Sarai Phase I, New Delhi, India, Hemant Dwivedi, M Sc, Integrated Population and Development Project, Rajasthan, United Nations Populations Fund, D-57 Chomu House, Sardar Patel Marg, C-Scheme, Jaipur, India, +91-141-2377139, unfpajpr@sify.com, and Dileep Mavalankar, MD, DrPH, Public Systems Group, Indian Institute of Management, Vastrapur, Ahmedabad, 380015, India.

The purpose of this presentation is to show how access to emergency obstetric services (EmOC) can be increased in the public health system in India. Maternal mortality ratio is very high in India. Maternal mortality reduction is being actively pursued by both federal and state governments. However the earlier approaches have not been successful in addressing reduction of maternal mortality and morbidities. The main reason has been the inability of government systems in ensuring availability of gynecologists and anesthetists to provide comprehensive emergency obstetric services (CEmOC). We conducted a needs analysis of the maternal health situation and evolved short term and long term strategy for our intervention focusing on Basic and Comprehensive EmOC respectively. The main components of the strategy was (1) training of graduate doctors and their support staff to be trained as a team in defined Basic Emergency Obstetric skills, (2) establishment of an Management Information System(MIS) for reporting on the UN Process indictors(3) initiation of safe infection prevention practices (4) undertaking community empowerment activities to utilize services made available. The Integrated Population Development project is being implemented since past 3 years by UNFPA. We have been able to increase access to basic EmOC facilities from 26 to 62 over 3 years. Met need of EmOC has also increased from more than 60% from 8.8% to 14.14% in 30 months. The project intervention is being considered for upscaling in the North Indian states. We will also present how a paradigm shift was brought about from ANC to EmOC.

Learning Objectives:

• By the end of the presentation, participants will be able to
• 1.Describe the maternal health situation in India and the strategy adopted to reduce maternal mortality.
• 2.Develop training protocols for training of general doctors and paramedics in basic and comprehensive emergency obstetric care.
• 3.Apply UN process indicators to evaluate maternal health interventions through appropriate Management Information Systems.

Keywords: Access to Health Care, Maternal Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 1266.0 kb)