141st APHA Annual Meeting

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285142
Process improvement of facility based newborn care in India

Monday, November 4, 2013

Abha Mehndiratta, MBBS, DCH, DNB , ACCESS Health International, Hyderabad, India
The largest absolute number of newborn deaths occurs in South Asia - India contributes a quarter of the world total. Hence, the Government of India has recognized that the reduction of neonatal mortality is essential for making an impact on the Infant Mortality Rate. Along with community‐based interventions, Government of India has decided to strengthen the neonatal care services in all public health facilities across the country under the Facility Based Newborn Care Initiative. In addition, the government is working in partnership with private providers by taking on the role of a payer with the introduction of public health insurance schemes in some states of the country. As the government is making huge amount of investments in increasing access to newborn care, little has been done in ensuring the quality of care delivered. Hospital-born babies in developing countries are at increased risk of neonatal infections because of poor intrapartum and postnatal infection-control practices. In view of the urgent need to improve the quality of services of Facility Based Newborn Care in India, ACCESS Health has initiated a neonatal collaborative which is based on the Institute of Healthcare Improvement's (IHI's) breakthrough series and the Model for Improvement. The initial focus of the collaborative is on decreasing Healthcare Associated Infections (HAI) and antibiotic resistance in the participating neonatal units.In the second phase, the pilot collaborative can be scaled by partnering with the public health financing schemes in the country. The backbone of any health reform would be maximum utilization of information technology for generation of data to guide the policy makers in the country. The role of a payer would be critical not only for generating data for bench marking but also, to create an incentive for empanelled hospitals to utilize this information for identification of areas of need and self improvement.

Learning Areas:
Provision of health care to the public
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Formulate data on the magnitude of problem Healthcare Associated Infections (HAI) pose in neonatal units, demonstrate proof of concept of improvement of outcomes by utilizing Institute of Healthcare Improvement’s Model for Improvement, develop a measurement system to provide real time data feedback on systems performance for and between the participating hospitals, develop a Change Package for decreasing HAI which can be used by other neonatal units in the country and build capacity in process improvement within the participating centers in order to develop centers of excellence

Keywords: Quality Improvement, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Leading the work on process improvement of clinical care. Working in partnership with Institute of Healthcare Improvement (IHI), Cambridge, Massachusetts, U.S. Conceptualized and initiated an innovative Neonatal Collaborative on improvement of Facility Based Newborn Care in India. Technical advisor for the Public Private Partnership project for improving infant survival in 3 focus districts of Orissa & Bihar under the Norwegian Indian Partnership Initiative (NIPI).
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
ACCESS Health International Process Improvement Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.