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Maternal and Newborn Health (MNH), is our program designed to influence policy and practice for maternal and newborn survival.
Objectives
To enhance systems and institutional capabilities for strengthening primary health care and city wide referral system to achieve sustained improvement in maternal and neonatal care and health status.
Our programmatic vision is based on the principle of working with existent systems and communities to simultaneously improve both the supply and demand side of health care and to bring about change in women and newborn health. We strongly believe in building capacity of the health care providers for improving the facility and patient management skills and backing it up with partnerships with private sector for mobilizing resources.
Our core strategies include creation of collective vision for change and involving every level in making it possible.
ACHIEVEMENTS/MILESTONES
Our SNEHA Sure Start initiative entered its conclusive phase showing improvements in the MNH indicators such as early registration and uptake of Janani Suraksha Yojana (cash benefit scheme to promote institutional deliveries) in the N ward of Mumbai. One community resource centre started by SNEHA was formally taken over by the community based organizations with an assurance to sustain its activities.
Initiated citywide scale up of antenatal clinics(ANC) at 30 health posts and citywide referral system in Mumbai. Partnership with Municipal Corporation of Greater Mumbai.
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FUTURE PLANS/NEXT STEPS
Institutionalizing the referral system and building capacity of health posts to improve the community outreach in the vulnerable slums of the 30 health posts
PAPER/POSTER PRESENTATIONS
- Presented a paper on ‘Experiences of and barriers of working with private practitioners on quality of care in Mumbai’ at the First Global Maternal Health Conference in New Delhi in August 2010
- Presented a poster on ‘Upgraded maternity and newborn care across Mumbai's municipal hospitals’ at the First Global Maternal Health Conference in New Delhi in August 2010
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CASE STUDY
Lalita was iLalita was in the first trimester of her pregnancy. But she had neither registered her pregnancy with any doctor/ hospital for delivery nor had she gone for any check-ups. A SNEHA field worker made regular home visits to Lalita and spoke about proper antenatal care, but she still did not see the need.
The field woThe field worker then called Lalita to a group meeting of other pregnant women. By design, the 15 women participating in the meeting were from various stages in their pregnancies. This included Lalita and two other women in their first trimester who had not registered their pregnancies. The importance of early registration, antenatal care check-ups, regular blood pressure and abdomen checks, were discussed during the group meeting. The women also shared experiences of how the information that they learned from the SNEHA field worker had helped them and their babies.
However, Lalita (and the two other women) were silent. They had nothing to share. Lalita realized that the trends in pregnancy had changed and that the information being shared was important for her. Her peers helped to change her behavior and perception.
When the SNEHA field worker next visited Lalita during the individual home visits, she learned that Lalita and the other two women had immediately registered their pregnancy at the local public maternity hospital, the day after the group meeting.
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IMAPACT
- Engaged with 30 health posts, 8 maternity homes, 4 peripheral hospitals, 200,000 slum population in N ward
- 14 Health posts are now offering weekly ANC clinics
- 41 HP staff including 11 doctors, 10 public health nurses and 21 auxiliary nurse midwives were trained in clinical and behavioral skills
- Reached out to 15,132 pregnant women with behavior change communication messages in N ward, which helped in improving early registration from 44 % to 84 % in 3 years ( refer graph)
- 597 pregnant women accessed the antenatal clinics at the health posts.
- The referral links in eastern region (8 maternity homes and 4 peripheral hospitals) have shown remarkable improvements in the appropriate referral from MH to peripheral hospital with improved documentation of cases referred
- Created communication material on MNH messages, danger signs, birth preparedness, complications and readiness and printed a souvenir bag with a 7 step message to ensure healthy newborns
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