A Call To Action: Supporting India’s Commitment to the Global Strategy for Women and Children’s Health Maternal and Child Health Integrated Program (MCHIP) Dr. Anju Puri Senior Advisor, Newborn and Child Health 16 th November 2010

MCHIP in India MCHIP is working to address major constraints in national efforts to improve MNCH and contribute towards achieving MDG 4 & 5 Vaccine Preventable Disease – Focus on expanding immunization coverage and improving quality to reduce morbidity and mortality Maternal Health – Strengthening Pre-service Nursing and Midwifery Education System – Revitalizing PPFP/PPIUCD program Newborn Health – Support the national program for care of the newborn through improved ENC, neonatal resuscitation and hand washing practices

Where

Immunization Status India

Vaccine Preventable Diseases Influencing national immunization policies and strategies and mobilize new resources – NRHM guidelines that make funding available for evidence-based, best practices – New vaccine, measles control, JE vaccine, cold chain, PIPs Using “ RED” for planning, management and monitoring Building capacity of stakeholders – Updating, leveraging resources for roll out and evaluating RI training packages for BHWs, MOs, DIOs, partners (more than 1000 workers trained; 150,000 across India) – Need-based job aids (used in UP, Jhk, Bihar, Maharashtra, Gujarat, Orissa, Punjab) – Pioneering a unique multi-partner supportive supervision approach (UP/Jharkhand, Orissa, MP) In selected blocks of focus districts, demonstrating successful approaches to utilize lessons from polio eradication for improving RI

Outcome

RED and RED like approaches REDMCHIP facilitating RED like activities 1. Re-establishing outreach servicesDistricts with low coverage identified, Revised micro-plans developed – using polio micro-plans 2. Supportive supervisionSS is adopted as an activity in the state PIPs; capacity building 3. Linking services with communitiesASHAs in place, trained by ANMs, inputs provided, Due lists prepared, Tracking Every Newborn (TEN) 4. Monitoring and use of data for actionData of monitoring used, District data reviewed, SS info used 5. Planning and management of resources District plans based on local situation with adequate funding provision

Job Aids (Immunization)

NMR trends and predictions

Causes of Neonatal Mortality

Newborn Activities Collaborate with the MOHFW and state governments to refine and roll-out essential newborn care programs, including NSSK – NSSK rolled out in 15/24 districts UP & Jharkhand respectively, – 239 trainers trained in UP & 82 in Jharkhand, quality monitoring of cascade training – Facility Readiness assessment & operationalization for Newborn Care – Preparation of job-aides Strengthen national, state level partnerships for improved policy dialogue and evidence based planning – Child health strategy and operational plan linked to PIP – National child health partner group under GOI – Expert group on Facility Based Newborn Care - MIS, Operational Guide on Facility Based Care – Desk Review of Perinatal Care in India Strengthen basic NBC and neonatal resuscitation content of INC pre-service training curricula for nurses Curricula updated and in line with NSSK Adapt and test the successful supportive supervision approach as key activity integrating lessons of immunization supervision model for newborn care

Strengthening Pre-service Nursing and Midwifery Education System Comprehensive initiative in partnership with INC/GOI to strengthen the foundation of ANM education resulting in  Better prepared service providers,  Higher functioning educational institutions and  ANMs who are competent, confident and ready to work upon graduation. Achievements  Commitment from GoI/ INC/ state Govt/ Donors  INC approved standards for education developed and in use  5 national nodal centers identified and work started  6 weeks curriculum for training tutors being finalized 12

Revitalizing PPFP/PPIUCD program in India Rationale  2/3 of PP women desired to space or limit future births but were not using appropriate services.  Method mix relied heavily on sterilization when IUCD could be an excellent option for many women.  JSY was bringing women to facility: supplying them with information and delivering high quality services -- goal of PPFP program.  National IUCD initiative Achievements  Increased interest at National/state level, FOGSI, private providers, donors  National Consultation on Family Planning for Maternal and Child Health in addition to Population Stabilization in May 2010  States developing PPFP strategy 13

Establishment of PPFP/PPIUCD Services  Developed national PPIUCD clinical guidelines, training materials including job aids, IEC material, approved by GoI  Developed 4 training sites including standardizing PPIUCD services  Doctor and nurse teams from two sites each in 16 states trained and PPFP/PPIUCD services established at > 32 sites  > 3000 PPIUCD insertions done In the newly established service delivery and training sites since February 2010.

Thank You