Syndicate content

Add new comment

Thank you Patricio for this insightful blog. As you say, maternal and child health can improve significantly through introducing simple and inexpensive changes in practice such as mandatory hand washing and other safe obstetric practices to avoid complications; Quality standards derived from evidence-based guideline recommendations offer a practical mechanism for driving these changes especially if they are used in the context of well- structured and coherent health system with support from policy makers and professional organisations.
As an example, the Government of Kerala (Health & Family Welfare Department) is implementing a Quality Standard (QS) on improving maternity care in eight pilot hospitals in the state. This initiative is a partnership between the National Rural Health Mission (NRHM) and the Kerala Federation of Obstetricians and Gynaecologists (KFOG) who joined forces to develop the QS and to introduce it in practice. Using international evidence based guidelines (WHO, The National Institute for Health Care Excellence (NICE) and local clinical guidelines, the local consortium produced a document that covers key components of maternal care linked to improved outcomes, including active management of Third stage of labour, prevention and management of Post Partum Haemorrhage (PPH), pre eclampsia, placenta previa Accreta, hypertension, HELLP and eclampsia. The document includes measurable process and outcome indicators. A concerted approach was required to implement the QS. This included training, staff redeployment, procurement of equipment, establishing data collection and reporting systems. The pilot is ongoing until the end of March 2014. Monthly review meetings chaired by the NRHM Mission Director are held with the KFOG all the pilot sites reporting their data and experience.
NICE International provided technical assistance to the local team. The project has been reported in the Indian press at various stages.