Evidence based advocacy for maternal and neonatal health

ARTH undertook an evidence based advocacy for maternal-neonatal health (including safe abortion) across the seven divisions of Rajasthan state, using a gender, rights and health systems approach, in collaboration with the Department of Medical Health and Family Welfare Services, Government of Rajasthan.

The focus of ARTH’s advocacy efforts had emerged from the various research studies that it had conducted. One of these was a qualitative study on neonatal care and childbirth practices at home and institutions, another was a quantitative survey of delivery practices, and there were 2 verbal autopsy studies for maternal deaths. These studies had thrown light on very crucial issues, including quality of delivery services, referral mechanisms, timing of discharge, costs of services and immediate neonatal & maternal care at home and in institutions.

As a part of this advocacy, various activities were carried out:

1. Seminar for faculty of training institutions of Rajasthan: Expanded Role of Nurse-Midwives in Providing Reproductive Health Services.
   In collaboration with the Department of Medical, Health & FW Services, Government of Rajasthan, we organized a one day seminar to orient the faculty of nurses’ training schools in the state, about the expanded role of nurse-midwives in providing safe abortion, delivery and newborn care services.The main objectives of the seminar were:

    

   • In the light of recent changes in policy and programmes, to review the expanded role of nurse midwives in providing key reproductive health services, viz. safe abortion, delivery and newborn care
   • To orient the faculty of training schools of Rajasthan, about the implications of these expanded roles for training nurse-midwives

   42 nursing tutors from different nursing colleges of the state participated in the seminar, that was held in the state capital, Jaipur in January 2010.

2. State level consultation of expert group on “evidence based delivery and newborn care” organized by ARTH in partnership with government of Rajasthan, UNFPA and UNICEF, in Jaipur on 11th&12th September 2009. The consultation brought together senior faculty members (gynecologists and paediatricians) of all the medical colleges of the State for review and adoption of evidence based practices. Principal Secretaries of MH&FW and Medical Education, Secretary (FW) & Mission Director NRHM, various officials from GoR and representatives of UNICEF and UNFPA were present in the consultation.
3. A booklet entitled “Recommendations for Key Delivery and Newborn Care Practices in Health Facilities of Rajasthan” has been printed and published.
4. In the month of August, GoR issued a notification directing all the public health institutions to follow evidence based obstetric practices.
5. Strong emphasis on evidence based care during training of trainers for skilled birth attendants: ARTH has so far trained more than 217 midwifery trainers across all districts of Rajasthan, whereby information on certain key practices during labor and delivery was collected, training on evidence based care in delivery and neonatal care was provided and at the end of the training, all participants made a plan for implementing these practices in their own institutions.