MSD For Mothers Committed To Bringing Down Maternal Mortality In India

When 45,000 young women, many in their 20s, die every year in India, primarily for reasons entirely preventable, it must stir an urgency to drive action. These women, otherwise healthy, other than the fact that they are pregnant, fall to a health system which in many ways fail to provide them the most critical need – the quality of care. It comes as no surprise that India has the second highest number of maternal deaths in the world.

The gaps in quality, appear in both public and private facilities. India is mobilizing to improve quality of care in the public health system with a slew of initiatives announced, but efforts to support quality improvement among private providers need to be accelerated. Private providers offer a significant portion of care in India and can act as a release valve for over-burdened public facilities. They also account for up to 30% of institutional deliveries in rural areas and up to 52.5% of institutional deliveries in urban areas. However, many are found not to be following recognized, evidence-based, quality standards of care in their labor and delivery wards. These challenges persist due to a widespread lack of technical resources, insufficient training and weak incentives for private maternity facilities to invest in quality improvement.

Streamlined quality improvement interventions that address these challenges with a practical and sustainable model is an important step forward for maternal health in India. MSD for Mothers, a 10-year, $500 million global initiative of MSD (Merck Sharp & Dohme), to ensure that no woman dies giving birth, is bringing focused initiatives in India that provide a compelling solution to this issue. Their programs primarily focus on much-needed quality intervention in the private sector, thus complementing national efforts in the public sector and strengthening total health systems to reduce maternal mortality.

Dr. Naveen A Rao, Lead, MSD for Mothers, who was in India recently, shared the enormity of repercussions if maternal health is ignored, with BW BusinessWorld.

“During my residency, my training year, I saw a child being born, and the mother is still on the stirrups, and she is bleeding, legs are wide open, the baby has come out and baby is not breathing. All the doctors, all the nurses go to the baby to help the baby breathe, and by the time they do that and turn around, they realize that the mother is dead. It’s all about the baby, it’s all about that newborn and in fact, the mother is just a vehicle to make babies sadly. When a mother dies, the ripple effect is enormous on the family, community and the nation’s economy; and hence there is a need for intervention at every step to address maternal mortality - while seeking care, reaching care and receiving care,” shared Dr. Rao.

MSD for Mothers has focused on three approaches to address the maternal health system gaps in India. The first is up-skilling and equipping private healthcare providers to ensure that set clinical standards of quality are upheld. Their flagship program Manyata, trains, equips and certifies private healthcare providers to ensure women receive the standard quality of care. This program is currently operational in UP, Jharkhand, and Maharashtra. The second approach is empowering and educating women so that they are able to make informed choices about the quality of care which is their right. They have developed a digital platform – Together for Her which authorizes women to rate their experience at a facility. The third approach is strengthening the healthcare systems, including supply chain and transportation.

“We believe it is essential to make collaboration and innovation the pillars on which sustainable change can be achieved in the area of maternal health, especially the quality of care,” emphasized Dr. Rao.

Dr. Naveen Rao further highlighted that, “Extrinsic and Intrinsic incentives which will drive a private hospital, doctor or provider to quality of care, are imperative. This allows us to build a sustainable model, such as Manyata, which is scalable, fundable and can be replicated in other parts of the world. It is a quality journey and the only way we believe to create an impact.”

In India, MSD for mothers is working in Uttar Pradesh, Rajasthan, Madhya Pradesh, Maharashtra and Jharkhand. They have collaborated with the government to work with public health systems in Rajasthan and Madhya Pradesh where they are using digital innovations to address quality of care.

While influencing systems-level change is time intensive and requires multiple collaborations and a clear strategy, interventions such as these, are a testament that this can indeed be achieved and scalable, self-sustaining models that can improve the lives of women for years to come, can be created.

“When you sit on the plane you hear the announcement, that put the mask on yourself before you put it on your child, the reason is if the mother doesn’t, then the child has no chance. I’m saying the same thing. Don’t forget the mother."