SBA - Presentation 6 (b)

Ensuring quality of care

Maternal Health Division

Ministry of Health & Family Welfare
Government of India
 Community involvement

Quality of care can be achieved only by sensitisation and

involvement of:
• the community
• the family

This helps in having a better outcome of pregnancy by

ensuring:
• Emotional support during pregnancy
• Readiness of the family/community for timely assistance
• Reaching the facility well in time for delivery of services

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 Community involvement

• Informing and involving the community in the process of

improving women’s health will go a long way in bringing
down maternal mortality

• Community should be empowered to tackle health problems

affecting their women

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 How to improve health status of
mother and infants

• Enquire about knowledge of people regarding maternal

morbidity and mortality in their area
• Discuss role of families and communities in preventing
maternal deaths
• Share key messages on maternal and child health with
community members

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 How to improve health status of
mother and infants

Discuss ways in which families can help woman during

pregnancy, labor and postpartum period:

• Recognizing & responding to danger signs during

these periods
• Accompanying woman for delivery
• Providing financial support
• Communication between husband & wife

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 How to improve health status of
mother and infants

Support the family & community in preparing action plan

to respond to emergencies:

• How to identify danger signs

• Importance of rapid response to emergencies
• Transport options available
• What emergency obstetric services are available & where
• Importance of blood transfusion in emergency
• Need for blood donation

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 How to improve health status of
mother and infants

Support to family in case of obstetric emergencies:

• Listen to the family, they will need to discuss their hurt or

sorrow
• Show empathy
• Tell the family as much they can understand about what
is happening
• Be honest and maintain the trust
• If language/dialect is a barrier identify someone to
translate for you

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 How to improve health status of
mother and infants

Establish links with ASHAs, AWWs, SHGs

and seek their cooperation:

• Discuss how you can support each other

• Respect their knowledge & influence in community
• Share with them your information on maternal morbidity
& mortality
• Involve them in counseling sessions for families
• Discuss recommendation that all deliveries
(Home/Institution) be conducted by SBA

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 Social review of maternal deaths
• Report every maternal death to the ANM/M.O. for review
• Undertake a social review of maternal deaths reported from villages under your
area
• Focus on finding social factors responsible for maternal
death e.g.
– Utilization of ANC services
– Place of delivery
– Who conducted the delivery
– Availability of transport
– Access to money
– Preparedness and response time during emergency call

The findings of social review to be shared in PRI / SHG meetings

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 Community involvement
Key messages
• Raise awareness among the community regarding danger
signs during pregnancy, labor delivery and postpartum
period
• Seek cooperation of other partners in the community such as
:
− Self help groups(SHGs)
− Community based organizations (CBOs)
− NGOs

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 Importance of counseling
• To avoid any problems arising due to complications during
pregnancy
• Avoiding legal cases against health providers in case of
adverse pregnancy outcomes

Hence the importance of disseminating correct information on

how to make pregnancies safer among women and their
families

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Points to be kept in mind while dealing with the
woman and her family
• Respect the woman’s dignity & privacy
• Be sensitive and responsive to her needs
• Be non – judgmental about the decision the woman
and her family have made for her care
• Provide counseling, if required, only after managing
the complication
• Respect the right of women to receive maternity
care services

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 Rights of women who receive
maternity care services

Every woman receiving care has right to :

• Privacy
• Information about her health
• Discuss her concerns
• Know relevant information regarding procedures performed
on her

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 Supportive care during normal delivery

• Ensure the woman has companion of her choice

during labor & delivery
• Encourage companion to take active part in the
woman's care
• Ensure privacy during and after delivery / event to the
woman and her family

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 Supportive care during emergency / complication

Emotional and psychological reactions of woman

and her family during emergency / complication
• Denial
• Guilt
• Anger (towards health care staff / self)
• Depression, disorientation

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 General principles of communication and support
during emergency/complication

At the time of event

• Listen to those who are distressed
• Inform the woman / family about the
emergency / complication
• Be honest and maintain trust with the woman
• If language a barrier to communication,
identify a translator

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 General principles of communication and support
during emergency/complication

After the event

• Give practical assistance, information and
emotional support
• Respect traditional beliefs and customs and
accommodate family's needs
• Explain the problem to help reduce anxiety and
guilt
• Give written information, if possible

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 Counseling and supportive environment

Key messages
• Respect the right of women to receive
maternity care services
• Respectful communication and empathy are
most important elements of quality maternal
care

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 Janani-Shishu Suraksha Karyakram

• Assures NIL out of pocket expenses in

all Government Health Institutions for
pregnant women & newborns

• Launched by Ministry of Health &

Family Welfare

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 Janani-Shishu Suraksha Karyakram
Entitlements for Pregnant Women
• Free delivery
• Free caesarian section
• Free drugs and consumables
• Free diagnostics (Blood, Urine tests and Ultrasonography,
etc.)
• Free diet during stay (upto 3 days for normal delivery and 7
days for caesarian section)
• Free provision of blood
• Free transport from home to health institution, between health
institutions in case of referrals and drop back home
• Exemption from all kinds of user charges

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 Janani-Shishu Suraksha Karyakram
Entitlements for Sick Newborn till 30 days after birth
• Free and zero expense treatment
• Free drugs & consumables
• Free diagnostics
• Free provision of blood
• Free transport from home to health institution, between health
institutions in case of referrals and drop back home
• Exemption from all kinds of user charges

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Thank you

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