ArticleBMC pregnancy and childbirth2022
Improving quality of intrapartum and immediate postpartum care in public facilities: experiences and lessons learned from Rajasthan state, India.
Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Essential newborn care practices in selected public health facilities using observation of 2603 normal deliveries in Uttar Pradesh, India.BMJ global health · 2025Observational
- Perceived effectiveness and recommendations from a childbirth quality assurance and improvement programme in India's private sector: a qualitative evaluation using the RE-AIM framework.BMJ public health · 2025Article
- Article
- Care of Healthy as well as Sick Newborns in India: A Narrative Review.Indian journal of pediatrics · 2023Review
- Implementing a quality improvement initiative for private healthcare facilities to achieve accreditation: experience from India.BMC health services research · 2023Article
- Does Quality Certification Work? An Assessment of Manyata, a Childbirth Quality Program in India's Private Sector.Global health, science and practice · 2022Article
- Impact of intrapartum quality improvement interventions on stillbirths: a systematic review and meta-analysis.Therapeutic advances in reproductive healthArticle
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Abstract
backgroundIn spite of considerable improvement in maternal and neonatal outcomes over the past decade in India, the current maternal mortality ratio and neonatal mortality rate are far from the Sustainable Development Goal targets due to suboptimal quality of maternity care. A package of interventions for improving quality of intrapartum and immediate postpartum care was co-designed with the Ministry of Health as the Dakshata program and implemented in public sector health facilities in selected districts in the state of Rajasthan of India since June 2015. This article describes the key strategies, interventions, results and challenges from four years of Dakshata program implementation.
methodsWe have conducted secondary analysis of program data (government data) collected from 202 public facilities across 20 districts of Rajasthan state. The data collected between June-August 2015 (baseline) and the data collected between May-August 2019 (latest) were analyzed. The data sources included: facility assessments, service statistics, monthly progress reports.
resultsDuring the period of program implementation, there were 17,94,249 deliveries accounting for 70% of institutional deliveries in intervention districts. As a result of the intervention, there was a notable increase in competency of health care providers, availability of essential resources, achievement of labour room standards and adherence to evidence-based clinical standards. We also observed reductions in the proportion of referrals for pre-eclampsia/eclampsia, postpartum hemorrhage and neonatal asphyxia by 11, 8 and 3 percentage points respectively. Similarly, data revealed a reduction in stillbirth rates in Dakshata intervention facilities (19.3 vs 15.3) compared to non-Dakshata facilities (21.8 vs 18).
conclusionsOur experience and findings indicate that the quality of intrapartum and immediate postpartum care can be improved in low- and middle-income countries with the approach presented in this paper.
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