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Parijaat: Improving Quality of Maternal & Newborn
Healthcare in Public Health Facilities of Rajasthan
Dr. Sharad Iyenger, from ARTH, Udaipur shared the gist of the programme, Parijaat
and how it helped bring about a marked improvement in the lives of new born infants
in the project areas. The project aimed to improve quality of delivery and newborn
care, in selected high case-load public health facilities of 12 districts of Rajasthan. It
demonstrated its effectiveness by using quality improvement for better supervision.
Coverage: Began with 12 districts and retreated to 10.
Implementing Agencies: Department of Medical, Health & Family Welfare; UNFPA;
Action Research & Training for Health (ARTH).
Implementation
Preparatory activities: Developed consensus in the state on recommended practices
at each stage of labour; Expert group consultation organised involving faculty of all
medical colleges; recommendations developed on key delivery and newborn care
practices in health facilities.
Strengthening safe practices: All institutional deliveries are not safe and safety itself
is linked to number of safe practices. The project suggested the following:
In 2011, conducted orientation training of service providers and managers; strengthened
SBA training; conducted quarterly quality improvement visits to each facility.
In 2012, undertook maternal perinatal outcome monitoring; ensured greater involvement
of block and district managers.
Strengthened Skill Birth Attendants (SBA) training; assessed gaps in training
infrastructure and quality; Training of trainers of SBAs (24 batches-410 trainers &
senior NMs); facilitated improvement in training processes.
Undertook Quarterly Quality Improvement visits and worked with project personnel and
people from the state.
Assessment of facilities: A number of tools were developed to assess quality of
childbirth and neonatal care services. These included facility assessment checklist;
delivery observation formats; interviews with women in postpartum wards; and records
review. Some of the findings of the assessment carried out in 88 facilities revealed:
• y Many irrational practices continue with the most critical pertaining to
augmentation of labour.
• y The project made use of Social Science Post Graduates trained by Parijat. They
were supported with PPTs, capsular videos and information and trained on finding
gaps and using appropriate resources, many of which were taken from already
developed archives of UNICEF and other development partners.
• y Adherence to current practices as also new born care and breast feeding
initiation improved.
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Consultation on Supportive Supervision to Strengthen
Capacity of Frontline Workers and Service Providers