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telangana birth PrePareDness anD Parental eDucation for better Maternofetal outcoMes 44 | MAkING A Difference : Good, Replicable and Innovative Practices
Improved set up L.Rs, organized A.N. clinics and parental education gradually increased the number of deliveries in 24x7 PHCs ProbleM stateMent Poor and inadequate preparation of the mother and family is one of the major causes of all preventable maternal and infant deaths (as observed during project period Medak district) including female infanticides in the Indian situation. PrograMMe DescriPtion a. Start date- month and year: March 2007 – May 2009. b. Project description. Background It is a series of planned and structured informative sessions given according to the trimester, on specific, set days to all expectant mothers and their important family members, like mother-in-law/mother and husband, so that they become partners with the providers to help the mother enjoy a healthy pregnancy, pleasant childbirth and a healthy child, ultimately leading to a reduction in MMR and IMR. Methodology • A specific day (Friday) was allotted exclusively for conducting antenatal clinic – the second Friday and third Friday of every month were allotted for second trimester and third trimester mothers consecutively. • A series of informative sessions were planned and prepared according to the trimester of pregnancy. Thus every mother who attends the antenatal clinic receives uniform information through group-teaching/ discussion and demonstration, and posters. • Birth preparedness and Parental Education was conducted for ten to fifteen minutes and mothers were taken to already improved and set Labour Rooms and shown the facilities that are available for them when they come to PHC for safe delivery. • Feedback from mothers in reference to Birth preparedness and Parental education – comments and feedback to be written in the parental education book that had to be maintained by the staff nurse or Head Quarters ANM. • Initiation of Birth preparedness and Parental Education Sessions. • Training of master trainers at Sweden, Karolinska institute. • Piloted in one district as one of the components of Medak Modal Project. • Five levels of interventions were implemented – Facility level, Provider level, Community level, Programme level, Policy level. • Operationalising Midwifery services in 36 round the clock PHCs, and 10 FRUs. • Parental education was taught in “Midwifery Skill Enhancement Trainings” (a three-day training programme for staff nurses and Head Quarters/OP ANMs). • Parental education was initiated at the provider level through PHC/Head quarters sub-centre at PHC kondapur in July 2007. • Champions identified, rewarded and programme disseminated to other PHCs 18 out of 36 24x7 PHCs in Medak districts. Population Covered: Since 2007, 1119 mothers attended the birth preparedness sessions. PrograMMe outcoMes Impact on the district during project period: Improved set up L.Rs, Organized A.N. clinics and parental education gradually increased the number of deliveries in round the clock PHCs. iMPleMenting Partners Sida through IIM Ahmadabad and ANSWERS, MITRI, Peddapur, Medak District. evaluation Indian Institute of Public Health (IIPH, Hyderabad), 2010. “A cross sectional survey of the PHCs.” financial ManageMent The financial expenditure for a two-year period for Medak district was 18-20 lakhs which included all five interventions. scalability For future scalability this intervention can be taken as a pilot study in three to five PHCs at different geographical situations. conclusions/lessons learnt Dedicating a separate day (other than UIP) for organising antenatal clinics helps service providers to give focused antenatal care, Birth preparedness and Parental education sessions according to the trimester uniformly throughout district. references 1. Sweden model of Parental education. 2. A New Text Book for Nurses in India Vol-I 1st edition Loise M. Marsilje and Veera K. Pitman. 3. Guidelines for Antenatal Care and Skilled attendance at Birth by ANMs and Staff Nurse – GOI 2005. Contact DPHNO/Nursing Consultant IIHFW, Vengalraonagar
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