Table 3 Maternal health policies, objectives and indicators of MAPEDIR's effectiveness in helping to meet the objectives, and outcomes
| Â | Â | State (District) Outcomes | ||
|---|---|---|---|---|
National RCH policy | District maternal health policy objectives and indicators | Rajasthan (Dholpur) N (%) | Madhya Pradesh (Guna and Shivpuri) N (%) | West Bengal (Purulia) N (%) |
Register all maternal deaths | "Unhide" maternal deaths: % of expected maternal deaths* reported by district before//after MAPEDIR implementation | Apr, 04-Mar, 05: 4% (5/116 deaths in 4 blocks)//Apr, 05-Mar, 06: 60% (35/58 deaths in 2 blocks) | Feb-Dec, 05: 47% (113/239)//Feb-Dec, 06: 57% (136/239) | July, 04-June, 05: 119% (114/96)//July, 05-June, 06: 127% (122/96) |
Investigate all (or a sample of) reported maternal deaths | Gather new evidence: % of reported maternal deaths investigated by district before//after MAPEDIR implementation | Apr, 04-Mar, 05: 0% (0/5)//Apr, 05-Mar, 06: 100% (35/35) | Feb-Dec, 05: 0% (0/113)//Feb-Dec, 06: 100% (136/136) | July, 04-June, 05: 0% (0/114)//July, 05-June, 06: 86% (105/122) |
Implement RCH programme planning and management: • Evidence-based | The state uses the new evidence: New maternal health interventions developed by/with the state health system based on MAPEDIR data | Statewide obstetric help line (implementation delayed); 141 FRU blood storage units equipped | None | Made all public maternity beds non-paying; expanded JSY to all SC/ST and BPL women; implemented new rural referral transport system |
• Decentralized | Decentralized MH planning: New maternal health interventions initiated at district level based on MAPEDIR data | District health society planned and mobilized obstetric helpline and referral transport system by partnering with civil society | Guna: mapped maternal deaths to prioritize & upgrade remote SHCs for 24 × 7 safe delivery services; Guna and Shivpuri: ensured 24 × 7 referral transport to all PHCs via call center and secured vehicles | None |
• Bottom-up | Community participation: New maternal health interventions developed by or with communities based on MAPEDIR data | Taxi union & NGO collaborated with district in implementing and running the obstetric help line and referral transport system | Guna: block PRI ensured referral transport for remote villages to upgraded SHC; Guna: communities donated 6 of 22 referral vehicles | GP-initiated 8 van rickshaws in 4 remote GPs of 4 Purulia blocks |