PROBLEM: India has the world's largest number of maternal deaths estimated at 117,000 per year. Past efforts to provide skilled birth attendants and emergency obstetric care in rural areas have not succeeded because obstetricians are not willing to be posted in government hospitals at subdistrict level. APPROACH: We have documented an innovative public-private partnership scheme between the Government of Gujarat, in India, and private obstetricians practising in rural areas to provide delivery care to poor women. LOCAL SETTING: In April 2007, the majority of poor women delivered their babies at home without skilled care. RELEVANT CHANGES: More than 800 obstetricians joined the scheme and more than 176,000 poor women delivered in private facilities. We estimate that the coverage of deliveries among poor women under the scheme increased from 27% to 53% between April and October 2007. The programme is considered very successful and shows that these types of social health insurance programmes can be managed by the state health department without help from any insurance company or international donor. LESSONS LEARNED: At least in some areas of India, it is possible to develop large-scale partnerships with the private sector to provide skilled birth attendants and emergency obstetric care to poor women at a relatively small cost. Poor women will take up the benefit of skilled delivery care rapidly, if they do not have to pay for it.
PROBLEM: India has the world's largest number of maternal deaths estimated at 117,000 per year. Past efforts to provide skilled birth attendants and emergency obstetric care in rural areas have not succeeded because obstetricians are not willing to be posted in government hospitals at subdistrict level. APPROACH: We have documented an innovative public-private partnership scheme between the Government of Gujarat, in India, and private obstetricians practising in rural areas to provide delivery care to poor women. LOCAL SETTING: In April 2007, the majority of poor women delivered their babies at home without skilled care. RELEVANT CHANGES: More than 800 obstetricians joined the scheme and more than 176,000 poor women delivered in private facilities. We estimate that the coverage of deliveries among poor women under the scheme increased from 27% to 53% between April and October 2007. The programme is considered very successful and shows that these types of social health insurance programmes can be managed by the state health department without help from any insurance company or international donor. LESSONS LEARNED: At least in some areas of India, it is possible to develop large-scale partnerships with the private sector to provide skilled birth attendants and emergency obstetric care to poor women at a relatively small cost. Poor women will take up the benefit of skilled delivery care rapidly, if they do not have to pay for it.
Authors: Marge Koblinsky; Zoë Matthews; Julia Hussein; Dileep Mavalankar; Malay K Mridha; Iqbal Anwar; Endang Achadi; Sam Adjei; P Padmanabhan; Bruno Marchal; Vincent De Brouwere; Wim van Lerberghe Journal: Lancet Date: 2006-10-14 Impact factor: 79.321
Authors: Manoj Mohanan; Sebastian Bauhoff; Gerard La Forgia; Kimberly Singer Babiarz; Kultar Singh; Grant Miller Journal: Bull World Health Organ Date: 2013-12-09 Impact factor: 9.408
Authors: Ellen Van de Poel; Gabriela Flores; Por Ir; Owen O'Donnell; Eddy Van Doorslaer Journal: Bull World Health Organ Date: 2014-03-17 Impact factor: 9.408
Authors: Gaurav Sharma; Matthews Mathai; Kim E Dickson; Andrew Weeks; G Hofmeyr; Tina Lavender; Louise Day; Jiji Mathews; Sue Fawcus; Aline Simen-Kapeu; Luc de Bernis Journal: BMC Pregnancy Childbirth Date: 2015-09-11 Impact factor: 3.007
Authors: Prem K Mony; Jayanna Krishnamurthy; Annamma Thomas; Kiruba Sankar; B M Ramesh; Stephen Moses; James Blanchard; Lisa Avery Journal: PLoS One Date: 2013-05-22 Impact factor: 3.240