Undertaking Situational Analysis to further strengthen Quality of maternal health services in Jammu & Kashmir
The Government of Jammu & Kashmir, through its National Health Mission, has done excellent work through successful implementation of many programs in area of maternal and child health. However, there is lack of systematic documentation and dissemination of best practices.
NIPI is assisting the Government of J&K in reducing preventable maternal deaths and improve maternal health through strengthening of pre-existing services and adoption of evidence based practices. In order to design effective strategies for strengthening maternal health care in UT of J&K NIPI and NHM planned to conduct situational analysis in identified facilities. As it is important to first understand true burden of maternal deaths; determine causes and geographic distribution; socio-economic variance and system’s readiness to address burden of maternal deaths and also to identify the major public health challenges, which in-turn feed into drafting recommendations and formulating a contextualized, state-specific strategy to improve status of maternal health in J&K.
Situational analysis will also attempt to conduct estimation of maternal mortality trends and help the Government to take informed data driven decisions while designing contextually appropriate action plans, establishing district level targets and estimating true coverage of program activities.
Key outcomes of Interest of the analysis envisaged are better Access to maternal healthcare; utilization of services, health seeking behavior; status and quality of maternal health services; existing and future estimates of MMR; distribution and causes of deaths; Inter-district variation, MMR projections till 2030; Annual rate of change in MMR; distribution of risk factors for maternal deaths; Perceived challenges and gaps in quality of MH services.
NHM J&K identified 12 high delivery load Facilities, six each in Srinagar and Jammu division from 9 districts (one aspirational and 8 non-aspirational) which includes 4 Medical colleges, 3 District hospitals, 2 sub-district hospitals and 3 CHCs considering that it will give over all status of the UT of J&K for designing appropriate strategy. NIPI team conducted assessments from 4-8 January 2021. The assessments were successfully completed in 6 facilities of Jammu division (MGS hospital Jammu, SDH Akhnoor, CHC Katra, DH Udhampur, SDH Sunderbani and DH Rajori). However, due to inclement weather in Srinagar division, the exercise could not be completed as planned and is rescheduled to be undertaken in April 2021. After each assessment team has shared detailed feedback with respective facility in-charges, concerned staff and relevant stakeholders for immediate corrective actions to be carried out at facility level. For suitable actions needed at the NHM level, NIPI team met with NHM officials and provided relevant feedback. Once the assessments in Srinagar division are completed, a detailed report will be submitted to Government of J & K.
Structured approach will be used for situational analysis which includes a systematic literature review, secondary analysis of maternal health data and inclusion of learning derived from field observations / discussions with service providers, beneficiaries. A triangulated approach will be followed utilizing different databases and diverse verification means. The learnings of field visits will be mapped to produce a layered meaningful analysis, enabling to fully explore status of maternal health.