On the eve of a grand general election, growth and development statistics may be readily bandied about on the campaign trails of various political parties; yet it is sometimes the quiet work that goes on in the background, and collaborations with partners near and far that make a genuine difference on the ground when it comes to critical human development areas for India, such as healthcare.
One such project, which is impacting the vital statistics on Maternal Mortality Ratio (MMR) across Tamil Nadu neonatal hospitals and speciality units is the result of a collaboration between the State’s Directorate of Public Health (DPH) and Preventive Medicine with Singapore Health Services and Singapore International Foundation (SIF), to impart training on combined obstetric resuscitation emergencies and enhancing maternal and child health (EMCH) services.
With Phase One of the project complete and Phase Two now underway, the project has already yielded results in terms of what the State’s Health Minister Ma. Subramanian described a few months ago as a drop in Tamil Nadu’s MMR to 52 per one lakh live births during 2022-2023, after the figure had surged to 90 during the COVID-19 pandemic.
Under the next two years of the second phase, the EMCH project will train “over 140 Maternal and Child Health (MCH) professionals in Tamil Nadu to identify and manage obstetrics and neonatal emergencies, as well as high-risk pregnancies, and this will be done through a series of workshops and clinical training,” said Shephali Tagore, Team Lead, Singapore International Volunteer and Senior Consultant, Department of Maternal Foetal Medicine, and Director of International Medical Programme OBGYN, KK Women’s and Children’s Hospital.
The most powerful driver of the programme is to directly target expansion of the core group of Master Trainers equipped to share their newly-acquired knowledge with their peers to benefit a larger community of Maternal and Child Health (MCH) professionals. In turn, an estimated 20,000 mothers and newborns are expected to benefit from this training, Dr. Tagore added.
Under this rubric, the teams also worked together to review their clinical and non-clinical work processes in obstetrics, anaesthesia, and neonatology – leading to the development and implementation of various protocols to manage postpartum haemorrhage, eclampsia, and other medical complications in participating hospitals.
There is good reason to believe that the formula will work this time too, for during Phase One, a key achievement of the multidisciplinary Singapore International Volunteer team driving the training efforts was that it successfully trained more than 1,000 local Maternal and Child Health (MCH) professionals in the State including obstetricians, anaesthetists, paediatricians, and staff nurses.
Initial target exceeded
“This is a 400% increase from the initial target of 200 in three years. A core group of 50 Master Trainers were also identified among this pool of Indian participants to cascade the training to peers in their own communities,” noted Jaryll Chan, Division Director, Programmes, Singapore International Foundation, who added that overall, a post-project evaluation done by the SIF also observed an increase in early identification and referral of high-risk and emergency cases to tertiary hospitals.
Indicating the robust spirit of collaboration in this project, Dr. Tagore noted that “Learning happens both ways,” and the Singapore team also took away insights and learnings from their Indian counterparts on their approach to maternity care and how they overcome challenges – she was especially impressed by the Indian participants’ “passion and hard work to make things happen despite limited resources. One such example was the joint effort of Indian and Singaporean neonatologists and obstetricians to create a standardised hospital protocol for “emergency code system” for the resuscitation of newborns, immediately after delivery.”
