Tuesday, August 30, 2022

FOGSI Inks MoU With NABH To Collaborate For Improving Quality Standards For Maternal Healthcare In India

The Federation of Obstetricians and Gynaecological Societies of India (FOGSI), India’s professional organization representing practitioners of obstetrics and gynaecology, today, announced its collaboration with the National Accreditation Board for Hospitals and Healthcare Providers (NABH)/Quality Council of India (QCI), India’s apex body for accreditation and quality promotion, to advance the Government’s vision to improve the quality of maternity services. This collaboration will ensure ‘One Nation One Standard’ where Maternity service providers (MSP’s) will be jointly assessed by NABH and FOGSI.

This is a crucial quality-improvement sectoral collaboration aimed at reducing maternal mortality in line with the Sustainable Development Goals (SDGs) and strengthening health systems for safer childbirth in India. Under the MoU hospitals and nursing homes having maternal care facilities, clinical standards will be assessed, ensuring consistent, safe, and respectful care for mothers during and after childbirth. This collaboration is envisaged to improve and standardize quality across all MCH facilities in the country, a landmark step in our evolving health system.

Emphasizing the need for quality at the foundational level, Dr. Mahesh Verma, Chairman of National Accreditation Board for Hospitals and Healthcare Providers (NABH) said, “We are driven to develop a culture of excellence, enhance healthcare systems, and promote continuous quality improvement and patient safety. We are delighted to collaborate with FOGSI to enhance maternal health standards in the country with its flagship initiative, Manyata.”

Dr. Atul Mohan Kochhar, CEO of National Accreditation Board for Hospitals and Healthcare Providers (NABH) added, “Improving the quality of maternal healthcare in the country is certainly the need of the hour as India has one of the highest numbers of maternal deaths in the world. We strongly believe that it is imperative to lift the quality standards in maternal healthcare to be able to improve our health outcomes overall. This collaboration with FOGSI is a crucial step forward to strengthen the maternal health ecosystem across the country.”

Dr. S. Shantha Kumari, President, FOGSI, and Treasurer, FIGO, said, “Embedding standards for quality of care in health systems hold great potential in reducing maternal mortality and achieving the health-related SDG targets. However, in India, despite the increase in the number of women delivered in facilities, maternal mortality remains alarmingly high, suggesting gaps in quality of care. The current SRS data suggests that India’s maternal mortality ratio (MMR) has improved to 103 in 2017-19, from 167 in 2011-13, highlighting improvements in our health systems but we still have a lot of ground to cover. With around 50% of women in the country delivering in private maternity hospitals, there is an urgent need for the adoption of clinical standards by the obstetric community. We welcome the collaboration with NABH that will only promise better outcomes and health for women in India.”

Dr. Hrishikesh D. Pai, President-Elect, FOGSI, and Chief Administrator, FOGSI-Manyata initiative, added, “We are delighted to come together with NABH towards improving the quality of maternity care as well as access to this care with Manyata so that every woman in the country receives quality services wherever and whenever she seeks care. This collaboration is a significant milestone and will strengthen our commitment to providing equitable and high-quality maternal care in India.”

Dr. Hema Divakar, National Convener, FOGSI-Manyata initiative said, "A decade of efforts has shown us that it is worth investing in strengthening maternal health care systems so as to bridge the gap between knowing and doing. Upskilling of existing human resources has made a huge impact on the quality of care in the Manyata accredited centers."

This collaboration will involve quality care sensitization workshops for Maternity Service Providers (MSPs) aimed at creating a pool of FOGSI specialists to assess facilities for NABH quality accreditation and assessments of MSPs by NABH as per FOGSI’s Manyata standards. 

Although the share of India's institutional deliveries has increased to 88.6% in 2019-2021 (NFHS 5), the country has one of the highest numbers of maternal deaths, globally. A considerable proportion of maternal mortality is in fact due to preventable causes such as obstetric haemorrhage, pregnancy-related infections and hypertensive disorders of pregnancy. To address this, the Government of India has increasingly prioritised quality maternal care by instituting quality improvement programmes in public health facilities. However, with a significant proportion of women choosing private care to deliver, the private sector plays a critical role in providing quality maternal care to women. This highlights the need for a national system to oversee the quality of maternity care among private providers and thereby improve maternal health outcomes.

To bridge this gap, FOGSI has been driving Manyata since 2013, a programme that promotes the adoption and practice of 16 clinical standards based on the World Health Organization’s (WHO) standards of quality care for antenatal, intrapartum and postpartum care. The programme evidence by Ariadne Labs (Affiliated to Harvard) shows a 70% increase in Manyata facilities being able to manage life-threatening complications, such as obstructed labour, pre-eclampsia and/or eclampsia, and postpartum haemorrhage greatly improved. Manyata’s footprint spans 22 states across a network of 1500 facilities in the country. It is a first-of-its-kind initiative which is building the capacities of healthcare workforce and providing certification, thereby setting a benchmark for maternal quality care. Manyata has laid the foundation for self-driven awareness and demand in Quality improvement amongst facilities and with this collaboration endeavours to scale together with NABH. The initiative is powering innovation through social health entrepreneurs and institutional business models as part of its sustainability and scale-up strategy. It has the potential to be replicated in nations with similar socio-economic demographic and mixed health systems.

Hence, the sectoral collaboration between NABH and FOGSI can create a paradigm shift in the maternal health ecosystem by complementing each other’s efforts to reach more mothers and create a more significant impact.

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