India has the second highest number of maternal deaths in the world. An increase in deliveries at hospitals has not reduced maternal mortality rate. Quality of care is inconsistent among private healthcare providers, where 40 percent of mothers seek maternity care. There is no clear consensus on standards and no mandatory national system to assure quality.

Efforts to improve quality among private providers has been an urgent requirement, especially because the private facilities offer up to half of maternity care in India and can act as a release valve for over-burdened public facilities.

A survey on quality improvement of private providers undertaken between 2013 -2016 showed that 75% providers improved their clinical/quality standards for childbirth after they underwent a skills training than 3% at the beginning of the program.

To complement efforts on quality care, The Federation of Obstetric and Gynecological Societies of India (FOGSI) with support from MSD for Mothers are working in Uttar Pradesh, Jharkhand and Maharashtra on a quality improvement program called Manyata.

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Your journey to quality maternal care with Manyata is undertaken as follows:

Facility Engagement:

• Sensitization and Letter of Intent: A sensitization meeting or CME is conducted for doctors in states. For interested doctors, a Manyata team analyses the basic eligibility of the facility for inclusion under Manyata initiative. Once selected, a Letter of Intent is provided by facility to FOGSI for formal engagement.
• Registration Fees: Facilities also pay nominal Manyata registration fees of Rs.10, 000. The fee covers sensitization, CME cost, centralized clinical training cost. The sites, which are ready for FOGSI assessment, pay an additional certification cost of Rs. 10, 000 which is valid for a period of three years.

Quality Improvement support:

• Orientation and baseline assessment: During the preparation phase, an orientation is conducted on Manyata Standard Operating Procedures (SOPs) where necessary tools and resources are shared by the local QI (Quality Improvement) hub. Following this, facility is encouraged to conduct a baseline assessment of themselves using FOGSI’s clinical standards. The baseline findings are then validated by local QI hub and an action plan and roadmap for quality improvement prepared.
• Training and mentoring: A series of centralized training sessions follows. This is supported by fortnightly visits (upto 3 months), where rigorous trainings (clinical checklists, skill drills, System Development Procedures) are conducted. The team then assesses the hospitals (mid-phase) on set deliverables.
• FOGSI external assessment and certification: Finally, an external assessment is carried out by trained FOGSI lead assessors. On passing the assessment, the hospital is awarded the Manyata certificate. By getting this certification, the enrolled hospital is recognized for its excellence in maternity care. In case they do not match the expected score of 85%, a period of three months is generally given for course-corrections and then, the center is re-assessed.