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Chiranjeevi Reducing maternal and neonatal mortality through PPPP Gujarat experience in safe motherhood and child survival Achieving MDG 5 . Dr Amarjit Singh IAS Principal Secretary (FW) & Commissioner Health Government of Gujarat Currently ED, Population Stabilization Fund, GOI
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Chiranjeevi Reducing maternal and neonatal mortality through PPPP Gujarat experience in safe motherhood and child survivalAchieving MDG 5 Dr Amarjit Singh IAS Principal Secretary (FW) & Commissioner Health Government of Gujarat Currently ED, Population Stabilization Fund, GOI 26th October, 2009
Why Chiranjeevi? 15% women have pregnancy related complications 5 lac deaths globally 1.5 lacs in India Huge morbidity
Development of ChiranjeeviFocus on the marginalised population • Development after a year long consultative process with • Insurance companies • IIM Ahmedabad • Sewa Rural Jhagadiya • GTZ • FOGSI • Public Health Experts • Advance to private ObGYNs; Legal support In case of death during delivery • One of the interventions in the package of maternal health interventions; the other interventions like trg SBAs; MOs in CeMOC and BeMOC skills continued • Scheme kept simple; Use of existing mechanisms such as BPL cards issued by RDD
Package Rates for Chiranjeevi for Private Institutions (Dollars)
Transport support for delivery Responded to 8.88 lac emergencies; average 2300 medical emergencies per day; around 2.76 lac (32%) pregnancies; delivery by EMT 6735 {5256 in ambulance; 1489 at site} 91% from rural areas;saved around 37,774 lives
Outcome of Chiranjeevi (CY) Scheme: Mothers & New Born babies saved ( Up to Sept-09) Increase in institutional deliveries • Normal Deliveries: 340977 • C-Section: 23155 (6.0%) • Complicated Deliveries: 20789 (5.4%) • Private specialist enrolled: 817/2000
Recognition Issues Doable- Unprecedented support from the Private OBGYNs – potential for replication in other areas Surge of demand - boon to the poor - Unindicated C-section in check High level of anemia in women - Availability of blood??? Demand side effort Prompt payments – awards to high performers - independent regulation of contract • SEARO, WHO conference in Gujarat • Asian innovation award • Publication in The Lancet • PM award for excellence in Pub Admn
Let us join hands to reduce maternal mortality. We make a living by what we get; we make a life by what we give! THANKS Dr Amarjit Singh Principal Secretary, FW, Department of Health & FW Government of Gujarat, Gandhinagar, Gujarat