About the Program

The Uttar Pradesh Technical Support Unit (UP TSU) was formed in 2013 to provide techno-managerial support to the Government of Uttar Pradesh (GoUP) pursuant to the Memorandum of Cooperation between the GoUP and the Bill & Melinda Gates Foundation. The University of Manitoba (UoM) leads the program and has partnered with IHAT to support the government in strengthening its Reproductive, Maternal, Newborn and Child Health (RMNCH) and Nutrition programs.

Uttar Pradesh in Numbers

The state has made great strides in its maternal and child health indicators. However, when it comes to national rates and goals, Uttar Pradesh, with a population of over 200 million still lags behind.

The Approach

To improve effective health coverage, IHAT aims to enhance availability, quality and utilisation of health services, across the continuum of care, for women and children. It builds on global best practices using program learnings to design innovative and comprehensive solutions to address critical barriers across the 3 main platforms – health facilities, communities and health systems. 

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What We Do

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  • MATERNAL, NEWBORN AND CHILD HEALTH

We support the government in its efforts to improve maternal, neonatal and child health services in Uttar Pradesh with focus on 28 high priority districts and aspirational districts.
The project supports the government to improve maternal, newborn and child health services by activating and strengthening critical services at facilities, including comprehensive emergency obstetric and newborn care at First Referral Units (FRUs), basic emergency obstetric and newborn care at the lower level facilities and pediatric services aiming to improve identification, management, appropriate referral and treatment of sick children. The project works to improve knowledge, skills and practices of service providers by mentoring of nurses by a nurse mentor and mentoring of specialist doctors in FRUs by medical college faculty. The project also trains and mentors Frontline Workers to mobilise women to seek and receive services, to adopt healthy practices during the antenatal, delivery and post-natal period and identify sick children within the community and to manage or refer them to an appropriate health care facility.

  • FAMILY PLANNING

We support the government to enable couples to plan their families by offering a basket of contraceptive choices at health facilities and within communities across the state.
We focus on strengthening facilities for seamless provision of FP services by addressing gaps in infrastructure, equipment, supplies and human resources. It works with counsellors and service providers at the facility, and with the Frontline Workers at the community to educate the couples on the importance of family planning and provide quality contraceptive services as per the couple’s need and choice. It also engages the private sector family planning service providers to augment the capacity of the public health facilities. The program has supported the GoUP in establishing review platforms which has helped rationalise the planning of family focus days to improve reach, improve FP commodity security and improve service provider engagement and performance.

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  • NUTRITION

We focus on reducing maternal and child morbidity and mortality by improving Maternal, Infant and Young Child Nutrition (MIYCN) in the 25 High Priority Districts of the state.
We support the government in building capacity of the Frontline Workers to counsel communities about maternal and child nutrition, with a focus on promotion of early initiation of breast feeding and exclusive breast feeding for six months, complementary feeding with a focus on diet diversity, iron and folic acid supplementation for pregnant women. The project also supports the government in effective implementation of Poshan Abhiyaan components in UP.

  • HEALTH SYSTEMS STRENGTHENING

 

We support the government by using data to inform health policies and by streamlining processes to strengthen the public health system in the state. 

We support the GoUP in improving the management of human resources for health, streamlining the public health procurement and supply chain processes, developing digital health solutions and strengthening data for decision-making. Few of the key areas where the UP TSU has supported the state in strengthening the health system include: 

  • the roll out of the Manav Sampada Human Resource Management System
  • addressing service provision gaps at first referral units by rationally  deploying service providers through the “Buddy-Buddy” model
  • establishing a nodal and independent Medical Supplies Corporation; 
  • implementing IT solution for streamlining of payments to Frontline Workers (particularly the Accredited Social Health Activist – ASHA)  through an innovative ASHA payments application
  • developing and rolling out a health dashboard for decision making and establishing platforms for periodic data review.
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Our Impact

Our Impact

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17
Lakh

Pregnant women provided support for ANC care in 25 High Priority Districts by supporting GoUP in VHND micro-planning

14
Lakh

Women provided improved care during delivery in the 25 High Priority Districts through Nurse Mentoring programs

Over
3.8 Lakh

Pregnant women reached annually by Anganwadi workers for counselling on Maternal, Infant and Young Child Nutrition under direct supervision of TSU staff

3.7
Lakh

Women with children younger than 6 months reached annually by Anganwadi Workers for counselling on Maternal, Infant and Young Child Nutrition under direct supervision of TSU staff

5.5
Lakh

Women with children younger than 2 years reached annually by Anganwadi Workers for counselling on Maternal, Infant and Young Child Nutrition under direct supervision of TSU staff

Estimated
10 lakh

Eligible couples reached with provision of family planning services annually across the state through counselling and improved availability of services

Over
1.5 Lakh

ASHAs and ASHA Sanginis trained on Family Planning counselling.

475

Doctors mentored on comprehensive emergency obstetric services since 2017 across 87 First Referral Units

Over
2000

Staff nurses trained and mentored on safe delivery practices since 2014

Over
4000

ANMs trained and mentored on safe delivery practices since 2014

Over
30,000

ASHA and Anganwadi Workers provided onsite mentoring for improved health and nutrition outcomes

10

ICT applications rolled out, including the Manav Sampada – HRMS application, DVDMS – LMIS application, UP HMIS, ASHA Incentive application and state health dashboard

Over
10

PPP engagements worth over INR 7500 crore done

Resources

The Buddy Buddy Model: For Rapid Activation of First Referral Units

First Referral Units (FRUs) are required to be equipped with a specialized workforce that can manage all the major medical causes of maternal and neonatal deaths. The Buddy Buddy Model is an innovative policy initiative for activation of FRUs. It incorporates policy enablers for posting and leveraging available MBBS government medical officers trained either in Emergency Obstetrics or in Life Saving Anesthesia Skills, as a pair with complementary skills that are required to conduct C-section deliveries at inactive FRUs.

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Categorizing and assessing comprehensive drivers of provider behavior for optimizing quality of health care

Inadequate quality of care in healthcare facilities is one of the primary causes of patient mortality in low- and middle-income countries and understanding the behaviour of healthcare providers is key to addressing it. This paper identifies contextual and internal behavioural drivers in staff nurses working in reproductive, maternal, newborn, and child health in government public health facilities in Uttar Pradesh, India.

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Scientific evidence of association of prenatal counselling and immediate postnatal support to enhance early initiation of breastfeeding in Uttar Pradesh

Timely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India.

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