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Greetings to the Manyata community!

Historically, as well as today, healthcare workers have been at the forefront of fighting epidemics and pandemics – always ensuring that patients receive high quality, respectful treatment and care.
 
The COVID-19 pandemic is a stark reminder of the vital role our doctors & nurses play. Without them, battle against outbreaks will never be won & Sustainable Development Goals or Universal Health Coverage will most certainly not be achieved.
 
Therefore, we would like to take a moment to salute all of you - our frontline warriors - who have continued to ensure safer deliveries & offer quality care to pregnant women despite the challenges of the lockdown and fear of virus transmission. This is a testament of your commitment to humanity. For this, we truly #ThankYouHealthHeroes.
 
Even as we are caught in an unprecedented situation, we are proud that our Manyata program continues to forge ahead with conviction. This month we bring you an expert take from Dr. Rishma Pai, the President, Mumbai Obstetrics & Gynecological Society (MOGS). She reflects on the principle that lies at the core of this program - Stronger case management helps in improving patient care outcomes.

We also have various important announcements and updates from the program in store for you this month.


Hope you enjoy reading it!
EXPERT OPINION
STRONGER CASE MANAGEMENT IS KEY TO IMPROVING PATIENT CARE
Every one of us, as healthcare providers, are keen to provide the best quality of care, improve patient outcomes and satisfaction. In today’s world, providing quality care is important as patients are increasingly informed and deliberately pursue treatment at hospitals or medical groups with a reputation for superior care and better outcomes and bundled payments are offered as value based reimbursements.
With the private sector practitioners offering up to half of maternity care nationwide, we carry a massive burden of improving the maternal care women receive in the country.  As we have seen, in the recent times, there is an overall increase in cases of medical negligence, with 2638 cases being reported in 2019.

In a scenario, where the private sector is unregulated for healthcare in India, there is a growing need for us to self-regulate, put in place stronger processes for adherence to clinical guidelines and define risk mitigation protocols.

Self-regulation can be implemented through adopting clinical practice guidelines. These guidelines are systematically developed nationally and globally to assist clinical decision-making (practice of evidence-based medicine) to assist practitioners and patient decisions about appropriate health care. Clinical guidelines are intended to offer concise instructions on how to provide healthcare services. The most important benefit of clinical practice guidelines is their potential to improve both the quality of process of care and patient outcomes.

Processes based on clinical practice guidelines, thorough case management protocols and robust documentation can ensure that the right decision is made at the right time. It would also detect and prevent any fraudulent activities, thus enabling healthcare providers to avoid facing an investigation which may cost them their reputation and revenue.

In cases of medical negligence claims, these clinical guidelines act as a source of information, provided they are a product of a recognized body and are deemed reliable. With Federation of Obstetric and Gynaecological Societies of India (FOGSI) being recognized as a professional organization representing practitioners of obstetrics and gynecology, with 258 member societies and over 37,000 individual members association, we should take pride in leading one of its kind quality improvement and certification program for maternal care- Manyata.

FOGSI led initiative - Manyata based on the national quality standards, presents an opportunity to promote self-regulation, adhere to policies and procedures, quality driven protocols- building a strong case against malpractice judgments, thereby enabling providers to take steps to keep patients satisfied.

I urge all Manyata family members to reach out to their peers, discuss the benefits of Manyata in terms of strong case management and patient protocols. With our combined efforts, through Manyata certification, we can achieve the long term goal of providing quality driven respectful care to all women, wherever they seek care.  


- Dr Rishma Pai
President, Mumbai Obstetrics & Gynecological Society (MOGS)
PROGRAM AT A GLANCE 
SENSITIZATION AND TRAININGS 
  • Sensitization sessions were organized in full swing in April & May especially with the Obstetrics and Gynaecology (OBGYN) societies across Maharashtra. These were led by our very own state champions – Dr. Sanjay Gupte & Dr. Nandita Palshetkar.
     
  • In the month of April, Dr. Sanjay Gupte facilitated online sensitization sessions for Presidents/Secretaries - in Akola, Wardha, Chandrapur, Dhule, Sangli, Hingoli and Pandharpur. This was followed by Dr. Nandita Palshetkar organizing virtual meetings with AMOGS zonal coordinators to aid in increasing provider enrolment.
Manyata Trainings Go Digital!
To ensure program continuity, Manyata has gone digital. Quality trainings for health workers continue to take place virtually. The program is also providing special COVID-19 trainings to Manyata doctors & nurses to enable them to adhere to all protocols of quality and safety while taking care of mothers and new-borns.
 
Since April, 6 virtual trainings have been conducted by leveraging the Manyata ECHO platform. Apart from module trainings, the valuable Mentoring Support Visits (MSVs) which are crucial for facilities undergoing Quality Improvement also took off using this platform.
FOGSI ASSESSMENTS
FOGSI has also been undertaking virtual assessments in all the states via zoom. Since last week of April, 24 virtual provisional assessments have been undertaken by FOGSI across all states – 9 in Maharashtra (including 1 re-assessment), 9 in Rajasthan, 4 and 1 in Uttar Pradesh and Jharkhand respectively.
Special COVID-19 Sessions for Manyata Providers
  • Throughout April, NPMU conducted complementary technical sessions for members of the OBGYN societies in Akola, Chandrapur and Wardha. State champions, Dr. Sanjay Gupte and Dr. Rahul Wani were guest speakers at these sessions. The focus was on Infection Prevention Protocols/ PPH Management. Similar sessions were conducted for the members of Yavatmal OBGYN society by Dr. Nandita Palshetkar, AMOGS President and Dr. Sanjay Gupte along with NPMU in May.
     
  • FOGSI is making sure that all Manyata providers have access to relevant information on COVID-19 released by the Health Ministry, Indian Council of Medical Research (ICMR) & World Health Organisation (WHO). The information has also been disseminated on Safe Delivery App.  
     
  • In order to ensure that every woman continues to get quality care during this time, our Manyata Champion from Jharkhand, Dr. Nivedita Datta, along with Jhpiego hosted a session on plausible response to COVID-19 in line with FOGSI and WHO guidelines. This was held for all the members of Ranchi OBGYN Society on April 30. The session was attended by Manyata-certified providers as well as new providers. The new providers were introduced to the Manyata program. 
     
  • Additionally, Utkrisht teams have been using digital platforms to maintain program continuity due to restricted field movement. Sessions under Utkrisht consist of training on standards (i.e. Manyata and NABH) as well as on COVID-19 protocols. Around 2609 online training sessions have been conducted so far of which 44% were related to COVID-19 sessions and the rest on NABH and Manyata standards. Since March 2020, Utkrisht teams have been sharing guidelines on COVID-19 pregnancy care, how to use and doff PPE. 300 hospitals under Utkrisht have also been given these trainings.
EMBRACE | EMBARK | EMPOWER 
Voices from the Manyata Community interacted with Global Maternal Health Experts
MSD for Mothers global team of experts connected with Manyata providers and their facility nurses in May. Through the interactions, the experts tried  to understand the current challenges faced by the providers in serving the pregnant woman during COVID-19. They also interacted with nurses from Manyata certified facilties to know their experience and the impact of Manyata trainings in their everyday workings.
WHAT'S NEW?  
MoHFW l Guidance Note on Provision of Reproductive, Maternal, Newborn, Child, Adolescent Health Plus Nutrition (RMNCAH+N) services during & post COVID-19 Pandemic
Summary: In India, with the second largest global population, the growing epidemic of Coronavirus requires that special efforts have to be made to continue the essential routine RMNCAH+N services. Therefore, MoHFW released the guidelines on “Enabling Delivery of Essential Health Services during the COVID 19 Outbreak” dated 14th April 2020 for provision of essential service.
 
Read more
UNICEF l Breastfeeding during the COVID-19 pandemic

Summary: Breastmilk is the best source of nutrition for babies and protects them against illness. But mothers will be understandably worried and asking themselves whether coronavirus can be passed on through breastmilk and what they can do to protect themselves and their babies. The article discusses some tips for keeping mothers and babies safe during the COVID-19 crisis.
 
Read more
Science Daily l Extra choline may help pregnant women decrease negative effects of COVID-19 on their newborns
Summary: The Centers for Disease Control and Prevention (CDC) predicts that COVID-19 will impact fetal brain development like other common corona respiratory viruses. The new study, published in the Journal of Psychiatric Research, specifically looked at whether higher prenatal choline levels can help protect the fetus's developing brain even if the mother contracts a viral respiratory infection in early pregnancy.
 
 
Read more
Explained: In pregnant women with COVID-19, injuries found in placenta

Summary: In 16 women who had tested positive for COVID-19 while pregnant, tests conducted immediately after birth found their placentas had evidence of injury. The study was conducted by researchers from Northwestern University, Chicago, and published in The American Journal of Clinical Pathology on Friday. The babies themselves did not contract COVID-19, senior author Dr Jeffrey Goldstein.
 
Read more
Who to follow

Partnership for Maternal, Newborn & Child Health (PMNCH)

The Partnership for Maternal, Newborn & Child Health (PMNCH) is the world’s largest alliance for women’s, children’s and adolescents’ health. It brings together over 1,000 partner organizations from 10 constituencies across 192 countries.

Website: www.who.int/pmnch  

Twitter: @PMNCH

Facebook: @PMNCH

YouTube: The Partnership PMNCH

Happy to help.

Please reach out to us at npmu.fogsi@gmail.com for queries/information.






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