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Time to Embed Quality in Health Care

India struggles with high maternal mortality due to significant inter-and intra-state inequities in maternal health services. However, the current SRS data suggests that India’s Maternal Mortality Ratio (MMR) has improved to 103 in 2017-19, from 113 in 2016-181, highlighting improvements in our health systems. While this may seem an encouraging sign that the country may […]

India struggles with high maternal mortality due to significant inter-and intra-state inequities in maternal health services. However, the current SRS data suggests that India’s Maternal Mortality Ratio (MMR) has improved to 103 in 2017-19, from 113 in 2016-181, highlighting improvements in our health systems. While this may seem an encouraging sign that the country may well be on its way to achieving the SDG target of Maternal Mortality Ratio (MMR) of 70/ lakh live births by 2030, we still have much ground to cover, especially when it comes to ensuring quality care, equity, and dignity for mothers. While as a country we have leapfrogged in making health care accessible and affordable for mothers, quality remains the missing link. Quality and quantity of care need to be integrated for better outcomes.

India accounts for 12% of all maternal deaths globally, according to the World Health Organization2. Most of these are preventable and linked to issues like severe bleeding, high blood pressure, post-childbirth infections and birth complications3. Moreover, the health system’s disruptions caused by the pandemic have exposed its frailties worldwide, impacting maternal health care immensely. As per a review by The Lancet4, global maternal and fetal outcomes worsened during the COVID-19 pandemic, increasing maternal deaths, stillbirth, ruptured ectopic pregnancies, and maternal depression. One way to help reduce fatalities is to intensify the support from the private sector as it can be an essential part of improving women’s reproductive and maternal health. The private sector’s expertise and market-based solutions can augment innovations in delivering solutions and creating advanced technologies to bolster health systems globally.

How Accreditation Can Transform Private Sector Integration in Maternal Health
In India, over 30% of mothers choose to deliver in private sector facilities, and this trend continues to rise. This makes the private sector crucial in reducing maternal and neonatal mortality. To achieve this, integrating private healthcare more deeply into the national health system is essential, especially through accreditation, which can standardize and improve the quality of care.

Private healthcare facilities, increasingly part of Ayushman Bharat, India’s universal healthcare scheme, serve a significant portion of the population. However, while public health systems have received considerable attention, the private sector must also be strengthened to close the gaps in maternal care. Accreditation programs like LaQshya, a government initiative focused on improving maternal and newborn care in public facilities, offer a model for how private sector facilities can enhance their care quality. By adopting similar standards, private hospitals can accelerate the decline in maternal and infant mortality, ensuring that care meets WHO-recommended guidelines.

The Sustainable Development Goals (SDGs) emphasize the importance of collaboration between governments, civil society, and the private sector to achieve universal health coverage (UHC). Public-private partnerships are vital for addressing health challenges, and India has made significant strides in this area. One notable example is the collaboration between the Federation of Obstetric and Gynecological Societies of India (FOGSI) and the Public Health Department of Maharashtra under the LaQshya-Manyata initiative, which aims to improve maternal care in private facilities.

FOGSI’s partnership with the National Accreditation Board for Hospitals and Healthcare Providers (NABH) is another key development. This collaboration supports the “One Nation One Standard” initiative, ensuring that maternal care standards are consistent across both public and private facilities. By setting and enforcing these standards, the partnership aims to provide safe, respectful, and high-quality care for all mothers.

Professional associations like FOGSI play a crucial role in bridging the gap between the government and the private sector, mobilizing efforts to improve maternal health outcomes. Programs like Manyata, which trains healthcare staff in private facilities, are helping to create a “Quality Culture” across India, ensuring that every mother receives the best possible care, even in remote or underserved areas.India’s focus on public-private collaboration in healthcare is a model of innovation, bringing the country closer to its goal of safe and healthy childbirth for every woman.

The author is the India Director at MSD for Mothers.

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