Saving mothers and newborns through an innovative partnership with private sector obstetricians: Chiranjeevi scheme of Gujarat, India
Saving mothers and newborns through an innovative partnership with private sector obstetricians: Chiranjeevi scheme of Gujarat, India
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DOI：
10.1016/j.ijgo.2009.09.008
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发表时间：
2009-12-01
影响因子：
3.8
通讯作者：
Singh, Prabal V.
中科院分区：
文献类型：
--
作者：
Mavalankar, Dileep;Singh, Amarjit;Singh, Prabal V.
目的：记录印度古吉拉特邦政府与农村地区私营产科医生之间的创新公私伙伴关系，为穷人提供分娩护理。方法：本研究采用描述性分析方案并分析二手资料。我们估计由于该计划而可能挽救的母亲和新生儿的生命。结果：800多名产科医生参加了该计划，两年来有269 000多名贫困妇女在私人设施分娩。我们估计，2007年4月至2008年9月期间，贫困妇女住院分娩的比例从27%上升到48%。此外，受益人中报告的产妇和新生儿死亡人数少于没有该计划时的预期死亡人数。结论：这一创新方案表明，至少在印度的某些地区，有可能与私营部门建立大规模的伙伴关系，以相对较低的成本向贫困妇女提供熟练的助产护理和产科急诊。这是解决低收入国家农村地区公共部门人力资源短缺问题以实现千年发展目标4和5的一个途径。我们还得出结论，这样提供的熟练护理可以降低穷人的孕产妇和新生儿死亡率。(C)2009年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To document an innovative public-private partnership between the government of Gujarat, India and private obstetricians in rural areas that provides delivery care to the poor. Methods: This is a descriptive analysis of the scheme and analysis of secondary data. We estimate the lives of mothers and newborns potentially saved because of the scheme. Results: More than 800 obstetricians have joined the scheme and more than 269 000 poor women have delivered in private facilities in 2 years. We estimate that the percentage of institutional deliveries among poor women increased from 27% to 48% between April 2007 and September 2008. In addition, there are fewer reported maternal and newborn deaths among the beneficiaries compared with the number of deaths expected in the absence of the scheme. Conclusions: This innovative program shows that, at least in some areas of India, it is possible to develop a large scale partnership with the private sector to provide skilled birth attendance and emergency obstetric care to poor women at a relatively low cost. This is one way of addressing the human resource deficit in the public sector in rural areas of low-income countries to achieve Millennium Development Goals 4 and 5. We also conclude that the skilled care thus provided can reduce maternal and neonatal mortality among the poor. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.