Scaling up Proven and Incubating New Innovations to Meet MDGs 4 and 5 in India

The maternal mortality ratio (MMR) is estimated to be 254 (SRS 2006-09) against the Millennium Development Goal (MDG) of 109 per 100,000 live births in India. The infant mortality rate (IMR) is estimated to be at 50 (SRS 2009) while the MDG target is 27. Despite significant progress, India is off-track for achieving these MDGs and maternal and child mortality decline needs to be accelerated through innovative program actions.

Therefore, a landscaping study of innovations on maternal and newborn care in India was undertaken. A total of 218 innovations were inventoried. An analysis revealed that, while there are several innovations addressing post-partum haemorrhage, program innovations are needed for targeting other direct causes of maternal deaths including eclampsia, sepsis and unsafe abortions. Very few innovations addressed low coverage of post-natal care. Based on criterion of potential scalability, forty one innovations were selected for in-depth review and documentation. These innovations were in different stages of scale-up: some for maternal health had already been scaled up nationally such as referral transport, a few were gradually being scaled up such as the Sick New Born Care Units addressing neo natal mortality and the remaining had potential for scale up but have not yet been taken to scale which include clinics for adolescents and youth, family health behaviour change, and strengthening health system for improved access and quality.

Based upon the above analysis, this paper recommends actions for a) building an innovation pipeline in key gap areas, especially addressing direct causes of maternal mortality through proactive incubation; b) systematically accelerating current process of scaling up promising innovations while adapting them for local conditions; and, c) greater advocacy towards initiating rapid scale up of other proven innovations through strengthening linkages between decision makers and innovators as well as through provision of technical and financial support.