Celebrate Solutions: The Sure Start Project in Uttar Pradesh and Maharashtra

By: Madeline Taskier, Partnership Coordinator at Women Deliver

Roughly 78,000 women in India die during pregnancy and childbirth per year, some of the world’s largest numbers of country-level maternal deaths. Uttar Pradesh and Maharashtra are the two largest and most populous states in India, generating a large percentage of the maternal mortality and morbidity in the country. In 2008, PATH aimed to address these disparities with the Sure Start Project, a holistic approach to maternal health systems strengthening. 

The project works in both the rural villages of Uttar Pradesh and seven cities in Maharashtra to streamline primary health care for pregnant women and to mobilize community health education for families across the states. With the support of the Bill and Melinda Gates Foundation and the integration of the 95 local partners, Sure Start reaches 24.5 million people in the region.

In Uttar Pradesh, Sure Start works with the National Rural Health Mission and its Accredited Social Health Activists (ASHAs) to promote healthy pregnancy practices for mothers in 12,000 villages. Since January 2008, The ASHAs have coordinated over 110,000 village group meetings of 322,000 women and their mother in laws on antenatal care, sanitation practices, newborn care, and the value of facility-based delivery. Sure Start has also launched a mass media campaign on billboards and 750 auto rickshaws to encourage facility-based births and involvement of male family members during pregnancy. Education materials on the importance of tetanus toxoid vaccines and vitamin supplements have been distributed to hundreds of partner primary health care centers. 

Sure Start has also implemented a number of public-private partnerships in seven cities of Maharashtra coordinating pregnancy care for women in NGOs, private hospitals, and community health centers. In the city of Nanded, the project launched a pilot community-based health insurance program which covers prenatal and postpartum maternal health care, general illness, emergency transportation reimbursement, vaccinations, and newborn care for a Rs. 250 (USD $5) premium. The project's partners distribute printed health materials to health centers and use street theater performances in urban communities to promote healthy pregnancy messaging. Over the last two years, there has been a documented increase in the number of hospital deliveries and antenatal registration by women in these seven cities.

By forging multi-sector partnerships with primary health care centers, community health workers, government national health initiatives, and social marketing tools, Uttar Pradesh and Maharashtra are on the right track to increasing healthy and safe pregnancies for Indian women and their families.

• Check out an in-depth presentation of PATH’s Sure Start Program.

Photo via: http://www.flickr.com/photos/pathsurestart/4114362872/sizes/m/