Evaluation and Learning for the Maternal Health Quality-of-Care Strategy in India: Midline Evaluation Report

Publisher: Cambridge, MA: Mathematica Policy Research
Feb 28, 2019
Authors
So O'Neil, Divya Vohra, and Emma Pottinger

Key Findings:

  • Provider training curricula should consider and incorporate modules to promote maintaining learned skills and delivering maternal health care consistently. This can be done by providing trainings to health workers, including management training for nonclinical staff and ongoing support and mentorship for all staff. A challenge here has been in institutionalizing quality assurance (QA) systems and processes.
  • Community accountability mechanisms can generate desired outcomes in improving MHQoC, especially if it involves educating community members about their health rights and promoting uptake of maternal health services. Further testing of these mechanisms could lead to a better understanding of how to sustain efforts.
  • Varying frames of reference among policymakers, implementers, researchers, and the community can lead to differences in interpretation, acceptance, and use of evidence. Anticipating policymakers’ questions and data needs can facilitate (though not guarantee) application of new evidence. However, the strategy has faced continued challenges in ensuring that even unexpected or controversial research findings are disseminated, discussed, and acted upon.
  • For-profit concepts require translation for adoption and use to improve nonprofit work; though NGOs are accustomed to branding the issues they work on to mobilize people, they are not used to concepts of branding and self-promotion of their own organizations to raise additional funding.
The maternal health quality of care (MHQoC) strategy (2015 – 2019) in India aims to catalyze a shift in focus within the maternal health community from increasing access to maternal health services to improving the quality of maternal health care. A previous Evaluation Report provided a snapshot of achievements during the early stages of the MHQoC strategy (O’Neil et al. 2018). The current report builds on the previous report by updating information about the Strategy’s progress in three key areas (supply, demand, and advocacy). It also reassesses the sustainability of the portfolio of MHQoC work at this stage, when more grantees have had an opportunity to consider their next steps after their Foundation funding ends.