Effectiveness of a collaborative model in improving maternal and child health outcomes among urban poor in Chandigarh, a North Indian city

合作模式在改善印度北部城市昌迪加尔市贫困人口妇幼健康状况方面的有效性

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Abstract

BACKGROUND: To ascertain the effectiveness of a collaborative model between the Department of Community Medicine and state health department to improve MCH outcomes among the urban poor in Chandigarh. MATERIALS AND METHODS: A quasi-experimental study was conducted from 2011-12 to 2015-16 in the intervention and control areas. A collaboration was established between the state health department and the Department of Community Medicine of an autonomous institute. The intervention and control areas were mainly inhabited by the poor migrant population. Critical elements of an efficient collaboration such as the early engagement of partners, clearly stated purpose with common goals, effective communication, and no financial conflict were implemented in the intervention area. MCH program's implementation was strengthened through supportive supervision, enhanced community engagement, male partner involvement, tracking of high-risk pregnant women, and identification of problem families. Trend analysis of MCH indicators was done. The difference-in-difference (DID) analysis was done to measure the net effect of the intervention. RESULTS: All the MCH indicators improved significantly in the intervention area compared to the control area (P < 0.05). DID analysis depicted a net increase in the early registration of pregnancies by 18%, tetanus toxoid immunization by 9.2%, and fully immunized children by 8.6%. There was also an improvement in the maternal mortality ratio by 121.1 points, infant mortality rate by 2.2 points, and neonatal mortality rate by 2.6 points in the intervention area. CONCLUSION: An innovative, collaborative model between the state health department and the Department of Community Medicine effectively improved the MCH outcomes in Chandigarh.

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