Maternal and Child Health – What’s new in 2015?

Our flagship programme on maternal mortality reduction in Nigeria has been described a "Masterpiece" by FIGO General Secretary Prof. Rushwan - this accolade originating from the world body representing Obstetricians and Gynaeologists, is special to us . We have reasons to celebrate the second accolade on our maternal mortality reduction programme Calmed in India - this time from the FIGO President Prof. Sir Arul ,who said ....” Calmed model to reduce maternal and neonatal mortality and morbidity ....is a major step for taking concrete actions that are sustainable and reproducible.” 

Calmed ( Collaborative Action in Lowering of Maternity Encountered Deaths....kaam’d) as a concept is based on the premise that maternal mortality in low resource settings is not only a medical issue –it is also a public health and societal/cultural issue. 

What is Calmed? 

Calmed programme has four components, based on evidence. 

1. It comprises of a Vocational Training Team (VTT) visit to an area of need – the aim is to increase the number of basic doctors and nurses in the emergency care of pregnant women and babies. It employs Training the Trainer model and uses modern methods of hands on skills transfer. Newer methods are introduced as the programme advances.
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2. Secondly, it raises awareness of childbirth related health issues, amongst community women’s groups by health activists ASHAs( Accredited Social Health Activists) using advances in technology.
   
   
3. Thirdly, Rotarians , through their advocacy role, and in partnership with Government, Inner Wheel and health professional groups, strive for improved access to maternal and child health care and satisfy unmet needs of family planning in the community.
   
   
4. Fourthly, continuing monitoring and evaluation within the policy framework of Government Health Programmes , are important elements of Calmed programme ?

Rotary collaborative initiative - Rotary Foundation Grants , support from the Government and Collaborators (FIGO,GLOWM,MAF,AYZH) helped introduction of the Calmed programme in Sikkim in 2013,Gujarat in 2014 and we are planning to introduce the third programme in Madhya Pradesh in 2015. 

A. First Calmed VTT programme in Sikkim – The Vocational Training Team of 7 trained 13 local Obstetricians to Master Trainer level. They then trained 19 doctors and midwives , as well as 39 basic health care workers. Pre and Post training tests of knowledge and skills showed significant improvement in all the groups. Maternal mortality ratio has fallen by 50 per cent in Sikkim, within a year and the number of trained professionals continue to rise ,thanks to the efforts of Master Trainers ,assisted by Inner Wheel and Rotary. 

VTT with Master Trainers in Sikkim 

A return visit had been undertaken in 2014 with training of 34 professionals by 9 Master trainers and the VTT (team of 3).Support from Government and health officials remain strong. Pre and Post training tests show significant improvement. 

B. Second Calmed programme in Gujarat – The VTT of seven trained 26 doctors as Master Trainers – they trained successfully another 26 doctors and nurses in emergency care of pregnant women. Thirty ASHA trainers were trained in the awareness programme. Pre and Post training tests show significant improvement in all the groups. 

Above - PRIP Kalyan Banerjee and Rotary Staff members in Bhuj 

VTT, Master Trainers and all Trainees in Bhuj 

C. Third Calmed programme in Madhya Pradesh – plans are advanced for this to be implemented in 2015. VTT may consist of trainers from the UK and India. 

PRIP Raja Saboo in discussion with Government Officials and Rotarians in New Delhi 

D. Rotary Support - PRIP Kalyan Banerjee , RI Manager John Wahlund and TRF Manger Abby McNear –were present at the VTT programme in Bhuj. PRIP Raja Saboo facilitated meetings with Health Secretariat in Delhi – the Principal Secretary and Joint Secretaries are supportive of Calmed programme introduction in areas of need in India ,in 2015 and beyond. Past RI Directors Sushil Gupta and Yash Das continue to act as guides and mentor to Calmed programme. 

PRIP Kalyan Banerjee and many Rotarians, Non- Rotarians pledge support for Calmed programme in Gujarat, at the valedictory session 

RFPD is poised to support this initiative in partnership with Government of India –the programme ,is based on evidence and aims at reduction of maternal and child mortality and of reducing unmet needs of contraception in the communities. Initial outcome measures are encouraging. 

PDG Dr. Himansu Basu
Calmed programme director,
Medical Director ,RIFPD 

January, 2015