Integrated approach to quality care for gestational diabetes, Madhya Pradesh, India

Objectives

To integrate HIP screening, diagnosis and care into ante-natal care services of the public health system in Madhya Pradesh State

Approach

The project builds on a 2015-2017 pilot project and seeks to expand and refine the HIP intervention model across two districts, based on India’s national HIP guideline and strategy, and combine this with the preparation for state-wide implementation. Main activities comprise:

Establishing a coordination group consisting of different authority levels and stakeholders, and, with JHPIEGO support, preparing a draft state-wide implementation plan based on various data analysis and clinic level assessments, etc; Monitoring and registration flows outlined
Implementing the HIP state-wide plan in two districts (Hoshangabad and Betul, total aggregated population of 2.5 million) with capacity building of ante-natal care services across the two districts incl training of HCPs and provision of basic equipment and registries. (ToT model; Trainers to receive comprehensive tuition within HIP incl post-natal follow up; Subsequent roll out of large scale trainings)
Institutionalisation of HIP screening at all targeted facilities. Pregnant women detected with HIP/GDM or found to be at-risk will be registered and provided continuous care and follow-up
Sensitisation of ASHA workers from across the two districts to raise awareness about HIP at community and household levels
Coordination group to ensure ongoing monitoring and data collection and to constantly review outcomes as preparation towards statewide replication (the replication itself is not part of the project proposal)

Results at completion

Road map for state-level scale-up developed and public funding mobilised for GDM services
533 clinics strengthened to provide HIP/GDM screening and care
73 physicians and 142 experienced nurses trained (by local JHPIEGO master trainers) as ToT trainers
84 doctors and 552 nurses and midwives trained in basic HIP screening and care, 1765 community health workers, incl. ASHA sensitised, and all trained staff provided necessary equipment, tools and support
At least 76,937 pregnant women screened for HIP/GDM, with 8,682 (11.2%) diagnosed and provided care and follow up
Adherence and clinical indicators tracked