Assessing the Effect of Integrated Health Interventions on Maternal and Neonatal Health Outcomes in an aspirational district of Uttar Pradesh: A mixed method study

Abstract

Abstract Introduction: India has made significant progress in maternal and neonatal health, yet challenges persist. This study examines Shrawasti, a Uttar Pradesh district, to understand strategies for enhancing maternal and neonatal health. It particularly focuses on birth asphyxia and postpartum haemorrhage due to oxytocin misuse. Objective: To compare pre- and post-intervention maternal and newborn complications in Shrawasti and identify factors decreasing postpartum haemorrhage, newborn deaths, stillbirths, and birth asphyxia. The study aims to elucidate effective interventions for improving maternal and neonatal health. Methodology: A retrospective observational study collected data from labour rooms and the Special Newborn Care Unit in Shrawasti. In-depth interviews with healthcare workers provided qualitative insights. Interventions were implemented based on initial findings and evaluated through systematic data organization and assessment. Results: Post-intervention, there was a significant reduction in stillbirths, asphyxia, and postpartum haemorrhage. Asphyxia decreased from 74.5% to 33.2%, stillbirths from 28.5% to 12.5%, and postpartum haemorrhage from 53.8% to 26%. Qualitative analysis highlighted improved healthcare practices, training effectiveness, staff behaviour shifts, and enhanced patient awareness. Documentation and monitoring practices also improved significantly. Conclusion: Interventions significantly transformed maternal and neonatal healthcare in Shrawasti. Enhanced awareness, revised practices in oxytocin administration, effective training, and improved documentation were pivotal in reducing adverse outcomes. Addressing challenges through targeted interventions is crucial for better healthcare outcomes.