India is at the crossroads of change. The indicators are everywhere. More and more Indians are making the Fortune 500 list, and the country’s many IT and industrial successes have generated much admiration and discussion around the globe. In the international world of art, culture, and entertainment, Indian literature and movies are now making headlines with unprecedented frequency. However, while there is much in these developments to be optimistic and confident about, if India truly wants to be a success story, it must look ahead to the needs of the generation to come.

1. Neonatal care in India: A new way for a new generation
India is at the crossroads
of change. The
indicators are
everywhere. More and
more Indians are
making the Fortune 500
list, and the country’s
many IT and industrial
successes have
generated much
admiration and
discussion around the
globe. In the
international world of
art, culture, and entertainment, Indian literature and movies are now making
headlines with unprecedented frequency. However, while there is much in these
developments to be optimistic and confident about, if India truly wants to be a
success story, it must look ahead to the needs of the generation to come.
As it stands now, a quarter of all maternal
and newborn deaths in the world occur in
India. This means that an estimated
78,000 mothers die giving birth every
year, and a million babies die within their
first month of life. The tragic fact is that
India has the highest estimated number of
maternal deaths in any country.
Part of the problem is limited access to
hospital and institutional support. In India,
65 percent of all births occur at home,
often without the assistance of a skilled
birth practitioner. Additionally, skewed
gender dynamics in Indian society do not
always make it possible for a pregnant
woman to be given her supply of
nutritional supplements or to avail of

2. adequate care. Expectant women live, and usually work, with their husbands and
mothers-in-law. By tradition, they eat last and least, so many go though pregnancy
underweight and undernourished. As a result, many mothers are unhealthy and give
birth to unhealthy children.
But perhaps even more dangerous, is the lack of awareness about this issue despite
endemic newborn and pregnancy-related deaths across the country. The majority of
the country’s population is struggling for the basics of survival, and the health of
mothers and their newborns is simply not seen as a priority.
So, how is a problem of this magnitude
tackled?
While the current picture is bleak, there is
hope in the form of the numerous people
and organizations who each day work
tirelessly tackling this issue. The Indian
government has recently launched a series
of innovative policies and schemes to
address this ongoing tragedy—for instance,
the National Rural Health Mission’s goal is
to improve the availability of and access to
quality healthcare for those on the lowest
rung of the socio-economic ladder. The
soon-to-be-launched National Urban Health
Mission has also given high priority to the
issue of maternal and newborn health in the
country. These are encouraging signs of
change for the better.
However, many challenges remain. While
the government is building new hospitals
and maternity homes, and offering free
supplies of vaccines and iron and folic acid
tablets, supply gaps will inevitably remain in a country of India’s size. Also, if a
change in attitude to maternal and newborn health is not achieved, then these new
healthcare facilities and nutritional supplies run the risk of being seriously under-
utilized. The motivation for behavioral change must come from within communities
and individuals themselves.
There is an important role here for the voluntary and nonprofit sector. Synergizing
the efforts of both local and international agencies, they can help to empower local
communities and this has the potential to save many, many lives.

3. One such organization is PATH, a global nonprofit organization that is running a
five-year program in India called Sure Start. The project works with rural
communities in Uttar Pradesh and among settlements of marginalized people in
Maharashtra’s sprawling cities.
Organizations such as PATH are implementing pragmatic maternal and newborn
programs and using innovative methods to effect lasting change. These include
building networks of community health workers to assist birth attendants and visit
mothers within the first few days of birth, training workers to recognize danger
signs during pregnancy and delivery, and developing savings programs to help
cover the cost of newborn and
maternal complications and referrals
In this way, these projects work in
tandem with the Indian government’s
efforts and help to develop
community-level systems for
improved services.
So often, development is a story of the need
for breakthrough innovation or for massive
shifts in government policy and budget
priorities. But let’s not forget what can be
achieved when people decide that things
have to get better and start working
together to achieve that end. In thousands
of villages across India, people are
awakening to the crisis in maternal and
newborn care and are now changing their
behavior to protect the health and wellbeing
of their women and children. Even the
smallest changes, when properly directed,
have already proven to have a large and
lasting impact for the good.
More about Sure Start Project:
Sure Start Website: http://www.path.org/projects/sure-start.php

4. Facebook:http://www.facebook.com/pages/Sure-Start-Project-by-
Path/178629192101
Twitter: http://twitter.com/pathsurestart
Flickr: http://www.flickr.com/photos/pathsurestart/sets/72157622703699725/
Slideshare: http://www.slideshare.net/pathsurestart
Videos:
http://www.youtube.com/watch?v=1ngzs0Pg9jQ
http://www.youtube.com/watch?v=EE9PVk3jGV0
http://www.youtube.com/watch?v=MdyKvbMwbOU
http://www.youtube.com/watch?v=TCtJj7D9MA4