When Gulistan had her first child nearly seven years ago, health facilities had not been trained in the “Care around Birth” approach and were not using many proven and available best practices. Now, as a mom-of-three, Gulistan is one of the more than 31,900 mothers in the Indian state of Uttarakhand who have benefitted from the USAID-supported “Care around Birth” approach.

Though India has a high burden of maternal and newborn mortality, they are a lower middle income country with the ability to resource their own continued development. Due to the size of India, maternal and newborn mortality comprise 15 percent and 26 percent of the respective global burden.

USAID partners with national and state governments to direct their domestic health investments and ensure they are used most impactfully. USAID provides evidence to governments demonstrating that certain interventions work to address lingering gaps in reproductive, maternal, newborn, child and adolescent health, then governments use local resources to scale-up and implement these proven programs across a state or country. After an initial three year, $14 million investment by USAID to demonstrate the impact of a number of interventions, India’s national and state governments have invested over $82 million to scale-up a number of these lifesaving approaches. And India recently announced a plan to increase their health spending by 11 percent.

One of these interventions is package of interventions associated with “Care around Birth”—a training approach that teaches health workers best practices, such as keeping skin to skin contact between mother and baby, known as Kangaroo Mother Care; encouraging exclusive breastfeeding; vaccinating newborns; as well as emergency skills, such as how to perform newborn resuscitation; monitor labor to prevent obstruction; and manage postpartum bleeding. Gulistan recently delivered her youngest child at Community Health Center, Bahadarabad in the district of Haridwar and was encouraged by the health staff to use Kangaroo Mother Care and exclusively breastfeed for the first six months. Gulistan also received counseling on the importance of waiting to have another child for both her health and the health of her baby, as a result of this she opted for a method of postpartum family planning and decided to follow-up at the health center for postnatal care, both of which are central to “Care around Birth’s” integrated approach.

Through Government funded expansion, the “Care around Birth” approach could save up to 4,686 mothers and 58,619 newborns in India every year.

By supporting the Government of India to identify gaps in care and target their investments toward high-impact interventions now and in the future, USAID’s comparably small investment to prove a concept is leveraged many times over, improving service capacity and benefitting women and children across Uttarakhand and all of India.

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