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Innovations, lessons learned and good practices

India 'Chiranjeevi Yojana: An innovative model of Public Private Partnership for reduction of Maternal Mortality' (Lessons learned)

Year: 2009
Major Area: Young Child Survival and Development
Language: English

Gujarat is considered one of the economically developed States of India, with an annual growth rate of more than 10 per cent and a higher per capita income than the national average. Yet, progress in the social sector has not been commensurate with that in the economic sector and thus increasing disparities are of major concern. The estimated maternal mortality ratio (MMR) and the infant mortality rate continue to be high (NFHS-3, 2005-2006). Among the major reasons for high maternal mortality are a large number of home deliveries by untrained or traditional birth attendants (37 per cent), particularly in rural and remote tribal areas, and limited availability of Obstetricians/ Gynecologists (Ob/Gyns) in the government system in these areas.

Taking into account the fact that a considerable number of private Ob/Gyns practice in the small towns and rural areas of Gujarat, the Government of Gujarat launched in 2005 an innovative model of Public Private Partnership – called ‘Chiranjeevi Yojana’ (Plan For a Long Life). Under the scheme, the Government contracted qualified private practitioners who have their own hospitals in rural areas. These practitioners are required to provide skilled care, free of charge, for deliveries and comprehensive Emergency Obstetric and Newborn Care (EmONC) to pregnant women and newborns belonging to families living below the poverty line. In return, the Government reimburses the doctors for delivery care including the cost of treatment of complications based on a service charge package. Following the successful pilot of the scheme in five remote districts of the State, it was scaled up to all the 25 districts across the state in January 2007. The number of Ob/Gyns registered has increased from 173 in December 2005 to 817 in 2009, and more than 384,920 deliveries have been conducted under the scheme by 2009. The Government has now extended this model of Public Private Partnership to provide pediatric care to newborns and infants as well, with over 220 private pediatricians being enrolled. This will also help in reducing neonatal and infant mortality in the State.

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