It was an offer the two Indian physicians couldn’t refuse—accompany Jhpiego’s Medical Director and maternal health expert, Dr. Harshad Sanghvi, on a week-long tour of medical colleges and “observe.” No preparation. No presentations.
As members of India’s professional organization of obstetricians and gynecologists, Doctors Hema Divakar and Parul Kotadawalla gladly accepted. They were excited to accompany an ob/gyn of Dr. Sanghvi’s stature on this adventure. The year was 2002.
“We marked a week off from work and were happy to go on a picnic with Harshad!” says Dr. Divakar.
The tour of the first facility “left much to be desired . . . the ground realities at the tertiary center . . . the chaos . . . the lacunae in imparting quality care . . . the disorganized systems . . . the lack of accountability.”
But before they left the medical school, the physicians realized fully the purpose of the visit.
“A site assessment—that’s what we had just done! The few positive points in the institution which were complimented upon and a series of suggestions for improvement and motivation to the entire team to reassess and audit,” Dr. Divakar says.
“By the time we went to the second institution, we had started helping Harshad with the slide-making. The next stop saw us undertake assessment of some sections of the ‘site’ independently. The fourth and the last stop, Dr. Parul and myself were surprised that we were confident of making the concluding presentation—all by ourselves!
“Without saying much—Harshad had achieved the task shifting and got us ready and passionate enough to do more.”
So began a lifesaving partnership between Dr. Divakar, FOGSI-India and Jhpiego to ensure that women and babies in India received skilled emergency obstetric and newborn care (EmONC). Additional assessments were done and the colleges chosen to train medical officers in EmONC. More than 100 medical officers received the training. But efforts to train non-medical officers in remote and rural India lacked funding.
Then came the call from Dr. Sanghvi: Hema, can you do something?
“As always, I replied without thinking, ‘Yes, Harshad. Why not?’ I just wrote to all those who I thought were passionate about ‘saving lives’ and asked them if they could invest on their own and come to Bengaluru for this training program and commit their time for the last lap of the EmONC project . . . and YES!—all of them arrived,” recalls Dr. Divakar.
From then on, there was no looking back. “That opened our eyes to a lot more we could do as individuals, as an organization. Until then FOGSI had looked to very short-term projects,” says Dr. Divakar.
“The Government of India supported this. Everyone in the organization started to acknowledge that something larger and something useful is happening through FOGSI. ‘Sustainable and to be brought to scale’ became the new buzz words. The medical officers were excited that they were doing better than ever before. Commitment to quality became a habit.”
For her part, Dr. Divakar got up the courage to forge a public-private partnership with the Government of Karnataka to improve quality of care at a village health center (first referral unit). The unit, which had been doing 10 deliveries a month, is now assisting in more than 250 births a month.
Local residents are proud of the quality care that is being offered, and the private medical college nearby sends their post-graduates to lend a helping hand and benefit by learning to work with higher volumes and in challenging circumstances, says Dr. Divakar.
“We have learned to innovate and inspire—we have learned to think out of the box,” says Dr. Divakar, one of Jhpiego’s distinguished alumnae. “We dare to explore and figure out what works for us and we have matured to share and network and bring it to scale.”