We support the Government of India’s efforts to improve the health of women, children, and communities, especially young people.
India is an economic powerhouse and an emerging leader on the global stage, fueled by a booming service industry and a rapidly growing population. The world’s largest democracy, India is also the second-most populous country in the world, home to 1.3 billion people representing hundreds of languages and subcultures. Despite its progress, the subcontinent faces significant challenges to the health and well-being of its citizens, especially women and children. Several of these challenges, such as limited access to family planning services and high rates of gender-based violence, have been exacerbated by the COVID-19 pandemic.
MOMENTUM supports the Indian government in its efforts to improve the health of women, children, and families through both the public and private sectors. Partnership is key to these efforts and helps women and children access high-quality health care now and in the future. Through our partnerships, we support federal and state governments to:
- Support nurses and midwives to deliver high-quality, respectful health care for mothers and children.
- Improve nationwide access to a full range of contraceptive methods, especially for youth.
- Make it safer for women to give birth by cesarean section.
- Improve the quality and use of data to help drive decisions about health care.
- Assist health facilities to provide safe and continued access to essential health services during the COVID-19 pandemic.
- Make health data more efficient, effective, and widely available.
- Vaccinate Indians in 18 states against COVID-19.
Supporting Nurses and Midwives to Deliver Essential Care
India is a leader in midwifery, home to over two million nurse-midwives and nearly a million auxiliary nurse-midwives.7 As midwives and nurses are critical to delivering health care to women and children throughout the country, MOMENTUM partners with the World Health Organization (WHO), the Indian Nursing Council, and the United Nations Population Fund (UNFPA) to help the Indian national government and subnational governments in several Indian states implement recommendations from the latest international guidance, including WHO’s State of the World’s Nursing Report 2020 and Strategic Directions for Nursing and Midwifery 2021-2025 and UNFPA’s State of the World’s Midwifery Report 2021.
Using workforce data collected by the government, we assist India’s national government and select state governments to address issues that negatively impact services delivered by nurses and midwives. This collaboration allows us to identify gaps in relevant health policy and understand how policies are implemented, enabling us to make recommendations to national and sub-national governments that align with global standards and help improve the quality of care that women and children receive.
Providing Access to a Full Range of Contraceptive Methods
There are 46 million women in India who want contraception but aren’t using it.8 Among those who can access contraception, sterilization is the most popular method: half of all Indian women undergo sterilization by age 35.9 We partner with local organizations and providers to help people access the information and services they need to make voluntary and informed decisions about family planning at every stage of their lives. This collaboration focuses on increasing awareness of long-acting reversible contraceptive methods, like intrauterine devices or contraceptive implants, and supporting public and private providers and individuals in six Indian states–Madhya Pradesh, Chhattisgarh, Jharkhand, Odisha, Assam, and Karnataka–to address common myths and misconceptions about contraceptive methods.
Supporting Young People to Make Informed Health Decisions
Young people in India face significant hurdles in planning their ideal families. One in five Indian adolescents wants to use contraception but isn’t using it,10 and one in four Indian girls is married before her 18th birthday, putting her at risk for early and unplanned pregnancies.11 MOMENTUM partners with youth champions and local leaders in the Indian states of Assam, Chhattisgarh, Jharkhand, Madhya Pradesh, and Odisha using a positive youth development approach to engage young people with their families, communities, and governments and help them make informed decisions about their health. In addition, our partnerships with local health systems help youth access a range of quality, affordable family planning methods, along with other essential health services, so they can lead healthy, productive lives and participate in India’s dynamic economy.
MOMENTUM helps civil society and youth-led organizations to champion family planning and reproductive health care for young people. We also support youth champions to change community norms and policies on issues like gender roles, gender-based violence, menstrual hygiene, and early marriage by working with local leaders.
To help make family planning services in both the public and private sectors more friendly and accessible to young people, we support provider training and mentorship to overcome potential biases, help facilities design services specifically for youth, and work with youth organizations to share health information through social media.
Making It Safer to Deliver by Cesarean Section
One in five Indian women who deliver their baby in a health facility do so by cesarean section.12 We work with local governments, technical resource groups, professional associations, and health workers to make cesarean deliveries safer and more accessible by:
- Helping develop and update technical guidelines.
- Strengthening midwives’ client counseling and supervisory skills.
- Creating and supporting systems that provide health workers with ongoing mentorship and oversight.
Maintaining Essential Health Services During COVID-19
COVID-19 has made it harder for many Indian women and children to access essential health services. We have partnered with the Chhattisgarh, Jharkhand, and Madhya Pradesh state ministries of health to improve sanitation services and infection prevention and control measures so that essential health services continue. We have also worked with government and health facility personnel to provide virtual quality improvement training and mentoring, repair infrastructure, obtain supplies, and use new innovative technologies to help staff follow effective sanitation and infection prevention and control measures.
The COVID-19 pandemic in India has been accompanied by a two-fold increase in domestic violence and sexual assault incidents against Indian women.13 MOMENTUM supports individuals, communities, and the health system to respond to and mitigate gender-based violence in the states of Assam, Chhattisgarh, Jharkhand, Karnataka, Madhya Pradesh, and Orissa by:
- Training health providers to identify and overcome their own negative gender-related biases.
- Partnering with community champions who promote gender equality, challenge negative norms around masculinity, and share resources with survivors of gender-based violence.
- Training and mentoring counselors to strengthen support for women at gender-based violence referral centers.
Improving the Quality and Use of Health Data
MOMENTUM works with partners in the states of Jharkhand and Karnataka to make health data more efficient, effective, and widely available so that it can be used for program budgeting, planning, and quality improvement monitoring. In India, we are working with our partners to investigate creating a digital portal to monitor obstetric surgeries at health facilities. We also support our partners to strengthen their health management information systems to improve data collection, quality, and monitoring related to cesarean deliveries.
Delivering COVID-19 Vaccines
The second wave of the COVID-19 pandemic in 2021 resulted in a massive surge of COVID-19 cases and deaths, putting the country’s public health system under tremendous strain.14 MOMENTUM is working with the Government of India and 18 state governments to help Indians get vaccinated against COVID-19. We are helping to improve the supply chain for COVID-19 vaccines; finding and training health workers to administer the vaccines; spreading best practices about the vaccines; and helping the vaccines reach every Indian, no matter how far away they live from health facilities.
MOMENTUM Country and Global Leadership India – Yash works to improve young people’s family planning and reproductive health, increase the coverage of midwives and nurses, and support health facilities to provide safe and continued access to essential health services during the COVID-19 pandemic.
MOMENTUM Safe Surgery in Family Planning and Obstetrics works to improve the safety of cesarean deliveries in India, improve the availability of a full range of contraceptive methods across the country, and mitigate the effects of increased gender-based violence during the COVID-19 pandemic.
MOMENTUM Routine Immunization Transformation and Equity works with the Indian national government and state governments to support the roll-out of the COVID-19 vaccine.
- Kaneda, Toshiko, Charlotte Greenbaum, and Carl Haub. 2021 World Population Data Sheet. Washington, DC: Population Reference Bureau. 2021. https://interactives.prb.org/2021-wpds/.
- Kaneda, Greenbaum, and Haub, 2021 World Population Data Sheet.
- Kaneda, Greenbaum, and Haub, 2021 World Population Data Sheet.
- Roser, Max and Hannah Ritchie. “Maternal Mortality.” 2017. https://ourworldindata.org/maternal-mortality.
- United Nations Children’s Fund. “Country Profiles: India.” 2017. https://data.unicef.org/country/ind/.
- Countdown to 2030. “Countdown Country Dashboard: India.” https://profiles.countdown2030.org/#/ds/IND.
- World Health Organization (WHO). “Midwives – central to providing quality care to mothers and newborns during COVID-19 pandemic and beyond.” May 2020. https://www.who.int/india/news/photo-story/detail/midwives—central-to-providing-quality-care-to-mothers-and-newborns-during-covid-19-pandemic-and-beyond
- USAID. “Partnerships for Health (India).” August 2021. https://www.usaid.gov/india/health.
- Shukla, Ankita et al. June 2020. “Share of Current Unmet Need for Modern Contraceptive Methods Attributed to Past Users of these Methods in India.” Journal of Biosocial Science 53 (3): 407-418. https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/share-of-current-unmet-need-for-modern-contraceptive-methods-attributed-to-past-users-of-these-methods-in-india/CC743A7C07657D5CEA7863D3F393EB61.
- Singh, Pragya, Kaushalendra Kumar Singh, and Pooja Singh. March 2021. “Factors Explaining the Dominion Status of Female Sterilization in India Over the Past Two Decades (1992-2016): A Multilevel Study.” PLoS ONE 16 (3): e0246530. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246530.
- Government of India Ministry of Health and Family Welfare. National Family Health Survey 2015-2016. December 2017. https://www.dhsprogram.com/pubs/pdf/FR339/FR339.pdf.
- UNICEF. 2019. Ending Child Marriage: A Profile of Progress in India. https://www.unicef.org/india/media/1176/file/Ending-Child-Marriage.pdf.
- Lee, Hwa-Young, Rockli Kim, Juhwan Oh, S.V. Subramanian. “Association between the type of provider and Cesarean section delivery in India: A socioeconomic analysis of the National Family Health Surveys 1999, 2006, 2016.” PLoS ONE 16(3): e0248283 https://doi.org/10.1371/journal.pone.0248283.
- National Human Rights Commission [India]. Human Rights Advisory on Rights of Women in the Context of COVID-19. 7 October 2020. https://nhrc.nic.in/sites/default/files/Advisory%20on%20Rights%20of%20Women_0.pdf