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Strengthening the Healthcare Facilities

Introduction

Ekam USA supports Ekam Foundation’s work to improve maternal and child health in India by upgrading and maintaining healthcare facilities and training hospital staff in government hospitals.

Since 2009, Ekam has supplemented the public healthcare system in more than 1,500 government hospitals by procuring and maintaining life-saving equipment and working to streamline hospital processes. Ekam also recruited and trained nurses, doctors, data operators, and other healthcare professionals to work in these government hospitals.

The Need

Dr. Sailakshmi visited one hospital where she witnessed a mother operating an Ambu bag—a hand-held device used to provide short-term ventilation to patients who are having trouble breathing—for her baby. Ambu bags are meant to provide temporary support until the patient can be put on a ventilator. When Dr. Sai asked the mother how long she had been providing breathing support for her baby by squeezing the bag every few seconds, the mother told her “7 days” continuously. The baby would have died if the bag was not squeezed for even a minute. There was a ventilator in the hospital, but it was new and had not been set up yet. Often, there are not enough ventilators for patients in need or the equipment is under repair and unavailable for use. This is unacceptable. That is why Ekam started working with maintenance engineers to install and maintain hospital equipment in a timely manner.

One of Ekam’s key initiatives is staffing and maintaining equipment for Sick Newborn Care Units (SNCUs) with the support of equipment maintenance engineers, NGOs and medical professionals.

Dr. Sailakshmi Balijepally


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Impact

  • 98% of equipment in the districts is now in working condition up from just 16%.
  • The team recruited 400 nurses, 80 doctors, and 30 data entry officers.
  • The alliance worked together to control infections in 16 hospitals.
  • Ekam trained over 200 mentor nurses in Tamil Nadu. These nurses were then placed in the public healthcare systems to train junior nurses and Village Health Nurses. Village Health Nurses were taught to identify critical conditions in babies in villages and refer them early for higher level care. Even small delays in these types of diagnosis can result in death.
  • In Tamil Nadu, the team trained 1,212 nurses in non-communicable disease nursing, 740 for the department of public health, 342 for newborn stabilization units, and 640 to manage SNCUs.
  • EKAM trained nurses care for 90,000 babies a year.

Updates

  • Linking additional services to make the initiative sustainable

    Ekam is now working on a new system to record patient’s addresses and phone numbers to ensure that they come in for follow-up checks after the mother and baby are discharged from the hospital. Ekam is also working to provide pregnant women and critically-ill patients in village areas with transportation to facilities.


Partners

Govt of Tamil Nadu

To address the primary concern of equipment breakdown and maintenance related mortality and morbidity, in 2010, the Tamil Nadu Government signed a Memorandum of Understanding (MOU) with Ekam Foundation to service, repair, and monitor SNCU equipment in 64 SNCUs. This initiative has helped improve care quality and decrease mortality rates related to equipment breakdown in SNCUs.

Govt of Chhattisgarh / UNICEF

Since 2014, Ekam Foundation has partnered with the Government of Chhattisgarh and UNICEF across sixteen districts to improve quality of care in government hospitals.

Success Stories

Stories from the Kondgoan SNCU:
In partnership with UNICEF and the Department of Health and Family Welfare in Chhattisgarh Ekam Foundation created a new SNCU unit in Kondgaon after discovering that the infant mortality rate there was much higher than the state average.

Akalbati Sethiya’s baby girl had to fight to survive from the moment she was born. She weighed just 2.2 kgs (4.8lbs) at birth despite being a full-term baby. Doctors attribute the baby’s condition to Akalbati’s poor diet and unstable emotional condition throughout her pregnancy.

The baby was admitted to Sick Newborn Care Unit (SNCU) in Kondagaon, where the doctors and nurses took good care of and the baby’s discharge weight was 2.3 kg.

The follow-up card shown below was provided to Akalbati to ensure that the baby was provided proper care in the following months.

Facility Visit Follow-up Weight Gain
8th day 1st follow-up 2.7 Kg
30th Day- 2nd visit
3.8 Kg
3rd month- 3rd visit 5.3 Kg
6 th month – 4th visit 6.9 Kg
1 Year – 5th Visit 8.3 Kg

A full-term baby born at a district hospital in Kondgaon suffered from perinatal asphyxia. The mother said, “this time my baby survived I believe because of SNCU where he was brought soon after birth. I am happy that despite being so small he is feeding well and gaining strength. All thanks to care he is receiving at this special hospital for babies.”

Everyday there are new success stories from the SNCU. Unfortunately, most cases have not been recorded. To address this information gap, the facility is putting systems in place to make recording each case a standard procedure.

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