The Maikhanda approach is based on continuous improvement of access to healthcare and improvement of provision of quality healthcare. This is achieved through interventions that empower the community to make wise decisions regarding their own healthcare and building the capacity of healthcare workers to provide quality healthcare services in maternal and neonatal care. The approach has become popular with the Ministry of Health and other MNH stakeholders. This popularity is based on the impressive results obtained in intervention areas over the 10 years of Maikhanda’s existence. There are three key parts of the Maikhanda approach.
Within communities, Maikhanda works with women to form women’s groups in villages. These groups are comprised of women of child bearing age. Usually there are around 20 to 25 women in each group covering a population of up to 750 people.
After forming the groups, these women meet regularly to discuss, identify and solve maternal and newborn health problems using sustainable means that are equally practical. These meetings follow a format that has proven to be an effective tool elsewhere such as India and Bangladesh. Maikhanda provides training for group facilitators so that they are able to follow a prescribed Participatory Learning Action (PLA) cycle as they facilitate the meetings within the community.
We believe communication engagement activities like the women’s groups and taskforces can only be effective if good quality healthcare facilities exist to support mothers and babies. At facility level, Maikhanda trains healthcare teams in the Quality Improvement (QI) methodology. The health workers comprising nurses, midwives, medical assistants, clinical officers, data clerks and Health Surveillance Assistants within the health facilities form these QI teams.
The teams meet regularly to identify gaps in healthcare processes and introduce changes to those processes in order to close those gaps. Quality Improvement teams from different health facilities also meet regularly to collaboratively share their experiences and insights of making changes in their local settings (health facilities).
Linking communities to healthcare facilities
Safe motherhood Taskforces act as the link between communities and healthcare facilities. These Taskforces are committees formed by 10 to 15 village volunteers under one group village headman. The taskforces are supervised by Health Surveillance Assistants (HSAs). Maikhanda supports the HSAs to undergo training in community based maternal and newborn health. They are trained in;
Basic home counseling of pregnant women
Follow-up of pregnant women
Recording new pregnancies
Keeping track 0f high risk pregnant women.
The Taskforce members and Health Surveillance Assistants meet regularly to discuss maternal and neonatal health issues and feedback progress to healthcare facilities. Maikhanda also supports the Taskforces with tools for data collection at community level. We facilitate the meetings where the community feeds back to the facilities their views and observations concerning the services they are receiving.