Avni Health

AMPLI PPHI

AHF — Thu, 07 Mar 2024 05:32:15 +0000

AMPLI PPHI goal is to catalyse early adoption and scale-up of new and recently recommended drugs to prevent or treat PPH in high burden countries as part of an integrated package of PPH.

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LDI – REACH

AHF — Thu, 07 Mar 2024 05:18:06 +0000

In its 2021-30 Strategic Plan, FIGO is committed to strengthening member associations to take a leading role in the transformation and improvements of national health systems through leadership, advocacy, education, knowledge sharing, research implementation and capacity building. To this end FIGO has launched the Leadership Development Initiative (LDI) which is currently being implemented in India in partnership with FOGSI.

The project funded by The Bill and Melinda Gates Foundation will run for 4 years till 2025. Besides India it is also being implemented in Bangladesh, Ethiopia, Kenya, Nigeria and Pakistan.

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Stop Violence Against Women

AHF — Wed, 25 May 2022 04:39:16 +0000

Stop Violence against Women - An initiative led by Prof Dr S Shantha Kumari, President, The Federation of Obstetrics and Gynaecological Societies of India (FOGSI) and UNICEF to stop violence against women.

Violence against women (VAW) and girls is a violation of their rights and dignity and a life without discrimination. Women bear the burden of unpaid productive work, single handedly responsible for raising future generations, yet are subjected to VAW leading to several health issues as well.

FOGSI a leader in the field of Women’s health in partnership with UNICEF has embarked upon this ambitious Pan India plan to contribute towards the addressing and preventing VAW through its 5 strategic pillars, support from its 40,000 members in 250 local district/city level society chapters and program delivery through an online module to sensitize, create awareness and build capacities of girls and boys (9-12th standards)/teachers/parents/professional medical bodies.

We are reaching out to schools to join this ambitious program which has very successfully begun across India since December 2021 and till date we have covered;

20,000 students 9^th to 12^th standards (girls + boys)
600 teachers
800 master trainers

A highly interactive training course for 2 hours covers the following;

Types of VAW?
Management of VAW – whom to contact, when to contact, confidentiality, consent, helpline numbers etc
Role of Bystanders. How can they help?
Bridging the Gender divide, stereotypes, roles, societal issues etc
Peer Pressure and how to Handle the same?

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Respectful Abortion Care

AHF — Wed, 25 May 2022 04:24:00 +0000

Respectful Abortion Care: Comprehensive Abortion Care (CAC) Refresher Trainings

An initiative led by Prof Dr S Shantha Kumari, President, The Federation of Obstetrics and Gynaecological Societies of India (FOGSI), WHO and GOI.

India first legalized abortion in 1971 to provide legal and safe abortion services to women. However, with the passage of time and advancements of medical technology for safe abortion, there was a need for increasing gestational limit for terminating pregnancies, especially for vulnerable women and for pregnancies with substantial fetal abnormalities detected late in the pregnancy.

In a historic move India amended the Medical Termination of Pregnancy (MTP) Act 1971 to increase access to comprehensive abortion care for all. The new Medical Termination of Pregnancy (Amendment) Act 2021 which came into force from 25 March 2021, aims to contribute significantly towards ending preventable maternal mortality to help in meeting the Sustainable Development Goals (SDGs) 3.1, 3.7 and 5.6 and expand access to safe and legal abortion services on therapeutic, eugenic, humanitarian and social grounds.

Key Amendments:

Gestational limit increased from 20 to 24 weeks for special categories of women, including the survivors of rape, victims of incest and other vulnerable women (like differently abled women, minors etc.)
Non-applicability of the provisions relating to the length of pregnancy in cases where the termination of pregnancy is necessitated by the diagnosis of any of the substantial fetal abnormalities diagnosed by a Medical Board.
Requirement of the opinion of only one provider for abortions up to 20 weeks and two providers for abortions between 20-24 weeks
Name and other particulars of a woman whose pregnancy has been terminated shall not be revealed except to a person authorized in any law for the time being in force.
The ground of failure of contraceptive has been extended to women and her partner.

FOGSI, WHO and GOI are working together to ensure all Obstetricians-Gynecologists in the FOGSI network across India are updated on the 2021 MTP Amendment and its corresponding rules through competency-based trainings to reduce conscientious bias in abortion care and provide dignity, quality, and respectful services to all women.

List of topics being covered in the trainings

Medical Termination of Pregnancy (MTP) Amendment 2021- key changes and implications
Methods of Abortion (MMA) – updates in technology, availability, and quality
Cross the line Game - WHO SAVER Toolkit- Safe Abortion Values, Evidence and Rights
Pre-post Abortion FP Counselling – need for online consultations

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Hyperglycemia in Pregnancy

AHF — Sat, 21 May 2022 13:07:46 +0000

India has more than 62 million diabetic individuals ^1,2, and according to Wild et al ³. the prevalence of diabetes is predicted to double globally from 171 million in 2000 to 366 million in 2030, affecting up to 79.4 million individuals in India. As of 2010, there were approximately 22 million women in the age group of 20 – 39 living with diabetes & an additional 54 million women in this age group with impaired glucose tolerance (IGT) or pre-diabetes have a likelihood of developing Hyperglycemia in Pregnancy (HIP) if they become pregnant. HIP in India is estimated to be in the range of 10 -14.3%. A field study conducted under the aegis of the Diabetes in Pregnancy – Awareness and Prevention project in Tamil Nadu, it noted that of the 4151, 3960 and 3945 pregnant women screened in urban, semi urban and rural areas, respectively, the prevalence of HIP was 17.8% in the urban, 13.8% in the semi urban and 9.9% in the rural areas ⁴. The incidence of HIP is expected to increase to 20% i.e. one in every 5 pregnant women is likely to have HIP ⁴. HIP, with its long term implications of obesity, diabetes and cardiovascular disease on the offspring will contribute to this epidemic as it has a major trans-generational impact to perpetuate diabetes.

Women develop high blood sugar because of the stress of pregnancy and their inability to increase insulin secretion to compensate for the high demand. This has harmful effects on the mother and the unborn baby resulting in worsening of maternal and newborn outcomes. Thus women with HIP are more prone to get pregnancy induced hypertension and preeclampsia a major cause of maternal deaths and preterm deliveries. Women with HIP have large babies leading to obstructed labor or shoulder dystocia requiring expert supervision of the delivery or cesarean delivery; prolonged labor and assisted delivery increases risk for postpartum hemorrhage (PPH) and high risk of infections the other major cause of maternal morbidity. There is also a high risk of abortions, still births and preterm births in women with HIP. Apart from birth injuries the babies born to women with HIP are at great risk of respiratory distress and hypoglycemia requiring intensive care for survival.

The initiative aims to work with the World Diabetes Foundation, International Federation of Gynecology and Obstetrics (FIGO), Avni Health Foundation, 11 medical colleges and district hospitals, Government of India (GoI) – Ministry of Health and Family Welfare (MOHFW) and the six State Governments – Ministry of health and Family Welfare to support its new broad strategic direction for improving maternal and newborn health by initiating and scaling up the implementation of Hyperglycemia in Pregnancy (HIP) program and contribute towards the improved maternal and infant outcomes (initiating, scaling up and improving equals framing the standard diagnosis and management guidelines, training, counseling, service delivery, monitoring, follow up and reporting). Increase in institutional deliveries in India offers tremendous opportunities, thus focusing on strengthening the competency of health care providers (ObsGyn, medical officers, staff nurses, lab technicians, ANMs and State program managers) in adhering to standard HIP management protocols for improving the pre, intra and postpartum care for women and their neonates will be a step in the right direction.

1 Joshi SR, Parikh RM. India - diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007;55:323–4. [PubMed], 2 Kumar A, Goel MK, Jain RB, Khanna P, Chaudhary V. India towards diabetes control: Key issues. Australas Med J. 2013;6(10):524–31. [PMC free article] [PubMed], 3 Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes-estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(3):1047–53. [PubMed], 4 Health and family welfare statistics 2013, National family health survey 3, Government of India annual reports 2013, GoI guidelines on the diagnosis and management of diabetes mellitus, December 2014.

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MATERNAL NEAR MISS PROGRAM

AHF — Thu, 24 Mar 2022 10:05:16 +0000

"Near-miss" events are more common than maternal deaths and studies can therefore be more comprehensive and provide additional information, review of "near-miss" events may give more insight into risk factors and possible means of prevention, particularly in facilities where deaths are uncommon and events associated with death may not be typical. As the woman survives, near miss reviews may be seen as less threatening than death reviews for the teams reporting the same. However we need to also consider that Near Miss Reviews come with their own set of challenges of defining the cases, and may also lead to wrongly placed trust in Health Care providers thus leading to complacency.

International Federation of Gynecology and Obstetrics (FIGO) has been awarded a grant by the Bill and Melinda Gates Foundation to implement a project on "Improving Maternal and Newborn Health in low resource countries through Strengthening the Roles of Obstetric and Gynecological National Associations" as a major maternal and newborn health Initiative.

FIGO has selected The Federation of Obstetric and Gynecological Societies of India (FOGSI) to participate in this initiative as the lead organization and Our team members as the project management unit for implementing all aspects of the project.

Under the larger umbrella of Maternal Death Review (MDR), FOGSI in partnership with Government of India – MH Division/Avni and Mahatma Gandhi Institute of Medical Sciences (OBGYN Department) – Sevagram, have initiated design and development (for pilot implementation) of a Near Miss program which will give additional value to complement information being received from the reviews of maternal deaths implementation.

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MATERNAL DEATH INFORMATION MANAGEMENT SYSTEM

AHF — Thu, 24 Mar 2022 10:04:14 +0000

Maternal Death Review (MDR) program has been taken up for implementation by several States as per the guidelines and directives of GOI. MDR as a strategy has been spelt out clearly in the RCH –II National Programme Implementation Plan document. It is an important strategy to improve the quality of obstetric care and reduce maternal mortality and morbidity. The importance of MDR lies in the fact that it provides detailed information on various factors at facility, district, community, regional and national level that are needed to be addressed to reduce maternal deaths. Analysis of these deaths can identify the delays that contribute to maternal deaths at various levels and the information used to adopt measures to fill the gaps in service.Out team members are supporting FOGSI (FIGO-LOGIC) in the MDR software initiative by designing, developing and deploying the MDR software.

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Taking Emergency Obstetric Care and Newborn Care to Rural India

AHF — Thu, 24 Mar 2022 10:03:21 +0000

High Maternal mortality and morbidity was and still remains an issue in our country. Building human resources with the necessary skills to manage emergencies during pregnancy continues to be critical, especially in rural and difficult to reach areas of our country. The Federation of Obstetric and Gynaecological Societies of India's (FOGSI) initiative is unique in the sense that one of the world's largest professional body of obstetricians and gynecologists forged partnerships with private bodies and the Government to secure technical and funding help to implement Comprehensive Emergency Obstetric Care (EmOC) program across 21 States. EmOC program over the last 6 years has created 6 nodal centers for training master trainers and has 197 medical college and 333 district hospital master trainers. A total of 34 medical officer training sites plus 235 district practicum training sites are ready. Using this massive infrastructure FOGSI has trained and built capacities of 1200 medical officer for providing comprehensive 24/7 EmOC services across India. EmOC is a 16 week long skill based program and each of the 34 training centers can do a maximum of 3 batches per year of 8 medical officers each, therefore it is an intensive course and maintaining quality over the 16 weeks is critical. The trained medical officers have demonstrated that the training has been useful since the number of out referrals is down and the number of women treated for emergencies in their centers has gone up. Avni is a key partner supporting the program planning and implementation.

EmOC Program Brief - Click to download

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