Impact of skill building of health care providers at public health facilities on maternal and newborn health in three districts of Uttar Pradesh

Background: Despite significant improvement in reduction in under-five and infant mortality in India, neonatal mortality is relatively stagnant. Facility level skilled perinatal care has been advocated as an important intervention in this context. An implementation research for improving knowledge and skill of birth attendants in perinatal and essential newborn care implemented in three districts of Uttar Pradesh also documented the documented the changes in antenatal, perinatal and postnatal care in the districts. Materials & Methods: This non-experimental pre-post study involved cross-sectional population proportionate to size cluster surveys at baseline (August 2014) and end-line (May 2016) in three districts of Uttar Pradesh. At baseline 642 women and at end-line 696 women who delivered in last 6 months participated in the survey. Data on care received by these women during pregnancy, delivery, postnatal periods, pregnancy outcome, neonatal status along with the socio-demography. Results: There was significant improvement in ANC contacts and quality of care during these contacts across all the districts. There was rise in birth preparedness counseling (37% to 70%) and awareness about danger signs (19% to 46%). There was sizable rise in the institutional delivery (70% to 84%) and skilled care at birth (66% to 76%). Postnatal care contact increased from 57% to 78%. Newborn care practices including delay in bathing (after 24 hours) and breastfeeding within one hour improved (70% to 91% and 44% to 74% respectively). Conclusions: Our findings indicate multi-dimensional impact of the knowledge and skill improvement interventions involving skilled birth attendants on the pregnancy and postnatal service delivery.