Improving assessment and monitoring of women in labour at District Women’s Hospital, Pauri, Uttarakhand, India

The District Women’s Hospital in Pauri Garhwal district in Uttarakhand State is a 33-bed facility and provides delivery care to 40 women a month, approximately six percent of all institutional deliveries in the district. The hospital has faced challenges in managing complications associated with deliveries. They do not have the ability to conduct Caesarian sections (C-sections), so often refer women to a nearby medical college. Unfortunately, many women are referred late and end up delivering in the ambulance. To address this, the improvement team set up a system to ensure that women are referred appropriately. This involved improving the initial assessment when women came into the facility in labour and using partograms to improve assessment of women in labour to pick up delayed progression of labour early, while it was still safe to transport women. After implementation, women are no longer delivering in ambulances, management of labour has improved, and referrals have decreased from 36 to 21 percent.
Report Author(s): 
Anisha Singh, Mahtab Singh, Nigel Livesley
USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project/URC
ASSIST publication: 
ASSIST publication
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