Scaling up quality improvement to reduce maternal and child mortality in Lohardaga District, Jharkhand, India
Lohardaga District in Jharkhand State has high rates of infant mortality, and State authorities recognized that the district needed additional support to reduce mortality. The USAID ASSIST Project initially started supporting four facilities to improve routine care of mothers and new-born babies. The facilities’ success in ensuring that nearly all mothers and newborns were receiving quality routine care prompted the district health authorities to scale up quality improvement initiatives to five other health centres and 29 sub-centres. The project supported district health authorities to develop a strategy to scale up quality improvement work in these sites through the government system, using government resources. Quality of care has also improved in the five scale-up facilities, and district officials have taken steps to scale up their quality improvement strategy to the rest of Lohardaga’s facilities.