Katharina Cavano l Palladium - Jul 28 2021
In the Face of COVID-19, Pivoting to Support Pregnant and Lactating Women in India

Credit: National Cancer Institute 

The Utkrisht Development Impact Bond team in Jaipur, Rajasthan, India works closely with the many private hospitals across the Rajasthan state of India, and when the world came to a halt in response to the outbreak of COVID-19 in the spring of 2020, the team noticed something concerning. Women, particularly pregnant and lactating women, were no longer coming in for their appointments and in turn, not receiving health care or services. Be it due to lockdown or travel restrictions, fear of contracting the virus, or poor communications from the hospital, these women weren’t receiving the critical care they needed.

In response, the Utkrisht team took a proposal to UBS Optimus Foundation, the investor of the Utkrisht Development Bond and requested a small grant to expand the scope of the original project to better support pregnant and lactating women associated with the private hospitals the team was already working closely with.

The solution? Tele-medicine and counselling for mothers and expecting women.

With this grant money, the team set up a small office within the Utkrisht office in July 2020 and hired trained nurses and counsellors to man the phones.

They contacted about 250 private hospitals to alert them of the service and encourage them to tell their patients that it was available free of charge for them. Tele-counsellors also contacted patients directly to discuss how they were faring and go over any health updates. The service wasn’t just good for the patients, it was good for the hospitals too. Overwhelmed by COVID-19 cases amidst the first wave in 2020, doctors and healthcare workers didn’t know what they were up against and warned healthy patients to steer clear from the hospital if possible.

This left many women stranded, unsure if what they were experiencing in their pregnancy or post-partum was normal or if it needed treatment from a doctor. And while the idea of tele-medicine seems like a logical solution, it wasn’t all smooth sailing, “Tele-counselling in maternal health isn’t popular,” notes Dr Adesh Chaturvedi, Utkrisht Team Leader. “It was challenging to reach women directly because they don’t often give their own phone number to the hospital.”

But once off the ground, the team was overwhelmed by the response they received. “After about three months, we started getting calls from directly women, even women not registered with the hospital because people had shared the service with family members and friends. Initially, we were struggling to talk to the women and later on we were getting more phone calls than we could handle,” Chaturvedi adds.

The team brought on more counsellors to cover more phones and even had both a paediatrician and OBGYN on call to chat for immediate help, with any fees covered by the project, rather than charging the women.

Beyond Maternal and Newborn Health

From advice on nursing and feeding, to consulting on whether symptoms were ‘normal’, counsellors’ roles quickly expanded to providing mental health services and consulting on matters around COVID-19. What began as tele-counselling for pregnant and lactating women had suddenly grown, shedding light on unfulfilled need in India’s healthcare system.

Despite loosening lockdown restrictions on citizens in India and increased understanding around COVID-19, many women continued to refrain from going to the hospital. The reality is that traveling to the hospital is time consuming, and often requires a woman to take off an entire day of work to get there and back, while accompanied by their husband or a male relative. The tele-medicine provided many women with a simple solution to receive care from trained providers without having to leave home or lose time at work. For most, their issues or questions were resolved via the phone, and if they needed to see a healthcare provider, they were directed to a hospital in their vicinity.

“If women can get free of cost services on the phone, it’s the best way forward and why there should be more telemedicine in India,” explains Chaturvedi.

In a span of less than a year, the team reached and provided tele-counselling to a total of over forty-five thousand women and infants through 180 private hospital facilities. Though the field operations of Utkrisht project closed in April 2021, and the tele-medicine program with it, Chaturvedi sees a great need for continued similar services in India and is hopeful for its future, “We had an excellent experience and heard from a lot of women with good wishes after they received services.”

Learn more about the Utkrisht, and contact info@thepalladiumgroup.com for more information.