Scaling the Maternal and Newborn Survival Initiative (MANSI)

The infant mortality rate (IMR) and maternal mortality ratio (MMR) are unacceptably high in many parts of rural India. This article focuses on a system analysis approach to the best practices for scaling and replicating of maternal and newborn survival initiative (MANSI), a field-tested pilot program for addressing high IMRs and MMRs. A system dynamics model of the village birthing system is used to understand the resources needed for the viability of scaling or replication, is constructed and incorporated in the analysis. The MANSI program is a public and private partnership between a few key players. Implemented in the Seraikela area of India's Jharkhand state, the program has achieved a 32.7% reduction in neonatal mortality, a 26.5% reduction in IMR, and a 50% increase in hospital births, which tend to have better health outcomes for women and newborns. The authors conclude with a discussion of the prospects for and difficulties of replicating MANSI in other resource-constrained areas, not only in India but in other developing countries as well.