Care Bundle
Our researchers from Imperial College London and other institutions in the UK and India, believe that we could help reduce the number of epilepsy cases in Indian public hospitals by improving the care given to women and their babies during childbirth. We call this a ‘care bundle’, which we aim to provide to 60,000 women and their babies in South India.
The care bundle has four elements – birth companions, intelligent fetal heart-rate monitoring, e-partograms and brain oriented neonatal resuscitation. These elements being practical, affordable and scalable, we believe that this could be a solution that could be easily implemented in all Indian public sector hospitals.
Birth companion
This element of the care bundle provides expectant mothers with trained birth companions (usually a family member or health care aide) to support and advocate for them during labour. It also helps establish a constructive rapport between the frontline labour room staff and the birth companions. This active participation of the mother and her birth companion will enhance the birthing experience.
Fetal Surveillance
A graphic Doppler is a low cost alternative to expensive CTG (or cardiotocography), and encourages the concept of ‘intelligent auscultation’. This will encourage the clinicians to look at fetal heart rate not just as a number, but to assess the fetal wellbeing by examining the small increases and decreases in the fetal heart rate.
e-partogram
A partogram is a useful method of monitoring labour by capturing maternal and fetal data, but it is time and labour intensive. The electronic version, based on WHO guidelines, is expected to reduce the work load of the frontline labour room staff while ensuring real time monitoring. Although this element will have initial infrastructure and software development costs, it is expected to be cost effective over the longer term.
Brain oriented resuscitation
This element incorporates simple steps for neuro-protection (like timely resuscitation and prevention of hyperthermia) into existing neonatal life support guidelines, without any additional cost.