Rajasthan is India’s largest state and home to 5.5% of the country’s population. Despite a significant reduction in maternal mortality in the last few years, the state fares poorly on maternal and child health indicators. The maternal mortality rate in Rajasthan is 318, compared to a national average of 212. The state also has one of the highest total fertility rates in India (3.1, compared to 2.5 for the country as a whole).

Although public health infrastructure in Rajasthan has grown substantially, it remains inadequate to meet the health requirements of the population. As in other parts of India, the bulk of the resources have been focused on health provision in towns, leaving the rural areas underserved. Health facilities struggle to retain skilled providers. Over 75% of human resources and advanced medical technology are found in the poorly-regulated private sector.

Merrygold Health Network

The Merrygold Health Network is a public-private partnership implemented by HLFPPT and supported by MSD for Mothers. The programme aims to reduce maternal mortality in 19 target districts by establishing a social franchising model to deliver high quality, affordable maternal healthcare and family planning services.

The three-tier network includes: (1) urban hospitals, staffed by qualified obstetricians, paediatricians and anaesthetists, equipped with labour rooms and facilities for ultrasound, emergency transport and blood transfusions; (2) rural clinics staffed by AYUSH practitioners, offering antenatal care, normal deliveries and postnatal care; and (3) a network of village-based community health workers, who counsel women on birth preparedness, family planning and newborn care, raise awareness of unsafe deliveries and refer women to facilities for antenatal care.

The network relies on a ‘hub and spoke’ referral system that links women in rural areas to large district-level hospitals, enabling them to access key services. To improve quality of care, HLFPPT offers training and quality assurance support to hospitals and clinics in its network.

Photo: Merrygold Health Network (Rakesh Kumar)