The neonatal mortality rate in India is higher than its neighbors, like Nepal and Bangladesh. While the government of India has worked hard to increase access to healthcare across the country, these efforts have not led to comparable declines in neonatal and maternal mortality. To address this challenge, the public health insurance program in the state of Andhra Pradesh, the Aarogyasri Health Care Trust, and ACCESS Health launched a quality improvement program called Safe Care, Saving Lives in 2014.

The Safe Care, Saving Lives program worked with more than fifty special newborn care units and neonatal intensive care units in public and private healthcare facilities in Telangana state and Andhra Pradesh. The program focused on improving the quality of care practices used to prevent and manage the three leading causes of newborn mortality: complications of prematurity, birth asphyxia and newborn sepsis. The goal was to improve quality of care processes to lower the mortality rate and identify best practices that could be used in future models of neonatal care.

Upon completion of the program, ACCESS Health and its partners developed this document to share the lessons learned through the life cycle of the program, from design stage to implementation. These lessons may help the reader draft their own programs in quality improvement, tackle roadblocks that may emerge, and inspire a new vision for existing healthcare initiatives. In particular, this document highlights the importance of leadership, culture, incentives, and systemic change to improve the quality of care for newborns. It also describes the critical importance of up to date, real time data and an information technology system that is transparent across all levels of care and governance.

In addition to this lessons learned document, ACCESS Health also created a quality improvement toolkit, change package, and set of standard operating procedures that providers and policymakers can use when implementing their own quality improvement programs.