Blended Tele-mentoring Support for Strengthening Antenatal Care by Private Health care Facilities: FOGSI VISTRIT INITIATIVE.

Introduction: The objective of the present initiative was to build capacity of health care providers in private sector along with standardisation of care during antenatal period for common antenatal problems of GDM and iron deficiency anaemia in private sector. Methods: A pilot project for all levels of health care providers including doctors, nurses, counsellors and laboratory technicians of 34 private facilities in six districts of Jharkhand was planned. Training modules for GDM and anaemia based on government of India guidelines were developed. End line evaluation included data collection and descriptive analysis of quantitative data quality scores from assessment standards on GDM and anaemia in pregnancy. Results: Knowledge assessment of health care providers and doctors through baseline and end line knowledge assessment survey questionnaire showed that 100% health care providers who were trained scored 85% or more in knowledge assessment questionnaires as seen by baseline and end line questionnaire results. All project hospitals (n = 34) in Jharkhand achieved quality standards of care in intervention period for gestational diabetes mellitus and anaemia in pregnancy. They achieved total score more than 80% and exceeded target of 80% of the quality standards. Conclusion: A systematic strengthening of private health care facilities through a blended tele-mentoring and onsite support is possible. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-023-01866-5.

Analysis of Survey on Violence Against Women and Early Marriage: Gyneaecologists' Perspective.

Violence against women and girls (VAWG) is one of the most widespread, persistent and devastating human rights violations in the world today and remains largely unreported due to the impunity, silence, stigma and shame surrounding it even in this era with huge social communication. The incidences of domestic violence, emotional violence, economical violence, sexual assault, rape, molestation, harassment at work place, exploitation, acid attack are increasing in our country and across the world. Violence against women commences before birth and continues throughout life in various forms. These range from infanticide, genital mutilation, child marriage, sexual abuse, domestic violence, sex selected abortions, domestic violence, cyber violence, dowry death, honour killing, acid attack, trafficking, physical abuse in situations of conflict and the neglect of the girl child, adolescent and ageing women. Data of violence against women available mainly from male and female partners of the community. But our study is conducted amongst gynaecologists regarding the data on violence against women they over all come across in their practice. Another problem addressed in the article was about age of marriage and early pregnancy through a survey conducted on similar grounds amongst practicing gynaecologists. Under-age marriage is a marker of multiple vulnerabilities. Early marriage is a worldwide problem associated with a range of health and social consequences including violence for teenage girls and women.

Correction to: Preliminary Results from the FOGSI's National Registry on Pregnancy with COVID-19.

[This corrects the article DOI: 10.1007/s13224-021-01537-3.].

Preliminary Results from the FOGSI's National Registry on Pregnancy with COVID-19.

BACKGROUND/PURPOSE OF THE STUDY: The obstetric population is believed to be more susceptible to adverse consequences of coronavirus disease COVID-19 as compared to the general populace. Clinical characteristics and outcomes data related to COVID-19 infection in obstetric cases are limited and evolving. Most importantly, studies reporting Indian data are strikingly few and of single centre. The objective of our study was thus to address these lacunae using data registered in the FOGSI's National registry on COVID-19 infection in pregnancy (FOGSI COVID registry). METHODS: We conducted an observational study using data retrieved from the FOGSI COVID registry. Fifty-three hospital departments participating in the registry populated data related to laboratory confirmed and hospitalized COVID-19 obstetric patients. Data for the period of 28 April 2020 to 28 August 2020 were extracted from the registry. A subset of the data was formatted, curated, standardized and harmonized. Descriptive analysis was carried out, and results reported. RESULTS: Of the 989 cases analyzed, 956 women were pregnant and 33 women were in the postpartum period. A total of 569 women (61.71%, n = 922) were multi-gravida, and 713 women (72.98%, n = 977) belonged to the 21-30 years age group. A total of 492 cases (52.73%, n = 966) had a gestational age > 37 weeks. A total of 754 women (83.41%, n = 904) were asymptomatic, and 32 cases (3.54%, n = 904) had severe acute respiratory infection (SARI). Fifty-six women (7.19%, n = 779) required critical care and ten women (1.01%, n = 989) died. A total of 771 pregnant women (97.23%, n = 793) gave birth of which 455 cases (59.01%) underwent a lower segment caesarean section (LSCS). There were 749 cases (95.17%, n = 771) of live birth that included eight cases of twin deliveries. 195 infants (28.34%, n = 688) were admitted to the NICU, and 13 infants (2.99%, n = 435) tested COVID-19 positive in the neonatal period. Twelve infants (1.54%, n = 779) died. CONCLUSION: 83.41% pregnant women were asymptomatic. COVID-19 infection in obstetric cases from India led to 59.01% LSCS procedures which are lower than many other countries. COVID-19 infection led to a higher maternal mortality and IUFD rate as compared to pregnant women that did not have COVID-19 infection in India. Vertical transmission rate is 2.99% and at par with other countries.

Indian Academy of Pediatrics Position Paper on Nurturing Care for Early Childhood Development.

Early childhood development (ECD) refers to the physical, motor, socio-emotional, cognitive, and linguistic development of a young child. The 'Countdown to 2030' global distribution of 'children at risk of poor development' indicates the need for urgent action and investment in ECD. Nurturing care enhances ECD, even in the presence of adversities. Strategic actions should exist at multiple levels: the family, community, health care providers and government. Previously, child health related policies and programs of the Government of India functioned in isolation, but have recently started demonstrating multi-sectoral collaboration. Nonetheless, the status of ECD in India is far from optimal. There is strong evidence that parenting programs improve outcomes related to ECD. This is dependent on key programmatic areas (timing, duration, frequency, intensity, modality, content, etc.), in addition to political will, funding, partnership, and plans for scaling up. Each country must implement its unique ECD program that is need-based and customized to their stakeholder community. Barriers like inadequate sensitization of the community and low competency of health care providers need to be overcome. IAP firmly believes that responsive parenting interventions revolving around nurturing care should be incorporated in office practice. This paper outlines IAP's position on ECD, and its recommendations for pediatricians and policy makers. It also presents the roadmap in partnership with other stakeholders in maternal, neonatal, and child health; Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum (NNF), World Health Organization (WHO), and United Nation Children Fund (UNICEF).

Perinatal-Neonatal Management of COVID-19 Infection: guidelines of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP)

During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. Process: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practicequestions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations. Objectives: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. Recommendations: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.

Perinatal-Neonatal Management of COVID-19 Infection - Guidelines of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP).

JUSTIFICATION: During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. PROCESS: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations. OBJECTIVES: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period. RECOMMENDATIONS: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.