Public Health

Maternal & Newborn Survival Initiative

Positive Care

A Systematic Approach to Saving Lives

Caregiving for Children Living with HIV/AIDS

Maternal & Newborn Survival Initiative

Change for Individuals, Families, and Communities

According to UNICEF, nearly a quarter of all maternal deaths worldwide occur in India. Their babies are far more likely to die in the first two years of life than babies whose mothers survive. Less than half of mothers deliver their children in hospitals or other healthy environments. For women in remote, isolated villages, access to – and knowledge about – care can be a matter of survival.

Designed to reduce maternal and child mortality in rural, impoverished areas, the Maternal and Newborn Survival Initiative (MANSI) utilizes a public-private partnership model to provide the resources and support required to empower local communities to care for their mothers and children while improving the local health system. MANSI provides preventative and curative care for both mothers and newborns all the way from the individual household to government health facilities to ensure new mothers and infants have the care they need to prepare for, survive, and thrive during and after pregnancy.

MANSI’s focus region is the landlocked state of Jharkhand, where dense forests and hillsides insulate agricultural villages from access to healthcare facilities and contribute to India’s second highest maternal and infant mortality rates. More than 280,000 children under the age of 6 have been born over the last decade. In the Seraikela-Kharsawan district, one of the poorest districts of Jharkhand, many villages must travel arduous distances of up to ten miles for healthcare, leading to a widespread practice of home deliveries that deny basic and essential care needed to ensure a healthy start to life.

“I will save each and every child of my village so that there is not a single helpless mother in the village like me who can do nothing but wait and watch her child collapse in front of her. It will be my tribute to my first child.”

— Champa Manjhi, Community Health Worker, Jankipur, Jharkhand

The project equips villages with a trained community health worker (sahiya) to provide home-based care, strengthening individual and family knowledge to promote positive health behaviors while building capacity for whole communities to provide peer-based care through an innovative surveillance system to create an innovative model for community- and home-based care. Through this system, timely referrals and emergency care during pregnancy ensure that mothers get qualified care when they most need it, improving access to and utilization of public and private healthcare services. By promoting social cohesion through mobilizing communities for collective action and increasing healthy deliveries in institutional settings by leveraging a government maternity incentive scheme, AIF is instituting a system for sustainability at all levels for the community and local Health Ministry to uphold over the long term.

Positive Care

Upholding the Fundamental Right to a Safe, Stigma-free Childhood

Of the 2.5 million people living with HIV in India, 70,000 are children. While this number steadily rises, the number of children that are orphaned due to HIV is expected to double in the next five years. Children living with HIV are subjected to discrimination in their own homes, their communities – and even child care institutions. Due to the pervasive stigma surrounding HIV, most orphanages are not willing to care for children who test positive.

Positive Care aims to reverse these trends by ensuring equal opportunities for children living with HIV by developing a high standard of care and a common platform for these orphaned and vulnerable children.  Through a comprehensive assessment of the standards and practices of childcare institutitions in high HIV prevalence states, Positive Care works to build the capacities of childcare institutions and families, and strengthen the linkages between institutions and existing services – to ensure children get the care, support and treatment they need while enjoying a stigma-free childhood.

Transforming Institutions into Loving Homes to Live and Learn

While motivated by compassion, childcare institutions focused on orphaned and vulnerable children lack the technical skills to focus on the overall development of a child. A comprehensive training manual for the capacity building of care home staff, based on assessment results from the experiences of different care home and childcare organizations, will be launched in the three high prevalence HIV states of Maharashtra, Karnataka, and Andhra Pradesh. The manual’s holistic approach provides institutional caregivers with a range of skills, practices, and applications to better care for and support children throughout their development. The four part manual focuses on HIV/AIDS, sex and sexuality, child care and special issues in the context of children living with HIV.

The training manual serves as the basis for the project’s comprehensive training program in institutional and community-based care settings. Taken together, these approaches work to transform institutions into caring homes where children freely exercise their rights to a loving, fun-filled childhood with access to essential healthcare, educational opportunities, and a safe and welcoming environment in which they can learn, grow, and explore.