PRONTO International in India


Number of  Mentors Trained: 120

Number of Participants Trained by Mentors: 1800+

Number of PRONTO Trainers and Master Trainers: 3

Funders: Bill and Melinda Gates Foundation

Collaborators and Partners: CARE India

Bihar, India’s third largest state by population has a reported Maternal Mortality Ratio (MMR) of 274 and a reported Infant Mortality Rate (IMR) of 48, both exceeding national averages.  In order to address these high levels of maternal and neonatal mortality, the government of Bihar together with the Bill and Melinda Gates Foundation (BMGF) and CARE India launched a program called AMANAT, meaning “something given in trust”. The AMANAT program is a large quality improvement initiative which aims to improve maternal and neonatal health outcomes in government facilities through interventions at all levels including supply procurement, provider skills, and management.

One component of the AMANAT project is a mobile nurse mentoring program where teams of Nurse Midwife Mentors (NMM) travel to Primary Health Centers (PHCs) throughout Bihar.  NMM spend one week each month for six to eight months at each facility with the aim of improving the quality of maternal and neonatal care delivered by Auxiliary Nurse Midwives (ANMs) at these facilities.

In order to effectively teach emergency response to ANMs, PRONTO International was asked to contribute to the project.  PRONTO integrated highly-realistic, in-situ simulation and team training into the AMANAT program in order to equip the NMM with the tools they needed to help improve ANM’s skills. This meant teaching NMM the facilitation skills necessary to run obstetric and neonatal simulations and debriefs effectively.  The curriculum that PRONTO developed to accompany the simulation and debriefing facilitation skills is modular and adaptable to each facility’s unique needs. The curriculum starts simple and builds in complexity during the 9-month training program as participants gain the experience and confidence to manage the various complications.

Under CARE India’s leadership, the AMANAT program with the integration of PRONTO’s approach to simulation and team training is being rolled out in 56 district hospitals (DH) and 320 primary health clinics (PHC) through the end of 2017.

PRONTO’s approach to simulation and team training in the AMANAT program is playing a vital role in improving the quality of obstetric and neonatal care in Bihar.

Watch these two videos that showcase the work being done in Bihar to improve health outcomes for mothers and babies.