PRONTO International in India

Number of  Mentors Trained: 700

Number of Participants Trained by Mentors: 3000+

Number of PRONTO Trainers and Master Trainers: 10+

Funders: Bill and Melinda Gates Foundation, John D. and Catherine T. Arthur Foundation

Collaborators and Partners: UCSF, CARE India, UPTSU/IHAT, Pathfinder


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. 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 nurse mentoring program where teams of Nurse Mentors (NM) travel to Primary Health Centers (PHCs) throughout Bihar.  CARE recognized a weakness in mentors’ capacity to teach emergency response so they brought PRONTO International as a simulation and team training expert to develop a new model for using simulation to train nurse and doctor mentors. The mentoring teams mentor in public health care facilities, which are plagued with basic supply and equipment shortages and are consistently understaffed with an extremely high delivery volume.

Under CARE India’s leadership, the AMANAT program with the integration of PRONTO’s approach to simulation and team training has been implemented in 353 facilities through the state. More than 700 government nurses have been trained as mentors and they have mentored over 3,000 staff nurses.

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.

AMANAT trainings improved intrapartum and newborn care with 37% overall improvement in intrapartum practice scores in normal deliveries, and 26% Improvement in newborn care scores in normal deliveries.

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

Uttar Pradesh

The Uttar Pradesh Technical Support Unit (UP TSU) is a consortium of health and development partners that support the Government of Uttar Pradesh (GoUP) in achieving its goals in reproductive, maternal, newborn, child, and adolescent (RMNCH+A) health, and nutrition. PRONTO works in collaboration with the UPTSU (IHAT) to implement simulation and team training in their Nurse Mentoring program in 200+ facilities in 25 districts in the state of UP. PRONTO’s curriculum is integrated into GoI’s LaQshya quality program that is being implemented across the state.

Madhya Pradesh

PRONTO collaborated with Pathfinder International on the project “To improve the quality of maternal care in public health facilities in the state of Madhya Pradesh in India” funded by the John D. and Catherine T. Arthur Foundation. PRONTO implemented simulation and team training for the nurse mentors with a focus on intrapartum and immediate postpartum care for both obstetric and neonatal emergencies. Five districts in the state of Madhya Pradesh were included in this project.