Village Birthing Teams: Impact of combined, evidence-based interventions to prevent maternal and newborn complications and timely access to emergency care.

While there is global agreement that investing in health systems is critical to reducing maternal and newborn mortality, complimentary community-based approaches have been given less attention. Recently it has been acknowledged that a mobilized community which acts to support families, communities and mothers knowledge around pregnancy and birth will contribute significantly to a reduction in maternal and newborn mortality. The innovation of Village Birthing Teams (VBTs) will be established in rural Uttar Pradesh, India, and comprised of the pregnant woman and her family and supported by the community Accredited Social Health Activists (ASHA) and the Auxiliary Nurse Midwife (ANM). This team will implement a combined package of essential and evidenced-based interventions known to prevent and mitigate pregnancy, post-partum and newborn complications around the time of birth and contribute to decreasing referral and transportation delays in emergency situations. This project would address barriers to accessing skilled delivery by mobilizing VBTs for birth planning and readiness such as transportation plans and integration of mobile phone referrals. VBTs would additionally be trained in emergency response to recognize, refer, and act on danger signs for pregnant women and newborns using prevention of post-partum hemorrhage (PPH) and Helping Babies Breathe approaches. We will compare the health-seeking practices (such as rates of accessing a skilled provider for deliveries) and responses (such as action for PPH) between groups of pregnant women/newborns who have the support of VBTs as opposed to pregnant women without VBT support.