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About Manyata
The Manyata certification is an initiative by the Federation of Obstetric and Gynaecological Societies of India (FOGSI) which aims to reduce preventable maternal and newborn mortality in India. The certification has been set up to establish a sustainable quality improvement and quality assurance mechanism for private maternity care facilities. This is to ensure quality care is standardised for private maternity care institutions, and facilities are encouraged to follow evidence-based treatment protocols during conduct of normal labour and management of obstetric complications.
The private sector is increasingly getting recognised for the role it can play in improving maternal and newborn health services. Given this scenario, Manyata’s endeavour is to strengthen private maternity facilities with robust mechanisms to provide quality service by upskilling facility staff, especially nurses. The program has numerous benefits:
Value for providers
- Capacity building & skilling for healthcare team: Builds a stronger and more capable team to deliver effective care and better manage life-threatening complications through training and hand-holding sessions for staff, continuous motivation through sensitisation and regular feedback for quality enhancement
- Manyata, with flexible training sessions, simplified standards and a mentoring approach, is a streamlined quality improvement model – designed to meet private provider’s diverse needs. Trainings reinforce team approach to childbirth and the staff is better prepared at handling complications and referrals.
- Ensures competitive advantage over non-certified peers: Helps clinics compete more effectively for patients.
- Ensures quality improvement and assurance at a low cost: Services offered are cost-effective as compared to other relevant certifications.
- Access to quality certified peer network: Connects providers with experts through a robust peer network with greater opportunities at learning and sharing knowledge. It also ensures peer recognition.
- Follows national quality standards: Manyata standards align with the Government of India and WHO quality standards.
- The program undertakes regular refresher and audits to sustain quality assurance. It ensures that quality standards are consistently maintained, over time.
- The program ensures validation during external enquiries and higher probability of protection from medico-legal cases with support from the FOGSI community
- Manyata gives access to reliable data on quality maternal care to providers to monitor their progress in real-time. Better reporting ensures transparent data capturing processes
Value for patients
- Receive better, safer experience for mothers during and after childbirth – Manyata can ensure that mothers receive better quality care, contributing towards improving maternal health outcomes
- Ensure respectful care
- Ensure consistent quality, so that every mother has access to safe and effective care no matter where she seeks care
Value for health ecosystem
- Give payers the assurance that private providers are adhering to national standards and are quality-certified
- Helps in creating an private sector in the state – with several clinics receiving prestigious accreditations
- Aligns with the Government of India’s national maternal health priorities for achieving Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) goals.
To create a stronger learning model for the providers, the certification has established training and mentoring support structures. As part of the Manyata certification, you will get access to a vast peer network and a larger community that is leading the quality movement for maternal healthcare in India. In addition to recognition within FOGSI, you will have the opportunity to become a leading voice for change, quality and for Manyata. Doctors who attend the Manyata training certification can join us as trainers or as assessors. They can also claim ICOG points as trainers.
Private sector offers up to half of maternity care in India and currently has no set standards to follow. Gaps in quality care need to be addressed in private healthcare facilities and FOGSI is keen to mobilise this in the private health system.
Manyata is available for any facility providing maternity services throughout the country.
In Maharashtra, the Manyata program is being run in partnership with the state public health department of the Government of Maharashtra under the name ‘LaQshya-Manyata’. It is different from Manyata because it is a joint initiative of the Government of Maharashtra and the Federation of Obstetric and Gynaecological Societies of India (FOGSI), whereas in other states it is solely run by FOGSI.
LaQshya-Manyata is aimed at improving and benchmarking quality of care for private providers who cater to women in low and middle-income areas in the state of Maharashtra. This program recognises private maternity providers who offer quality maternity care thereby, ensuring consistent, safe and respectful care for mothers during and after childbirth. The standards defined under the initiative are in line with the national government’s LaQshya and World Health Organization (WHO) standard guidelines. As part of the program, providers and their nursing staff will be able to build their skills and competencies by participating in drills, on-site mentoring and learn to develop and use standardised data collection tools so they can track the quality journey. The registered ones will be trained on clinical, essential patient care, safety and facility improvement components based on set of 26 quality standards. By addressing quality care in the private sector, the program complements other public sector efforts towards building a holistic health system. The goal of this initiative is to reduce preventable maternal deaths in every district of Maharashtra, particularly semi-urban areas, through a strong network of ob-gyn societies as well as the National Health Mission.
At a juncture where the private sector accounts for nearly one third of the institutional deliveries in the state, this partnership between the Government of Maharashtra and FOGSI comes at an opportune time. LaQshya-Manyata will be rolled out in every district of Maharashtra. To know more about the program, log on to https://www.maharashtralaqshayamanyata.org/
The Manyata package comprises of several value-packed components offered at extremely attractive costs. The Manyata program will provide you the following:
- Trainings and skill drills for nursing staff
- Mentoring Support Visits (MSVs)
- Modules for staff (English/Hindi/Marathi)
- Manyata Certificate from FOGSI
- Member of Manyata Community (WhatsApp groups, Facebook page and closed group, Twitter, LinkedIn and YouTube channel, Newsletters and invitations for Manyata session at FOGSI Conferences)
- Branded collaterals for printing
- Free Refresher Courses for staff on Manyata-ECHO Platform
- Access to certified peer network
- Documentation support to achieve NABH certification
- Opportunity to become certified master trainer and/or assessor
- Opportunity to become a FOGSI-nominated regional champion at local obgyn chapters
The program promotes the adoption and practice of clinical standards based on World Health Organization’s (WHO) standards of quality care on antenatal, intrapartum and postpartum care. The program also has a component of facility-based standards as a criteria for achieving certification. There are total of 26 standards based on clinical, essential patient care, safety and facility improvement components. If a facility adheres to 85% of the defined 16 clinical standards, they qualify for the Manyata certification. In Maharashtra, if a facility adheres to 85% of the defined 16 clinical standards and 65% of 10 facility standards, they qualify for the LaQshya-Manyata certification.
The standards focus on clinical protocols for antenatal, intrapartum and postpartum care and C-sections as well as facility-based standards for patient care. These include processes and practices in the labour room, OT and the facility.
The Manyata maternity care standards are aligned with the World Health Organization’s standards of quality care, and facility standards are in line with GOI standards and are endorsed by FOGSI.
An interested provider may register his/her facility on manyataformothers.org and click on the icon –certification. This will lead you to a new page where you can register your facility into the Manyata certification. FOGSI’s National Program Management Unit (NPMU) will formally communicate your enrollment into the certification, once you have registered and paid.
The selection criteria for the Manyata quality certification is based on the following:
- Any private healthcare facility with focus on maternal and newborn care will be eligible to participate in the program
- Priority is given to facilities where doctors are members of FOGSI.
A fee of Rs. 20,000 is charged for facilities with less than 20 beds, which includes training (Rs. 10,000) and assessment fee (Rs. 10,000). The fee is payable to FOGSI. For corporate hospitals and private hospitals with more than 20 beds, a fee of Rs. 30,000, inclusive of trainings and assessment is levied.
Certification is valid for a period of two years from the date of assessment. After 2 years, re-certification must be sought.
The Federation of Obstetric and Gynaecological Societies of India (FOGSI) recognizes the Manyata certification. In Maharashtra, the certification is jointly recognized and endorsed by the Public Health Department, Government of Maharashtra, and FOGSI.
Registering with the government alone does not help you improve your quality of care nor indicate to the public that you are a high quality facility. Hence, it is important to adhere to the clinical standards focusing on maternal care, which are covered under the Manyata certification.
Manyata branding, including the logo, posters, standees, leaflets, and other collaterals, can only be used by Manyata-certified facilities after seeking permission from the National Program Management Unit (NPMU).
Certification Process
The entire process from engagement to certification depends upon the readiness of the facility. It may take approximately 3-6 months depending on the preparedness of the facility.
The trainings will be conducted for all skilled staff and doctors in the facility.
Yes. The certified facility needs to log on to manyataformothers.org/certification/#/login wherein they can book additional trainings for their new staff by paying a fee.
Both FOGSI and non-FOGSI private maternity facilities can register for the program.
To create a stronger learning model for the providers, the program has established training and mentoring support structures. For the operational aspect of the initiative, Centers for Skill Enhancement (CSEs) have been established in every state which would facilitate centralised trainings and host ECHO India sessions.
No. A structured set of training is part of the certification process. For additional trainings, a request and a nominal fee must paid to FOGSI.
The Manyata program has various quality improvement partners, who work in selected states across the country, such as Jhpiego, PSI, HLFPPT and ARTIST. Staff of these quality improvement partners will conduct Manyata trainings.
There is no specification for the area-wise space requirements for entry-level standards, but a facility should have sufficient space for all relevant services and specialties that the facility claims to provide, such as operation theatre, labor room, emergency wards, OPD, reception, waiting areas etc.
Project ECHO is a digitally blended-learning platform being used to scale Manyata’s reach. The platform has been designed to increase access to skill and empower private maternity facilities on set quality standards. Using a hub-and-spoke digital model, communication in between trainers and trainees/staff nurses occurs through the exchange of video and image files to be reviewed later or in real-time exchanges. The platform saves time and is a cost-effective method for training.
Supported by our strong approach toward digitisation, we have ensured that every registered facility can create a user id and password to log onto manyataformothers.org/certification/#/login wherein they can access all the modules, training videos, other resources and track their quality journey online. Registered facilities can also subscribe to Manyata’s YouTube channel to access revision sessions and videos explain the standards.
Apart from this, a facility can also book for additional trainings by paying a nominal fee.
You can log in on our Manyata website manyataformothers.org/certification/#/login, self-assess, book MSVs (mentoring support visits) and training packages to update your staff on the set standards.
To facilitate widespread reach of the Manyata certification, an IT platform has been developed. It will help in scaling up the certification at a fast pace in the areas of high demand.
Once a provider registers on the website*, the IT platform will help in –
- Streamlining the on-boarding and registration process to make it easier and less effort-intensive
- Allowing providers to track their quality journey from the comfort of their hospital/home
- Giving providers instant access to e-learning and other electronic resources
Under our current Manyata training package, we use an app called The Safe Delivery App. It is an innovative clinical tool aimed to skill birth attendants and provide them direct access to evidence-based clinical guidelines on Basic Emergency Obstetric and Neonatal Care (BEmONC). The App is used as an immediate life-saving reference during childbirth complications. It is free and can be downloaded from the Google Play Store. The app is available in Hindi and English language.
Some of the key features include:
- Engaging learning materials, in the form of animated, instructional videos, visual action cards, interactive games and quizzes to test knowledge;
- Lists of essential drugs for obstetric and neonatal care;
- Practical step-by-step instructions on delivering quality care,
- All features and functions are designed for low literacy, low-income settings and work offline once downloaded
The trainings will help your facility prepare for NABH Certification.
Once your facility is Manyata certified, you will be required to send periodic self-assessment reports on adherence to the Clinical and Facility Standards. Random checks of the certified facilities may also be conducted.
The objective of monitoring and surveillance is to ensure sustained adherence to standards.
Besides this, Manyata champions will host repeated ECHO Refresher Sessions, which will be a crash course covering the entire curriculum. These sessions will help your nurses and paramedic staff revise everything that was taught during the trainings.
The ECHO Platform also facilitates interaction from participants, hence nursing staff can ask questions, share experiences and solve case-based queries from the experts. Providers will be intimated about upcoming ECHO Refresher Sessions through the nearest Centre for Skill Enhancement (CSEs) or through social media posts.
FOR CLINICAL STANDARDS
If the facility fails to demonstrate adherence to desired level of care (<85%) upon external assessment, the course of action will depend upon the current level of performance by the facility;
If facility scores between 60% – 85% – FOGSI’s National Program Management Unit (NPMU) will formally share the assessment findings, and based on this the facility will be asked to submit the action taken and closure report to NPMU within 1 month from the date of receipt of non-compliance report from the facility along with relevant evidences which support the efforts the facility has taken to close the observed gaps. If facility fails to submit the action taken and closure report within stipulated timeframe, they will have to apply for re-assessment using facility module in the Manyata digital platform and will have to pay the assessment fee afresh. No complementary Quality Improvement (QI) support will be provided to the facility in the form of training and/or mentoring. However, facility will be encouraged to use the resources provided through facility module in the digital platform to close the observed gaps. Facility may also opt for paid training and mentoring support, as they feel appropriate.
If facility scores < 60% – NPMU will formally share the assessment findings and observed non-compliances along with recommended action plan to ensure adherence to clinical standards within 1 week of the submission of assessment report by the assessor. Facility will be requested to undergo a repeat assessment at least after 3 months of intense QI exercise as per the suggested action plan. No complimentary QI support will be provided to the facility in the form of training and/or mentoring. However, facility will be encouraged to use the resources provided through facility module in the Manyata digital platform to close the observed gaps. Facility may also opt for paid training and mentoring support, as they feel appropriate.
FOR FACILITY STANDARDS
If the facility fails to demonstrate adherence to desired level of care (<65%) upon external assessment, the course of action will depend upon the current level of performance by the facility;
If facility scores between 50% – 65% – NPMU will formally share the assessment findings, based on this the facility will be asked to submit the action taken and closure report to NPMU within 1 month from the date of receipt of non-compliance report from the facility along with relevant evidences which support the effort facility has taken to close the observed gaps. If facility fails to submit the action taken and closure report within stipulated timeframe, they will have to apply for re-assessment using facility module in the digital platform and will have to pay the assessment fee afresh. No complimentary QI support will be provided to the facility in the form of training and/or mentoring. However, facility will be encouraged to use the resources provided through facility module in the digital platform to close the observed gaps. Facility may also opt for paid training and mentoring support, as they feel appropriate.
If facility scores < 50% – NPMU will formally share the assessment findings and observed non-compliances along with recommended action plan to ensure adherence to facility standards within 1 week of the submission of assessment report by the assessor. Facility will be requested to undergo a repeat assessment at least after 3 months of intense QI exercise as per the suggested action plan. No complimentary QI support will be provided to the facility in the form of training and/or mentoring. However, facility will be encouraged to use the resources provided through facility module in the Manyata digital platform to close the observed gaps. Facility may also opt for paid training and mentoring support, as they feel appropriate.
Outcomes for the possible scenarios is enlisted below:
| Clinical Standards | Facility Standards | Outcome |
|---|---|---|
| >85% | >65% | Certified |
| >85% | 50-65% | Need to close the NC for Facility Standards within the timeframe in order to get certification |
| >85% | <50% | Re-assessment |
| 60-85% | >65% | Need to close the NC for Clinical Standards within the timeframe in order to get certification |
| 60-85% | 60-65% | Need to close the NC for Clinical and Facility Standards within the timeframe in order to get certification |
| 60-85% | <50% | Re-assessment |
| <60% | >65% | Re-assessment |
| <60% | 50-65% | Re-assessment |
| <60% | <50% | Re-assessment |