Strengthening Maternal and Child Health through Public Private Partnerships: Assessment of MCH Wings in Eastern Uttar Pradesh

Abstract

Maternal and child health (MCH) continues to be a major public health concern in Uttar Pradesh, particularly in the eastern districts that face persistent gaps in access, quality, and continuity of care. To address these challenges, the Government of Uttar Pradesh initiated a Public-Private Partnership (PPP) model between 2020 and 2022 for operational management of Maternal and Child Health (MCH) wings. This assessment aimed to evaluate the functionality, quality, and effectiveness of these PPP-managed facilities to inform future policy directions. 

A mixed-methods approach was adopted, combining structured facility assessments, service data review, and qualitative interviews with staff and beneficiaries.

Findings indicate that the MCH wings achieved high institutional delivery loads, with over 80% bed occupancy, reflecting strong community utilization. However, alarmingly high caesarean section rates (70–90%), weak antenatal and postnatal continuity, limited diagnostic capacity, and lack of quality certifications (NQAS/LaQshya) highlight systemic deficiencies. Human resources were available as per norms but constrained by long shifts and inadequate supervision. Infrastructure was largely adequate, though gaps in patient amenities and safety features persisted. Moreover, overlap with existing public facilities in some districts led to inefficiencies and duplication.

Overall, while the PPP model has enhanced service availability, its long-term sustainability depends on stronger clinical governance, quality assurance mechanisms, and clearer contractual accountability to ensure equitable, efficient, and evidence-based maternal and newborn care.

Keywords: Maternal and Child Health (MCH); Public-Private Partnership (PPP); Institutional Delivery; Quality of Care; Health Systems; Service Utilization; Facility Assessment