Eleven medical college hospitals in Bihar and Uttar Pradesh states have launched efforts to integrate quality improvement programs in implementing standard MIYCN protocols for service delivery and strengthen maternal, infant, and young child nutrition (MIYCN) within their undergraduate curricula, adopting a program introduced by Alive & Thrive over the last two years. The expansion to the new colleges brings the total to 20 across the two states.

“Implementation of the MIYCN-focused curriculum will help in creation of a future generation of medical practitioners who are skilled and competent in delivery of quality MIYCN interventions in clinical practice, which will result in better health and well-being outcomes for women and children,” said Sebanti Ghosh, Alive & Thrive Senior Technical Advisor. “This will improve MIYCN service delivery both in the public and private health sector.”

In India, medical colleges are strategically placed in the health care delivery system, making them an excellent platform to apply the latest scientific evidence to improve the quality of care. With the right support, these colleges and their attached hospitals can play a critical role in strengthening maternal, infant, and young child nutrition (MIYCN).

Beginning in 2018, Alive & Thrive forged strategic partnerships with nine government medical colleges in Bihar and Uttar Pradesh to leverage their platform. The alliance sought to build the capacity of future generations of medical practitioners in evidence-based MIYCN practices by strengthening the undergraduate medical curriculum and improving the quality of MIYCN service delivery at critical contact points in the attached hospitals and district health facilities. 

Under the leadership of the college deans, Alive & Thrive formed technical committees with senior faculty and national level experts to guide the prioritization & integration of MIYCN topics in the undergraduate curriculum and step-by-step service delivery protocols based on global and national MIYCN guidelines. 

The experiences in the nine initial medical colleges were the subject of case studies published in 2021. Read the brief.

The 20 medical colleges collectively enroll almost 3,000 medical students.

The support of government has contributed to the initiative’s expansion. Each state government has designated one college as a nodal college for MIYCN to support the scale up in collaboration with Alive & Thrive. An official at the nodal college in Uttar Pradesh said the initiative has been effective.

“With technical support from Alive & Thrive, faculty members of our institute were trained in MIYCN service delivery and integrated MIYCN curriculum for undergraduate students,” said Dr H. S. Joshi, professor and head of the Department of Family Medicine & Community Medicine at AIIMS, Gorakhpur. “Now we have introduced the modified skill-based curriculum for undergraduate students which is looking interactive, and easy to learn and will be helpful in improving skills of students. Also, we, as a nodal institute, have trained the faculty members of four other government medical collages, which will be helpful in dissemination of knowledge & skills among students.”

Government officials were similarly satisfied with the initiative.

“The work on maternal, infant, and young child nutrition in medical colleges is a good intervention to focus on nutrition both through curriculum and service delivery improvements,” said Dr K. Kishor, IAS, Additional Secretary, Health Department, Government of Bihar. “This is a good way of enhancing local institutional capacity and creating resource center to support nutrition agenda. 

“Government of Bihar has endorsed the approach and extends full support to this intervention including scaling up to additional colleges and providing support to district level facilities through medical colleges.”

The contributions of the faculty at the medical colleges have been critical, too, and they lauded the positive outcomes.

“The Quality improvement work has been initiated in my college and giving encouraging results for improving EIBF in normal and C-section delivery,” said Dr P.K. Choudhary, Principal, Vardhman Institute of Medical sciences, Pawapuri. “We are also supporting in Nalanda District Hospital by training and mentoring the doctors and nurses. This is a wonderful initiative to improve health, nutrition. and wellbeing of children in the state of Bihar.”

The program has also engaged the medical colleges in supporting quality improvement in MIYCN service delivery at the district hospital level, an important element, Ghosh said.

Scaling up the initiative to even more medical colleges would lead to important improvements in MIYCN in India, said Praveen Sharma, assistant director and lead for Uttar Pradesh and Bihar programs for Alive & Thrive. Sustained funding for the program and the need to institutionalize the quality improvement mechanism at all levels of health facilities are two challenges, she said, adding that the positive impacts so far are reason for optimism.

“Wider uptake is necessary across states and currently we are advocating at national level for endorsement through appropriate authority – the Medical Council of India – in partnership with key stakeholders,” she said.

The new colleges now implementing the program include:

In Bihar State:
•    Indira Gandhi Institute of Medical Sciences (IGIMS)  
•    Jawahar Lal Nehru Medical College & Hospital, Bhagalpur
•    Government Medical College & Hospital, Bettiah
•    Vardhman Institute of Medical Sciences, Pawapuri
•    JanNayak Karpuri Thakur Medical College & Hospital, Madhepura
•    Nalanda Medical College, Patna 

In Uttar Pradesh State:
•    AIIMS, Gorakhpur
•    AIIMS, Raebareli
•    Government Medical College, Ambedkar Nagar
•    SN Medical College, Agra
•    MLB Medical College, Jhansi