The Indian Council of Medical Research (ICMR) is conducting an 8-center study which applies known risk factors to design a system and feasible methodology which uses the high risk approach to maternal and child health (MCH) care within the existing health care system in India. The primary health centers or subcenters include Delhi, Ahmedabad, Chandigarh, Gwalior, Jaipur, Lucknow, Pune, and Varanasi. 3 stages make up the study: situation analysis of each health center (6 months), developmental phase (1 year), and intervention period (3.5 years). The situation analysis has revealed that even though the health centers and subcenters had medical officers, they lacked adequate numbers of paramedicals. Paramedicals lacked practical knowledge and experience. The community did not use MCH services. All the centers needed resuscitation equipment and anesthesia and lacked other equipment. As part of the developmental phase, ICMR has obtained necessary equipment. It also has done some baseline surveys at the centers. ICMR has assigned 1 intervention to each health center which serves 80,000-1,690,000 people. Broad intervention strategies are reorientation training of paramedicals and medical officers, community education, decentralization of MCH/family planning, goals, and development of a referral system. 2.5 years into the intervention stage indicates improvement in prenatal registration (50-80

作者：K, Maitra

来源：Indian pediatrics 1991 年 28卷 12期