3. KEY NMTI STAKEHOLDERS

This section provides information about the various stakeholders and the roles they will play in implementing the NPM programme in a particular state.

3a. Government of India The Ministry of Health and Family Welfare (MoHFW), Government of India (GoI), is the centralised body that has developed the Guidelines for Midwifery Services (2018), the Curriculum as well as the Scope of Work for the NPM programme. It is important to keep in touch with MoHFW, periodically, so that the implementing organisation is aware of any changes that may have been introduced.

3b. Selected State Government Liaisoning with the local state government is extremely important, as Health is a state mandate. Understanding the structure within the State Health Department makes it easier to navigate and follow up with the relevant people and enable the programme to move.

Some essentials while working with the State Government:

• An MoU to effectively move the NPM Programme forward.

• One person who represents your organisation and sits in or frequents the State Health Department. This person should be able to balance the organization's needs while handling the work within the department.

• Constant touch with the PoC within the department through monthly or bi-monthly reports, emails and WA, if required. Regular meeting cadences may be difficult, given the erratic schedules these officials tend to have.

• The organisation should know all the officials, so that if the need arises, then we meet the right people at the right time.W, periodically, so that the implementing organisation is aware of any changes that may have been introduced.

3c. Medical Education Department This is also a very crucial department to liaise with, right from the start. The Medical Education department will be solely responsible for conducting examinations, rolling out the results, and providing the NPM certificates.

In Karnataka, the Medical Education department has two regulatory bodies for nursing – one is the Karnataka State Nursing Counsel, and the other is the Karnataka State Diploma Nursing Education Board. While the former provides registrations for the midwives, the latter is the authority that conducts examinations, and rolls out results.

The structure of the Medical Education Department in Karnataka is given below. However, this may vary from state to state, as education is also a state mandate.

3d. Indian Nursing Council (INC) and State Nursing Council (SNC) INC (until the National Nurse and Midwifery Council [NNMC] comes into existence) and the state specific SNC are also important stakeholders, as they need to recognise both the course and qualification. Since they are regulatory bodies, midwives coming from this new cadre, will have to be recognised, so that they are well-positioned within the system. Additionally, these bodies are also responsible to provide a document that allows International Midwifery Educators (IMEs) to practice in India.

3e. Selected Government Facility It is helpful to build bridges and establish contact with the Practice Site (selected government hospital) before the NPM programme starts. Through regular interactions between the midwives and the staff at the hospital, everyone gets a chance to become familiar with each other. It would also be useful to have short introductory sessions about midwifery, the NPM programme and respectful maternity care, so that the hospital staff know what to expect.

In Karnataka, the NMTI is hosted at Vanivilas Hospital, a tertiary public healthcare facility, with around 18,000 births annually. From the time we completed the gap assessment, we visited the centre at least twice a month. This ensured we had established a bond with relevant stakeholders and created some awareness about midwives and the NPM programme.

3f. Implementation Partner (if any) Generally, there is one implementation partner, who is responsible for running the NPM programme. In this section, a brief about the work carried out by the implementing organisation, and their role in executing this programme can be described.

In Karnataka, Aastrika Foundation has been working closely with the Government of Karnataka, and UNICEF in implementing the NPM programme.

3g. Donor Organisation There are a few donor organisations, such as BMGF, WHO, UNFPA, UNICEF, etc. who have invested very heavily in the NPM programme. In this section, one could mention the funding partner and any other relevant details.

In Karnataka, Aastrika Foundation, has largely played the role of the donor, with some additional support from other stakeholders, such as UNICEF.