First Referral Units (FRU) strengthening is as a core project activity. The activities includes assessing the First Referral Units program across the five project states of Jharkhand, Uttarakahnd, Chhattisgarh, Haryana and Odisha and using the state level First Referral Units review meetings to function as a platform to discuss issues and identify priorities. The overall support for the First Referral Unit strengthening includes First Referral Units assessment to Identify Barriers and Facilitators for quality care; Optimizing services at Newborn Stability Unit: Plugging the gaps in Facility Based Newborn Care & Safe Delivery App: Leveraging technology for capacity building of service providers.

A rapid assessment of First Referral Units situation within the focus states aims to assess the situation of FRUs with respect to quality of care. The study is being conducted in five states in India - Jharkhand, Chhattisgarh, Odisha, Haryana and Uttarakhand. The focus is on identifying gaps and challenges in strengthening FRUs and improving labor room birthing practices in these states. The assessment will guide Vriddhi interventions for FRU strengthening.

The aim of this intervention is to develop and institutionalize the Newborn Stabilization Units (NBSU) implementation model in select FRUs in Aspirational Districts. Newborn stabilization units were envisioned as the first point of contact for small and sick infants and play an important role in saving newborn lives. Vriddhi support includes rolling out a 3-day training package for newborn stabilization unit staff based on the FBNC guidelines to build the capacity of newborn stabilization unit to admit and manage infants who come to Newborn stabilization unit. It will also develop indicators for tracking progress of Newborn stabilization unit.

Vriddhi is collaborating with the Maternity Foundation, to pilot and test the usability of a Safe Delivery Application (SDA) in select FRUs in project supported Aspirational Districts. The project aims to provide technical assistance on development of new modules on normal delivery and Family Participatory Care to enhance the range of the content. The Safe Delivery Application (SDA) developed by the Maternity Foundation in collaboration with the University of Copenhagen and the University of Southern Denmark. The SDA provides skilled birth attendants direct and instant access to evidence-based and up-to-date clinical guidelines on Basic Emergency Obstetric and Neonatal Care (BEmONC). It contains the latest WHO clinical guidelines on BEmONC for infection prevention, post-abortion care, hypertension, active management of third stage of labor, prolonged labor, post-partum haemorrhage, manual removal of placenta, maternal sepsis, neonatal resuscitation, newborn management and low birth weight management. The application is a compilation of 5-7-minute videos on the BEmONC guidelines which can be downloaded on smartphones and used for both self and peer learnings. The videos are designed for low literacy and low-income settings, are easy to understand with animated instructions and work offline.