Saving lives at scale

In 2018, Dr. Marissa Becker moved her family to India.

For the next four and a half years, she worked alongside teams in Uttar Pradesh helping strengthen the systems that support maternal and newborn care, from staffing and health data to supplies, equipment and frontline services.

Now back in Winnipeg, she still travels to India six or seven times a year to meet with partners, visit communities and stay connected to the work.

“Trust is so important with partnerships,” says Becker, executive director of UM’s Institute for Global Public Health and a professor in the College of Community and Global Health. “It’s essential to be there face to face.”

Becker is one part of a much larger team, including colleagues working on the ground in India and several other UM faculty members who contribute to the work.

Since 2014, UM has worked with the Government of Uttar Pradesh, with funding from the Gates Foundation, to strengthen maternal and child health across India’s most populous state. Uttar Pradesh is home to more than 220 million people and a public health system spanning approximately 30,000 health facilities.

When the work began, more than 45 out of every 1,000 newborns were dying within their first month of life.

Since 2013, the Gates Foundation has provided approximately US$237 million in funding for UM’s work in India. That includes US$21.1 million in funding provided in 2014 and a further US$87 million committed over five years in 2022 to continue and expand the partnership.

Improving outcomes at that scale means strengthening the systems behind care. UM and its partners have worked with the state government to identify gaps in health-care staffing, improve how health data is collected and used and strengthen the supply of essential drugs, diagnostics and equipment.

“If you walk into any labour room in Uttar Pradesh, you need to know that the required drugs and equipment are available to provide emergency obstetric care to mothers as needed,” Becker says.

Today, the work is helping prevent an estimated 39,000 neonatal deaths annually.

For Becker, the scale of that impact comes into focus when she spends time with frontline health workers and families in the communities they serve.

Field visits allow her to see where changes are working and where challenges remain. They also reinforce the approach that has guided the partnership from the beginning: listen first.

“We try never to come in with our own agenda,” Becker says. “It’s to support the government in achieving its public health goals.”

That means working alongside the people who know their health systems and communities best, with local teams increasingly sharing what they have learned with partners in other countries.

“You see the significance of the work, the scale of the work and the challenges that are faced,” Becker says. “But it’s also really exciting to think through how you can be a little bit a part of that process in terms of trying to help the system work better.”