Sustainable Maternal and Newborn Care in India: A Case Study from Ladakh

This chapter describes 40 years of maternal and newborn outcomes at an award-winning hospital in the Ladakh region of India from the perspectives of a medical anthropologist, obstetrician, and pediatrician. We describe how our team of providers at Sonam Norboo Memorial Hospital (SNMH) in Leh, Ladakh collaborated with each other across departments to acquire diverse training, equipment, and essential medicines to build a woman-centered sustainable model of maternity and midwifery care that has saved multiple lives. The hospital’s MMR (maternal mortality ratio) of 37/100,000 live births between 2000 and 2020 was one-sixth of India’s average MMR in the same period. The hospital was twice recognized with the all-India Kayakalp award and its founding obstetrician was honored with two of India’s highest civilian honors, the Padma Shri and the Padma Busan awards, due to its high quality of care and excellent maternal and neonatal outcomes in one of India’s most remote and neglected districts. We close by describing how lessons from Ladakh in lean maternity care can be scaled across other parts of India that still face substantial challenges in improving newborn and maternity care and health outcomes.