Home > Where We Work > India

One maternal death occurs in India every ten minutes. An estimated 50,000 maternal deaths occurred in 2013 and 779,000 newborn deaths in 2012.



The Problem


With a population of over 1.2 billion, India is the second most populous country in the world. Almost a fifth of all global maternal deaths occur in India with 190 deaths per 100,000 live births. Thirteen percent of these deaths are due to maternal infection, often avoidable through simple infection prevention techniques.


Our Work


Between 2013-2014, in collaboration with colleagues in India, Bangladesh and the UK, Soapbox developed and implemented novel research methods for capturing evidence on cleanliness and the relationship to water, sanitation and hygiene (WASH) conditions and infection prevention and control (IPC) in health facilities in low-income settings. The research methods included the use of photography and simple microbiology methods, and involved ward cleaners in data collection and capture of photographic evidence.

Results of the research indicated a common problem affecting maternity unit cleanliness across countries – the absence of formal, systematic training of cleaners in IPC and the reliance on visual cleanliness as a proxy for ‘safety’.

Our Impact


Dissemination of the WASH & CLEAN results has generated much interest in both the findings and the data collection tools. The tools have been adapted for use in Zanzibar and Malawi and the CD based WASH & CLEAN Toolkit, which provides a guide to data collection and tools, has been distributed to stakeholders in India, Bangladesh and the UK. Requests for access to the online toolkit have been made from both Africa and Asia. Presentation of results at an expert meeting convened by WHO and UNICEF in Geneva in early 2015 has resulted in the toolkit being used as an example of facility needs assessment and improvement tools to international audiences.

The WASH & CLEAN Toolkit – Assessing Hygiene on Maternity Units: A Guide to Data Collection & Tools is available through our Resources page.

A training manual for IPC and environmental hygiene has also been developed and piloted in the Gambia. Click here for more details.

Our Partners


  • Indian Institute of Public Health, Gandhinagar
  • BRAC in Bangladesh