Tuesday, January 12, 2016

Perambalur brings maternal deaths to near-zero

From http://timesofindia.indiatimes.com/city/chennai/Perambalur-brings-maternal-deaths-to-near-zero/articleshow/50544518.cms

CHENNAI: In the hinterland of Tamil Nadu, a doctor-turned collector has achieved something that could turn health policies on their head. Daraz Ahmed's intervention programme has brought down maternal death to near-zero in four years.

The maternal mortality ratio (MMR) in India during 2011-2013 was 167 per 100,000 live births, down from 327 during 1999-2001. In Tamil Nadu, during the same period, it was brought down from 167 to 79, and is believed to be 72 now.

Maternal mortality ratio is the number of women in the 15-49 age group who die from pregnancy-related causes within 42 days of pregnancy termination per 100,000 live births.

For a year since October 2014, Peramabalur registered no maternal death, but this record was broken when a woman died in November 2015 soon after labour. If extrapolated for 100,000 deliveries, Perambalur's MMR will be 10.

Soon after assuming office, Ahmed ensured that all pregnant women with anaemia took iron tablets, and every other woman with highrisk pregnancies underwent caesarean sections. Half the 10,000 deliveries between October 2014 and December 2015 were through C-sections.

Experts feel Perambalur's success can be a case study , but are not sure about its scalability as medical opinion may be divided on elective caesarean, and not everyone may be able to bear the extra cost. "We ask all states to segregate high risk women and do intensive intervention to ensure they have a safe delivery . But it may not be possible to replicate a similar model across the country because most places don't have the resources. In most places, the decision to do a C-section is taken during labour or closer to the due date," said National Rural Health Mission managing director C K Mishra.

Ahmed's measures have achieved quick results. "Maternal deaths are inevitable but our aim is to stop all preventable ones," said Ahmed.

Caesarean section comes with its share of risks -another reason why only 10% of deliveries in the country are such. Ahmed and his team of doctors say they planned C sections when they knew the risks were higher in normal delivery.

"Ours is a small district.Our anganwadi workers and village health nurses know almost every family they work with. They know it when a woman skips her first period.They bring them for antenatal check-up. We identify risks early; for up to 30% of the women we plan a C-section while they are in the second trimester because we know chances of normal delivery are slim. We understand surgeries carry risk, but we have been able to reduce not just risks of surgery but risks of maternal death as well," said Ahmed.

Facebook discussion is at this link and this link

No comments:

Post a Comment