The Hindu : Kerala News : Initiative to reduce maternal death rate

Online edition of India's National Newspaper
Monday, Oct 11, 2004

Kerala

Kerala

Initiative to reduce maternal death rate

By Maleeha Raghaviah

KOZHIKODE, OCT. 10. A confidential review of maternal deaths aimed at reducing the death rate is now on in the State. The exercise is initiated by the Kerala Chapter of the Federation of Obstetrics and Gynaecology Society of India (Fogsi).

Speaking to The Hindu , the chairman of the Kerala chapter of the Maternal Medicine and Foetal Commission, V.P. Paily, who is spearheading the programme, said since January details of maternal deaths were being reported to an executive committee for a confidential scrutiny.

``We seek to detect the defects responsible for the death without assigning any blame. There is total anonymity too as opposed to a departmental inquiry when those involved may not speak up as openly,'' Dr. Pylee said.

Government order

The initiative is being carried out on the basis of a Government directive on the issue. `No names, no blame' is the criterion. The identity of the patient, the doctor and the hospital are not revealed.

It is a `fact-finding', and not a `fault-finding' mission, it is pointed out.

``As of now, as many as 50 maternal deaths have been reported to the executive committee. This is not a foolproof figure since some omissions are likely, especially in border districts. For example, those in Kasaragod could seek medical aid from Mangalore, and deaths in such cases would not be brought to our notice. Another omission is when a maternity-related death takes place in another department such as cardiology,'' Dr. Paily said.

Copies of case records of the deaths are being sent to the executive committee through the district coordinators. The cases are discussed individually and collectively, away from the scene of happening by senior doctors.

The executive committee held two meetings in this regard. At the end of one year the findings will be collated, and the report prepared on the basis of this. Specialists such as cardiologists too take part in the meetings.

The reasons for the death are probed, and the evidence gathered would act as a guideline to prevent such deaths in future.

Four zones

Four zones have been created for carrying on the initiative. The former State president of Fogsi, P.K. Shekharan, is the coordinator of the Kozhikode zone, with K.A. Srinivasan (Thrissur), Ajith Kumar (Alappuzha) and V. Rajasekharan Nair (Thiruvananthapuram), being the other coordinators.

Senior professors of the Kozhikode and Thiruvananthapuram medical colleges also take part in the discussions.

Causes of death

Dr. Shekharan says that postpartum haemorrhage, pregnancy imposed hypertension and jaundice are the main reasons for maternal deaths.

The maternal death rate in Kerala is 70 a lakh when compared to 1,000 a lakh for Madhya Pradesh and some other States.

The State Government has issued an order in this regard that all maternal deaths in Government and other hospitals should be notified to the Fogsi committee.

A similar initiative has been carried out in the U.K. and some other countries for the last 50 years with a great deal of success, Dr. Shekharan adds.

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