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Maternal mortality rate on rise

Shastry V.Mallady

68 deaths in Madurai district during 2010-11; it was higher than State average

— K. Ganesan.

measure:District health officials conducting medical officers' review meeting in the city on Saturday.

MADURAI: Even as the public health infrastructure in Madurai district has been improved phenomenally, maternal mortality rate still continues to be a worrying factor for district health officials.

As per the Health Department statistics, 68 maternal deaths were reported in Madurai district in 2010-11 while the maternal mortality figure in 2009-10 was 53. The district recorded a maternal mortality rate of 1.2 per 1,000 live births which was higher than the State average of 0.9.

The district health authorities have now swung into action to reduce pregnancy and delivery-related deaths by instructing the medical officers to take precautionary steps and create awareness among women and adolescent girls as well.

“We will set right the lacuna by analysing block-wise statistics. The first priority for us is to control anaemia as it is one of the main causes for maternal death. Pregnant women identified as high-risk cases by doctors will be given special attention,” V. Shanmugasundaram, Deputy Director of Health Services, Madurai district, told ‘The Hindu' here on Saturday.

The maternal death figure of 68 is for the whole district including Government Rajaji Hospital (45), private nursing homes (13) and deaths during transit (7). Following the directions given by the Directorate of Public Health, the district health authorities are evolving strategies for prevention and control of maternal deaths.

R. Abdul Kareem, Assistant Director (Health), gave the breakup of how the 68 maternal deaths took place. Sixteen women had died during pregnancy while one lost her life during actual delivery.

In the postnatal period, 51 women died in Madurai district after delivering a child. Maternity period lasts for 42 days after delivery. Reasons for deaths were postpartum haemorrhage, pregnancy-induced hypertension and aspiration with cardiac arrest.

One consolation for the district health authorities was that not a single maternal death occurred in tPrimary Health Centres in 2010-11 even though the number of deliveries had gone up substantially in recent years.

“We identify the high risk mothers and refer them to Government Rajaji Hospital or other Government hospitals while they come for check up to the PHCs. Safe delivery and good training for staff nurses are our objectives,” said Dr. Shanmughasundaram. The Health Department is intensely focusing on anaemia control as it is a prime reason for maternal death. Iron tablets and iron injections for pregnant women are being given. Maternal audit for the entire district is done periodically and medical officers' review meetings conducted here each month.

“Anaemia has to be corrected even before marriage and it should start from adolescent girls. Pre-marital intervention for checking anaemia is the ideal way to prevent a maternal death,” the Deputy Director explained. Block-wise report of Madurai district for 2010-11 has indicated that 11 maternal deaths took place in Madurai East block-Kallandhiri area. In Tirupparankundram, maternal deaths during this period were six while in Alanganallur block there were five maternal deaths.

Officials said that the Madurai Corporation area had 16 maternal deaths while Chellampatti block had five during the same period.

The officials' advice for pregnant women is that they should be alert when the delivery due date approaches and it is better if they get admitted to hospital or PHC a day or two before the due date given by doctor.

One step contemplated by the public health authorities of Madurai district is to have a tie-up and link with the ‘108' ambulance service by giving the particulars of delivery due dates/high risk cases of pregnant women. “By doing this, village health nurses and local health staff will be in touch with the 108 ambulance service so that the women can be shifted to hospital well in advance for delivery without delay. Maternal deaths during transit can also be avoided,” Dr. Shanmughasundaram observed.

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