Tamil Nadu has seen the biggest drop in its Maternal Mortality Ratio since the Sample Registration System (SRS) data of 2004-2006, recording a dip of 16 per cent to bring the MMR down to 66. The state retains its position of being third in the country in terms of MMR.
The latest SRS data on MMR (the number of maternal deaths per 1,00,000 live births) released by the Office of the Registrar General of India on Wednesday added heft to Tamil Nadu’s ongoing campaign to reduce both MMR and infant mortality rate.
While it has been fast tracking changes in the maternal and child care segment, health managers in the state attribute the current drop to the efficiency of the new Pregnancy and Infant Cohort Monitoring and Evaluation (PICME) tool being used to track mothers who have just delivered and their babies across the State.
“We have a new process in place that makes a mother’s registration mandatory for deriving benefits from the Muthulakshmi Reddy Maternity Assistance Scheme. Under this scheme a sum of ₹12,000 is paid in three instalments to the mother, to help her get through her pregnancy and assist the newborn. A great deal of the coverage that we have been able to do is thanks to this scheme, and PICME,” said J. Radhakrishnan, Health Secretary. The year under consideration by SRS (2014-2016) also saw a communicable disease challenge, dengue, leading to many maternal deaths, he added.
Health department officials said that the emphasis on building Comprehensive Emergency Obstetric and Newborn Care centres helped render immediate assistance to mothers and newborns. Besides this, a number of Primary Health Centres in Tamil Nadu too allow for Caesarian sections to be performed, have a good stock of blood products and an assisted reference to a secondary or tertiary care centre.
Core challenge
The core challenge that remains, and one that will have to be addressed to bring down MMR, would be to prevent deaths among higher order births, where a woman has more than two children.
While the higher order births per se has been brought down to 7 %, this contributes to nearly 25 per cent of the MMR and is a cause for concern. This is going to be addressed, health officials explain, by including these women in the Maternity Assistance Scheme, currently restricted to only two children.
In addition, in order to derive the benefits under the scheme, the state will insist on spacing — the mother will have to give a gap of at least two years between each pregnancy.
“We do believe that our upcoming project – to provide nutrition kits to mothers that will help improve their health indices – will address the last challenge and make a significant impact on lowering our MMR,” said Radhakrishnan.
Tamil Nadu is among the states with a really high percentage of deliveries that happen in the government sector.
“With 65 per cent institutional deliveries happening in the government sector, even Kerala which has a better MMR is much lower, the steady reduction of MMR is an indicator that we can deliver,” Radhakrishnan said, and added,
“We have no doubt we are well on track to achieve our own goal of MMR 25 by 2023.”