Maternal Mortality Rate (MMR) has been decreasing in the State and efforts of Anantapur district stood out as shining example of how coordinated effort could lead to 50% reduction in just one year.
State MMR, which came down by 21 points during current financial year, was possible due to a major contribution of 66% in that by Anantapur district alone, which many health officials had not expected from a ‘poor’, ‘arid’ region of the State with largest geographical area.
Detailing the salient points of district-specific action plan designed and implemented — ARMMA (Campaign for Ameliorated Reduction in Maternal Mortality and Morbidity in Anantapur) — District Medical and Health Officer K.V.N.S. Anil Kumar told The Hindu that coordination among government departments led to bringing down maternal deaths from 134 in 2014-15, to 33 in 2018-19.
While the deaths have been reducing at a slower pace, 110 deaths in 2015-16, 105 in 2016-17 and they rose to 113 in 2017-18. But the coordination brought the desired results with not a single death reported in January. Postpartum Hemorrhage and Sepsis were one of the key reasons for the mortality and those complications arose from anaemic condition of pregnant women, which was as high as 77% in Anantapur district.
A ‘safe delivery calendar’ was prepared for each of the 88 Primary Health Centres and Urban Health Care units as the government healthcare institutions handle 60% of the 6,800 deliveries annually. Every pregnant woman is tagged to a healthcare person like ANM or a Supervisor if it was a high-risk case and monitoring of health condition is done by calling them periodically.
Non-compliance
Eight check-ups are done regularly and iron and folic acid tablets or Rapid System IV Sucrose injections given as per the patient’s requirement. This helps keep their haemoglobin levels intact, says Dr. Anil Kumar, But despite all efforts, some cultural misconceptions lead to bad dietary practices among pregnant women leading to the anaemic condition. Non-compliance of doctor’s advice was as high as 15% among these women, he said.
Free food
Nutritious food is served free to all expectant mothers while they are at the PHCs for check-up and undergoing 19 routine tests every Friday and this was done on a pilot basis in Guttur Mandal, with philanthropic persons arranging the diet on the PHC premises.
This has now taken roots as a massive movement and spread across entire district to all 88 PHCs within the last six months, he observes.