Improving maternal health and reducing the Maternal Mortality Ratio (MMR) has
been a persistent goal for India due to the prolonged distress over maternal
mortality. The MMR refers to the rate of maternal fatalities in a specific
timeframe for every 100,000 live births that occurred in the same timeframe.
The
maternal mortality rate can be utilized to gauge the reproductive well-being of
females residing in a particular region. A considerable number of women who are
of childbearing age pass away as a result of issues that arise during or after
giving birth, or from undergoing an abortion.
As per World Health Organization, "Maternal death is the death of a woman during
pregnancy or within 42 days from the date of termination of pregnancy,
regardless of the time and location of pregnancy, related to or aggravated by
pregnancy or management, but not accidental or accidental; ".
Reasons for women's death
Complications occurring before and after childbirth are responsible for women's
deaths. The majority of these complications arise during pregnancy and can be
avoided or remedied. Pre-existing complications that a woman may have can become
aggravated during pregnancy if they are not properly addressed as a part of her
healthcare.
The major complications that account for nearly 75% of all maternal deaths
are:
- severe bleeding (mostly bleeding after childbirth);
- infections (usually after childbirth);
- high blood pressure during pregnancy (pre-eclampsia and eclampsia);
- complications from delivery; and
- unsafe abortion.
Measures to save women's lives?
Preventing unintended pregnancies is crucial in order to prevent maternal
deaths. It is necessary for females of all ages, including teenagers, to have
the ability to obtain contraception, safe abortion procedures that comply with
legal regulations, and high-quality post-abortion medical care.
The prevention or management of complications that lead to maternal deaths are
widely known within the healthcare industry, making them avoidable. It is
necessary to provide all women with excellent healthcare services during
pregnancy, as well as before and after giving birth. The health of the mother
and the health of the newborn are intricately connected.
The presence of
experienced healthcare professionals during childbirth is crucial since prompt
medical intervention could determine whether both the mother and the baby
survive or not.
- If left unattended, a healthy woman can die within a few hours due to
excessive bleeding after delivery. Administering oxytocics promptly after giving
birth significantly decreases the likelihood of postpartum hemorrhage.
- By practicing good hygiene and promptly recognizing and treating early
signs of infection, it is possible to prevent infection following
childbirth.
- It is important to identify and manage pre-eclampsia before it progresses to
the point of causing seizures (eclampsia) or other serious, potentially fatal
issues. The risk of a woman developing eclampsia can be reduced by administering
drugs like magnesium sulphate for pre-eclampsia.
Maternal Mortality Rate in India
Over the years, India has experienced a high number of deaths resulting from
pregnancy and childbirth, however, recent data indicates that there has been a
reduction in India's maternal mortality rate. The precise measurement of
maternal mortality is challenging unless detailed data on deaths and their
causes are accessible. Surveys and census are utilized for approximating the
rates of maternal mortality.
At present, RAMOS is regarded as the most effective method to estimate maternal
mortality ratio (MMR). Analysing various sources and records is done to collect
information about the mortality of women who are capable of reproduction.
Additionally, a verbal autopsy is used to estimate the number of deaths. A
regression model is utilized to calculate the MMR every five years, both on a
global and regional scale.
The maternal mortality rate in India is estimated using the Sample Registration
Survey (SRS). In March 2022, a specific bulletin regarding the maternal
mortality rates in India was published by the Sample Registration System (SRS)
under the Office of the Registrar General.
Policies Of Government
There are various policies being introduced by the government of India. Some
of them are as follows:
Janani Suraksha Yojana (JSY)
JSY, which falls under the umbrella of NHM, is a program designed to encourage
pregnant women to give birth in a healthcare facility, as it aims to decrease
maternal and newborn mortality rates. JSY is a scheme sponsored by the central
government that combines financial support with both pre and post-natal
services. The Yojana has recognized that the Accredited Social Health Activist (ASHA)
serves as a valuable connection between the Government and expectant mothers.
Surakshit Matratva Ashwasan (SUMAN)
In 2019, the Ministry of Health and Family Welfare initiated the Surakshit
Matritva Aashwasan (SUMAN) program.
The goal is to offer reliable, respectful, and high-quality healthcare services
without charge to women and newborns who go to a public healthcare facility,
with a strict policy against refusal of service. This objective is aimed towards
eliminating any preventable deaths or sicknesses during childbirth and ensuring
a pleasant delivery experience.
The program offers a range of complimentary healthcare services to pregnant
women, mothers within six months after delivery, and new-borns, which include up
to four prenatal examinations and six home-based evaluations of new-born care.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
In June 2016, the Ministry of Health & Family Welfare (MOHFW) initiated the
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA). Pregnant women across the
nation are offered a guaranteed, high-quality Antenatal Care on a designated day
at no expense through the PMSMA program. As a component of the campaign, the
recipients are given a basic set of antenatal care amenities which feature
examinations and medications on the 9th day of each month.
Laqshya -Labour Room Quality Improvement
The main objective of this program is to provide assistance to Public Health
establishments. Their maternity operation theatres will be improved to assist
them, and the quality of care in labour rooms will be enhanced.
The implementation of this program will span across all CHCs, FRUs, District
Hospitals, and Medical College Hospitals.
Anmol app:
The MOHFW has created a complex android application for mobile tablets that
serves various functions including identifying and keeping track of individual
beneficiaries at an early stage.
The app would facilitate the monitoring of recipients to ensure they receive
adequate healthcare and encourage them to adopt family planning practices. The
system aids in timely delivery of complete antenatal, postnatal, and delivery
services, as well as tracking children to ensure they receive full immunization
services.
Conclusion
The government's commitment to 'Surakshit Matritva Aashwasan' for the women by
developing a responsive healthcare system that aspires to achieve zero
preventable maternal and newborn deaths is strengthened by India's success in
reducing MMR. The goal is to lower MMR below the target of 70 per lakh live
births when India celebrates its "Amrit Kaal" and to sustain a steady drop going
ahead. India is concentrating on improving the standard of in-facility maternity
care and increasing awareness of the importance of reproductive health in order
to meet this goal.
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