As per Health Information Management System (HMIS) data Tamil Nadu Government, against 62 maternal deaths recorded per one lakh live births in 2020-21, recorded only 25 maternal deaths Dharmapuri In 2021-22. This is less than half the state average and less than some of the more urbanized districts. During the same period, Tamil Nadu’s MMR average fell from 73 to 62.
Doctors in Dharmapuri said that tracking every pregnant woman from the first trimester and regular follow-up of high-risk patients helped them reduce MMR.
Chennai, on the other hand, reported 40 deaths out of 73,627 live births, recording an MMR of 54. Coimbatore had 18 deaths out of 44,163 deliveries with an MMR of 40. The MMR in Trichy, Madurai and Salem is 78, 55 and 53.
Of maternal deaths that occurred between April 2021 and March 2022, 17% of deaths were due to postpartum haemorrhage – when the woman lost 500 ml or more of blood within 24 hours of delivery. About 14% of the women died due to hypertension, 12% suffered from viral pneumonia, 9% had neurological disorders and a similar percentage had heart diseases. Health officials said strengthening of standard protocols like regular monitoring of pregnant women and antenatal care could further reduce MMR.
Dharmapuri, considered one of the backward health unit districts in Tamil Nadu with low indices in health, education and social sector, has the lowest Maternal Mortality Ratio (MMR) along with Palani in Tamil Nadu, which is one of the 46 health unit districts . State.
State-maintained Health Information Management System (HMIS) data shows that there were 25 maternal deaths per one lakh live births in the district in 2021-22, compared to 62 in 2020-21. Of the 24,260 live births, six women died during this period. Palani reported two deaths for 10,062 deliveries.
During the same time, Tamil Nadu recorded a decline from 73 in 2020-21 to 62 in 2021-22.
The death registry showed 571 deaths for 9,13,272 live births. In both the years, the deaths due to COVID-19 have been omitted for the purpose of analysis. The Covid Registry maintained by the state’s Public Health Department showed 256 maternal deaths, including seven in Dharmapuri.
Tamil Nadu enrolls all pregnant women in the Pregnant and Infant Cohabitation Monitoring and Evaluation (PICME) and asks urban and rural health nurses to track pregnant women at risks such as gestational diabetes, hypertension and anaemia. These nurses encourage women to eat healthy, exercise and follow medication regimens prescribed by doctors. They also bring them in for routine medical check-ups, vaccinations and scans. “This follow-up of pregnant mothers and antenatal care for them ensured a low mortality rate,” said Dr Soundammal, deputy director of health services, Dharmapuri.
Dharmapuri has a large tribal population. He said some mothers were hesitant to visit hospitals or seek the help of medical professionals.
“We took the help of panchayat leaders to get them registered with PICME. This helped us quickly list high-risk mothers. We monitor them until they reach the labor room. Apart from this, when pregnant women from other districts come to Dharmapuri for delivery, then the nurses in the district get an alert. Nurses prepare a list of expectant mothers who are about to deliver at the beginning of every month. “We filter high-risk pregnancies and provide them with extra care,” said a 40-year-old rural health nurse from Coimbatore. “We also track women who prefer private hospitals, track their medication and check their high blood pressure levels.”
About 66% of deliveries in Tamil Nadu and about 73% in Dharmapuri take place in government facilities. Between 2021 and 2022, about 77% of all deliveries occurred in comprehensive emergency obstetric and neonatal care service centers, secondary or tertiary care hospitals with adequate doctors, nurses and facilities including life-saving medicines, equipment and blood banks. “There has been a marginal increase in C-sections in both private and public hospitals in Tamil Nadu,” Health Secretary J Radhakrishnan said.
The National Family Health Survey (2019-21) showed that around 45% of women in the state undergo C-sections, compared to 34% in 2015-16. Tertiary care centers like Medical College Hospital or maternity hospitals like Women’s and Children’s Hospital in Egmore have a higher number of C-sections because they deal with the most complex cases in the state. “In most cases, augmentation is a life-saving surgery due to increased risk factors such as high blood pressure, but we are working on policies to keep normal deliveries high,” he said.
He said that Tamil Nadu is among the states where the cost of delivery in government hospitals is the lowest. In addition to antenatal medical check-up, the health department provides maternity benefits including cash and nutrition kits to help pregnant women. “Following these strategies will reduce maternal deaths. Preventing maternal death should be the responsibility of every family. The husband, mother and father of the woman should ensure that the woman is healthy,” said director of public health Dr TS Selvavinayagam.
M Thangavel, director of Vizhuthugal NGO in Coimbatore, said that despite significant progress, there are gaps in the distribution of nutrition kits. “Those who seek treatment in private hospitals do not always get it. Anganwadi workers should be properly trained to distribute nutritional health mix to mothers,” he said. In case of daily wage earners and guest workers who continue to work even into their third trimester, providing financial assistance makes a difference. “If the funds earmarked for them under the Dr Muthulakshmi Maternity Benefit Scheme are released without any delay, they can stay at home,” he added.