26/01/2015

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Activistsgiverecommendationstoreducematernaldeaths|DownToEarth

http://www.downtoearth.org.in/content/activistsgiverecommendationsreducematernaldeaths

Activistsgiverecommendationstoreducematernaldeaths
Lossofblood,anaemiaanddelayinmedicalcareidentifiedasmajorreasonsformaternaldeathsinIndia
ArecentstudybyaninternationalnonprofitrankedIndia137thamong178countriesinmaternalandchild
health(PhotocourtesyFlickr)
Nonprofitsandactivistsworkingintheareaofmaternalhealthhavemaderecommendationsonreducing
maternalmortalityinthecountryafteratwodayconferenceinDelhionJanuary5and6.Thetwomain
recommendationsforreducingmaternalmortalityare:changingreferralsysteminpublichealthfacilitiesto
reducedelaysandimprovingdrinkingwatersupplyinremoteareas,whichcanalsoreducepregnancy
relatedcomplications.

Theconsultation,organisedbyCommonHealth,anationallevelcoalitionoforganisationsandindividuals,
andnonprofitOxfamIndia,waspartofalongdrawnprocesstounderstandmaternalhealthissues.The
process,calledDeadWomenTalking,aimstounderstandmaternalhealthfromaperspectiveofsocial
determinants.Aspartofthis,CommonHealthandJanSwasthyaAbhiyan,IndiachapterofPeople'sHealth
Movement,releasedastudyinNovember2014DeadWomenTalking:acivilsocietyreportonmaternal
deathsinIndia.Thereportdocumentsprofilesandreasonsin124maternaldeathcasesin31districtsof10
statesofIndia.Throughindepthinterviewsoffourtofivefamilymembersofeachdeceased,thereport
suggestedsomerecommendationswhichwerediscussedduringthetwodaysofconsultation,beforethe
newsetofsuggestionswereagreedto.
"Inthepresentreferralsystem,thepatientissentfromahealthfacilitytothenextleveloffacilitygradually.
Forexample,theyarereferredfromaprimaryhealthcentretocommunityhealthcentreandthentothe
districthospital,whichleadstodelays.Insteadofthis,thepatientshouldbesenttotheappropriatehealth
facilitydirectly,whichwillsavecrucialtime,"saidspokespersonofCommonHealth.Itwasrecommendedthat
thestaffintheambulanceshouldbetrainedtodecidetheappropriatehealthfacilityforaparticularpatient
andthattheyshouldbegivenpowertotakethepatientaccordingly.Thiswillreducethetimefurther.
Theresearchersofthereportfoundthatlackofdrinkingwatersupplyisalsoconsideredonereasonforill
healthbypeople.Women,especiallyintribalareas,havetowalkupanddownfromthemountainstofetch
water.Thisdutyhastobeperformedmultipletimesadayevenduringpregnancy.Suchhardworkhas
potentialtocreatecomplicationsduringandafterdelivery.
"Inmostofthecases,simpleinterventions,likeavailabilityofblood,managementofanaemiaandproper
referralsystem,couldhavesavedlives.Ourrecommendationsaddresssuchissues,"saidBSubhaSri,
Chennaibasedgynaecologistandmember,CommonHealth.
Amongtheprobablemedicalcausesformaternalmortality,lossofbloodandanaemiaemergedasthe
biggestreasons,whichcanbetreatedwithsimplemanagement.While23percentofthedeathshappened
duetolossofbloodfollowingchildbirth,nearly18percentwereduetoanaemia.
Thereportshowedthat34percentofthewomendiedatapublichealthfacility.Butasubstantialnumber,26
percent,diedathome.Another26percentdiedinvehiclesduringtransitfromhometohealthfacilityorfrom
onehealthfacilitytotheother.Almost15percentofthedeathsoccurredinaprivatehealthfacility.

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