Fostering commitment to stop maternal deaths: Addressing delays and systemic issues in India
India's Maternal Mortality Ratio (MMR) has declined to 93 (2019-21), but significant disparities exist across states, with Kerala having the lowest (20) and Assam the highest (167). The article highlights "three delays" contributing to maternal deaths: delay in recognizing danger and seeking care, delay in transportation to health facilities, and delay in initiating specialized care at health facilities. Systemic deficiencies include high vacancies of specialists in community health centres, lack of blood banks, and inadequate management of postpartum bleeding, obstructed labour, and hypertensive disorders. The author emphasizes the need for a differential approach across states, focusing on basic tasks in Empowered Action Group (EAG) states and fine-tuning quality in southern states, advocating for a Confidential Review of Maternal Deaths model.
Key Points
- India's Maternal Mortality Ratio (MMR) has decreased, but regional disparities remain significant.
- Maternal deaths are often attributed to "three delays": seeking care, transportation, and receiving timely specialized care at health facilities.
- Systemic issues like specialist vacancies, lack of blood banks, and inadequate management of obstetric emergencies contribute to high MMR.
- A differential strategy is needed, with EAG states focusing on basic tasks and southern states on quality improvement.
- The Kerala model of Confidential Review of Maternal Deaths is suggested for emulation to further reduce MMR.
Exam Facts
- India's Maternal Mortality Ratio (MMR) for 2019-21 was 93 per 1,00,000 live births.
- Kerala has the lowest MMR at 20, while Assam has the highest at 167.
- The "three delays" concept by Deborah Maine of Columbia University is crucial for understanding maternal deaths.
- The National Rural Health Mission (NHRM) was launched in 2005.
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