What’s killing Bihar’s mothers?

PATNA: Why is it that even though the Bihar Government has improved health services manifold, more than 6,000 women die after delivering babies?

Even as more Biharis are going to PHCs and hospitals for childbirth, which are being recognised as the safer option, a recent study says most of the maternal deaths in Bihar take place at home. This is probably because that even though the delivery may be institutional, the mother does not – or is not allowed to – stay in a hospital for mandatory 48 hours after delivery.

At least 6, 500 maternal deaths are reported from Bihar every year.

The recent review of maternal deaths – conducted by Unicef, Bihar Voluntary Health Association and State Health Society of Bihar in 38 blocks of Gaya and Purnia districts – reveals a significant shortage of health infrastructure at the rural level.

Norms prescribe 15 basic delivery centres per 5 lakh population, but Gaya and Purnia have 35 and 44 such centres against the requirement of 135 and 104 respectively as per the norms. Less than half of the emergency C-section obstetric care centres are available against the required number and, worse, most of them are not functioning as per norms, the study says.

Causes and circumstances leading to 157 maternal deaths were studied. The distance from home to institution caused several deaths. At least 22 deaths occurred because the nearest health institution was more than 20km away. Another 11 women died because the institution was 16 to 20km away. Many of the cases were referred to a higher health centre, but they could not reach there in time.

 

What worsens the situation is the lack of adequate ambulance services. At least half of mothers who died were transported in autos or private vehicles.

 

“At times doctors do untimely and unnecessary referrals to higher health centres. This leads to deaths of mothers,” the study says and adds at least 20 mothers who died were referred without any explanation.

Then there is the economic condition of the family. Lack of money also contributed to the deaths. More than half of the cases researched could not afford  treatment in a higher centre.

Post-partum haemorrhage (excessive loss of blood after delivery) appears to be the biggest cause of death. Bleeding after delivery is common and if the patient isn’t given a blood transfusion in time, death occurs. The study says that lack of blood at health institutions caused doctors to refer cases elsewhere and that ultimately caused about  49 maternal deaths.

Ante-natal checkups (ANCs) play an important role in ensuring safety of expectant women. They must have five ANCs before delivery. However, the study hints proper protocol is not being followed in conducting ANCs. Of the 157 maternal deaths studied, ANCs were conducted on 104 cases at sub health centres “which are not properly equipped to conduct them”.

The study found at least 24 of the 157 deaths were in the age group 15-20. Incidentally, 45.9% of girls in Bihar are married before the legal age for marriage of 18 years.

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Posted by on March 31, 2015. Filed under Bihar,Breaking News,HEALTH,INDIA -WIDE. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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