New tool to audit maternal deaths tested in six states

New tool to audit maternal deaths tested in six states

New Delhi: For every 100,000 births in India, 301 mothers die annually. According to the Registrar General of India’s Sample Registration System, an estimated 80,000 pregnant women or new mothers die each year from preventable causes including hemorrhage, eclampsia, sepsis and anemia and this does not include unrecorded cases of maternal deaths that occur in the anonymity of homes and en route to medical facilities.

A new tool -- the Maternal and Perinatal Death Inquiry and Response (MAPEDIR) developed by the John Hopkins Bloomberg School of Public Health with Unicef was adapted to local needs and tested in the states of Rajasthan, Madhya Pradesh, West Bengal, Jharkhand, Orissa and Bihar over the 2005-2008 period amongst 1600 women, the largest sample of audited maternal deaths in the world.

The findings which were released yesterday at a National Consultation highlighted the efficacy of the tool in promoting surveillance as a key strategy to lower maternal and child mortality, especially within the context of the National Rural Health Mission (NRHM).

State government health and nutrition officials and NGO members, headed by a member of the local village council or Panchayati Raj Institution, conducted interviews with surviving family members at the community-level. The findings will help communities and health systems to analyse the underlying medical and social reasons behind the deaths and guide them as they develop appropriate, high-impact, local interventions to bring down maternal mortality.

“The tragic reality is that too often maternal deaths are not visible. They don’t leave any trace behind, and their deaths are not accounted for," said Chris Hirabayashi, Unicef India deputy director of programmes. Medical records only capture part of the story, documenting the biological causes of death. “Unless we know the main reasons for maternal deaths we cannot take effective measures to tackle them. The traditional system did not deal with the issues adequately," said Dr S.P. Yadav, director of Medical and Health Services in Rajasthan. The second phase will see MAPEDIR being implemented in other districts across the country.