Abstract of Dissertation

Keyword : Maternal Death; National Health Mission; Causes of Death; Burden of Maternal Death

Objective : • To describe the type of delay commonly contributing to the burden of maternal deaths in Mahisagar District during study period • To study the causes of deaths and recommend some other possible interventions to reduce & prevent maternal deaths.

Background : High Maternal mortality continues to be a challenge in reaching MDG 5 targeting. India still has not shown satisfactory progress in its MDG 5 achievements. Maternal death review is a way to understand the hurdles and bottlenecks in reaching the target. There are many interlinking factors which can prevent women from access high quality maternal and family planning care. Recognizing the different barriers women face in achieving the timely and effective medical care needed to prevent deaths occurring in pregnancy and childbirth should be on top of the agenda for health care systems promoting Safe Motherhood Practices. The three Delay Model provides such a frame work to explore and identify different barriers women face in accessing quality, timely and effective maternal health care services needed to prevent such deaths. The model identifies three groups of factors which may stop women accessing the levels of maternal health care which they need: delay in making decision to seek care, delay in reaching the care and delay in receiving appropriate and adequate health care (MoH, 2010). This study will therefore provide an assessment framework based on the Three Delay Model to identify which of these factors are impacting on the current burden of maternal mortality in Mahisagar District, Gujarat.

Methodology : A community based (Review of verbal autopsy/Maternal Death Forms) cross-sectional study was adopted. Last 2 years Maternal Death Review Verbal Autopsy Forms of Mahisagar district were collected and reviewed for analyzing causes of maternal death. Causes were analyzed with respect to three delay model, other contributory factors, and associated socio-epidemiological factors. A total of 62 maternal deaths records were reviewed

Recommendations :65% of total death of the women occurred due to delay at the third level. Third delay was mainly due to lack of equipment and lack of blood storage. Main causes responsible for first delay were unawareness of danger signs related to pregnancy, beliefs and customs regarding not delivering at health facility. Delay in mobilizing funds for treatment and delay in getting transportation were found as the main causes responsible for second delay. Majority of women in the study area were found married before the age of 20 years. Early marriage may be the reason for more than half of maternal deaths in the age group of 20 to 24 year in that particular area. More that half of the mothers died due to some other medical complications of Anaemia.