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Study of Maternal Deaths Reported During 2011-12 in Bhavnagar District, Gujarat


  • Muktesh M. Rayaguru
  • Agency : MDG-5, MMR, RCH-II, BHO, IEC, HBNC, Counselling, FHW, E-tracking, M-tracking, E-mamta.
  • Objective : to identify the direct and indirect causes of maternal deaths & to outline possible interventions for reduction and or prevention of maternal deaths in Bhavnagar District.



  • Background : MDG-5 Target for Gujarat is to reduce MMR to 109 per 100000 live births by 2015.But looking at the progress till now Gujarat has MMR of 148 per 100000 live births as reported by SRS 2009 published in 2011. So, efforts are needed to give an impetus to the improvement of maternal health status & thereby devise strategies to overcome those causes.  MDR as a strategy has been spelt out clearly in RCH-II National Program Plan Implementation Document. The main purpose of the CBMDR is to identify the various delays and causes leading to maternal deaths, to enable the health system to take corrective measures at various levels. Identifying maternal deaths would be the first step in the process. The second step would be the investigation of the factors/causes which lead to maternal death whether medical, social, and systemic. The third step would be to take appropriate and corrective measures on these depending on their amenability to various demand side and communication interventions.




  • Methodology : It is a retrospective cross sectional study.A total of 27 maternal deaths were reported during 1st April 2011 to 31st March 2012.Secondary data was collected by seven Block Health Officer (BHO) by a structured verbal autopsy form.



  • Findings :
    • 51.8 percent of the mothers who died were illiterate or just literate.
    • The leading direct cause of maternal death was Haemorrhage in 37.04% of the cases.  
    • 22 percent maternal deaths were due to PPH alone.  
    •   Indirect causes accounted for 33.3% of the total deaths in that period.   Medical diseases accounted for 22.2% of the total deaths but 66.6% of the indirect causes.   59% of maternal deaths occurred in post partum period and 26% in Antepartum period. 
    •  The delay in seeking medical care accounted for 44.4%.  
    •   Delay in receiving appropriate treatment accounted for 40.7%.



  • Recommendations : Not Available

    Suggestions:
       IEC activities in context to behavioral change communication at Community level should be improved

    •   Home visits for pregnant women and infant children should be done by FHW, AWW, ASHA to create awareness about various kind of health program for maternal and child heath as per HBNC program.    Counselling of mothers for Family Planning practices. 
    •  Many programs are being run in the district toward safe motherhood. Hence, vigorous training sessions of FHWs, AWWs, ASHAs, ANMs and LHVs should be held to make them more efficient and competent in their job.
    •  Educating young girls should be focused more.   
    •  E-tracking & M-tracking of pregnant women esp. high risk pregnancy cases with help of E-Mamta.


to identify the direct and indirect causes of maternal deaths & to outline possible interventions for reduction and or prevention of maternal deaths in Bhavnagar District.