Tuesday, October 18, 2011

Maternal Health Care in Palamu - Red letter day

Today was a red letter day in the history of maternal health care of our region.

The UNICEF along with the district health authorities of Palamu district had arranged for a training session on Facility Based Maternal Death Review. I understand that soon there would also be efforts taken for training grassroot workers on Community Based Maternal Death Review.

Mr Prabodh Kujur and myself represented NJH as we have quite a large burden of adverse maternal events including maternal mortality. Over the last 1 year, we calculated about 20 maternal deaths within the facility. This excludes at least 5 patients who were brought dead.

One of the key messages which was conveyed to all the doctors who came was about the absence of a blame factor in the whole exercise. Many a time, adverse health events are not reported because of a fear of punishment. I was very glad that the message was conveyed well.

As I sat there, images of mothers who died or almost died, those who ended up with lifelong complications and dead babies flashed before me.

I remembered AB's baby who just made it whereas she should have been referred faster. BD, whose life has turned for the worse was a poignant face whom I would remember for the rest of my life. One of the major finding I would expect from the reviews is the strong association between malnutrition and anemia. 

The mental stress that KD's family endured was still fresh in my mind. Our experiences with patients like RD, who lost her baby or SD, for whom we had to intervene heroically have already taught us that the delay in taking the decision to go to the healthcare provider and the delay in implementing the decision is quite costly in the lives of mothers and newborn. I'm certain that this is going to be one of the major learning in this exercise.

I'm excited about the whole excercise. We look forward to a time of learning and understanding determinants influencing maternal health care in this region during the maternal death review meetings at the institutional and district level.

More than that we look forward to a period in our surrounding communities where pregnancy is more safe whereby families will cherish and enjoy motherhood which would be the ultimate aim of such an exercise.

1 comment:

  1. Hi Jeevan, Keep up the good work. There are times when we have to speak the truth even though we become unpopular. I remember my time in Asha Kiran when we had a spate of deaths from anthrax (which we got confirmed from CMCV) and the district authorities wanted me to report it as "food poisoning" which I refused.However the press got the information from us and flashed the news. This forced the authorities to make major efforts to control anthrax and many precious lives were saved. We can be the "voice for the voiceless"! May God give you wisdom and courage.