Hyderabad: Back in 2014, the Infant Mortality Rate (IMR) in Telangana was at around 40 infant deaths for 1,000 live births. The Maternal Mortality Rate (MMR) was 91, which meant that 91 pregnant women out of 1 lakh live births used to die from complications.
Fast forward to 2020 and within a span of six years, the present IMR stands at 27 while the MMR has gone down to 38. The reduction in infant and maternal mortality was possible due to the centrepiece initiatives aimed at improving Mother and Child Health (MCH) services, not only in Hyderabad but across Telangana, by the State government.
Reducing fatalities of infants and pregnant women needed holistic plan aimed at addressing deficiencies at multiple levels. Through special focus on MCH services, the State government in the last six years had sought to consistently plug gaps in human resources and infrastructure shortages in maternity hospitals.
A series of initiatives at government hospitals, including development of infrastructure, investing on developing paediatric wings at teaching hospitals like Gandhi Hospital, recruiting obstetricians, gynaecologists and anaesthesia specialists, who are vital to ensure safe deliveries, promoting midwifery, Kangaroo Mother Care (KMC) and last but not the least, the KCR Kits scheme along with the financial benefits scheme, have played a vital role in improving maternal and infant care at government hospitals.
Focus on infrastructure
In the last five years, authorities concerned have set up nine MCH centres, each with 150 beds at a cost of about Rs 90 crore. In the coming year, another 200-bed state-of-the-art MCH facility at Gandhi Hospital campus will be taken up at a cost of Rs 30 crore. The budget to start construction of the MCH facility at Gandhi has already received approval in the recent budget.
The authorities have also developed 20 intensive care units (ICUs), with each unit having 10 beds, at a cost of close to Rs 30 crore. A speciality post-operative ICU facility was established at Petlaburj maternity hospital, which provides critical post-operative care to women who undergo complicated caesarean sections.
Senior paediatricians and public health specialists have said the improvement in Neonatal Intensive Care Units (NICUs) in Hyderabad and district hospitals has played its part in improving the IMR levels in the State.
“There is no denying the fact in the last few years the State government has given top priority to mother and child healthcare services in Telangana. Another heartening development is the recruitment of specialists from Anaesthesia, Obstetrics and Gynaecology, who are vital to ensure safe deliveries,” said senior paediatrician from Niloufer Hospital Dr Narahari Bappanapally.
KCR Kits a game changer
Within months of launching KCR Kits, small and medium nursing homes for pregnant women started reporting a drop in patient admissions. Within a year, several such healthcare facilities with limited financial resources had to shut down, as pregnant women chose government hospitals.
The KCR Kits and the attached financial benefit scheme was a game changer for pregnant woman in the State. “It single-handedly increased the institutional deliveries and at the same time also ensured there was a reduction in number of caesarean sections,” says Dr Usha Rani T, Head, Paediatrics, Niloufer Hospital.
The midwifery cadre introduced in Telangana scored many firsts in the country, in terms of improving quality of care for pregnant women. For the first time, the midwives cadre introduced the concept of giving respect to pregnant women in government hospitals and laying the foundation to improve pregnancy outcomes by reducing caesarean cases and increasing natural deliveries.
Moreover, State-run health care facilities were also introduced to the concept that birthing was a human right and all women, irrespective of their financial background, must have access to quality pregnancy care.
The first batch of 30 midwives was introduced in Mother and Child Health (MCH) centres at Karimnagar and Sangareddy districts. Between March, 2018 and April, 2019, the midwives safely delivered 2,294 infants in both the institutions while the target was to conduct just 40 normal deliveries.
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