~CHILD BIRTH A JOYFUL MOMENT~
Pregnancy and giving birth to a child is a joyous moment in a woman’s life but unfortunately the prospect of dying during childbirth is an imminent threat. As per Govt. records about 67, 000 Indian women die every year due to complications arising during childbirth. One million newborns die within four weeks of birth, 75% die within 1st week and majority of them die within 2 days after birth. The first 28 days of infancy period is very important and critical to save infants. About 70 per cent of them can be prevented through early detection of complications and ensuring timely access to quality services and emergency units at public health facilities. According to SRS 2018, for every 100,000 live births, 165 mothers die during pregnancy, childbirth and post-mortem period in Jharkhand. The main reasons of maternal deaths are nutritional deficiencies, lack of nutrition awareness among pregnant women and lactating mothers. One-third of women of reproductive age are undernourished or malnourished, with a body mass index less than 18.5 kg/m2.
Anaemia is the second leading cause of maternal death accounting about 20% of maternal deaths. Iron deficiency leads to anaemia, and anaemia during pregnancy is well associated with conditions leading to postpartum haemorrhage, low birth weight, premature births, stillbirths and maternal deaths.
According to our study IFA consumption by pregnant women has been only 15.3% in 2017. There is no tracking mechanism for consumption of IFA by target beneficiaries. ( write something about anaemia outcome or present position.)
Maternal and newborn deaths need to be detected and provide health services to check probable death. The rate of institutional delivery is 61.9%% in Jharkhand. in Jharkhand is 61.9% (NFHS-4) whereas as per HMIS data of Jharkhand (FY: 2018-19) it is 74.8 per cent. As per entitlement/protocol of Janani Shishu Suraksha Karyakram (JSSK) (Mother Child Safety Program), the post-partum mothers should stay at facility 3 days in the case of normal delivery and seven days in case of a caesarean. But, most of post-mortem mothers are discharged from facility within 24/48 hours of delivery. According to the HMIS data of Jharkhand, (2018-19), stay at facility below 48 hours by post-partum mothers was 82 per cent, maternal deaths – 757 and newborn deaths – 3213. The maternal and child deaths review (MDSR & CDR) of all of the deaths should be done at community level. But it is partly done which is a major issue in the state. As per HMIS data, only 52.2 per cent maternal deaths were reviewed during previous year (2018-19).
Adolescent pregnancy is another issue of life and death to the teenagers.Pregnant teenagers face many of the same pregnancy related issues as other women. Teenage pregnancy increases burden of low birth weight, pre-term birth, anemia, high blood pressure and pre-eclampsia those are concerned with biological factor. From various studies it is cleared that around 58 per cent girls of Jharkhand get marriages before the age of 18 years.
As we know adolescence is a phase of rapid growth and development during physical, physiological and behavioural changes occur. As per NFHS-4 data, the rate of teenage pregnancy in Jharkhand is very high i.e. 12 per cent. Teenage pregnancy poses a higher risk to the life of both mother and foetus. Morbidity and mortality occurring mostly in teenage mothers can be preventable.
‘Saving Lives at Birth’ Intervention:
1.To know root cause of poor consumption of IFA tabs by pregnant women and also to promote for increasing of iron intake by pregnant and lactating women on regular basis through short term and long term strategy.
2.To know whether the rural communities are acquainted with the key messages of 1000 days/Window Opportunity for reduction in maternal deaths.
3.To know about tracking mechanism for detection of high risk pregnancy so that possible causes of maternal &newborn deaths can be prevented and also to explore near miss opportunity for saving lives of mothers and newborns.
4.To know about responsible factors involved in promotion of early marriage and teenage pregnancy.
5.To create awareness among community for saving life of mothers and newborns after completion of baseline study and also to conduct endline study for impact assessment of the program.
6.To strengthen Maternal & Newborn Health (MNH) programs for reduction in maternal and newborn deaths.