With an aim to bring down maternal mortality ratio of Uttar Pradesh from 300 per one lakh live births to 200 by 2017,the state unit of National Rural Health Mission (NRHM) will now be closely monitoring maternal deaths across the districts and conduct community-based maternal death reviews with the help of its grassroots-level health workers.
Uttar Pradesh had started maternal death audits on a pilot basis three years ago. However,the performance of the state in reporting maternal deaths and reviewing maternal deaths has been poor in the past one year.
As per the government report,in the year 2012-13,against the expected 19,268 maternal deaths,merely 1,337 deaths were reported and death review was done of 1,180 deaths,which is 6.12 per cent of the total deaths. It is evident that the scheme is not being taken as a priority in the districts, said the guidelines issued earlier this week by Mission Director Amit Ghosh.
As per the guidelines,maternal death review committees established under the District Magistrates,and in medical colleges,district hospitals for women as well as 200 earmarked First Referral Units have to meet once a month to review the maternal death reviews in their areas. The reported deaths and death reviews are to be further analysed at the district and division level every three months. The government has set 80 per cent of the expected deaths as the target for reporting and reviewing maternal deaths in each district.
At the block level,the ASHAs of each district are to be trained about maternal death reporting and death review in the month of July. The ASHAs will also be given an incentive of Rs 200 for reporting within 24 hours any suspected maternal death of women between the age of 15 and 49 in their village,apart from deaths due to accident,murder etc.
For the community-based maternal death review,the medical officer will conduct an investigation within a month of the reported death and interview family members of the deceased related to underlying delays which contributed to the death including social determinants, said the guidelines.
As an incentive,ASHAs,anganwadi workers and one of the family members will also be given Rs 100 each under NRHM for community-based maternal death review.
Explaining the importance of maternal death reviews,a senior health official said that death reviews is an important strategy to improve the quality of reproductive health care. The idea behind death reviews is to trace the cause of maternal deaths so that appropriate steps can be taken to reduce maternal deaths.
Depending upon its population and maternal mortality ratio,each district has been given a target of maternal death which are to be reported and reviewed in a year. A total of Rs 4.40 crore has been sanctioned and allocated to the state for maternal death reviews in the year 2013-14 under NRHM.