THE state health department has identified 25 blocks in seven districts in the tribal areas of Maharashtra where the infant mortality rate is more than the state average of 21 per 1,000 live births. Intensified home-based care for the newborn and daily visits by the Accredited Social Health Activists (ASHA) are among the robust measures to be adopted this monsoon to prevent infant deaths, Dr Satish Pawar, director of health services, Maharashtra, told The Indian Express.
The state health minister Deepak Sawant had, while replying to a question during the Legislative Council session earlier, said that 6,148 infants had died during April-August 2016 in Maharashtra while 881 mothers had died between April-November 2016. In September last year, the National Human Rights Commission had sent a notice to the state government over 600 malnutrition deaths from the tribal belt of Palghar in a year.
Anaemia, sepsis, pneumonia and low birth weight are among the prime causes of the number of infant deaths over the years. During monsoon, there is a greater need to reach out to the high risk group as they do not voluntarily seek preventive measures, state health officials said.
Pawar pointed out that 245 hospitals have been identified where paediatric care will be strengthened and guidelines are now being issued about the use of antibiotics to prevent pneumonia and sepsis. Dr Archana Patil, in-charge at the Pune-based state family welfare bureau, told The Indian Express that nodal health officers have been designated to monitor the situation in these tribal areas of seven districts — Nashik, Amravati, Nandurbar, Yavatmal, Gadchiroli, Palghar and Gondia.
ASHA workers are required to conduct daily visits to check on mother and infant during the first six months after the delivery, Patil said. At least 70-100 villages in each block will have a state-level nodal officer making official visits to monitor the situation. There are 35 functional Nutrition Rehabilitation Centres and Child Treatment Centres will now be started at the Primary Health Centres (PHCs), Patil added.
To ensure that tribal women go to hospitals for delivery, the state has provided monetary incentives to the “dai’s” in these areas. The dai’s who are responsible for delivering the child at tribal homes, are encouraged to bring the women to hospitals and a cash incentive has been allocated for the purpose. There is a high percentage of home-based deliveries at Palghar, Nashik, Nandurbar, Amravati and Gadchiroli districts and the dai’s at 15 high risk tribal blocks are trained as part of the incentive.
PMC’s health department and Save the Children launched “Project Kushal” at 16 civic nursing homes to upgrade maternal and newborn care services. Dr Anjali Sabne, acting chief medical officer, PMC, said that the project was aimed at strengthening healthcare services through IT-enabled solutions. The project, supported by IT company Avaya, will enable capacity-building and mentoring of doctors and paramedics.