A total of 1,201 infants died in 2015-16 in the Pune circle area, comprising Pune, Satara and Solapur. During the same period, 173 maternal deaths and 536 child deaths, in the age group 1 to 5 years, were registered, according to an audit of maternal and child deaths undertaken by the state’s health department.
Postpartum haemorrhage and septicaemia are the major causes of death among pregnant women in the rural areas. Prematurity, asphyxia and low birth weight are the main reasons for infant and child deaths.
The audit for the Pune circle from April 2015 to March 2016 reported 89 maternal deaths from Pune rural, followed by 59 from Solapur and 25 from Satara.
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Pune rural registered 433 infant deaths in the same period, followed by 258 infant deaths in Satara and 510 in Solapur. There were 323 child deaths in Pune rural, 88 in Satara and 125 in Solapur. Fever, pneumonia and diarrhoea have been among the top causes of death among children in the age group 1 to 5 years.
H H Chavan, deputy director of health, Pune circle, said the idea behind the maternal and child death audit was to try and find out the possible causes of the deaths, whether these could have been prevented and what necessary steps should be taken to avoid these.
Also, additional efforts were being taken to bring down the maternal and infant mortality rates with the setting up of special newborn care units, he said.
Hypertension due to pregnancy induced a problem in city areas
The maternal death audit conducted by the Pune Municipal Corporation for 2015 -16 indicates that pregnancy induced hypertension is a worrying issue.
There were 53 maternal deaths in the PMC area in 2015-16 and a majority had pregnancy induced hypertension and eclampsia, said Dr Anjali Sabne, nodal officer for maternal death review in the corporation. All 53 died at hospitals and not a single death was at home or while in transit.
One girl less than 18 years died during pregnancy, and a total of 22 women who died, were in the age group 19 to 25 years. As many as 27 women were in the age group 26 to 35 years and three over 35 years. There were 13 stillbirths and the causes of the deaths included illnesses like TB, meningitis and heart diseases.
There were delays in treatment in 15 cases.
An approximate 50,000 deliveries were carried out in Pune city, and presently, the maternal mortality rate (MMR) is 106 per one lakh live births.
The PMC audit for maternal deaths also indicated that private nursing homes should get registered under the Bombay Nursing Home Act and referral of high risk and complicated cases should be done in time to proper institutions.
“We are now ensuring that a proper referral chain is set up so that there is no delay in treatment and a maternal death can be prevented,” Sabne said.
Officials said that most of the deaths could be prevented with early Ante Natal Care (ANC) registration, at least 5 ANC visits to the clinic for check up, routine investigations, screening for high risk pregnancy, maintaining normal haemoglobin level by balanced diet, along with additional supply of iron and folic acid tablets and calcium supplement.
‘Child deaths decreasing’
The child death audit figures have to be compiled for 2015-16 but there has been a decreasing trend, says Dr Sanjeev Wavare, Assistant Medical Officer of Health. The child death audit of 35 cases, conducted mainly from slum areas in 2014-15, made it clear that the leading cause of death is low birth weight. The chances of mortality are more if low birth weight is associated with prematurity. The second leading causes are prematurity, pneumonia, septicaemia and birth asphyxia. However, the infant mortality rate (IMR) has gone down and is now pegged at 15 per 1000 live births.