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Sunday, October 24, 2021

Project Sahara: In Ahmedabad, new tool to help reduce maternal mortality

While there were 8 maternal deaths in the district because of PPH between January and November 2018, since the introduction of this initiative there have been no PPH deaths.

Written by Sohini Ghosh | Ahmedabad |
Updated: July 29, 2019 4:58:06 am
maternal mortality rate, Maternal Mortality Ratio, India Maternal Mortality rate, Child mortality, child birth, national rural health mission, Project Sahara, Project Sahara Gujarat, Indian express The use of non-pneumatic anti-shock garment contains blood loss due to postpartum haemorrhage, thus saving the lives of new mothers. (Sanathal PHC)

On the evening of June 7, 22-year old Mohini Saxena gave birth to a baby boy at the Sanathal primary health centre (PHC) of Ahmedabad district, but soon after she suffered from postpartum haemorrhage (PPH) that led to continuous and excessive bleeding. The rapid loss of blood because of PPH reduces the body’s blood pressure and can even cause death. But, Mohini was fortunate because the medical staff at the PHC quickly wrapped her in a non-pneumatic anti-shock garment (NASG), which applies pressure to the lower body and abdomen, thereby forcing the blood that was getting accumulated in the pelvic area to other essential organs of the body. The neoprene garment quickly stabilised Mohini’s vitals and gave her doctor enough time to take her to the nearest civil hospital.

The availability of NASG at this PHC wasn’t just a stroke of luck. It was part of a local initiative by the district’s development officer, Arun Mahesh Babu. A 2013-batch IAS officer, Babu is a native of Kerala, a state that excelled in social sector indicators especially health. Gujarat’s relatively poor record on health outcomes such as maternal mortality rate and infant mortality rate came as a shock to Babu. “I had not heard of such things of mothers dying during childbirth or a child dying within a year,” he says. According to Sample Registration Scheme results of 2016-17, Gujarat’s IMR (per 1,000 live births) was 30 and MMR (per 100,000 live births) was 91 — better than the national averages but quite high for a relatively more prosperous state.

As such, in November 2018, Babu started a new project, called Sahara, that aimed at reducing haemorrhage-related maternal deaths by providing new mothers with a special suit —the NASG. Babu reasoned that if they targeting reducing maternal deaths, it would, in turn, also improve infant mortality. There were several reasons why he chose to further target PPH-related deaths. For one, he found that a lot of mothers were anaemic because of poor nutrition. This weakness compounds the damage caused by excessive and sudden bleeding. Moreover, women delivering children in rural areas are far away from district hospitals when such complications occur. Data showed that almost 30% of the maternal deaths in the state were because of PPH and these primarily took place within the first 4 to 24 hours after childbirth. Among all the other causes, deaths due to PPH could be averted.

The results are there for all to see. While there were 8 maternal deaths in the district because of PPH between January and November 2018, since the introduction of this initiative there have been no PPH deaths. Today, 40 PHCs in Ahmedabad have an NASG suit each — each suit can be used 140 times — and the government has spent Rs 14,500 per suit under the Janani Shishu Suraksha Karyakram. The suit is manufactured in Hong Kong and a Bengaluru-based supplier imports it. Not surprisingly, the scale-up of this project is well underway. District development officers of Porbandar, Narmada, and Jamnagar are already looking at this cost-effective initiative, while Bhavnagar has already ordered three such suits.

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