Tamil Nadu’s maternal mortality rate at 54, has to drop further
The Tamil Nadu healthcare system received another boost recently. According to a special bulletin from the Union Health Ministry, the state’s (MMR) dropped to 54 per one lakh live births in 2018–20 against 58 in 2017–19. In comparison, the national figure stands at 97. TN is among the eight states that have achieved the Sustainable Development Goals target of an MMR under 70 for one lakh live births by 2030.
However, the state cannot afford to rest on its laurels. Its laurels look shabby when seen against the performance of its neighbours. A comparison with other southern states puts TN in fourth place, with only Karnataka behind it. The Telugu states—Telangana (56 to 43) and Andhra (58 to 45)—are ahead
of TN while yet again, Kerala (30 to 19) remains the nation’s leader on this front.
The state already tracks every pregnant woman and has schemes tailored to meet their nutritional needs and incentivise institutional delivery, which is nearly 100%. Every maternal death is audited on four levels. Health officials have identified postpartum haemorrhage (PPH) and pregnant-induced hypertension as the main causes of maternal deaths. A study on trends in maternal mortality in India over two decades, published recently, noted that in ‘richer’ states such as TN, the proportion of hypertension-related maternal deaths was higher compared to PPH in ‘poorer’ states and argued there must be better efforts to prevent, diagnose and treat the condition.
The health department plans to do just that by focusing on 11 districts with a concentration of such cases and providing anganwadis with BP kits to identify hypertension at the earliest. It also initiates yoga classes at the PHC level to help pregnant women. Doctors have also suggested the state open more Comprehensive Emergency Obstetric and New Born Care Centres. Interventions that have succeeded in some well-performing districts could also be replicated elsewhere.
In this context, the health minister’s crusade to reduce C-section deliveries to “zero” in government hospitals may be a distraction. Arbitrary targets will not help the state’s efforts. Rather, careful, granular analysis and tailored interventions backed by the requisite monetary commitments are the need of the hour. A state whose pioneering initiatives in healthcare have been replicated in other states cannot afford to rest on its laurels and fall behind.