VISAKHAPATNAM: After the death of another pregnant woman in Pedabayalu mandal in Vizag Agency due to profuse bleeding after walking 20 km to consult a doctor, maternal deaths in Agency reached four this month with the total going up to 22 till August this year.
According to medical and health officials, Materal Mortality Ratio (MMR) has decreased in the district compared to previous years, but the deaths in the Agency continue to be high triggered by anaemia, gravida (multiple pregnancies) and failure of pregnant women to inform their last menstrual wperiod (LMP).
Incidents of pregnant women being shifted to the hospital in a make-shift stretcher with complications are commonplace in the Agency.
Around 6.8 lakh tribal population live in 3,636 habitats in the Vizag Agency.
Many interior villages such as Chintapalle, Araku, Munchingput, Paderu, Hukumpeta and Dumbriguda mandals lack road connectivity; pregnant women with complications are commonly reported from these areas.
Thanks to the awareness campaigns by Asha workers, many tribal women get admitted to hospitals a few days before the scheduled date of delivery. However, there are still many more in interior villages, who still believe in delivery at home and shift to hospital only after if complications arise in the woman’s pregnancy.
The condition in interior tribal villages, which don’t have road connectivity, is even worse. When it rains, an ambulance cannot reach the area. As per the statistics of District Medical and Health department, there were 14 maternal deaths in the district till July this year.
In the past few years, there was a decrease in MMR, which is far short of the target of health officials.
Around 79 maternal deaths were reported in 2015-16, 78 in 2016-17, 66 in 2017-18 and 69 in 2018-19 and eight maternal deaths in August, including four from the Agency.
The maternal deaths in tribal areas were 27 in 2016-17, 18 in 2017-18, 33 in 2018-19 and seven this year up to August.
At least 13 to 14 deliveries take place every month in each PHC and there are 36 PHCs in the Agency. Doctors in the PHCs say there is a need to increase number of institutional deliveries in the Agency. The PHCs have recently developed calendars to mark high-risk pregnancies and scheduled date of deliveries of pregnant women.
On being advised to get admitted in the hospital a few days before the scheduled date of delivery, many women get admitted only when they develop complications.
“When the Asha workers counsel them for institutional delivery, they refuse to get admitted in hospital and stick to home deliveries. But during house calls, we tell the pregnant women to get admitted in hospital two to three days before the due date,” an Asha worker said.
Meanwhile, the Health and Family Welfare department has put 43 ambulances at the disposal of PHCs, CHCs and areas hospitals. For the tribal hamlets where there is no road connectivity, 42 feeder ambulances have been arranged for shifting the patients to the nearby hospital.
“There is no scanning equipment in PHCs and CHCs. Only a qualified technician can operate the scanning machine. Many tribals, being illiterate, fail to mention their last menstrual period to the doctors; this also complicates things,” DMHO Tirupati Rao said.
The DMHO told TheNew Indian Express, “In some cases, the pregnant women in remote tribal areas use medicines given by rural medical practitioners (RMPs) and develop complications at the later stages. In a recent case, the woman with a third pregnancy got labour pains a month before the delivery date.”