CHENNAI: For the first time in Tamil Nadu, zero maternal death has been recorded in a Health Unit District (HUD) in one year. From April 2023 to March 2024, of the 7,991 deliveries recorded in the Virudhunagar HUD, no maternal death was recorded, officials said. About 30 to 40 primary health centres (PHCs) are clubbed together to form HUDs across the state. The HUDs are different from revenue districts. Virudhunagar, which is one of the 45 HUDs of Tamil Nadu, had recorded 8,483 live births and six maternal deaths in 2022-23, sources said.
As per the Health Management Information System (HMIS) data, the overall maternal mortality ratio (MMR) in TN has also fallen to 45.5 from 52.3 per one lakh live births in 2023-24 compared to 2022-2023. Better coordination between PHCs and secondary and tertiary care hospitals is one of the key reasons for achieving this feat, sources said. Virudhunagar HUD comprises 22 primary health centres. In Virudhunagar revenue district there are two HUDs — Virudhunagar and Sivakasi. Sivakasi HUD recorded two maternal deaths until February 2024.
Dr Pitchaikali, district mentor of Obstetricians and Gynaecologists, credited the success to the joint efforts of health department officials and collector. There was a good referral system between PHCs and hospitals, she said. Virudhunagar Collector in 2022 started a WhatsApp group where all private and government doctors would share updates on deliveries. If any complications were reported, the patient concerned will immediately be shifted to the tertiary care hospital, she said.
First step was identification of all low-risk and high-risk pregnant women. High-risk women will then be referred to the nearest Comprehensive Emergency Obstetric and Newborn Care (CEmONC) centres for delivery. Better infrastructure in CEmONC centres also helped, Dr Pitchaikali said.
‘Other districts should follow Virudhunagar HUD model’
Speaking to reporters, Health Minister Ma Subramanian said other districts should follow the Virudhunagar HUD model. He further pointed out that 99.9% of deliveries in TN happen in hospitals, and 59% of them happen in government facilities. Audit will be conducted on caesarean section deliveries done in private hospitals, the minister said.
The health department on Monday conducted a workshop on “Bringing Down the Maternal Mortality, Rate Connecting Missing Dots” for health officials and workers.
According to health secretary Supriya Sahu, analysis of maternal deaths in the 10-year period between April 2014 and March 2024 showed that 75% of deaths occurred during the postnatal period and 25% during prenatal period.
Shilpa Prabhakar, mission director, National Health Mission-Tamil Nadu, said the aim of health officials should be to stop preventable deaths. Pregnant women should be followed up regularly.
Dr T S Selvavinayagam, Director of Public Health and Preventive Medicine, said maternal deaths are mainly due to haemorrhage, hypertension, sepsis, and others.