TIRUCHY: The efforts of health workers like village health nurses and Makkalai Thedi Maruthuvam personnel to curb the maternal mortality rate (MMR) in Tiruchy district have paid off well in the 2024-25 period after the rate worsened the previous year.
Data from the health authorities show there is a sharp decline in maternal mortality, thanks to a proactive shift from monthly to weekly monitoring of high-risk pregnancies. The MMR plunged from 67.5 in the April 2023-March 2024 period to 42.1 from April 2024 to January 2025, whereas it was only 48 in the corresponding previous year, 2022-23.
Officials said the lives of many pregnant women have been saved due to timely interventions made possible by increased surveillance brought about by a joint initiative by the Integrated Child Development Services (ICDS), the social welfare department and the health department.
With the MMR increasing a year ago, the ICDS in its 16 zones was instructed to send anganwadi workers on weekly home visits to closely monitor high-risk pregnancies. The shift from monthly to weekly check-ups has played a crucial role in early detection of complications and timely medical intervention, officials added.
"When we noticed a steady rise in maternal deaths, it became clear that monthly monitoring wasn't enough for high-risk cases. Weekly visits help us identify warning signs much earlier, allowing doctors to intervene before complications become fatal," said M Nithya, district Integrated Child Development Project Officer.
Over the past year, village health nurses and anganwadi workers have conducted door-to-door surveillance. They record vital details such as immunisation, weight, blood pressure, and haemoglobin levels, submitting weekly reports to officials. In addition, anganwadi workers play a key role in providing dietary advice and ensuring nutritional support.
"This shift to weekly monitoring has allowed us to intervene at the right time for high-risk mothers. We now have better data on malnourished mothers, those with comorbidities, and women expecting their second or third child, who face greater risks," said V C Hemachand Gandhi, deputy director of health services.
Currently, over 12,000 pregnant women are under active supervision, with 3,914 classified as high-risk. One of the key interventions has been ensuring that high-risk mothers receive adequate nutrition. Health mix supplements are provided regularly, along with dietary counselling, particularly for those suffering from anaemia and malnutrition.
"Many working-class mothers often skip nutritious meals and avoid medical tests due to work pressure or lack of awareness. In such cases, we coordinate with nearby ward hospitals or even contact control rooms to ensure they undergo necessary medical tests," explained an anganwadi worker. Despite the success of the initiative, deep-rooted traditional beliefs continue to pose challenges.
Many women, particularly in rural areas, resist medical intervention, convinced that home births are safer, even in high-risk conditions. A critical case took place last year in Lalgudi where a pregnant woman expecting her third child escaped and relocated with her family weeks before delivery to avoid hospitalisation.
Her family feared that doctors would perform a caesarean section, despite her high-risk pregnancy due to a dangerously thin uterus. Thanks to the weekly reports from anganwadi workers, health officials acted swiftly, deployed resources to locate her, and ensured she was admitted to a hospital in time for a life-saving C-section.
"Our weekly visits sometimes bother them. We are often disrespected or ignored, but we continue because we know how important this work is," shared an anganwadi worker. The initiative is now being looked at as a model for other districts to ensure safer pregnancies and further reduce maternal mortality rates, say officials.