Student Dissertation

Agency : Maternal Death; Maternal Mortality; Rural Health; Gujarat

Objective : ï‚· To identify the major cause and delay in maternal death in Rural area in Surendrnagar District During The year 2015-16 by Analysis of verbal autopsy form. ï‚· To suggest measure to Reduce MMR in Surendranagar District.

Background : The high level of maternal mortality in the developing world is an issue of public health concern. India accounts for over 20% of the world’s maternal deaths. Maternal mortality is ascribed usually to complications that generally occur during or around labour and cannot be accurately predicted. The major causes of maternal mortality are haemorrhage, sepsis, hypertensive disorders, obstructed labour, and abortions. All of these causes are mostly preventable through proper understanding, diagnosis, and management of labour complications. Maternal mortality ratio is dependent upon the general socioeconomic status, nutrition level of maternal healthcare in community. Approximately 529,000 women die from pregnancy-related causes annually and almost all (99%) of these maternal deaths occur in developing nations. One of the United Nations’ Millennium Development Goals is to reduce the maternal mortality rate by 75% by 2015. Causes of maternal mortality include postpartum haemorrhage, eclampsia, obstructed labour, and sepsis. Many developing nations lack adequate health care and family planning, and pregnant women have minimal access to skilled labour and emergency care. Basic emergency obstetric interventions, such as antibiotics, oxytocics, anticonvulsants, manual removal of placenta, and instrumented vaginal delivery, are vital to improve the chance of survival.

Methodology : A retrospective cross sectional study is conducted. Study is based on secondary data. The data were collected by block health officer in structural verbal autopsy form. Total 25 verbal autopsy forms were filled BHO in 10 talukas of Surendranagar district. Study Design: A retrospective cross sectional study is conducted. Study area: - 10 block in Surendrnagar district. Sample size: - Twenty-five maternal deaths recorded in the year 2015-16. Data collection: -Primary data- Structured questionnaire (verbal Autopsy form for maternal death). Verbal autopsy was filled up (for 3 maternal death) with BHO from February 2016 to April 2016. Secondary data- Secondary data was collected using 22 verbal Autopsy form already proposed between April 2015 to Jan. 2016. -Analysis Verbal Autopsy reports of Maternal Death Reported in 2015-16 in surendranagar district. Process- MS Excel is used to analyse the data

Findings : Report suggested Block Dhrangdhra reported a maximum of 6 i.e. 25% of total maternal deaths in district followed by 4 maternal deaths in Patdi and 3 deaths in Wadhwan and Chuda block. Maternal death analyses of period wise, report suggested 56 percent deaths reported occurred in postnatal period, 28 percent deaths happened in antenatal period and 12 percent death reported during delivery time. Social parameter suggested that out of total death 27 percent mother were illiterate, 54 percent mothers were in primary level. Home delivery accounted to 4 deaths i.e. 16 percent of total maternal deaths and 4 deaths in government institution and 12 deaths, 48 Percent recorded in private hospitals.

Recommendations : Block Dhranghra show less institutional delivery nearby 60% and less delivery point as per annual report of Surendra nagar, so more delivery point required. Chief District Officer and taluka health officer done mapping. Post-natal period most of the death occurred, so required to do more focus on HBNC programme, taluka health officer done concurrent monitoring for the same. IEC for the institutional delivery to be conducted for the awareness of the health-related issue in ANC period.

What are the major risk factors contributing to Maternal death of Rural Area in Surendranagar District during the year 2015-16.