The Tamil Nadu Government Doctors Association (TNGDA) has decided to boycott the maternal death audit to be held on Thursday. The State Health Department has introduced a system of monthly review of the reason for maternal deaths. The State conducts two kinds of audits — at the State level and district level.
The district-level audit is conducted in the presence of the family of the deceased woman and all the doctors who examined the patient, from the first obstetrician, who saw the woman to the doctor who certified the death, are interviewed by two retired specialists. This includes private practitioners whom the woman visited. At the State-level audit, the specialists undergo another such session through videoconferencing.
Hurt sentiments
The TNGDA has said the doctors feel intimidated and insulted by patients’ families when the case is reviewed in their presence. “There is no doubt that the CeMONC centres are a success but they must also be staffed adequately. More than 60% of the 124 CeMONC centres have only three or two obstetricians when there should be four. We have four centres per district. The government could merge those that are inadequately staffed,” said K. Senthil, president, TNGDA. The association wants the audit to be conducted based on the evidence and reports presented by the government and private practitioners (if any) and the district administration should prepare its audit report and send it to the State administration based on which action may be taken. Doctors from primary health centres, district and taluk headquarters hospital will not participate in the present system of videoconferencing until the government gives up this mode of audit, Dr. Senthil said.
A health department official, however, said the goal of the audit was to prevent maternal deaths. Sometimes, a woman dies because her BP reading was not tracked or because of haemorrhage. “In the heat of the moment, the family may get emotional but the goal is to address preventable maternal death,” the official said.
