With the inability to closely follow-up on women during their pregnancy period impairing its ability to bring down maternal mortality rate, the State government has rolled up its sleeves to address the problem.
The solution, here too, seems to lie in technology. The Directorate of Public Health has commissioned the use of the Pregnancy Infant COHORT Monitoring Evaluation (PICME) software for all staff members, primarily in all primary health centres (PHC), and for outreach workers.
The software is calculated to keep tabs on the mother throughout her ante-natal period and the child until the age of one year, R.T. Porkaipandian, Director of Public Health, has told The Hindu.
By ensuring that the mother is followed up right through the term, and the child for a year, there is a better guarantee for the health of both, he explains. “If we are able to make sure that the mother gets all the required check-ups and health care during the pregnancy period, safer deliveries and healthier children are likely to be the result in the long run.”
The inability to track the mother right through using conventional systems lies in a cultural practice in Tamil Nadu, explains K.Vanaja, joint director (immunisation). “Here, women have the practice of going to their maternal house during pregnancy. Some women also shift frequently between the husband's place and the mother's. When they move, they go to different PHCs and forget to take their health cards with them.”
Without the card, which contains all health information pertaining to the pregnant woman, treatment and follow-up become inconsistent and random. Women who are in the high-risk category may not get the required attention in such cases.
PICME will generate a unique number for every pregnant woman/mother which can then be called up at any PHC that the woman can go to. Once called up, it will generate all information relating to the pregnant woman; for instance, weight, scan results, anaemia, nutrition details.
For a year after the child is born, the little one's weight, height and immunisation details will come up on the screen. “We are sure this will make an impact on our efforts to reduce our MMR and infant mortality rate,” says Dr. Porkaipandian.
In addition, all pregnant women and mothers who have delivered since January 1 this year have been issued new health cards, duplicates of which will be stored at the PHC where the woman is registered.
All PHCs have internet-enabled computers, and in centres where connectivity is an issue, the centres have been asked to buy data cards, says Dr. Vanaja. Sustained connectivity is absolutely crucial to the success of the project, since the software is web-based.
Eventually, this will also mean the elimination of bulky patient registers in the PHCs. “At one time, there used to be 12 registers at a PHC where delivery takes place. It was the nurse's duty to correlate the information across these registers and trace the mother. Now, there are nine registers,” according to Dr. Vanaja.
PICME will also store the mobile numbers of the women (or close family members) and generate text messages informing them of the dates to report at the PHC, ultra sound scan and immunisation details, she adds.