Lack of appropriate services at the healthcare facilities led to three maternal deaths in one block of Deoghar district of Jharkhand while seven others died due to lack of back up emergency facilities during delivery and mechanisms to deal with postpartum complications. These maternal deaths were reported from Devipur block between march 2010 and February this year.
A Maternal Death Audit conducted by the Network for Enterprise, Enhancement and Development Support (NEEDS) suggests that Deoghar district hospital denied admission to Sabita Devi due to the unavailability of blood when she came for delivery while the same hospital also denied services to Asha Devi since her family members allegedly did not agree to give bribe for emergency services. In the case of Shanti Devi, the Dumka district hospital refused treatment to her as there was facility for operation at that time.
Member of the District Maternal Death Committee at Deoghar, NEEDS reviewed 40 maternal death cases of which 11 deaths were certified as `maternal deaths’ by the Medical Officer. The review was done by group discussions, interaction with women self help groups, health workers and verbal autopsies by talking to the family members of the deceased women.
Of these 11 cases, one case was dropped due to unavailability of adequate data in one case, and the survey revealed that the doctors were unavailable after 3 p.m. in Devipur block primary health centre (PHC) which was supposed to be running round-the-clock which made the family rush to Deoghar district hospital in emergency instead of seeking emergency care at the nearby PHC. The district hospital is 20 kms away from the PHC and as the road condition is poor, it takes about 2 hours to cover the distance.
Three women of these 10 died on the road while travelling to Deoghar and if both the PHC and the sub-centre provided 24/7 services to them, they might be alive today, according to Tanmoy Saha and Amitav Gautam of NEEDS.
Verbal autopsy of Sabita Devi’s family revealed that she was denied appropriate care at Deoghar district hospital due to the unavailability of blood following which her family admitted her to a private hospital where the doctors did not conduct the operation which she badly needed. The family said the doctors were for fulfilling the formalities including payment of operation fee in advance and by the time the payment was made, Sabita Devi had died.
In the case of Shanti Devi, Dumka district hospital denied her admission as it did not have the necessary equipment to conduct the surgery. She was then taken to a private hospital where the doctor after checking her said she would be operated upon the next morning. However, Shanti Devi passed away at 6-30 in the morning, hours before the operation was scheduled.
Two women – Neha Devi and Sonu Murmu – reportedly died of postpartum complications while two died at home during delivery without any treatment by the recognised doctors.