A nation will be healthy only when the mothers are healthy. This is because only a healthy mother can deliver a healthy baby who will be a healthy citizen in future.
Healthcare during the pregnancy period of a woman has become a vital aspect in public health management these days. Lot of interventions and schemes are being taken up by the State Government to reduce maternal mortality and these initiatives are delivering good results.
In Madurai district, the Health Department officials are keeping a complete track of pregnant women in urban and rural areas and the mother’s health is just a click away.
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A pregnant woman who is miles away from Madurai is being tracked by health officials through a hi-tech health system called Pregnant and Infant Cohort Monitoring and Evaluation (PICME) which keeps an eye during the entire pregnancy period starting from conceiving till the third dose of immunisation of the newborn child.
“This mother and child online racking system called PICME of the Tamil Nadu Government’s Directorate of Public Health and Preventive Medicine is a very effective monitoring system. We can track the health status from the Health Department office itself and all Primary Health Centres are networked into this system which has been completely streamlined now,” says S. Senthilkumar, Deputy Director of Health Services, Madurai District, while explaining about the tracking system.
The follow-up is done comprehensively and every antenatal visit of the mother is recorded in the PICME system. Already, every PHC in the district has broadband facility and very soon the Village Health Nurses will be given laptops so that they can enter the data pertaining to pregnant women.
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S. Usha, District Maternal and Child Health Officer, is happy with the outcome of this online tracking system since the maternal mortality rate is coming down in the district. She cites two examples of how pregnant women have been advised by the Health Department after seeing their health status via PICME.
A 28-year-old woman of Vickramangalam who became pregnant the second time was advised medical termination of pregnancy after being referred to the Government Rajaji Hospital (GRH) as her health indicators were not conducive for safe delivery. Another woman from Alanganallur block, aged 25 years, too was advised not to go for second delivery as the pregnancy parameters were not sound. “Despite our advice, she continued and unfortunately she died,” Dr. Usha said.
Every pregnant mother is given a unique number and through PICME she is tracked for haemoglobin, ultrasound, HIV and foetal movements. When the expected date of delivery comes close, the health staff will be on alert.
“Nurses in urban and rural areas are playing an important role. Even if it is a small hamlet, we are able to monitor pregnant women closely. Those in high risk category with anaemia, diabetes and congenital deformity get special attention,” Dr. Senthilkumar says.
By using PICME system, the public health authorities have brought the Dr. Mutuhulakshmi Reddy Maternity Assistance Scheme data online. “Our goal is to reduce maternal mortality. So, we are making early referrals to the GRH to prevent pregnancy connected deaths. Right hospital at the right time is our focus. All the 51 PHCs in Madurai district and 314 health sub-centres are making online registrations and that is helping us to effectively track the expectant women,” the Deputy Director said.
Safety of pregnant women assumed significance as maternal mortality continued to haunt the health department. The numbers, however, are coming down. Last year, 58 women died in the district and this year so far the maternal mortality stood at 42. This month, six deaths of pregnant women have been reported.
The importance of good tracking system can be understood from the data which says that 75 per cent of the total deliveries in the district are happening in Government sector. Every month, Madurai district records 4,000 deliveries of which nearly 1,750 are in the GRH while 1,200 babies are born in PHCs. In private hospitals, 1,100 deliveries are taking place on an average per month.
Gynaecologists are counselling the pregnant women to eat nutritious food. In fact, the habit of eating rich diet must begin from teenage itself among girls, says Dr. Pricilla Gunasekar, consultant gynaecologist and infertility specialist, Vadamalayan Hospitals.
“We stress on nutritious food for teenage girls because by the time they get married and become pregnant, their health status will be good. Iron rich food, milk, eggs, meat, soyabeans and plenty of greens are advised for pregnant women as they should not be anaemic,” she says.
Dr. Pricilla tells women that taking proper antenatal checkups during pregnancy is of paramount importance. Also, right amount of right food as advised by gynaecologists should be followed.
Counselling for safe delivery of healthy child also comes from P. Angayarkanni, senior gynaecologist and Professor and Head of Department of Obstetrics and Gynaecology at the GRH.
“Problems arise in late referrals and sometimes it leads to maternal death. Anaemic women and those with heart diseases must be very careful,” she says.
Dr. Angayarkanni suggests that prevention of anaemia should begin from adolescent stage because haemoglobin level during pregnancy holds the key. In GRH alone, more than 50 deliveries take place every day.
Deputy Director of Health Services Dr. Senthilkumar sums up by saying that women must bear in mind the warning signs and go to hospital at right time. So, the Health Department is taking all pains to ensure safe deliveries and good health of pregnant women in Madurai district.