ANDHRA PRADESH

Kalaburagi sees 70 maternal deaths in seven months

Irreparable loss:A woman grieves over the death of her daughter in Kalaburagi district, Karnataka.ARUN KULKARNI

Irreparable loss:A woman grieves over the death of her daughter in Kalaburagi district, Karnataka.ARUN KULKARNI  

Kalaburagi is a backward district in northern Karnataka notorious for its extreme heat and perennial water crisis. Many are its relative socio-economic inadequacies within the State. However disconcerting the other conditions there may be, the stories that virtually every village in the district tells — of a growing number of poor young women dying at childbirth — are probably the grimmest. Many of the deaths, it has turned out, were preventable.

The district, official sources said, tops the State in the high rate of maternal deaths: 70 maternal deaths in the seven months from April to October this year. The situation of young mothers dying after giving birth has alarmingly worsened since last year: Kalaburagi district had 52 maternal deaths in 2016–17. At least 120 newborns and other children were orphaned in the last 19 months, data provided by the District Health and Family Welfare Department shows.

In all but one of the cases, the deaths occurred after the women reached healthcare institutions. Most of them went to a district hospital or an equivalent private facility that claimed to be equipped for emergencies.

“The ground reality is worse as 15 to 20% of maternal deaths go unreported,” said Teena Xavier, health rights activist from Karnataka Janarogya Chalavali (KJC). The KJC interviewed the kin in over 60 maternal death cases that took place in 2016–17 and 2017–18 and found three leading causes of deaths: pregnancy-induced hypertension, post-partum haemorrhage, and sepsis.

‘Preventable causes’

“All these causes were preventable and largely driven by anaemia during pregnancy. The pathetic condition of the public health system pushed most of these women to the [much costlier] private hospitals — which again pushed the poor and the vulnerable families into huge debts,” Ms. Xavier said.

A survey conducted by the KJC in August and September this year showed that about 75% of maternal deaths were reported among the less privileged: people from the Scheduled Castes, Scheduled Tribes, and Muslims. Over 80% of deaths occurred after child birth; the remaining deaths were during advanced stages of pregnancy or during labour. About 40% of the women died on the day of delivery, and 71% died within a week of delivery, indicating serious gaps in managing pregnancies during later stages and post-delivery care.

The alarming rise in the number of maternal deaths has made the district administration sit up and take a few actions. Deputy Commissioner R. Venkatesh Kumar recently met department officers and deans of four medical colleges to find a way out of the situation. A multi-pronged approach would be taken to reduce or prevent maternal deaths, he said, admitting to the systemic gaps.

He said government facilities were getting burdened beyond their capacity in handling critical delivery cases. High-risk pregnancies were being referred at the last minute to the district hospital — which does 1,000 deliveries a month on an average and well beyond its capacity. The absence of specialists and anaesthetists at the taluk level also forces these government health institutions to increasingly refer critical cases to district hospitals.

“We have only three anaesthetists for the entire district and each of them is assigned two taluks. Specialist doctors are not keen on joining government institutions although we offer them Rs. 2 lakh a month,” Mr. Kumar said.

The cost of delivery is another factor. “I have appealed to all medical colleges in the city to perform deliveries at their own establishments instead of referring them to district hospital. But the government pays Rs. 3,000 per delivery while they charge a Caesarean section delivery around Rs. 25,000,” he said.



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