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Mapedir trainer slides session1.2 mm causes&prevention_01_july07_pp95-2003

Mapedir trainer slides session1.2 mm causes&prevention_01_july07_pp95-2003






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    Mapedir trainer slides session1.2 mm causes&prevention_01_july07_pp95-2003 Mapedir trainer slides session1.2 mm causes&prevention_01_july07_pp95-2003 Presentation Transcript

    • Causes and prevention of maternal deaths India State: State Date: Day, Month, Year
    • What is a maternal death?
      • The death of a woman:
      • while pregnant or within 42 days of termination of pregnancy
      • irrespective of the duration or site of pregnancy
      • from any cause related to or aggravated by the pregnancy or its management
      • but not from accidental or incidental causes
    • Maternal Mortality Ratio (MMR)
      • The number of maternal deaths per 100,000 live births.
      • In India, the MMR is estimated at the national and State levels by the Sample Registration System (SRS)
      • District and sub-district levels are unknown due to incomplete reporting of deaths
    • How many maternal deaths take place?
      • In the world – more than one death every minute: 530,000 deaths/yr
      • In India – about one death every 6-7 minutes: about 78,000 deaths/yr
      • About 15% of all maternal deaths in the world are in India
      • In State – #,### deaths/yr
        • Average block -- ## deaths/month
    • When do maternal deaths occur?
    • Biological causes of maternal deaths
    • There are several cultural and social factors that also contribute to maternal deaths Factors contributing to maternal death
    • What are some common practices and beliefs underlying maternal deaths?
      • Too early and too many pregnancies
        • Inadequate birth spacing
        • Son preference contributes to this
      • Delivery in unclean
        • Due to belief that labor process is dirty
      • Unskilled birth attendant
        • Because its never caused a problem
      • Inadequate food while pregnant–due to belief that more food leads to:
        • Larger baby: difficult delivery for mother
        • Larger baby: will get squashed
    • What are some common social factors contributing to the “ three delays ”?
      • Low social status of women
        • Last to eat, receive health care, etc.
      • Lack of knowledge of danger signs
      • Preference for traditional health care
      • Lack of economic resources for care
      • Not knowing where to go for care of severe illness
      • Hospital provides inadequate care
    • The first delay
      • Delay in decision making –
      • Delay in recognizing the need for health care
        • Lack of knowledge of danger signs
      • Delay in deciding to seek formal care
        • Women’s low social status
        • Lack of economic resources
        • Preference for traditional care
        • Other responsibilities, etc.
    • The second delay
      • Delay in reaching the appropriate health facility
      • Arranging money for transportation and health care
      • Locating the transport
      • Knowing where to go
      • Distance to the appropriate facility
      • Infrastructure for transporting the patient – bad or no roads, etc.
    • The third delay
      • Delay in receiving health care at the facility
      • Inadequate resources at the facility
        • Health personnel, supplies, equipment
      • Inappropriate treatment and referrals
      • Which of these delays do you think contributes most to maternal deaths in District(s) ?
    • Preventing maternal deaths
      • All pregnant woman are at risk for life-threatening labour and delivery complications
        • It is not possible to accurately predict which women will have a complication
        • Therefore, all women require skilled birth attendance (ideally in a health facility) and referral and access to emergency obstetric care when needed
    • Preventing maternal deaths
      • Individual birth preparedness
        • All pregnant women have a “birth plan”
        • Includes “complication readiness”
      • Community birth preparedness
        • Communities take responsibility and action to prevent maternal deaths
        • Maternal death inquiries identify local causes of death and suggest effective action plans
    • MAPEDIR plans for State (below is an example – modify according to State plans)
      • Block meetings to sensitize Panchayat secretaries
      • VHC and SHG meetings to sensitize the community regarding causes of maternal deaths, birth preparedness, and the need for maternal death inquiries
      • Identify and interview every family with a suspected maternal death
      • Analyze and share the information with the community and health officials
      • Help the community take effective action and advocate for improved services
    • MAPEDIR plans for State (below is an example – modify according to State plans)
      • Train state-level trainers
      • Trainers train 3-4 staff at each block (interviewer, recorder, supervisor)
      • Community death notifiers
      • ? Health facility inquiries ?