Showing papers by "Indian Institute of Management Bangalore published in 1990"

Light on maternal mortality in India.

Abstract: Since the majority of deliveries in India occur in the home under the supervision of traditional birth attendants official statistics tend to underestimate the extent of maternal mortality. To overcome this bias source and obtain more precise information about the degree and causes of maternal mortality health facility records for a 1-year period in 1984-85 in Andhra Pradeshs Anantapur District were analyzed and interviews were conducted in villages and hamlets. Health facilities serving a total urban population of 569500 and a rural population of 1090640 were visited as part of the investigation. At the grass-roots level informants about maternal deaths included opinion leaders school teachers revenue officials traditional birth attendants and village children. Overall 7.98 maternal deaths/1000 live births (8.30/1000 in rural areas and 5.45/1000 in urban areas) were identified--a rate that significantly exceeds that reported in official documents. More than half the maternal deaths occurred at home or en route to the hospital indicating the insufficiency of studies based solely on a review of hospital records. 35% of deaths among women in the 15-49 year age group were related to pregnancy and delivery. Only half of the maternal deaths identified were noted in health facility records while under one-third were recorded in primary health center records. Of the 248 maternal deaths for which detailed information was available 63% involved live births 14% were associated with stillbirths 10% with abortions and 13% with nondelivery. Prolonged labor was a factor in half of these deaths. Antepartum intrapartum and postpartum deaths accounted for 19% 12% and 69% respectively while 2/3 of deaths were due to direct obstetric factors. 80% of these deaths could have been prevented by prenatal care treatment of predisposing medical conditions and rapid transport to a hospital.