Till three decades ago, a large percentage of women in the tribal hamlets on the fringes of forests in southern Karnataka were giving birth to babies at their homes. But, a project taken up in tribal-dominated taluks of Chamarajanagar, Mysuru and Kodagu district has ensured 2,656 institutional deliveries between the beginning of 2020 and end of 2022, accounting for 98.8 per cent of all deliveries.
Ashraya Hastha Trust (AHT) and Swami Vivekananda Youth Movement (SVYM) have taken up a project to ensure Reproductive, Maternal, Newborn, Child and Adolescent Healthcare Services (RMNCH +A) services in 10 tribal-dominated taluks from Gundlupet in Chamarajanagar district to Somwarpet in Kodagu district, covering a population of 63,000 tribals in 387 hamlets.
The project registers more than 1,000 pregnant women every year in these hamlets and ensures ante-natal care (ANC) during pregnancy. “This includes ANC check-ups, doorstep health monitoring, mothers’ meetings, baby shower programmes, health events, immunisation and so on”, said a statement from SVYM.
“The percentage of institutional deliveries during the three-year period has increased from 95.9% to 98.8%. Although there have been three unfortunate maternal deaths in the last three years (out of which one was due to non-reproductive reasons), it is indeed an achievement that the maternal mortality has been brought down to this level among indigenous tribal communities out of which one is a Particularly Vulnerable Tribal Group (PVTG)”, the statement said.
The increase in institutional deliveries means lesser home deliveries, which are considered potentially risky in view of the lack of medical supervision during childbirth, associated with complications.
The major reasons for the tribal communities not using institutional care included financial constraints, lack of suitable transportation facilities, lack of attendant at home and also a hesitation to seek medical care in an unfamiliar infrastructural setting, the statement pointed out.
The SVYM, which has been working with government health functionaries, has tried to progressively address these challenges.
The project focuses on providing targeted care towards high-risk pregnant women. “Two major reasons for high-risk pregnancy are anaemia and pregnancy-induced hypertension. To ensure early identification of high-risk pregnancy, the team has ensured deployment of Reproductive and Child Health kits among its field-level health facilitators. Hence, the high-risk factors such as anaemia are being quickly identified and monitored periodically to ensure mitigation before delivery”, the statement said.
The project is also working towards strengthening the government system with its teams regularly working with local government health systems, especially Asha and anganwadi workers. The percentage of deliveries facilitated in government health centres including taluk or district hospitals in the region too has increased even amid the difficult pandemic conditions, the statement said.
The institution deliveries covered not only government health centres, but also private and NGO facilities.
