Shillong:
The refusal of pregnant women to get admitted in health care institutions due to fear and stigma of contracting Covid-19 and also their refusal to test for Covid-19, thus depriving them of medical attention and care, have contributed to the death of newborns in the state.
This emerged in an action taken report (ATR) into the death of 877 newborns and 61 pregnant women submitted by the Under Secretary in-charge Health & Family Welfare B Wahlang to the National Human Rights Commission (NHRC) Consultant (Law), M-6, CS Mawri on Saturday.
At that point of time, it was mandatory to segregate Covid-19 and non-Covid-19 cases, hence testing was done to avoid the spread of the cases of virus, especially in the hospital ward. It was found that most of the cases in the normal Covid were Covid positive. So measures to curb the infection had to be taken.
The report said though the pregnant women abstained from visiting the health facilities and availing the health care services, the ANMs and ASHAs were regularly monitoring the health of the mother and child through regular home visits and counseling to avail the services in the health care facilities especially mobilising them to come for institutional deliveries.
The state government is aware of this fact and necessary interventions were made to spread awareness to pregnant women and family members on the importance of institutional deliveries and availing essential health services as and when required, it said. Guidance notes on Essential MCH Services during Covid-19 provided by the Ministry of Health & Family Welfare were shared with all the districts.
Essential services were not neglected and health officials and staff were given clear instructions to carry out their duties, giving their best effort to curb the pandemic and not neglect the pregnant women and child health, it added.
The report also stated extra emphasis is being laid on IMR and MMR during the Covid-19 period, through weekly review meetings with the districts. Here, the MCH scenario in all 11 districts is reviewed extensively, chaired by the Principal Secretary Health with the Deputy Commissioners, DMHOs and District Health Officers of the districts.
It said these weekly reviews have revealed that the underlying cause of high maternal and child deaths in the state can be attributed not only to clinical/public health management but more so, the underlying and often unaddressed socio-economic and gender dimension.
It was found that the importance of creating awareness on this issue, discussion with all sections of the society, to get the inter sectoral coordination, is to be done.
The report said various programmes like SAANS, Pneumococcal Conjugate Vaccine for the children have also been initiated and rolled out.
On the occasion of National New Born week, visits to the various districts by the state health team were done for mentoring and monitoring of services to the newborns.
A health team which has been constituted at facility level is to identify all pregnant women and to ensure that all the pregnant women are registered on the MOTHER App.
The team is to identify all anaemic women in the first trimester itself and ensure correction of haemoglobin levels by the 2nd trimester. The CDPOs are responsible for ensuring this under the rescue mission
The team is to identify mothers with underlying diseases such as high blood pressure, hypertension, diabetes etc. These pregnancies will be considered as high risk and will include elderly primigravida, multipara and teenage pregnancies.
No high-risk pregnant woman should deliver at home, they should be brought to the facilities for 1-2 weeks before the expected date of delivery.
The state and district administration have been focusing on managing the Covid-19 pandemic with great vigour and intensity.
But at the same time it is critical that the state does not dilute its emphasis on saving all matters as per the goals of the rescue mission brought out by the state to reduce maternal and child deaths.
The rescue mission would continue alongside Covid management as a fundamental part of the work of the department.
All districts should make efforts to reach 100 per cent ANC registration for early treatment and prevention of MMR. To this end, a six-point strategy to continue activities under rescue missions during Covid times is in place. This is to ensure all pregnancies are registered using the MOTHER App.
It further added that the respective deputy commissioners need to issue instructions to the concerned PHC/CHC for identification of high risk mothers and their referrals to the hospitals for safe delivery.
Training of trainers for tackling maternal and infant mortality rate in the state through video conferencing has also been held.