Saving Mothers Caring Family (Gujarat)

Problem Statement

Maternal Mortality Ratio (MMR) in Gujarat has declined from 172 per one lakh live births in 2001-3 to 91 in 2014-16. Special efforts are needed in implementing Comprehensive Emergency Obstetric Neonatal Care services to bring about a significant decline in maternal and child mortality. Many pregnant women and neonates die due to repeated referral or due to non-availability of specialists or health services.

Programme Description

Generally, CEmONC services are provided at First Referral Unit level and above. A functional FRU impacts availability of qualitative maternal and neonatal health affecting the overall mortality and morbidity.

Since the state has a population of 6.5 crore (Census 2011), about 129 First Referral Units (FRU) are ideally needed in Gujarat. As such, the state has opted for restructuring existing FRUs in a phased manner.

Time line of Implementation

103 FRUs were identified in the first phase in. Google Map was also used to identify functional FRUs within 50-km distance from each delivery point to ensure adequate coverage. for which the number of CEmONC facilities has gradually increased to 132 FRUs in 2017-18.

The innovative methodology

1. The state has considered various co-factors to ensure availability of comprehensive emergency obstetric and neonatal care services within the ‘Golden Hour’.
2. Special requisition to allow blood storage units at First Referral Units (with less than 2000 units per year consumption).
3. District-level functionaries are actively involved in ensuring that all areas have access to good telecommunication links, as well as improving road connectivity/ transportation facilities in these areas.
4. The ‘Plan-Do-Study-Act’ (PDSA) measures are being considered to ensure accessible and qualitative CEmONC facilities across all designated FRUs.

Programme Outcomes

These continuous measures have resulted in making available C-Section facilities in 83% (115) of designated FRUs. 388 maternal and 7416 infant death per year have been averted by providing CEmONC service.

Source : We Care Coffee Table Book - Good, Replicable and Innovative Practices 2019