Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
Background: Most maternal, perinatal and neonatal complications and mortality occur at or shortly after labor and delivery. In order to significantly impact maternal and newborn mortality and attain the MDGs and SDGs, India has implemented various strategies to promote skilled birth attendance and incentivize institutional deliveries. Objective of this presentation is to present the trends in maternal, perinatal and neonatal deaths in Belgaum district of Karnataka, India.
Methods: Maternal Newborn Health Registry (MNHR) of the Global Network for Women’s and Children’s Health Research is a prospective ‘Pregnancy Tracking System’ to quantify the trends in pregnancy outcomes in low-resource settings, and provide population based statistics on stillbirths, and neonatal and maternal mortality. An annual household survey of Married Women of Reproductive Age (MWRA), adapted from the Ministry of Health’s Eligible Couple Survey, identifies women who are currently pregnant and those who are likely to conceive. Comparing projected and actual enrollments confirms completeness of the registry. Consenting pregnant women who are permanent residents of the area are enrolled. Follow-up visits are completed at delivery and 42 days postpartum.
Results: The MNHR has captured 82,275 pregnancy outcomes from 2009 to 2013. During this period, maternal deaths decreased from 34 out of 14,921 live births to 13 out of 15,718 live births. Similarly, the PMR declined from 46.0 to 33.4 per 1000 births. However, Early (7-day) Neonatal Mortality (20.9 to 18.1 per 1000 live births) and 28-day Neonatal Mortality (26.0 to 23.2 per 1000 live births) have remained unchanged.
Conclusions: Mapping visualizes the distribution of maternal and newborn deaths in geographical areas and their relationship to health facilities. MNHR model, supported by a simplified household survey of MWRA, could form the basis for a national vital registry system. It can assist policy makers to assess health care needs and implement targeted interventions from pre-conception to postpartum period.