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Reduction in Deaths following Sterilization

This article discusses the efforts made by Tamilnadu in reducing deaths related to sterilization and maternal health through audits and interventions. It highlights the composition of sterilization methods and the causes of maternal deaths. The article also proposes strategies to address key issues contributing to maternal death, such as high order births and high-risk pregnancies. Additionally, it presents improvements in the MCTS portal and proposed conditionalities for fund transfer in the MRMBS scheme.

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Reduction in Deaths following Sterilization

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  1. Reduction in Deaths following Sterilization & Maternal Death Audit- Tamilnadu Experience MD NHM TN

  2. Tamilnadu achieved replacement levels of fertility in 1990’s and now we have a TFR of 1.7. • Every year Tamil Nadu has a birth cohort of approximately 10 lakh live births which comprises of 8% higher order births (HOB). • This cohort needs a basket of choice in contraceptive practices to promote maternal health by various methods like IUCD, PPIUCD, Puerperal Sterilisation, interval sterilisation, Laparoscopic sterilisation etc. appropriately. The maternal and child health outcomes are closely linked to spacing, which is fundamental to healthy pregnancy outcomes.

  3. COMPOSITION OF VARIOUS METHODS OF STERILISATION 2016-17

  4. COMPOSITION OF VARIOUS PERMANENT STERILISATION METHODS IN TAMIL NADU 2016-17

  5. Year-Wise Analysis of Sterilisation Deaths

  6. Auditing of sterilisation death and identifying the real cause of death • Proper audit mechanism by district and state quality assurance committee of these deaths revealed major underlying causes to be related to pregnancy not sterilisation. Pregnancy related complication was the major factor and the state and District quality assurance committee was able to identify the real issues. • With 80% of sterilisation with in 7 days of delivery the improvement had to be in maternal health care . • Any intervention to reduce deaths needed to have a strong maternal health component

  7. Over View of Maternal Death - Tamil Nadu

  8. Maternal Mortality Ratio Source: SRS (2001-03 to 2011-13) State HMIS (2013-14 to 2016-17)

  9. Cause Wise Analysis (Apr'15-Mar'16) (Apr'16-Mar'17)

  10. Maternal Death Due to Heart Disease Vs Gravida Inference : Even a heart disease mother goes for repeated pregnancies which ultimately leads to the death of the mother

  11. Interventions Planned Based on Cause Wise Analysis

  12. Gravida Wise Maternal Deaths (Apr'15-Mar'16) (Apr'16-Mar'17) 8% of High Order Birth Contributes to 30% of Total Maternal Deaths 72000 high order birth out of 9 lakhs contributes to 166 maternal deaths (2016-17)

  13. Special strategies to tackle key issues contributing to Maternal Death based on the above analysis

  14. > 30 years Maternal Deaths (Apr'15-Mar'16) (Apr'16-Mar'17) 5% of total deliveries of mothers more than 30 years contribute to 19% of maternal deaths- Automatic high risk

  15. Period of Death & Type of Delivery Wise (Apr'15-Mar'16) (Apr'16-Mar'17) PostNatal PostNatal Twin Pregnancy – (I-Normal, II-LSCS) Out of total maternal deaths, 23% is in the antenatal period (2016-17)

  16. Antenatal Cause of Death (Apr'15-Mar'16) (Apr'16-Mar'17)

  17. Interventions Planned Based on Cause Wise Analysis

  18. State MCTS Apr’16-Mar'17 To capture the unbooked mothers in State MCTS portal revamped MCTS portal is in trail run in three pilot blocks

  19. Improvements in Newer MCTS Portal

  20. Improvements in Newer MCTS Portal

  21. To Ensure all High Risk Mothers (HOB, Migrant, Private Maternity Care Mothers) are booked –Proposed Conditionalities for Fund Transfer in MRMBS Scheme Rs. 18000 Per Mother

  22. To Ensure all High Risk Mothers (HOB, Migrant, Private Maternity Care Mothers) are booked – proposed Conditionalities for Fund Transfer in MRMBS Scheme

  23. To Ensure all High Risk Mothers (HOB, Migrant, Private Maternity Care Mothers) are booked – proposed Conditionalities for Fund Transfer in MRMBS Scheme Rs. 18000 Per Mother.

  24. To Ensure all High Risk Mothers (HOB, Migrant, Private Maternity Care Mothers) are booked – proposed Conditionalities for Fund Transfer in MRMBS Scheme

  25. THANK YOU

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