Sunday, 22 July 2007

Maternal mortality discussed

Maternal mortality discussed

The Imphal Free PressIMPHAL, Jul 21:

Against the backdrop of the recent spate of pregnancy-related deaths, a CME cum panel discussion on maternal mortality was organised at the Jubilee Hall, RIMS by the Imphal Obstretic and Gynaecological Society today.

The meet, attended by top doctors and public leaders, focussed as much on the related issue of deteriorating doctor-public relations, as on the issue of maternal mortality in the state.

Prof AD Singh, president of the Indian Medical Association, Manipur branch, observed that maternal mortality rate in Manipur is actually quite low, having been reduced to 1% from 4.3% in the last ten years, but error of judgement, or accidental damage do occur as a result of which some patients are put at risk.

However, it is by no means intentional, he stressed and sought encouragement from the public in the form of suggestions to improve the service as well as for better patient-doctor relations.

Dr L Fimate, director, RIMS, on his part observed that maternal mortality rate of the state is good compared to even advanced countries, but due to development of various unwanted cultures, including gun culture and hate doctor culture, as well HIV/AIDS, the state is lagging behind by a century from its neighbouring states.

He further observed that erosion of doctor patient relationship leads to victimising of doctors for each unfortunate happening. Hence better understanding among doctors and patients is sought to avoid such demoralising problems in between the doctors and patient parties.At the same time he also requested the doctors to not to forget the humanitarian aspect in treatment of patients, and in their professional practice.

Dr Y Mohen, medical superintendent, RIMS hospital, observed that relations of patients and doctors is still well and good, but relation of doctors and patient parties is so bad, that doctors have begun to adopt defensive practice, which is more expensive.

He also expressed fears of losing gynaecologists of the state in future and appealed to the public not to lose faith in doctors.

Medical practitioners participating in the discussions made the point that apart from the general factors such as poor female health, poverty, low education and awareness, inadequate availability of maternity services, which account for the high maternal mortality status in India, there are many unpredictable factors beyond their control, which contribute to maternal mortality.

They observed that reduction of maternal deaths is possible by compulsory registration of all pregnant women, prenatal screening of high risk cases, referral to well equipped hospital, increasing the number of maternity beds in hospitals etc.

Reorganisation of reproductive and child health services with emphasis on rch sector in health planning and budgetary adjustment and health education of women would also improve the situation.

In the meantime, according to Dr, Manglem, head of the gynaecological department of RIMS, who spoke separately to IFP, in the last five years, out of 50,057 deliveries, there were cases of 32 deaths in RIMS Hospital.

5 deaths each occurred in 2002-2003 and 2003-2004 out of 9,093 and 10,264 deliveries respectively, nine deaths took place in 2004-2005 out of 9,852 deliveries, five deaths took place in 2005-2006 out of 10,595 deliveries, and eight in 2006-2007 out of 10,253 deliveries.

When asked if the rate of maternal mortality has increased at RIMS, Dr Manglem, said, "The number of maternal mortality did not increase. But the mindset of the people has changed. People are more aware now about the concept of healthy mother. However, along with this increased awareness, the manpower and infrastructure remain poor."

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