It is 11 am and 67-year-old gynaecologist Dr Hema Devi Goswami is busy examining pregnant women at the Dhirenpara First Referral Unit in Assam’s Kamrup district.
Dr Goswami is one among those private practitioners from the State who have enrolled with the Modi Government’s unique safe pregnancy plan, Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), launched last year in November in collaboration with the UNICEF.
Under the scheme, gynecologists and radiologists from the private sector across the country are invited to volunteer to provide free antenatal care services (ANC) on the ninth of every month to pregnant women , especially those from under-served, semi-urban, poor and rural areas.
Since its launch six months ago, around 3,636 gynaecologists across India have registered online on www.pmsma.nhp.gov.in. In Assam, 62 private doctors have registered with the PMSMA.
The aim is to provide specialist care to improve the health of pregnant women and their newborns and lower India’s maternal mortality rate (MMR) and infant mortality rate (IMR). India’s MMR of 167 per 1,00,000 births, has failed to meet its Millennium Development Goals (MDGs) target of bringing down maternal deaths to under 140 by 2015.
In India, one pregnant woman dies every 12 minutes, with 45,000 dying each year. Of them, less than one in five (19.7 per cent) undergo prenatal health checks.
The situation in Assam is no different. With the highest MMR of 300 per one lakh live births, double than the country’s average, the North-Eastern State now pins hopes on Dr Goswami and her ilk from the private sector to help improve its health indicators.
“I have enrolled with the scheme. last week, I got a call from the State health officials to offer my services at this First Referral Unit on May 9.
It feels good to help these needy women,” said Dr Goswami. Commending the scheme, she hoped that her fraternity will come forward to dedicate at least one day a month to helping pregnant women in rural areas in the State, who often die in childbirth due to poor access to healthcare.
“Among pregnant women, anemia tops the list followed by irregular menstruation, hypertension, diabetes, multiple pregnancies, more than three miscarriages and congenital abnormalities,” she said, pointing out that the list is long.
For instance, Phulbano (19), who has come for a check-up for the first time from nearby lokhara Village, is acutely anemic. Her first child died in the womb itself and now she’s taking iron tablets as advised by the ASHA worker accompanying her.
like Phulbano, many others, belonging to the BPl category, have come from far off areas like Gualpada, Kamrup rural and Managldoi village for check-up.
Dr Pankaj Suthar, State maternal health consultant, UNICEF, is very optimistic. “The scheme is gradually picking up. So far, gynecologists have rendered services at Pandu First Referral Unit, Mahendra Mohan Choudhury Hospital, Panbazar, and Dhirenpara First Referral Unit, to name a few. We have been constantly writing to the private gynecologists.
“Since June 2016, we have covered 1.50 lakh pregnant women under the ANC services in our 288 health facilities in 32 districts. Our yearly target is 7.9 lakh pregnant women. We want to focus on high risk pregnancies to cut down mortality rate.
“Though ultra-sonography facilities are only in 69 First Referral Units, we have identified 288 sites for ANC services under PMSMA. If needed, help from other hospitals and private clinic is also taken.”
As part of the scheme, women are tested for anemia, blood pressure, high blood sugar (gestational diabetes), and other problems associated with pregnancy and provided free ultrasounds to track the health and development of the baby in the womb.
A Das, a gynecologist with the Pandu First Referral Unit stressed on creating awareness about the scheme among the targeted beneficiaries and holding regular meeting with the private doctors to sensitize them.
Dr JP Sharma, in-charge of the Dhirenpara First Referral Unit, echoed similar views saying Assam registers not only high MMR but also a very high IMR of 48 per one thousand live births as against 41 all India average. “High MMR is in certain belts like tea pockets and rough terrain where facilities are out of bound,” he said and hoped that PMSMA would give encouraging results.
Dr Sharma said that high-risk pregnant women are being identified and counseled about nutrition, family planning and overall birth readiness for newborns and postnatal care.
The programme has been initiated on the premises that if each and every pregnant woman in India is examined by a physician and appropriately investigated at least once during the PMSMA and then appropriately followed-up, it can help in reducing the number of maternal and neonatal deaths in the country.